Depression- DOWN BUT NOT OUT 

by Lynn Hinderliter CN, LDN

depressionThere are times in all our lives when events can overwhelm us, & times when we suffer such a severe loss we may think we will never recover. When such things happen, it is no wonder that our psyche suffers a blow, and we succumb to depression: there is a time to mourn, a time to heal, and it takes time to learn that these things are part of the lessons life has to teach us. Eventually most of us pick up the pieces, and life goes on.

Finally, it is being recognized that psychiatric guidelines for determining depression are not correctly taking into account what one might call JUSTIFIED sorrow;  a 2007 study suggests that almost a quarter of those diagnosed with depression, are simply reacting normally to stressful events. The study suggests that therapy, rather than medication, may be the preferable option: our psyches may NEED to feel sorrow in order to recover fully.

I recommend a book which delves into the fact that the normal process of grieving has come to be seen as a medical condition in the US:  Wakefield and Allan Horwitz have written a book called “The Loss of Sadness: How Psychiatry Transformed Normal Sorrow Into Depressive Disorder.” Depression

Yes, suffering is an unfortunate part of life: what is not so easy to explain is the impenetrable black cloud that can become a terrible part of the lives of some unfortunates who have no apparent cause to be depressed. One of the worst parts of this is the impossibility of explaining to others what one is experiencing – even assuming one has the energy to try. Life simply no longer seems to hold anything worthwhile, and even the simplest undertaking requires an insurmountable effort. Depression

Modern medicine has a wide choice of drugs to offer for depression: unfortunately, they have a tendency to perpetuate a cycle, because at this point in time, nearly all of the antidepressants available have as their side effect the very problem for which they are prescribed, so that while at first they may seem to help, eventually they will make the problem worse. Depression

In addition, most of them are extremely addictive by nature, and attempting to discontinue their use is such a difficult project that medical advice is required to do it without causing further harm. In fact, a recent report from the US Agency for Healthcare & Research in Maryland found that rates of depression have seen very little significant change in the last 20 years, even with the addition of the heavy hitters, Prozac and Fluoxetine. Depression

They also report that any drug therapy only sees a 50% response rate.  Depression

There are a number of medications with depression as a side-effect to include many cholesterol lowering drugs, antacids and corticosteroids, and also some nutrients in very high doses, and this possibility must certainly be considered before taking anything else to help, whether drug or nutrient.

Alternative medicine does have something to offer for moderate depression, because it looks at the whole person and attempts to identify the imbalance that is causing the problem, rather than treating the symptoms

What is often found is that depression is aggravated by nutritional deficiencies, and mega amounts of certain nutrients are sometimes required just to reach normal function .It is also very important to identify and address possible allergens, since the brain can be very sensitive to allergies .In one study, depressed patients had four and a half times as many reactions to 33 foods and inhalants!

I hope in this article to be able to convince you that there is a more benign and natural approach to the problem of moderate depression and anxiety than the chemical one, because it seems that more and more people are coming to me  suffering from depression. Many of them are reluctant to resort to chemical answers, and want to know what a more natural approach has to offer. Fortunately a great deal of research is being done to investigate claims for natural therapies, and many of the results are promising.

How do you know if you are depressed?  I append the list of symptoms from Dr. Mercola :  you can find some good information there about depression.  http://www.mercola.com

Emotional reactions. This is the easiest one in that you feel depressed most of the day. This is an obvious clue, especially if you feel this way nearly every day, or feel sad or empty, or have others tell you that you do. Depression

Symptoms: feel sad, feels empty or lacks feelings of all kinds, tired (“everything is an effort”)… nervous or restless, angry and grouchy (especially in kids), irritable, overreacts to criticism… bored, apathetic, “nothing is enjoyable,” feels socially abandoned and/or has less interest in relationships, sex, food, drink, music, current events. Depression

Physical changes. Fatigue or loss of energy nearly every day is probably the most common symptom in depression. It is one of the most common symptoms that I see in my practice. There are many reasons that you could be fatigued other than depression, but most depressed people have fatigue as part of their illness.

