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Medication for mood
My patient told me she knew she was depressed, she’d had this problem before. However, she adamantly did not want to take antidepressants. In the past, she had been on them and felt dulled and sluggish. She knew there were other types than the two or three she had taken, but she wanted to do something different.
I respect the individual who wants to take control of their condition rather than expecting someone else to fix things for them. First, though, I wanted to know if she was suicidal. If she was, I would not be willing to work on alternative treatments. They might take too long to help and put her in danger. She assured me she was not going to take her life. She believed things could get better, but not on their own. I told her I would work with her on some alternatives. I also asked that she try a different medication if one of the alternatives failed to help her condition. She agreed.
What is depression?
Most of us have the occasional down day where nothing feels good and we don’t look forward to anything. We might call that depression. From a clinical perspective, though, depression is more than a bad day. It morphs into daily feelings of sadness, hopelessness, or helplessness. It may even include thoughts of wishing ourselves dead or considering suicide.
Some people feel guilty about being depressed. They may blame themselves for being a cry baby. They may say if they just had more faith they wouldn’t feel this way; that other people have it worse, they’re just weak. But depression isn’t a sin, it’s a sickness. And treating its causes can go a long way toward remedying the feeling.
Not all depression is the same.
There are different types, intensities, and causes of depression. Some depression is caused, or worsened, by hormone or vitamin deficiencies. Low thyroid hormone and low Vitamin D can affect mood. Post-partum depression, the kind that occurs after a pregnancy is over, may be the result of the severe hormone shifts that occur at this time. For this last type of depression, I emphatically do NOT recommend alternative therapy. This is a time for professional help. For Vitamin D and thyroid hormone deficiencies, I recommend having these checked out before starting a supplement.
Traumatic events can trigger depression. The sudden loss of a loved one or a terrifying experience can cause depression.
However, many, if not most, episodes of depression occur without an obvious cause. This type likely has a strong hereditary component. Some people are just primed for depression, and it does run in families.
Is medication always necessary?
Not every episode of depression needs to be treated with medication, hormones, or vitamins. Sometimes ‘talk therapy’ can be quite helpful. Unfortunately, insurance often doesn’t pay for this type of treatment or doesn’t pay for it long enough to have the desired effect. However, there is good evidence that some depression can be effectively treated this way.
Non-herbal Alternative treatments
GET GOING! You have to do something to feel good, not wait until you feel good to do something. Vigorous physical activity can be quite helpful in the treatment of depression.
The sufferer may not feel like getting up and getting moving, but sitting doing nothing can worsen things.
Bright light therapy, which I’ve talked about before can be beneficial in treating depressed mood. Many people think you only use this in the winter months. But broad-spectrum light therapy isn’t just for Seasonal Affective Disorder (SAD). Using it at any time of the year when your mood is low is useful
Yoga, Acupuncture, Music Therapy… There is evidence that each of these approaches may
be beneficial for some people and some types of depression. I suggest going to the National Center for Complementary and Integrative Health (NICCAH.nih.gov) website to find more information on these.
Herbal and supplements treatment
One of the biggest problems with using some herbs and supplements is that they can interfere with mainstream medications. If you take medication for other conditions, please check about possible interactions.
If you take a conventional antidepressant and for some reason want to add an herbal or supplement to boost the effect, DON’T. Or at the very least talk it over with the person prescribing the medication. There is a risk that the combination can result in the medication reaching toxic levels.
St. John’s Wort (SJW): is probably the best-known alternative treatment of depression. I have had patients who used it, some successfully, for improving their mood. However, many people find that if they’re taking enough of this substance to help their mood they also have
nausea and diarrhea. Another problem is that it’s famous for causing problems with conventional medications. Bottom line is - check it out carefully.
People ask me about the dose of SJW. The best thing to do is check the dosage recommendation on the bottle. Different brands may have variations in ingredients that will affect the amount you need to use.
S-adenosylmethionine (SAM-e): This is a chemical that occurs naturally in the body. It may boost the levels of some of the chemicals (neurotransmitters) that help with mood and improve depression. Regarding dose, again, since preparations vary, it’s best to follow the directions on the label. I have had some of my patients improve depression-wise when they used SAM-e and without the kinds of side effects, I often see with SJW. Once again, however, it's important to check to see if it has any interactions with other medications you're taking.
Omega 3 fatty acids: These are some of the "polyUNsaturated" (good) fatty acids found in the body. We get them naturally by eating such things as flaxseed oil and fatty fish such as salmon. Many claims have been made about the usefulness of omega 3s, including in the treatment of depression, but the evidence isn't strong. Plus it, like St. John's Wort, tends to interfere with a number of conventional medications, so it needs to be used cautiously. I have not personally seen it to be helpful for my patients with depression, unlike both SAM-e and St. John's Wort.
Summarizing:
Not all depression has to be treated with conventional medications.
If you are someone you're working with is suicidal, pregnant, or suffering from postpartum depression I strongly urge you to seek professional help rather than trying alternative therapies.
There are a number of successful alternative approaches to treating depression including supplements (St. John's Wort, SAM-e), exercise, psychotherapy, and yoga among others.
The National Center for Complementary and Integrative Health (NCCIH.nih.gov) is an excellent first stop in researching alternative approaches to treating depression.
Image of chamomile by:© Can Stock Photo Inc. /gajdamak
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