Who doesn’t know someone suffering with depression?
At some point in life most people go through it (especially the more mild version).
Like most mental/emotional disturbance there are a range of causes and different levels of severity.
The effectiveness of conventional treatments (SSRIs are the most used drug) is considered to be “not statistically significant” in mild and moderate depression but significant in severe depression. That isn’t to say that they can’t have value in more mild forms of depression when combined with Cognitive Behavioural Therapy (and everyone is different so they will work for some and not others anyway).
My point is this – It is time for a radical change in the way we treat depression. It is too reductionistic to rely on SSRIs for the bulk of the population, treating everyone as being the same, only referring for counselling in the most extreme of circumstances and using psychiatric referrals (and subsequently more harmful medications) when treatment success isn’t reached.
Holistic healing methods, an individualized approach and a multi-therapy treatment plan is the way of the future. Yes, it requires more resources. Yes, it requires more listening, planning and care. Yes, it works and people get better.
I have had first hand experience with this in my own practice.
With the community I live in, the patients I see and they type of medicine I practice I spend much of my time working to pull patients off of medications. It isn’t a process to be taken lightly. Don’t try it for yourself until you have medical supervision.
This article is about the basics of what can be used as an alternative to SSRIs in mild and moderate depression. In more severe cases these treatments are also useful but the addition of a few other more intense therapies is essential (and the timeframe can be much longer).
The first step in treating depression is recognizing it within yourself. The symptoms can be very clear: low mood, fatigue, insomnia, possible anxiety, negative thoughts, lack of joy, lack of desire, etc.
Your doctor can tell you “you have depression” but until you actually accept it as being real (and treatable – this is the key – knowing you can heal) nothing can be done. It is often said that this recognition means you are 50% healed. Without it there is no chance for healing. With it there is a huge chance.
Now something can be done.
There will be signs of depression. It isn’t something that occurs out of the blue. Isolation is common, you notice that life hasn’t been very fun for a while, major negative life events (such as a death in the family, a loss of a job, etc) often accompany the symptoms.
Figure out if you or someone you know is at risk and get guidance early.
Lets Start With The Root Cause:
In holistic healing and Naturopathic Medicine the root cause is everything. It is the foundation for how our medicine sees such great results for patients. Yes, patching up the symptoms gives us time to find the root cause but putting major resources toward removing the root is usually when the most healing occurs.
Depression isn’t any different.
The causes of depression are widespread. Often a few of these need to be corrected. It can be a chain reaction of multiple causes that lead to the flurry of depressive symptoms. It is helpful to know this list and cross check it with your current lifestyle. Check in with some of the things you may have been neglecting recently.
If you or someone you are close is suffering from low mood (but not all the time) there are a few sneaky causes of depression that need to be assessed before moving forward. At this point we have stepped into preventing the onset of depression but also removing the cause.
The following is a list of possible causes of depression that aren’t normally considered. Have these assessed if you think you are at risk for developing depression.
- Thyroid disease
- Congested city living
- Low omega 3 intake (from fish or fish oils)
- Birth control pills
- Other medications
Then we have our classic causes of depression. Do you relate to any of these?
- Emotional trauma (loss of a loved one, loss of a job, mental or physical abuse)
- Genetics (family history of depression)
- Isolation (lack of support system)
- Substance abuse
- Severe illness and/or pain
- Lack of sunshine
These are just a few of the possibilities that may need to be either removed, corrected or worked on. The first step is recognizing. The second step is making change.
Make a Dramatic Change:
In treating most cases of depression the quickest route to success does not involve drugs. It requires dramatic or significant state change. This state change I am speaking of could be a fixing one of the causes above or adding something different that shakes life up. Often this comes in the method of giving, volunteering, connecting with others, having fun, trying something new, getting into nature, waking up earlier, a diet overhaul, etc.
You get it. Adding something extremely healthy that causes endorphins (or the “happy” chemicals of the brain) to be released. Lifestyle change can also significantly impact dopamine and serotonin levels in a way that SSRI’s cannot. It is more holistic, has less side effects and is sustainable long term.
These changes are always easier when working with a support system, expert, guide (such as an ND, MD, psychologist, counselor, family or friends, etc). It is important to figure out which will be most beneficial to you. Often this process takes trial and error.
For mild and moderate depression there is good evidence for exercise, nature walks and sleep cycle improvements. If the problem is more on the anxiety spectrum meditation is highly indicated (also is useful in depression).
One simple trick that can help to pull a person from a chronic fatigue, low mood situation is contrast hydrotherapy. It is simple, inexpensive and really works. The method is this: Try turning the shower to as cold as possible for 30 seconds, then warm for a minute. Repeat 5 times and end on cold. This is very stimulating to the body. It is a powerful tool and can be done every morning.
Once one significant change has been achieved and the benefits are apparent it is very motivating and more options will want to be considered. This is how healthy lifestyles are built.
My three keys to a healthy lifestyle are as follows. If you need a dramatic change start with these. They are free and simple to correct:
Once you have these anything is possible. If one was able to be achieved in the first round of change add in another.
I can’t speak enough about the importance of sleep. I wrote an entire post about it here.
Most people with depression have a hard time falling asleep or do not sleep through the night. This can be fixed without medications. There are many things to try. It is really easy to try different things to help with sleep. Most of them are very safe and the positive results can make life much better.
When you don’t sleep the brain becomes fatigued. When it is fatigued it is much more difficult to actively lift the mood. It is more difficult to do the things that make us happy or participate in pleasant thought patterns (when conditioned to think negatively). Lack of sleep is taxing on the adrenal glands and can cause decreased desire, lack of motivation and increased anxiety (or fear, doubt and worry).
