Depression

If there is one thing we can say for sure about depression, it is that it is very complex.  This rather bland word covers the whole range of negative human experience from “feeling blue” to terrifying anxiety and suicidal despair, as well as physical symptoms ranging from flu-like aches and pains to a sense of profound tiredness.  Depressed people – and one in five of us will come into this category at some point during our lives – tend to feel very cut off from the rest of humanity.  The stigma which traditionally surrounds “mental illness” makes the sense of misery even worse and stops many people from seeking help.  But depression is not anyone’s fault; it is a recognized illness which can be effectively treated in a whole range of ways.

And as befits a complex condition, depression has a range of causes as wide as life itself.  Stressful events which cause a deep sense of loss – such as bereavement, divorce, physical illness or the loss of a job – can trigger depression.  Some people believe that bottle-up anger and frustration also turn into depression.

There is evidence that depression runs in families, although no one has ever found a gene for depression.  Perhaps growing up with depressed parents is enough to make us depressed; it’s certainly true that our childhood experiences are crucial to our long-term mental and emotional health.

Chemistry also has a part to play in depression: when you feel very low, chances are that your brain is lacking in vital nerve messengers called neurotransmitters, although whether this is cause or effect is not clear.  Similarly, hormonal changes (as women with P.M.S. know all too well) can make us feel depressed.  People who suffer from depression linked to the hormone melatonin, which is produced in the brain during the hours of darkness.

THE ORTHODOX APPROACH

Orthodox physicians look for the following symptoms in identifying depression: feelings of worthlessness and guilt; impaired concentration; loss of energy; thoughts of suicide; loss or increase of appetite and weight; insomnia or oversleeping; agitation or a sense of being slowed down.  If you have had four of these for two weeks or more, without another illness which could be causing them, you are likely to be diagnosed as depressed.

Until recently orthodox medicine relied chiefly on drug treatments to lift the symptoms of depression.  Modern antidepressants work to increase the quantities of neuro-transmitters in your brain, although getting a drug to suit your symptoms without unpleasant side-effects is often a matter of trial and error.

Yet while antidepressants can give us the lift we need to tackle the causes of depression, most of us don’t like taking pills for what we perceive as a problem of mind, body and spirit.  Increasingly, modern physicians are taking a two-pronged approach: prescribing drugs, but also referring depressed patients to counsellors who can help identify the roots of the problem.

THE HALE APPROACH

Depression is principally endogenous (caused by a lack of chemicals in the brain) or exogenous (caused by external events).  This differentiation is important, since drug treatment is often required for the former, whereas good counselling can put an end to the latter without recourse to drugs.  A counsellor or psychotherapist is a good starting point, and referral through them to a physician or psychiatrist would be beneficial.  Complementary therapies will speed up most treatments.

Many different events in a person’s life, both physical and mental, may trigger depression.  It is important for the individual patient to be properly advised at the outset which treatments are likely to be most effective for them.  For example, some depression may be aggravated by physiological problems such as hormone imbalance, blood sugar problems allergy or lack of vital nutrients for brain chemistry.  In these cases nutritional advice or light therapy may be necessary.  Other patients may benefit from acupuncture and homeopathy, which address both the physical and the mental aspects of depression.  With others, psychotherapy, hypnotherapy, or counselling will be necessary.  For many patients a combination of treatments will be necessary.

The Hale Clinic would therefore advise seeing our complementary medical consultant or a psychologist, who can advise patients suffering from depression on the best course of treatment for their particular case.  If it was felt appropriate, we might refer a patient for another medical opinion regarding medication.

HYPNOTHERAPY

Hypnotherapy, perhaps more than any other complementary therapy, shows how much power your mind really has when it comes to influencing health.  At the very least, hypnotherapy helps you to relax without drugs, reversing the stress effects which soften contribute to depression. It is especially useful in relieving depression in people who are terminally ill or undergoing acute medical treatments.

For one practitioner hypnotherapy is a form of psychotherapy.  “I begin with a guided relaxation and then I use hypnotherapy to reassure, comfort and uplift,” he says.  “It helps people to express their feelings because when you are sufficiently relaxed your unconscious has the ability to rise close to the surface.

Hypnotherapy makes it possible to listen to – and talk to – the unconscious.  For instance, it can help to imagine and visualize feeling better.  At the same time I employ a range of counselling techniques”.

He stresses the importance of his role as a careful listener: “In the way depressed people describe themselves you can often find the way out.  One of my patients came to me after a year of worsening depression.  She was intelligent, well-to-do and had a great deal to live for, but she had thoughts of suicide, low spirits, insomnia, and loss of appetite and libido.  There was clearly a spiritual component to her depression and she told me that she had lost the ability to pray; I encouraged her to try to pray – and that was the catalyst which began the process of her recovery”.

A person’s qualities, successes and achievements are often submerged by depression.  It is important, by slowly but surely developing strategies for change, to re-empower a sufferer so that they learn to recognize their qualities. And inner strengths. More about hypnotherapy...

HOMEOPATHY

Both chronic and acute depression can be helped by homeopathy; although you should contact a physician immediately if you or someone close to you is having thoughts of suicide.

Not only is depression tremendously variable, but homeopathic remedies are very individual.  “There are some 200 to 300 homeopathic remedies for depression”. Explains one practitioner, “but in simple terms, low-potency remedies of 30x or below work on mental symptoms, while high-potency remedies of 200x or above treat mental symptoms of depression”.

Homeopathy is “excellent” for the depression which follows distressing life events (often called reactive depression): “It also works well for depression caused by lack of chemicals (often called endogenous) when prescribed in conjunction with nutritional supplements such as zinc and Vitamin B6“.   In addition to homeopathy, some form of counselling or psychotherapy is essential to understanding why you have become depressed.