The second most important symptom is early morning awakening. If you are waking up at 2 to 4 AM on a regular basis one of your first thoughts should be to consider the possibility that you are depressed. Most people with depression feel extremely tired insomnia or have hypersomnia nearly every day.

One also needs to be alert to weight issues, either gaining or losing weight. The part of the brain that controls appetite is almost invariably affected. If you have a significant weight loss when not dieting or your appetite is decreased, or if you have an increased appetite and have a significant weight gain, you should consider the possibility of depression.

Symptoms — difficulty sleeping or sleeping excessively, awaking early… hyperactivity or sluggishness, diurnal moods (worse in the morning)… low sex drive, loss of appetite, weight loss or gain, indigestion, constipation, headaches, dizziness, pain, and other somatic problems or complaints. Depression

Attitudes and motivation. A depressed mood is a major change from your normal mood. Typically relationships with your friends, family, job or school take a significant impact by the change in your mood.

A markedly decreased interest in all, or almost all, your activities most of the day, nearly every day is a strong indicator of depression. It is as if there is nothing in life gives you any pleasure anymore.

Symptoms: low self-concept, lack of self-confidence and motivation, pessimistic or hopeless, feel helpless or like a failure, expects the worst… self-critical, guilt, self-blaming, “People would hate me if they really knew me”… suicidal thoughts, “I wish I had never been born.” Depression

Behavioral excesses. Some experts believe that you can’t be depressed unless you have thoughts of wanting to take your life. You may or may not have a specific plan for committing suicide but you feel that it would just be better for all involved, especially yourself, if you just weren’t here anymore. Depression

Symptoms — complaints about money, job, housing, noise, poor memory, confusion, loneliness, lack of care and love… acting out (adolescents), running away from home, rebellious, aggressive… obsessed with guilt and concern about doing wrong, about being irresponsible, about the welfare of others, and about “I can’t make up my mind anymore”… crying… suicidal threats or attempts. Depression

Behavioral deficits. You lose the enthusiasm to be with people and talk with family and friends. Depression is one of the more common reasons for sexual dysfunction.

Symptoms — socially withdrawn, doesn’t talk, indecisive, can’t work regularly, difficulty communicating, slower speech and gait… loss of appetite, weight change, stays in bed… less sexual activity, poor personal grooming, and doing less for fun. Depression

Lack of skills. Another very common pattern is a significant negative change in your thought processes. If you have feelings of worthlessness or excessive or inappropriate guilt nearly every day or have a diminished ability to think or concentrate, or indecisiveness, nearly every day, then your body may be giving you a huge clue that you may be depressed. Depression

Symptoms — poor social skills, frequently whiny or boring, critical, lack of humor… indecisive, poor planning for future and unable to see “solutions.” Depression

In Europe, St. John’s Wort ( an olde English word for “weed”, incidentally) is used with great success to treat minor to moderate depression: in one double blind study, 66.6% of the patients improved using the herb, versus 26.7 using the placebo. In fact, clinical studies have shown it to be more effective at relieving depression than Elavil or Trofinil, without the side effects.

I would add, don’t be misled by recent studies which purport to show St. John’s Wort ineffective:  if I were truly paranoid, I would be inclined to suspect they were designed with this end in mind!  Testing something for a purpose it is not intended for, and then saying “See! It doesn’t work” is an old game. No one has ever claimed that St. John’s Wort will help major depression,  which is what these particular researchers set out to test. Depression

A serious caveat, however.  Because St. John’s Wort affects a very important liver enzyme essential for the metabolizing of certain medications, it would be unwise to use it if you are using ANY prescribed meds, without consulting your Doctor to find out if you will be affected by the combination. Depression