Nutrition is an important one that shouldn’t be ignored. In order to feel good we need to eat nutrient dense foods (and absorb the vitamins and minerals). We need water and we need fibre. Simple changes that make a big difference are:
- Eat more fruit (including tropical fruit, berries and apples)
- Eat more vegetables (including green leafy veggies)
- Have nuts and seeds for snacks
- Drink 2L of water per day
- Consume fish 2-3 times per week
When it comes to exercise we are trying to get the cardiovascular system working so that blood flow to the brain is increased, endorphins are released, large amounts of oxygen are brought in and toxins are excreted via sweat.
My more common/basic recommendations are as follows:
- Walk in nature (or anywhere) for 30 minutes everyday (or most days)
- Adopt some kind of strength training routine
- Do fun things that involve movement such as swimming, sports, camping, etc
These are the big three but others mentioned above are also effective. Again, these are very effective for mild and moderate depression but are not the complete answer for severe depression caused by illness (although would be included as part of a larger program).
Once basic lifestyle components are met we move to step three… Add in what is missing in life. Fill the void.
This is very personal and requires looking within (as described above). Some of these may have already been taken care of when tightening up the lifestyle and others require a bit more deeper work.
Add in What You Might Be Missing:
I divide this section of treatment into three; chemical, spiritual and lifestyle. The lifestyle we have already covered.
If you are a poor eater, don’t sleep well or never exercise you already know this. Your don’t need someone to tell you. Correcting any aspect of the lifestyle can be the answer to pull someone out of depression. If those are all in order it may be one of these other two.
This component is about neurotransmitters. The main neurotransmitter referred to in depression is serotonin. Changes in serotonin effect mood, appetite, social behaviour, sleep, memory and learning. Most of it is found in our digestive tract where it contributes to intestinal motility. When serotonin is low we are much more likely to crave carbohydrates and subsequently gain weight.
Serotonin is made in the brain using the amino acid tryptophan and its synthesis can be regulated though diet, supplementation and exposure to sunlight. Tryptophan is found in many protein sources but it is most famous for being found in turkey. Here is a short list of foods that contain tryptophan:
- Organic Soy
- Egg Whites
- Sesame Seeds
Supplement wise 5HTP is the most common recommendation for boosting serotonin levels. It is the closest precursor to serotonin available. See your ND for dosages.
St. John’s Wort is the most common herb used in depression. It isn’t indicated in severe depression and can’t be combined with any depression medications. The active ingredient in the herb is called hypericin and its job is to prevent the breakdown of serotonin so that you have more of the neurotransmitter around longer. See your ND for dosages.
Vitamin D may be useful in all types of depression but it is especially useful in Seasonal Affective Disorder. In the last 3 years systematic reviews have been done showing that low vitamin D levels are associated with depression. It is a fat soluble vitamin (stored in fat) so that means it can be toxic at very high doses. See your ND for dosages.
New studies are showing a casual relationship between vitamin D and serotonin. Vitamin D has been shown to activate serotonin in the brain (as a precursor to enzymes in the synthesis of serotonin). Therefore it is essential to our happiness!
In people who have suffered from a heart attack, angina, stroke or heart failure depression is more common if omega 3 intake is low. Omega 3’s (from fish or fish oil) help to keep the cardiovascular system healthy and at the same time prevent depression.
Vegans, vegetarians (anyone with low meat intake) and those with chronic digestive disorders (like Crohn’s disease) who are suffering from depression may be lacking B vitamins. Low values of B6, B9 and B12 have been linked to depression and they are very easy and inexpensive to supplement.
Finally, L-tyrosine can be used in depression. Its role to to increase dopamine levels in the brain. This causes increased mental energy and motivation which eases depression symptoms. See your ND for dosages.
An important component for a program to lift depression includes the following practices. I call them the spiritual component because they influence the connection of self and spirit. They help to develop a connection to something greater. Practicing them makes it easier to have faith, to be able to look forward to a positive future and to see beyond the potential negative circumstances of the present time.
- Finding purpose
- Dispelling fear, doubt and worry
- Practicing gratitude and forgiveness
- Developing/finding true passion
These are the components of a healthy spiritual/mental-emotional outlook. The thought patterns and emotions that flow from the mind are spiritual in nature.
To lift depression the spiritual focus can often start with asking simple questions like “how can I serve”, “what is my purpose”, “what am I grateful for”. These need to be thought of as empowering questions. They lead to big answers if they can be used productively. The answers are often surprising.
I’m not going to say more about this topic as I think it deserves its own article. Each of these examples serve the body by calming the mind and raising the mood. Practicing one for 5 minutes in the morning can cause significant change in mental atmosphere for the rest of the day.
Laughing, having fun, trying new things and participating in hobbies are easy ways to inject a ‘lightness’ into life. They lift the mood, help us to get out of the house and surround us with friends and family. Sometimes it is this easy. Sometimes a partner, family member or friend knows exactly what is needed. Support systems are key and I didn’t want to end this article without mentioning them.
Healing Starts With One Action
When it comes to lifting depression, raising mood and feeling good simple changes can make a huge difference. Taking action requires will power but once the ball is rolling change becomes easier and easier.
Start with something simple like adding more fruits and veggies to your diet or by practicing gratitude for 5 minutes in the morning. Watch your mood evolve from there.
Everyone is unique. Some things will work better for some people. Remembering that trial and error is the way to success in depression is important.
Have you had success treating your own depression with natural medicine? We would love to hear your story in the comments below!
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The British Journal of Psychiatry Feb 2013, 202 (2) 100-107; DOI: 10.1192/bjp.bp.111.106666
The use of St John’s Wort in the treatment of depression
The Psychiatrist Jun 2000, 24 (6) 232-234; DOI: 10.1192/pb.24.6.232
Major depression is associated with lower omega-3 fatty acid levels in patients with recent acute coronary syndrome.
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