Most people equate Depression with a state of prolonged sadness. However, the spectrum of symptoms associated with sadness include a gammut of psychological and physical symptoms affecting our Mind, Body and Spirit.
Psychological symptoms of sadness may include sadness, detachment from multiple aspects of life, poor concentration, guilt, shame or blame and at its worst, instances of suicidal ideaton and self harm.
Physical symptoms may include a loss of energy, poor sleep, headaches, an increased likelihood of chronic pain (which also may be the cause of Depression) and general changes in the function of most body symptoms such as gastrointestinal function and reduced immunity.
The Continuum of Depression
It is helpful to understand Depression as a continuum, ranging from sadness in reaction to a single of set of unfortunate incidents, to ongoing low mood, with the extreme being Organic Depression with its origins in the neurochemistry of the brain. As a continuum Depression may intensify over a prolonged period, or improve with treatment.
Understood in this way it therefore becomes important to individualise your management of Depression to match your personal needs. For instance, mild episodes of sadness may not need treatment. Ongoing sadness could require counselling and skills development in response to specific circumstances, while moderate to severe Depression may encourage the use of a multi-faceted approach integrating both physiological and psychological therapes if successful treatment is to be achieved.
What may cause my Depression?
The causes of Depression are multi-factorial in nature spanning the entire range of human experience. They may include:
Genetic predisposition leading to Organic Depression.
Nutritional or biochemical imbalance(s)
Poor coping skills in general
A specific medical condition leading to psychological and physiological risk of Depression (e.g. chronic pain, cancer etc)
A specific relationship, occupational or financial crisis
A loss of meaning and connectivity to life (Spiritual Crisis)
Any combination of the above
Will Depression affect my Overall Health?
As for chronic stress, Depression is significantly linked to many diseases. For instance, Cardiac Disease and Diabetes are both strongly linked to Depression.
How helpful are Anti-depressant Drugs?
These can be effective for many people, mainly those with severe depression, yet others have significant side effects including, ironically, an increased risk of suicide. For this reason many less risky therapies should be trialled either prior to or in coordination with the use of anti-depressant drugs in order to avoid or minimise their usage unless you have severe Depression.
An important concern with the anti-depressant drugs (e.g. the SSRI drugs, MAO inhibitors) is the risk of drug-nutrient-herb side effects. This is another instance where you must consult with your doctor when taking either nutrients and/or herbs (e.g. St John’s Wort, tryptophan) with anti-depressant drugs as you may otherwise be put at risk.
What about St John’s Wort?
The use of St John’s Wort for Depression is supported by studies indicating that it may be used for mild to moderate cases. Growing evidence suggests it may also be of benefit in some cases of severe Depression. There are less side effects when using St John’s Wort as compared to other pharmaceutical interventions.
The down side to St John’s Wort is that, through its effects on the liver, it decreases the effectiveness of many pharmaceutical medications including the SSRI and MAO inhibitor anti-depression drugs. It also may influence other drugs such as warfarin, oral contraception, digoxin and cyclosporine, to name a few.
Given the extensive list of drugs that ST John’s Wort interacts with, you MUST discuss its use with your prescribing doctor before ever considering it as a combined therapy when you are on any pharmaceutical medication.
Can I use Tryptophan, Tyrosine and other select Amino Acid Neurotransmitter-Precursors?
Many of the brain’s neurotransmitters are derived from amino acids through bioconversion in the body. Thus amino acids such as Tryptophan, Tyrosine, Phenylalanine, Cysteine, Glutamine, etc in combination with supportive nutrients (Magnesium, Vitamin B6, Zinc etc) can be used to good effect in attempting to achieve a healthier neurotransmitter balance in the brain.
These prescriptions are usually individualised and are part of carefully constructed programmes. Tailor-made supplementation may be provided by compounding chemists, although this is not always essential.
Therefore given the complexity of these approaches they should always be managed by an integrated medical practitioner trained in such prescriptions (experienced Doctor, naturopath, nutritionist), always respecting whether you are simultaneously on any pharmaceutical medication.
Specialist training in this area has been provided by organisations such as:
The Bill Walsh Institute
The Pfeiffer Institute
Are there any other Nutrients/Herbs you can Consider?
Fish Oils are very important to brain function. High dose Fish Oils in the range of 6 to 9 standard doses per day can be effective in treating Depression. Concentrated formulas with higher levels of EPA in particular may be indicated when treating Depression.
SAMe (400-800mg/day) is a natural compound found to have use in treating Depression as it can assist in the inter-conversion of neurotransmitters as well as the hormone, Melatonin, our natural sleepng hormone.
The B Group Vitamins including Folate may be important, particular where low folate has been identified. B6, B12 and folate are important in controlling the conversion of homocysteine, which has been linked to Depression.