The active ingredient in St. John’s Wort, Hypericin, is both a potent antidepressant and anti viral. This herb has been widely available in this country for some time, and standardized extracts of the strength used in most trials are recommended: look for products guaranteed to contain .3% hypericin for optimal results. The greatest number of studies – over 23 – have been performed using St. John’s Wort standardized to hypericin. Only one clinical study used Hyperforin as a marker, and it needs to be emphasized that hypericin was also present: there are many compounds in St. John’s Wort which work synergistically. (Interestingly, a German study found that the hyperforin in St. John’s Wort is extremely effective against Staphylococcus Aureus and Corynebacterium Diptheriae, two common bacteria and ones which are becoming resistant to all known antibiotics.) This is why I like a product that has not only the standardized extract present, but also a base of the actual herb. One of our most scrupulous companies, as a matter of interest, went back and analyzed its St. John’s Worts for hyperforin, and found it already present accompanying the hypericin, so that they now guarantee a 4% hyperforin and 3% hypericin. An excellent time-released version became available recently, which you only have to take once a day. Depression

A warning with St. John’s Wort is that photosensitive persons may be even more sensitive to light when using the herb – interestingly, a study testing the effectiveness of St. John’s Wort against depressed AIDS patients was discontinued, because more than half of the thirty subjects reported a red, itchy rash after exposure to sunlight. If you are using birth control and experiencing depression, be careful about choosing St. John’s Wort : it seems that with some people, the herb reduces the effectiveness of the hormones – and may affect other medications similarly.  The Lancet suggests not using it with protease inhibitors, or cyclosporin.   The thinking is that St. John’s Wort caused the liver to metabolize these substances more quickly.  So be careful, or you may have something to REALLY be depressed about! Depression

Women who suffer from depression as a consequence of menopause are now able to try Black Cohosh Extract, ( Cimifuga Racemosa) in the knowledge that in a study of 80 patients given either the herbal extract, conjugated estrogens or a placebo daily for 12 weeks, the extract produced better results in the Hamilton anxiety test, as well as relieving the symptoms of menopause. If the depression is due to hormonal imbalances, Black Cohosh is definitely a herb to consider. (Therapeuticum. 1987, 1:23-31.) Depression

I have found many women to be helped even more if they add capsules of Evening Primrose Oil to the Black Cohosh – this is a source of certain important essential fatty acids which play a role in the production of hormones, as well as the chemistry of the brain.   In fact, sometimes when a woman on birth control pills is suffering minor depression and weight gain, I find that the addition of the EPO will restore balance to her life. (The original EPO, Efamol, was used for much of the research, but there are other excellent brands available). It  would seem reasonable to suppose that it would also be helpful for women on hormone replacement therapy.

Recent research (Time Magazine quoted, May 24 1999 p.94) has shown that Omega 3 fatty acids from fish can help people with manic depression: a preliminary report showed that patients who took 10,000mg of Omega 3 a day for 4 months were twice as likely to go into remission as those on placebo. Studies on depression (not manic) have shown results at 1,2 and (best of all) 4gms.  See RESOURCES for a review. Depression

Depressed because you are in pain?  You need to be aware of the dangers of using certain pain medications and anti-depressants together!In a recent analysis of medical studies on this link, researchers found that 67 percent of upper gastrointestinal bleeding cases occurred in patients taking both NSAIDs and SSRIs, after a median of only 25 weeks of use.(Loke YK, Trivedi AN, Singh S. Meta-analysis: gastrointestinal bleeding due to interaction between selective serotonin uptake inhibitors and non-steroidal anti-inflammatory drugs. Aliment Pharmacol Ther. 2008 Jan 1;27(1):31-40.) Depression

Another recent study indicated that patients using both types of drugs suffered a ninefold increase in gastrointestinal bleeding risk when compared with controls.(de Abajo FJ, García-Rodríguez LA. Risk of Upper Gastrointestinal Tract Bleeding Associated With Selective Serotonin Reuptake Inhibitors and Venlafaxine Therapy. Interaction With Nonsteroidal Anti-inflammatory Drugs and Effect of Acid-Suppressing Agents. Arch Gen Psychiatry. 2008;65(7):795-803) Depression

