Yes, suffering is an unfortunate part of life: what is not so easy to explain is the impenetrable black cloud that can become a terrible part of the lives of some unfortunates who have no apparent cause to be depressed. One of the worst parts of this is the impossibility of explaining to others what one is experiencing - even assuming one has the energy to try. Life simply no longer seems to hold anything worthwhile, and even the simplest undertaking requires an insurmountable effort.

Modern medicine has a wide choice of drugs to offer for depression: unfortunately, they have a tendency to perpetuate a cycle, because at this point in time, nearly all of the antidepressants available have as their side effect the very problem for which they are prescribed, so that while at first they may seem to help, eventually they will make the problem worse.

In addition, most of them are extremely addictive by nature, and attempting to discontinue their use is such a difficult project that medical advice is required to do it without causing further harm. In fact, a recent report from the US Agency for Healthcare & Research in Maryland found that rates of depression have seen very little significant change in the last 20 years, even with the addition of the heavy hitters, Prozac and Fluoxetine. 

to include many cholesterol lowering drugs, antacids and corticosteroids, and also some nutrients in very high doses, and this possibility must certainly be considered before taking anything else to help, whether drug or nutrient. 

What is often found is that depression is aggravated by nutritional deficiencies, and mega amounts of certain nutrients are sometimes required just to reach normal function .It is also very important to identify and address possible allergens, since the brain can be very sensitive to allergies .In one study, depressed patients had four and a half times as many reactions to 33 foods and inhalants!

I hope in this article to be able to convince you that there is a more benign and natural approach to the problem of moderate depression and anxiety than the chemical one, because it seems that more and more people are coming to me  suffering from depression. Many of them are reluctant to resort to chemical answers, and want to know what a more natural approach has to offer. Fortunately a great deal of research is being done to investigate claims for natural therapies, and many of the results are promising.

How do you know if you are depressed?  I append the list of symptoms from Dr. Mercola :  you
can find some good information there about depression.

Emotional reactions. This is the easiest one in that you feel depressed most of the day. This is an obvious clue, especially if you feel this way nearly every day, or feel sad or empty, or have others tell you that you do.

Symptoms: feel sad, feels empty or lacks feelings of all kinds, tired ("everything is an effort")... nervous or restless, angry and grouchy (especially in kids), irritable, overreacts to criticism... bored, apathetic, "nothing is enjoyable," feels socially abandoned and/or has less interest in relationships, sex, food, drink, music, current events.

Physical changes. Fatigue or loss of energy nearly every day is probably the most common symptom in depression. It is one of the most common symptoms that I see in my practice. There are many reasons that you could be fatigued other than depression, but most depressed people have fatigue as part of their illness.

The second most important symptom is early morning awakening. If you are waking up at 2 to 4 AM on a regular basis one of your first thoughts should be to consider the possibility that you are depressed. Most people with depression feel extremely tired insomnia or have hypersomnia nearly every day.

One also needs to be alert to weight issues, either gaining or losing weight. The part of the brain that controls appetite is almost invariably affected. If you have a significant weight loss when not dieting or your appetite is decreased, or if you have an increased appetite and have a significant weight gain, you should consider the possibility of depression.

Symptoms -- difficulty sleeping or sleeping excessively, awaking early... hyperactivity or sluggishness, diurnal moods (worse in the morning)... low sex drive, loss of appetite, weight loss or gain, indigestion, constipation, headaches, dizziness, pain, and other somatic problems or complaints.

Attitudes and motivation. A depressed mood is a major change from your normal mood. Typically relationships with your friends, family, job or school take a significant impact by the change in your mood.

A markedly decreased interest in all, or almost all, your activities most of the day, nearly every day is a strong indicator of depression. It is as if there is nothing in life gives you any pleasure anymore.

Symptoms: low self-concept, lack of self-confidence and motivation, pessimistic or hopeless, feel helpless or like a failure, expects the worst... self-critical, guilt, self-blaming, "People would hate me if they really knew me"... suicidal thoughts, "I wish I had never been born."

Behavioral excesses. Some experts believe that you can't be depressed unless you have thoughts of wanting to take your life. You may or may not have a specific plan for committing suicide but you feel that it would just be better for all involved, especially yourself, if you just weren't here anymore.

Symptoms -- complaints about money, job, housing, noise, poor memory, confusion, loneliness, lack of care and love... acting out (adolescents), running away from home, rebellious, aggressive... obsessed with guilt and concern about doing wrong, about being irresponsible, about the welfare of others, and about "I can't make up my mind anymore"... crying... suicidal threats or attempts.

Behavioral deficits. You lose the enthusiasm to be with people and talk with family and friends. Depression is one of the more common reasons for sexual dysfunction.

Symptoms -- socially withdrawn, doesn't talk, indecisive, can't work regularly, difficulty communicating, slower speech and gait... loss of appetite, weight change, stays in bed... less sexual activity, poor personal grooming, and doing less for fun.

Lack of skills. Another very common pattern is a significant negative change in your thought processes. If you have feelings of worthlessness or excessive or inappropriate guilt nearly every day or have a diminished ability to think or concentrate, or indecisiveness, nearly every day, then your body may be giving you a huge clue that you may be depressed.

Symptoms -- poor social skills, frequently whiny or boring, critical, lack of humor... indecisive, poor planning for future and unable to see "solutions."

