Description: people are beginning to realise just how common this debilitating condition is and how many potentially productive lives it ruins. While life events play a large part, for many people there is also a biochemical abnormality affecting the illness.
Depression can vary from just feeling low, right through to being totally incapacitated or contemplating suicide. Unipolar depression is just depression, bipolar varies from depression to mania (excessive confidence, happiness, energetic and productive -many famous people were bipolar and the mania sessions created their achievements).
What your doctor can do
- Psychological and psychiatric assistance. Counselling, exploring the past and looking for solutions can be very helpful, but is only available to the minority of our patients. However it can be very effective, but the counselling does need to be skilled, as people often open very painful sores from the past and may need help to deal with them. However for many people, just bringing these hurts out into the light can lift a great weight from them.
- Drugs. For unipolar depression, in addition to psychotherapy, the initial drugs used are in the SSRI (selective serotonin reuptake inhibitors (citalopram, fluoxetine, paroxetine, sertraline), then ‘atypical antidepressants (bupropion, mirtazapine) if they cannot take SSRI. The older drugs (amitryptiline, monoamine oxidase inhibitors) had many side effects and often took some weeks to start working.
We also recommend that people try to avoid taking tranquillisers and sleeping pills as both can increase the symptoms of depression. Note these drugs, especially SSRIs can cause suicidal thoughts especially in teens and need to be watched carefully. - Bipolar depression – the SSRI and other drus above can help with the depression, but other drugs can also be used to reduce the switching from depression to mania. These include lithium, valproate, carbamazepine, or second-generation antipsychotics such as quetiapine, lurasidone, or olanzapine. The decision on the use of these drugs needs skilled supervision.
What you can do
Lifestyle
- It is essential for you to have someone to whom you can talk, in confidence and without fear. This may be a doctor, friend, social worker, church member or minister, counsellor.
- Regular exercise such as walking helps release endorphins (mood elevating hormones), and also helps with sleep which is often of poor quality in people with depression. It is best to walk with a friend or a dog! (In a study in the American Journal of Preventive Medicine, depressed people who exercised 30 minutes 3-5 times a week, halved their depression symptoms!)
- Diet. Many people with depression tend to either overeat or to shun food altogether; either way the body suffers. In a study from Deaken University, of those depressed patients who ate a mediterranean diet, 30% improved, while only 8% of the controls who just received counselling did.
- Avoid depressing or negative experiences (consider your choice of films, TV, books and even friends) and watch and listen to as much positive reinforcing material as you can. We would strongly recommend watching or reading books by authors such as John Kehoe and Wayne Dwyer.
- Some people find meditation and affirmation very helpful. Walking and enjoying the beauty of nature and sunshine can be therapeutic.
Nutritional supplements
These are almost ignored by the medical profession, even though in the late 1800’s people discovered that many mental disorders were caused by vitamin deficiency. Many people were discharged from asylums after being given vitamin B. It still happens to this day (click here). Depressed people often eat poorly so providing optimal nutrition to the brain and nerve cells is especially important. The value of nutrition is best shown in this TED talk by Dr Julia Rucklidge on treating mental illness (click here)
- A good multivitamin/multimineral makes sure that brain has all the nutrients and minerals it requires to function perfectly.
- Omega 3 fish oils, 1–2 grams daily. These are very important for good brain function, children whose mothers had high fish oil intake during pregnancy had higher IQs. In depression, a high omega 3 intake can be very beneficial.
- Calcium and magnesium, 800-1,000mg/day, Magnesium has a calming effect, promoting restful and restorative sleep and enables people to cope better during the day.
- Probiotics – it is believed that the gut can play a major role in many diseases and especially mental disorders.
- Vitamin D affects the production of some brain hormones (L tryptophan and dopamine), and people with high intakes of vitamin D have less depression. Take 5 – 8,000 iu daily and/or get plenty of sun exposure
- L tryptophan is a building block for serotonin which transmits nerve impulses in the brain, and also induces sleep and tranquillity. Many patients with depression have low L tryptophan and serotonin levels. L tryptophan can be taken as a supplement, and is also found in cottage cheese, milk, brown rice, meat, peanuts and soy products. Note discuss this with your doctor before starting L tryptophan supplementation, as it may affect other antidepressant drugs.
- St John’s wort (Hypericum perforatum) is a prescription drug used in Germany for depression and appears to be as effective as conventional antidepressants in patients with mild depression. In a review of over 20 trials involving 1757 patients, St John’s wort was much more effective than placebo and slightly more effective than conventional drugs in improving symptoms. However, it took 6-8 weeks for the maximal benefit to be seen, so continue treatment for at least 3 months before making any decision on its value. In most countries it is sold as a supplement and is freely available. Note before starting St John’s Wort (which is safer than most drugs), discuss it with your doctor.
Body/mind/spirit/energy therapies – most people appreciate that a person with a positive outlook and happy disposition is much more likely to overcome a disease than those who turn their faces to the wall. When we consider that the atoms that make up our bodies are actually spinning energy particles (electrons, quarks, leptons, bosons, neutrinos….), then it is obvious that energy can affect our bodies. Some therapies (acupuncture, Reiki, healing touch…) address these directly, and there are many simple, safe and beneficial ways of improving the energy round out bodies. These include looking positively, forgiving events of the past, loving, hugging, meditation, listening to good uplifting music or TV programmes, Tai chi, hypnosis, massage, aroma therapy. Accept the support and love of others. Studies have shown that positive thoughts, prayers, love and concern can travel around the world and lead to beneficial outcomes. We don’t understand it, but then there are many things we don’t understand. Just accept it as another implement in your recovery – possibly the most powerful tool. Meditation is also very helpful in any problem to do with the mind. For a very clear and clever short video on meditation click here
The Nutritional supplements I use and recommend to my patients
For depressed patients – USANA – Cellsentials *, Biomega, Active Calcium plus, Ginkgo, Proflavanol C, probiotic, and vitamin D –
A good quality St John’s wort