Another herb that I myself use in “down” moments, and find very effective, is Kava Kava. The German Komission E Monograph admits its use for conditions of nervous anxiety, stress and restlessness. This herb has been known to the Western world since the 18th century, but within the last year or two, because of its effectiveness, its reputation is growing. I prefer a liquid extract, and find it immediately calming and relaxing, but others like the capsule form. I will confess that I am a very highly charged and impatient driver, and now when I go for any distance in the car, I carry an under the tongue spray of Kava Kava with me to cut down on my stress – my daughter has even been heard to say that she won’t accompany me without it!   Kava Kava has been part of the ceremonial traditions of the Polynesian Islands since they were discovered by Westerners: there are photographs of Lyndon Johnson partaking of a sip of the beverage, with no great expression of delight visible on his face, and also Hilary Clinton, who looks a little more eager to experience it.  The Islanders believed that Kava Kava preserved the goodwill of Kings and chiefs, and often used it when reconciling with an enemy. Perhaps its application to Road Rage should be carefully investigated – though I hasten to add my driving reactions are nowhere near that radical!  Be careful not to use kava Kava with anything that affects the liver adversely, or if you have liver problems. Depression

Kava Kava should not be used if you have any reason to suspect your liver function is compromised. Depression

Kava Kava can be helpful for panic disorders, but the most convincing study to date was done with Inositol, using 4 grams 3 times daily. This was a placebo controlled study, and found that over a period of 4 weeks, episodes of panic attacks and agoraphobia were significantly reduced: there were no side effects, and a maintenance dose of 2 -4 grams per day seemed effective after the initial high therapeutic doses. (Am J Psychiatry 152(7):1084-6, 1995.) Depression

Just as depression is a vast subject, so there are many possible nutritional causes and approaches. I don’t want anyone to think that the things I mention here are the only ones which may be helpful, but they are the ones I am reading most research about at the moment. Three more I need to add to this list are 5-HTP, a close relative of the amino acid Tryptophan,  and SAM-e, a relative of the amino acid Methionine. Double-blind clinical trials comparing 5-HTP to Tryptophan, found the former to be clearly superior, and some 1991 studies in Switzerland found 5-HTP to be equal in efficacy to the antidepressant drug fluvoxamine, as well as being better tolerated with fewer side effects. (Psychopathology. 1991,24:53-81) Depression

Lithium Orotate, the safe natural version of the high dosage, toxic prescription medication, has been used for bi-polar disorder, but also aaddresses depression – its mode of action appears to be inhibition of shrinkage of the hippocampus in the brain, such shrinkage being a factor in many neurological and psychological conditions. Recent research has shown that it may also be a factor in preventing Alzheimer’s disease. Depression

SAM-e has been the subject of about 75 studies in Europe, dating back to the 1980s, but has only just recently become available in the U.S. Not only do experts claim that (by a process of methylation which detoxifies compounds damaging to the nervous system) SAM-e returns the pleasure to everyday living, it also appears to have the ability to repair and desensitize damaged joints. Interestingly, people with severe liver problems, such as cirrhosis, tend to be deficient in SAM-e, because of problems metabolizing Methionine. It is a leap, I know, but perhaps cleansing the liver, or taking liver-supportive herbs might be helpful, particularly for women taking hormones and suffering from depression. Remember, hormones are deconjugated in the liver, which places a tremendous burden on it. On a practical note – when buying SAM-e, make sure the tablet is enteric coated, otherwise it will break down too soon and not be absorbed at the proper site: it will simply be digested and used as Methionine.  A new study presented in 2000 at the Congress of Neuro Psycho Pharmacology  in Belgium shows SAM-e and imipramine performed equally well for Major Depressive Episodes,  but SAM-e was better tolerated by the 281 participants in the double-blind study.   Slightly fewer of the SAM-e group responded to the supplement. Depression

It is easy to run the risk of forgetting the horses as we look at the zebras! In other words, while there is quite a selection of highfalutin’ supplements to help depression, some of the basics should not be ignored. The B vitamins, in particular, are essential to good mental health. In fact, folic acid and B-12 tie into the cycle of Methionine metabolism which produces SAM-e, and B-6 is necessary for supporting the pathways of Tryptophan and 5-HTP metabolism. Calcium and magnesium should not be ignored either, as they have important roles to play in our nervous systems.