Vitamin B6, Magnesium and Zinc are essential to the producton of almost all our neurotransmitters. Other vitamin and minerals act as significant co-factors in these reactions such as Iron, Calcium, Vitamin B3 and Vitamin D.
Gingko biloba may also be of benefit for Depression, including the possble treatment of the side effects of SSRI drugs (e.g. reduced sexual function)
Do I always need medication or nutrient/herbs?
No, but they may help. Where your Depression is reactive, that is, in response to a specific event, psychological interventions may be a preferable primary treatment.u down even further. Start slowly with what you can manage and aim for small day by day changes until the bigger picture with the more intensive interventions is achievable.
What types of Psychological Interventions have been found to be of benefit?
There are many forms of psychological intervention and you may be more personally attuned to one over any other, depending on your condition.
Studies, however, suggest that cognitive behavioural therapy and interpersonal psychotherapy may be of most value. Whatever ever the form of therapy, all should enforce the vital components of positive support, reassurance and the importance of developing skills to allow you to cope whatever crisis you are facing.
What about Group Therapy?
Many people with Depression lack a feeling of belonging/connectvity and believe they are alone. Group therapies can therefore be of major benefit, particularly if you are young or have a specific problem. Often people gain valuable support when depression is also linked to health conditions, where fellow members of the group uplift their experience of the disease and mutually motivate its members on.
Does Stress Management help?
This is another tool that can be used. The critical key is not just to focus on decreasing the effects of stress, but to look to positive and optimistic approaches to meeting the challenge of what has caused your stress in the first place.
How about Meditation and Relaxation?
Both may help, but it depends upon your state of Depression. These techniques, that can leave you alone with your mind, may be a risk when acutely unwell (particularly if suicidal or seriously afflicted with a psychological instability).
On the other hand, if you have your depression adequately controlled, these can be very effective techniques in controlling much of the mind chatter that drives your Depression. One tip is that you should begin with forms of Relaxation/Meditation that distract you away from your mind chatter such as Guided and Creative Visualisation, Spiritual Meditation, Music etc in which the mind is actively engaged.
In a state of Depression/ Anxiety, it can be very hard to still the mind or follow techniques such as Mindfulness Meditation as they may, at first, be overwhelming. These are therefore forms of Relaxation/Meditation that you can evolve towards as you become more skilled in the techniques.
Is Spirituality Important?
Yes. However, please interpret this word in whatever meaning it has for you. The believer, the atheist and the agnostic all have a spiritual need, if we are interpreting the word to mean Connectivity with something greater than our immediate surrounds.
You may be grateful to God above for this life, yet you might simply be grateful to life itself. The key here is to find...
Meaning and Purpose
For many people Depression is a ‘Dark Night of the Soul’ in which they are confronted with a lack of meaning or purpose, however much they have done in their live. Knowing who we are and what we want to BE rather than Do can be a major confrontation in our lives.
Are you experiencing a classic mid-life crisis? Have you suddenly realised life is not all about success and security?
Part spirituality, part Life-Balance, Meaning and Purpose are essential keys to happiness and avoiding Depression, and the first step to achieving the former may be to simply sit down and define who you wish to BE in the future, so you can place the idea in your mind’s eye, and work towards it. Writing a Mission Statement is a great place to start, regardless of how much of a cliché it has become.
Often the person who we wish ourselves to Be is actually the person who we already are. Because of our lfe experiences, our natural protectve defence mechanisms have caused us to build layers upon layers upon our true selves such that we have forgotten our fundamental BEING. We simply have to trust Our Selves and Remember!
Passion and Pleasure
Of course once you know what you want out of life it is time to set aside time every day to pursue your passions. Life is about transformation, as much from day to day living towards a life inspired, as from out of the shadows and into the light. You must give yourself time to heal and grow and this is why you must dedicate yourself to becoming passionate.
Motivation is difficult at first, particularly if the road appears steep, so you should also dedicate time (yes, more time for yourself!) to deliberately setting out to enjoy Your Self. Construct a pleasure timetable, access pleasurable activities. Work at it if you have to for it is much more important than anything else that you are happy. So in whatever small part of the day you can set aside, dedicate Your Self to pleasure as much as you dedicate to Your Self to work!
Yes, seek it. Give yourself permission. Surround yourself with laughter.
Some people believe that "planned" laughter has help them to overcome major chronic diseases such as cancer as well as helping them to survive the hell of concentration camps. No apologies are made for this example, for it really does emphasise the power laughter has to help lives, through not only its psychological influence, but the sea of hormones it helps to release.
And Sex? ....but not while laughing; it may depress your partner!
One of the four ‘F’s of the flight, fight, freeze and f...f...f....fornicate response, the physiological stress response, is sex. It, along with laughter, pleasure, passion and purpose can drive adaptationtowards postive neurotransmitter balance in order to overcome Depression.
