Depression FAQ - Part III - Alternative treatments, lifestyle choices
Category: Newsletter Articles
Part III concludes with alternative treatments, lifestyle choices including diet, exercise, sleep, and religious/spiritual practice, coping skills, and suicide prevention. All links but one are to articles on this website.
Are there alternative or complementary treatments for depression?
Yes. These include St John's wort, Sam-e, omega-3 fatty acids, vitamin and mineral supplements, and acupuncture.
Tell me about St John's wort.
St John's wort is a common weed which numerous studies have found effective for treating mild to moderate depression. Major studies have found, however, that it is not effective for major depression. Those who try St John's wort should be advised that natural does not mean harmless. Because of the way it is metabolized in the liver, St John's wort has dangerous interactions with other drugs. Consult your doctor before using, and buy only from a reputable supplier.
Tell me about Sam-e.
Sam-e is a molecule responsible for more than a hundred processes in the body. A number of small European studies have found the substance effective and fast acting (working in a matter of days as opposed to weeks), with virtually no side effects. Sam-e is chemically unstable, so buy only enteric-coated tablets and don't take them out of their containers until you are ready to use them. Buy only from a reputable supplier and use under a doctor's supervision.
Tell me about omega-3 fatty acids.
Omega-3 is found in deepwater fish such as salmon and in flax. One study found that countries with low fish consumption coincided with high depression rates. A pilot study using an omega-3 extract found the substance to be effective in treating depression. Until we know more, it is advised that omega-3 be considered as a complement to, rather than as a replacement for, one's normal meds. Buy only preparations that have more EPA than DHA.
Tell me about vitamins and mineral supplements.
Unfortunately, much of the food we eat comes from soil depleted of nutrients. The raw materials for producing neurotransmitters are nutrients. A deficiency of vitamin B6, for instance, may affect how serotonin is synthesized. The trick is finding a doctor willing to order the tests to tease out these deficiencies. In lieu of precise knowledge of one's individual deficiencies, all-purpose supplement combinations may be an option. Use under a doctor's supervision. It is advisable to use supplements as a complement to meds rather than as a replacement.
What about acupuncture?
A pilot study comparing depression treatment (where the needles were placed at specific "depression" points) to sham treatment (the needles were randomly applied) found those in the depression treatment group experienced a 42 percent reduction in symptoms compared to 22 percent for the controls, with virtually no side effects. A larger study is underway.
What about lifestyle choices?
These include diet, exercise, sleep, avoiding stress, and religious or spiritual practice.
What about diet?
Diet is crucial to good mood. When choosing a healthy diet, there are no right or wrong choices, though in general high fat, high sugar, and high carb diets should be avoided, and junk foods, caffeine and alcohol restricted. Folate (from leafy green vegetables) deficiency and high sugar intake have been linked to depression. Carbohydrates get processed into sugar, which can boost serotonin but also induce mood-busting sugar crashes. Chocolate can act as a tasty antidepressant, with an endorphin-like effect, but can also set one up for a sugar crash. Paradoxically, eating too much sugar can lower blood sugar levels in some people, which results in further unhealthy cravings. Be mindful about switching to NutraSweet, however. One small study of patients with depression found they had severe reactions to its working chemical, aspartame.
What about exercise?
Numerous studies have found aerobic exercise works as effectively as antidepressants. Generally, the last thing you want to do when you're depressed is exercise, but even a five minute walk can help. Exercise restores regular sleep and eating, raises energy levels, generates endorphins, boost serotonin levels, and may stimulate new brain cell growth.
What about sleep?
Too little or too much sleep affects just about everyone with depression. A major key to establishing good sleep hygiene is going to bed and waking up at a regular hour. For those who continue to experience difficulties, talking therapy can help, as well as sleeping pills and wakefulness agents.
What about avoiding stress?
Stress is toxic to anyone disposed to depression, so every effort needs to be made to reduce stressful situations from one's life and develop appropriate skills for coping. This may involve major life decisions regarding work and personal relationships. Numerous talking therapies can help people work through difficult job and relationship situations so that stress is less of a factor in one's life. Therapy can also teach a range of coping skills. Other coping strategies include exercise, meditation, yoga, and relaxation exercises.
What about religious or spiritual practice?
A multitude of studies have found those who are religious or spiritual live longer, are healthier, recover from illnesses quicker, and are less depressed. Much of this undoubtedly has to do with the support one gets from one's religious community, as well as the more healthy lifestyles these people tend to lead, not to mention the comfort that belief in a higher power can bring. In addition, the exercises and practices associated with religion and spirituality such as meditation, prayer, and yoga have positive benefits on mental and physical health. Scientists also speculate the immune system and other biological processes may be enhanced by religious or spiritual practice. Finally, don't rule out pure God-power.
What about attending a support group?
A major study found that online support groups have a positive impact on depression. Face to face support groups have a similar benefit. At a support group, you meet people who have walked in your shoes, who have unique insights into the illness that they are all too happy to share, and are willing to be with you in a time of crisis.
How do I cope day to day?
Over time, you will develop your own personal bag of tricks. These can range from prayer to keeping a journal to taking some time out for yourself to volunteer work. In general, any project that makes it worth your while to get out of bed or any activity that induces you to get out of the house and be with other people should be regarded as beneficial.
I am feeling suicidal. What should I do?
Get help immediately. Treat this as a crisis every bit as life-threatening as a heart attack, which it is. Every year, one million people worldwide die by their own hand, most as a result of depression or a depression-related illness. The true figure is probably many times higher, disguised as death by accident or death by risky behavior. Contact a trusted friend or family member. In the US, the national suicide hotline is 1 800 SUICIDE. Just as someone with a heart attack goes to the emergency room, that is where you should be, unless someone competent has decided you are not in danger.
How should I prepare for a suicidal crisis?
Have a good support network in place, people you can contact at a moment's notice. Have a good relationship with your doctor or psychiatrist, as you may need to call him or her in the middle of the night. Commit the national suicide hotline to memory, if you live in the US, and have local hotline numbers handy.
How can I help others in a suicidal crisis?
Be supportive. Do not be judgmental. Treat the situation as life-threatening, which it is. Ask if he or she has a plan - this can determine how serious the problem is. If you are in a position to do so, offer to take positive action, such as calling his psychiatrist or driving him to the emergency room.
Depression has ruined my life. It has destroyed my relationships and my career.
It is pointless to disregard the full destructive power of depression, and because of it some people may have to considerably scale back their expectations in life. On the positive side, you have survived one of the most malevolent forces on the planet, and you are a much stronger person as a result, in closer touch with your own humanity and divinity. Please do not underestimate these gifts and the power you now have to lead an even deeper and more meaningful life, however different it may be from the one you had been pursuing.
Do you have any final thoughts?