Naturalpath

What you need to know

1. Get active: Exercise that increases your heart rate at least three hours a week (or 30 minutes a day) may help boost your body's natural mood-enhancers (endorphins)

2. Check out St. Johns wort: Take 600 to 1,200 mg a day of a standardized herbal extract containing of 0.3% hypericin to help with mild to moderate depression but talk to your doctor first as St. John's wort can interact with certain medications

3. Get enough iron: A lack of iron can make depression worse; check with a doctor to find out if you are iron deficient

4. Try B vitamins: Take a supplement that contains folic acid and vitamins B12 and B6 to help correct deficiencies associated with depression

5. Seek counseling: A mental health professional may help you make a full recovery

These recommendations are not comprehensive and are not intended to replace the advice of your doctor or pharmacist. Continue reading the full migraine headache article for more in-depth, fully-referenced information on medicines, vitamins, herbs, and dietary and lifestyle changes that may be helpful.

About depression

Depression is a condition characterized by unhappy, hopeless feelings. It can be a response to stressful events, hormonal imbalances, biochemical abnormalities, or other causes.

Mild depression that passes quickly may not require any diagnosis or treatment. However, when depression becomes recurrent, constant, or severe, it should be diagnosed by a licensed counselor, psychologist, social worker, or doctor.

Diagnosis may be crucial for determining appropriate treatment. For example, depression caused by low thyroid function can be successfully treated with prescription thyroid medication. Suicidal depression often requires prescription antidepressants.

Persistent mild to moderate depression triggered by stressful events is often best treated with counseling and not necessarily with medications. When depression is not a function of external events, it is called endogenous.

Endogenous depression can be due to biochemical abnormalities. Lifestyle changes, nutritional supplements, and herbs may be used with people whose depression results from a variety of causes, but these natural interventions are usually best geared to endogenous depression.

What are the symptoms?

A diagnosis of depression requires at least five of the following symptoms.

• Depressed mood.
• Diminished interest or pleasure in all or most activities, most of the day, nearly every day.
• Significant weight loss or gain when not dieting (e.g., more than 5% of body weight in a month).
• Insomnia or excessive sleeping nearly every day.
• Agitation or depression in voluntary muscle movements nearly every day.
• Fatigue or loss of energy nearly every day.
• Feelings of worthlessness or excessive and inappropriate guilt nearly every day.
• Diminished ability to think or concentrate, or indecisiveness nearly every day.
• Recurrent thoughts of death (not just fear of death), recurrent suicidal ideation without a plan, or a suicide attempt or specific plan to commit suicide.

Medical options

The most commonly prescribed antidepressants are the selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine (Prozac), paroxetine (Paxil), sertraline (Zoloft), and citalopram (Celexa), and escitalopram (Lexapro).

The tricyclic antidepressants, such as amitriptyline (Elavil), imipramine (Tofranil), and doxepin (Sinequan), are still used on a regular basis, as are other agents, including trazodone (Desyrel), bupropion (Wellbutrin), and venlafaxine (Effexor).

MAO inhibitors, such as phenelzine (Nardil) and tranylcypromine (Parnate), are rarely prescribed.

Psychological counseling is an essential component of therapy.

Dietary changes that may be helpful

Although some research has produced mixed results, double-blind trials have shown that food allergies can trigger mental symptoms, including depression. People with depression who do not respond to other natural or conventional approaches should consult a doctor to diagnose possible food sensitivities and avoid offending foods.

Restricting sugar and caffeine in people with depression has been reported to elevate mood in preliminary research. How much of this effect resulted from sugar and how much from caffeine remains unknown.

Researchers have reported that psychiatric patients who are heavy coffee drinkers are more likely to be depressed than other such patients. However, it remains unclear whether caffeine can cause depression or whether depressed people were more likely to want the lift associated with drinking a cup of coffee.

In fact, improvement in mood is considered an effect of long-term coffee consumption by some researchers, a concept supported by the fact that people who drink coffee have been reported to have a 58-66% decreased risk of committing suicide compared with non-coffee drinkers. Nonetheless, a symptom of caffeine addiction can be depression.

Thus, consumption of caffeine (mostly from coffee) has paradoxically been linked with both improvement in mood and depression by different researchers. People with depression may want to avoid caffeine as well as sugar for one week to see how it affects their mood.

There is evidence that people with major depression may have insensitivity to insulin and impaired glucose tolerance. Whether treatment of impaired glucose tolerance helps depression is unknown, but a doctor can order laboratory tests to detect such abnormalities, and initiate treatment as appropriate.

The amount and type of dietary fat consumed may influence the incidence of depression. Previous studies have found that diet regimens designed to lower cholesterol levels may reduce death from cardiovascular disease, but may also heighten the incidence of depression.

Does low cholesterol cause depression? It appears not, since studies have shown no adverse effect on mood in people taking cholesterol-lowering drugs. The connection more likely has to do with the balance of fats in the diet. Diets to lower blood cholesterol usually focus on restricting total fat intake while increasing the intake of polyunsaturated fats (e.g., corn and soybean oils). These oils are very high in omega-6 fatty acids, but the recommended diets otherwise lack important omega-3 fatty acids (EPA and DHA).

A high intake of omega-6 fatty acids relative to omega-3 fatty acids and an inadequate intake of omega-3 fatty acids (e.g., from fish and fish oils) have been associated with increased levels of depression. People who eat diets high in omega-3 fatty acids from fish have a lower incidence of depression and suicide.

Lifestyle changes that may be helpful

Exercise increases the body's production of endorphins - chemical substances that can relieve depression. Scientific research shows that routine exercise can positively affect mood and help with depression. As little as three hours per week of aerobic exercise can profoundly reduce the level of depression.

One trial compared the effects of an exercise training program with those of a prescription antidepressant drug in people over 50 years of age. The researchers found the two approaches to be equally effective after 16 weeks of treatment.

Holistic approaches that may be helpful

Acupuncture may improve depression by affecting the synthesis of neurotransmitters that control mood. Controlled trials have found electro-acupuncture (acupuncture accompanied by electrical currents) equally effective as antidepressant drug therapy without causing side effects.

However, a controlled trial found that both real and fake acupuncture improved depression equally well compared to no treatment. It is well known that placebo effects are common in the treatment of depression, so more controlled trials are needed before accepting the usefulness of acupuncture for depression. Many people who are depressed seek counseling with a psychologist, social worker, psychiatrist, or other form of counselor.

An analysis of four properly conducted trials of severely depressed patients comparing the effects of one form of counseling intervention, cognitive behavior therapy, with the effects of antidepressant drugs was published in 1999. In that report, cognitive behavior therapy was at least as effective as drug therapy. While the outcome of counseling may be more variable than outcomes from drug or natural substance interventions, many healthcare professionals consider counseling an important part of recovery for depression not due to identifiable biochemical causes.

A rhythmic breathing technique called Sudarshan Kriya Yoga (SKY) may be an effective alternative to antidepressant drugs as an initial treatment for people with clinical depression. In a controlled trial, daily 45-minute SKY sessions six days per week produced a 67% remission rate among people with a diagnosis of depression.

This effect compared favorably with the effects of electro-shock therapy and the antidepressant drug imipramine; however, no placebo was used in this study. SKY technique is taught by the Art of Living Foundation.

In a controlled trial, magnetic stimulation to the front of the skull and underlying brain produced modest reductions of depressive symptoms in depressed people who had not responded adequately to standard treatment. The procedure was performed by psychiatrists using sophisticated electromagnetic medical equipment, not a simple magnet.

---