Please note that we are here suggesting ths in a supportive relationship rather than a desperate search for affection.
Unfortunately, many people find their sex drive reduced during Depression.
Again, like laughter and pleasure, this may need to be "planned". Libido may be decreased, yet it can often be overcome by setting the right environment.
Yet a Hug and Shoulder may help just as much...
Support in a crisis is vital. Our friends cannot solve our problems, but they can smply be there so that you may have a shoulder to cry on and an ear to listen. The key, however, is to be careful in who you choose. You do not necessarily need advice and you definitely do not require condemnation.
Aim for Life Balance
The above elements form part of the concept of Life Balance. Many people assume Life Balance simply involves balancing Life with Work, yet there is balance between non-work elements that also needs to be achieved. There are ways of setting out your life, irrespective of the balance you which to achieve, that are important, such as concepts of Life Pace, not putting too many of your eggs in one basket, life role management etc.
Relationships and Emotional Intelligence are Critical
Striving for healthy relationships s vitally important, and we need to continue to work on these relationshps even when we are happy. We should always consider the consequence of our actions not only upon ourselves, but also how they affect those with whom we have a relationship and do not wish to harm.
To respect relationships we need to learn the vital skills known as Emotional Intelligence. In fact knowing how to identify our own and others' emotions, communicate with others and effective relate in a mature manner is considered one of the vital skills sets to not only success at work, but Life itself.
To err is Human, to forgive Divine!
Many people may need to seek resolution within themselves before they will ever be happy. Forgiveness does not necessarly mean a need to reassociate with the cause of your pain. You can forgive without forgetting, and resolve emotion without opening yourself up to more abuse.
Should I Exercise?
Back to the physiological control of Depression. Exercise is one of the most powerful Depression treatments available, stimulating neurochemical change supportive of good health. Try to get at least 30 minutes of exercise per day, preferably in natural environments such as outdoors, at the beach etc.
A mix of anaerobic and weighted training can give widespread effects. Yoga is also a powerful tool as it combines positions, breathing, relaxation and meditation. Tai chi may have a similar effect.
Can my Diet affect my Depression?
A Food Elimination Regime followed by a Low Stimulant Healthy Eating Plan (or the latter on its own) is highly recommended, especially if you are also dealing with an addiction.
If you tend to miss meals, a quality protein powder is strongly advised as the first step to assisting neurotransmitter balance through broad based amino acid supplementation.This is also important as hypoglycaemia is a common cause of low moods.
Being overweight is a common cause of depression. Seek help in weight loss if you need to.
Smoking, Alcohol, Recreational Drugs....
Are all probably being driven by your emotional state or long term internal conflict (abusive history etc). This must be addressed if you are to proactively manage your Depression.
Sometimes, however, you may be patient while other treatments kick in. All too often you may be self medicating with nicotine, alcohol and recreational or phamaceutical drugs to avoid facing your demons and taking on too much at once may be dangerous.
A graduated and integrated programme is always best.
Sunlight is Enlightening
Perhaps the simplest treatment at all. Achieve adequate sunlight without the risk of skin cancer. This will help activate Vitamin D, thought to be linked to Seasonal Affective Disorder that occurs in climates with limitiedsunlight exposure during winter months. Indeed, Vitamin D deficiency is strongly linked to depression.
What about hormones?
Depression may also be driven by hormonal influences including excesses or insufficiencies of oestrogen, testosterone, adrenal and/or thyroid gland hormones. You should see a practitioner who can advise you as to what might be happening with your hormones and/or have your levels checked as appropriate if your mood swings occur in cycles related to pregnancy, post pregnancy, menstruation and menopause.
The pill has been linked with an increased incidence of Depression in some users.
Men, of course, are not immune either from hormonal influences upon Depression.
Managing other Medical Conditions
The sickness response is an innate reaction in the body, part of which includes Depression. Managing all of your Medical Conditions as successfully as possible is critical in controlling Depression as are many of the factors specific to different clinical diseases.
So many treatments, so little time!
Do not try do everything at once, particularly if you feel fragile. This may destabilise you and in some instances, may catapult you down even further. Start slowly with what you can manage and aim for small day by day changes until the bigger picture with the more intensive interventions is achievable.
Find your motivation to succeed!
Motivation is a whole website of its own. Where ever possible, surround yourself with excellence, whether it is an affirmation of optimism, a support network, a book, whatever you need.
Eliminate the toxins from your life that will drain away motivation. Politely deal with negative people and relationships, avoiding or moving away from unhealthy environments. Remember the beauty, innocence and loyalty of pets.
By shifting your focus upon happiness, not sadness....
Look for the positive, however small. Be grateful that Life gives you the opportunity to be happy and work towards focusing upon this more than anything else.
Before learning to accept what you cannot change...
Good luck on the journey!