While you are advised to consult a qualified practitioner, this homeopath suggests that if, for example, you feel depressed after deep grief or heartbreak you may benefit from Ignatia 200x or Natrum mur. 200x, to be taken in three doses, one each night.  If this is the right remedy for you, depression should begin to lift within a week. More about homeopathy...

PSYCHOTHERAPY

Psychotherapy, which gives you precious time and space to talk about how you are feeling – and why – with a qualified practitioner, can be enormously beneficial in coming to terms with complex and deep-seated depressions.  One psychotherapist works with individuals as well as groups to address the events in your life which my have contributed to depression.  More about psychotherapy...

NUTRITION

If it’s true that you are what you eat – and 98 percent of your body’s cells replace themselves each year – food is essential to your mental and physical health.  One nutrition consultant uses a combination of psychological and physiological methods to combat depression.  “I ascertain whether depression is blood-sugar related, or (in women) cyclical and hormone related.  “The therapy is very individual, and varies according to the symptoms.  I may use nutritional supplements because brain biochemistry – and hence mood – can be altered with nutrients”.

He aims for “total cure” when depression is hormonal or sugar-related, although she finds that improvements may be more gradual in depression which is fundamentally psychological. 

DEPRESSION & NUTRITION

“Food is the most important influence in determining the organisation of the brain and the behaviour that the brain organisation dictates” J Z Young

Possible causes of depression:

PSYCHOLOGICAL CAUSES                                 BIOCHEMICAL IMBALANCES

Loss of loved ones                                                   Genetic

Lack of intimacy                                                       Substance abuse

Victim of abuse                                                         severe nutrient imbalance

Stress (family, work, finances)                                chronic illness

Psychological causes can lead to biochemical imbalances AND Biochemical imbalances can affect the psyche.

DEFICIENCY IN ESSENTIAL FATTY ACIDS (EFA)

How to determine an EFA deficiency?

• A tendency to substance abuse or feel that it affects you differently from others
• Trouble with alcohol in your teenage years
• Depression among close relatives
• A family history of alcoholism, depression, suicide, schizophrenia
• Depression that persists while you are abstinent from alcohol
• A personal or family history of Crohn’s Disease, hepatic cirrhosis, cystic fibrosis, atopic eczema, Sjogren-Larsson syndrome
• A personal or family history of Ulcerative Colitis, IBS, diabetes
• Winter depression that lightens in spring
• Experiencing an emotional lift from certain foods or vitamins

VITAMIN AND MINERAL DEFICIENCY AND DEPRESSION

The B-complex vitamins are essential to mental and emotional well-being. They cannot be stored in our bodies, so we depend entirely on our daily diet. B-vitamins are destroyed by alcohol, refined sugar, nicotine and caffeine.

A number of symptoms can be triggered from deficiencies in any of the following:

B1 (thiamine), B3 (niacin), B5 (pantothenic acid), B6 (pyridoxine), B12, Folic Acid, Magnesium, Calcium, Zinc, Copper, Iron, Manganese and Potassium.  These symptoms of depression include:

• Low self esteem                   
• Insomnia                   
• Excessive sleep                  
• Agoraphobia                        
• Substance abuse    
• Panic attacks
• Negative outlook on life     
• Suicidal thoughts    
• Poor libido 
• Appetite lack or increase   
• Fatigue                      
• Inappropriate behaviour

HEALING

In healing, the body, mind and soul are seen as one entity in which good health depends on harmony.  It can be a powerful form of therapy for depression, which so many of us experience as a kind of profound discord.  One healer perceives depression as a tangible weight which she works to remove from the patient’s spirit.  “I find that I can literally reach in and pull out all those negative emotional states which people store up from childhood onwards”, she says.  Sometimes, when people have severe psychological difficulties, she suggests they have psychotherapy first and come for healing later.  But with depression and/or anxiety states which follow illnesses or the usual painful losses in life, she finds that “when people are ready to let go of depression, healing can be instant”.  More about healing...

SUPPORTIVE TREATMENTS

Acupuncture

Depression is traditionally associated with the liver, so an acupuncturist would concentrate on the liver meridian to regulate the flow of chi (vital energy) in the body.  “Improvement or cure” might be expected within six sessions.

Aromatherapy

Massage with essential oils working on specific acupressure points helps lift patients out of depression, enabling them to help themselves and be positive about change.  Advice would be given on diet, exercise and counselling or psychotherapy may be recommended.

SELF-CARE

Aromatherapy

It is important to look for the root cause of the depression in order to choose the most appropriate oils, whether for massage, to put in the bath or to inhale.  Mandarin is particularly good for calming nervous tension, anxiety and feelings of isolation; ylang-ylang also relieves tension and boosts low self-esteem; bergamot or rose help counteract the lethargy that often goes with depression.

Yoga/T’ai Chi/Chi Kung

By balancing the body’s energies, these exercises can help reduce stress and remove toxins from the system.  They enable you to slow down, find your own centre and restore mental balance.

TIPS

If you are feeling under pressure, try to cut down on your work load and to take some time off – perhaps going out with your partner or a close friend.  Avoid tea and coffee and increase your intake of B vitamins (found in many foods, including cereals, wheat germ, milk, and green leafy vegetables) and Vitamin C (found in fresh vegetable and fruits, including tomatoes) You can also apply your own DIY light therapy, making the most of natural light by going outside whenever possible, especially at midday, or get a full-spectrum light box to use at home.  Try to leave off contact lenses and glasses in order to expose your eyes to daylight – and perhaps take a midwinter break in a sunny resort.