I always ask my clients to consider, also, whether they may be suffering from a highly acidic body system: this condition can make it impossible for the cells of the body to unload toxins or absorb nutrients, meaning that no matter what nutrients you take, they will be doing you minimal good until your body is in balance. This can be checked by the use of pH strips, and regulated by dietary adjustment – most proteins are acid-producing, most fruits and vegetables are base. Certain supplements are also buffers, among them green super foods, lecithin, brewer’s yeast and calcium.  There are some dietary supplements specifically formulated to adjust pH levels.   We do try to insist that a dietary adjustment be undertaken, for reasons too many to enumerate, but sometimes diet alone is not enough. Depression

Perhaps the most powerful mood elevator is brisk exercise (and for the depressed person, one of the hardest to administer) & those who have forced themselves to begin a program of fitness have benefited enormously. Combined with proper nutrition and supplementation and allergy control (where applicable) many people find their depression totally eliminated. Depression

Last but not least, consider the possibility of long term damage to body systems from prolonged use of anti-depressant drugs:  a recent source of excellent information I have found (you may want to sign up for their newsletter) is www.hsibaltimore.com.   There you will find this information expounded on from the point of view of its effect on digestion and health: Depression

HSI Panelist Richard Cohan, D.D.S., M.S., M.B.A., sent (HSI a comment)  regarding xerostomia (dryness of the mouth), which is a common side effect of pharmaceutical antidepressants. Dr. Cohan says that antidepressants cause more xerostomia than any other group of drugs. He adds, “Xerostomia leads to an increase in caries (cavities), periodontal disease, and candidiasis, a yeast infection in the mouth often referred to as thrush. While not everyone whotakes antidepressants experiences these side effects, those who do are often left with serious, permanent damage. For instance, these conditions can lead to irreversible loss of periodontal support of the teeth and the loss of teeth themselves. Just more of the hidden dangers in taking these drugs.” Depression

Consider also the possibility that long term treatment with anti-depressants may worsen the course of the condition – more at http://www.psychiatrist.com/abstracts/200302/020303.htm – and that there may be a connection between heart problems and some anti-depressants: Depression

A new study has shown that depressed patients taking an older type of medication called tricyclic antidepressants had twice the risk of having a heart attack as nondepressed people. Patients taking medications from the newer class of antidepressants known as selective serotonin reuptake inhibitors (SSRIs) did not show an increased risk of having a heart attack. (Lynn: to that I would add the word “yet”) Depression

There is help out there for that Black Cloud, and it isn’t always necessary to accept the many risks that come with the use of potent chemical antidepressants: there are many effective natural therapies that can be tried first. Depression

One of my favorite sources of information and inspiration is Red Flags Daily (http://www.redflagsdaily.com/index.php).  Their columnists have lived life, asked the hard questions, and traveled the back roads.  I encourage you to visit them, and see what they have to say.This quote from Marilyn Holasek Lloyd has particular relevance: (http://www.redflagsdaily.com/lloyd.html) Depression

“I was diagnosed with breast cancer. When I mentioned to my physician-husband about 6 weeks after diagnosis that I may be depressed, he quickly said, “There is something you could take for that.” Depression

Once again, I had a lot to be depressed about; loss of peace of mind; loss of intimate body parts due to the mastectomies and then a hysterectomy/oophorectomy that threw me into menopause. Depression

As luck would have it, I happened to have a whole stack of Science News magazines piled up to read.  The very first magazine on the top of the pile had an article in it about  the new type of anti–depressants that were similar in structure to certain anti-histamines and that could possibly and inadvertently cause tumor growth. Depression

After reading the article, I decided that there was no way I was going to take any drugs. Depression

I was going to use my own coping strategies, and find new ones, if needed. With the help of talk therapy, meditation, walking, and the support of family and good friends, I continued on with my life.

In relating these anecdotes, I am not suggesting that people should not be treated for their depression, especially if someone suffers from a neurotransmitter imbalance. However, I am saying that it is too easy these days to reach for a pill, or to be given a pill for transient reactive depressions, also called “life event depressions.” Sooner or later, a person has to learn to cope with what has happened in their life.

Maybe I’m completely biased on this argument of happy pills, but I feel that the people I know who take them are somehow not being true to the experiences of life.  They seem to be walking around in some fake happy place. And God forbid if one brings up any negativity in their presence.  They don’t want to hear it. Depression

In reporting the truth of my own life experience, I want to make it perfectly clear that I have reached for a Librium once in a great while. In my 59 years, I’ve probably taken fifty pills or so. Depression

But I also believe that given all of those hard times in my life, if I had been a pill popper, I would not be the person I am today.  I guess I’m one of those people who believes that suffering is a part of life that no one can avoid.  Sometimes I have even gone so far as to label people who seem oblivious to the feelings and suffering of othersas people who have not suffered enough to gain important life insights.

Don’t get me wrong, I wish that everyone could avoid suffering.  However, I am still grateful that for the most part, I went cold turkey with the hard stuff.” Depression

Find the recommended supplements here

Other articles you  may find interesting:

Quick Links

Worry – and how not to – http://superperformance.com/worry2.html

Managing Stress & Anxiety – http://www.hypnosisnetwork.com/hypnosis/stress_anxiety.php

Happiness by Prescription – http://www.time.com/time/magazine/article/0,9171,824739,00.html

NOsteoporosis – http://www.alternativemedicine.com/common/news/store_news.asp?task=store_news&SID_store_news=1609&storeID=02AD61F001A74B5887D3BD11F6C28169

Statin’ the Truth – http://www.medicalconsumers.org/pages/cholesterol_skeptics.html

Antidepressants not the Answer – http://anxietyanddepression-help.com/drugs-depression.html

Manufacturing Addiction – http://www.benzo.org.uk/amisc/benzobrief.pdf

Vacci-Nation – http://www.prisonplanet.com/articles/february2007/060207nolaw.htm

A list of medications which may be implicated in the development of Depression.

www.benzo.org.uk gives invaluable information to people on how to taper properly from the benzodiazepine class of drugs

Review of some studies on Fatty Acids and Depression – http://search.lycos.com/default.asp?loc=searchbox&query=health&tab=web

Magnesium Glycinate and Depression – http://george-eby-research.com/html/depression-anxiety.html

Rapid recovery from Depression using Magnesium Glycinate – http://www.ncbi.nlm.nih.gov/sites/entrez?db=pubmed&uid=16542786&cmd=showdetailview&indexed=google

TWO SUCCESSFUL PROGRAMS

Stress & Anxiety Control through Mind Control – http://www.hypnosisnetwork.com/hypnosis/stress_anxiety.php

Accepting and Receiving suggestions for change through Hypnosis

Core Inner Strength – http://www.hypnosisnetwork.com/hypnosis/self_esteem.php?hn=1632

 a hypnosis program developed by Dr. Shirley McNeal, is a fun and easy way to improve your self-esteem. In just four hypnotic sessions, you will discover the life-changing secrets behind experiencing comfort and safety in yourself, raising your self-esteem and self-confidence, and finding your inner strength.

Omega 3 and Depression in Diabetics – http://www.onderzoekinformatie.nl/en/oi/nod/onderzoek/OND1284172/