In Europe, St. John's Wort ( an olde English word for "weed", incidentally) is used with great success to treat minor to moderate depression: in one double blind study, 66.6% of the patients improved using the herb, versus 26.7 using the placebo. In fact, clinical studies have shown it to be more effective at relieving depression than Elavil or Trofinil, without the side effects.

 I would add, don't be misled by recent studies which purport to show St. John's Wort ineffective:  if I were truly paranoid, I would be inclined to suspect they were designed with this end in mind!  Testing something for a purpose it is not intended for, and then saying "See! It doesn't work" is an old game. No one has ever claimed that St. John's Wort will help major depression,  which is what these particular researchers set out to test.

The active ingredient in St. John's Wort, Hypericin, is both a potent antidepressant and anti viral. This herb has been widely available in this country for some time, and standardized extracts of the strength used in most trials are recommended: look for products guaranteed to contain .3% hypericin for optimal results. The greatest number of studies - over 23 - have been performed using St. John's Wort standardized to hypericin. Only one clinical study used Hyperforin as a marker, and it needs to be emphasized that hypericin was also present: there are many compounds in St. John's Wort which work synergistically. (Interestingly, a German study found that the hyperforin in St. John's Wort is extremely effective against Staphylococcus Aureus and Corynebacterium Diptheriae, two common bacteria and ones which are becoming resistant to all known antibiotics.) This is why I like a product that has not only the standardized extract present, but also a base of the actual herb. One of our most scrupulous companies, as a matter of interest, went back and analyzed its St. John's Worts for hyperforin, and found it already present accompanying the hypericin, so that they now guarantee a 4% hyperforin and 3% hypericin. An excellent time-released version became available recently, which you only have to take once a day.

A warning with St. John's Wort is that photosensitive persons may be even more sensitive to light when using the herb - interestingly, a study testing the effectiveness of St. John's Wort against depressed AIDS patients was discontinued, because more than half of the thirty subjects reported a red, itchy rash after exposure to sunlight. If you are using birth control and experiencing depression, be careful about choosing St. John's Wort : it seems that with some people, the herb reduces the effectiveness of the hormones - and may affect other medications similarly.  The Lancet suggests not using it with protease inhibitors, or cyclosporin.   The thinking is that St. John's Wort caused the liver to metabolize these substances more quickly.  So be careful, or you may have something to REALLY be depressed about! 

Women who suffer from depression as a consequence of menopause are now able to try Black Cohosh Extract, ( Cimifuga Racemosa) in the knowledge that in a study of 80 patients given either the herbal extract, conjugated estrogens or a placebo daily for 12 weeks, the extract produced better results in the Hamilton anxiety test, as well as relieving the symptoms of menopause. If the depression is due to hormonal imbalances, Black Cohosh is definitely a herb to consider. (Therapeuticum. 1987, 1:23-31.)

I have found many women to be helped even more if they add capsules of Evening Primrose Oil to the Black Cohosh - this is a source of certain important essential fatty acids which play a role in the production of hormones, as well as the chemistry of the brain.   In fact, sometimes when a woman on birth control pills is suffering minor depression and weight gain, I find that the addition of the EPO will restore balance to her life. (The original EPO, Efamol, was used for much of the research, but there are other excellent brands available). It  would seem reasonable to suppose that it would also be helpful for women on hormone replacement therapy. 

Recent research (Time Magazine quoted, May 24 1999 p.94) has shown that Omega 3 fatty acids from fish can help people with manic depression: a preliminary report showed that patients who took 10,000mg of Omega 3 a day for 4 months were twice as likely to go into remission as those on placebo. Studies on depression (not manic) have shown results at 1,2 and (best of all) 4gms.  See RESOURCES at right for a review.

Another herb that I myself use in "down" moments, and find very effective, is Kava Kava. The German Komission E Monograph admits its use for conditions of nervous anxiety, stress and restlessness. This herb has been known to the Western world since the 18th century, but within the last year or two, because of its effectiveness, its reputation is growing. I prefer a liquid extract, and find it immediately calming and relaxing, but others like the capsule form. I will confess that I am a very highly charged and impatient driver, and now when I go for any distance in the car, I carry an under the tongue spray of Kava Kava with me to cut down on my stress - my daughter has even been heard to say that she won't accompany me without it!   Kava Kava has been part of the ceremonial traditions of the Polynesian Islands since they were discovered by Westerners: there are photographs of Lyndon Johnson partaking of a sip of the beverage, with no great expression of delight visible on his face, and also Hilary Clinton, who looks a little more eager to experience it.  The Islanders believed that Kava Kava preserved the goodwill of Kings and chiefs, and often used it when reconciling with an enemy. Perhaps its application to Road Rage should be carefully investigated - though I hasten to add my driving reactions are nowhere near that radical!  Be careful not to use kava Kava with anything that affects the liver adversely, or if you have liver problems.

Kava Kava should not be used if you have any reason to suspect your liver function is compromised.

Kava Kava can be helpful for panic disorders, but the most convincing study to date was done with Inositol, using 4 grams 3 times daily. This was a placebo controlled study, and found that over a period of 4 weeks, episodes of panic attacks and agoraphobia were significantly reduced: there were no side effects, and a maintenance dose of 2 -4 grams per day seemed effective after the initial high therapeutic doses. (Am J Psychiatry 152(7):1084-6, 1995.)

Just as depression is a vast subject, so there are many possible nutritional causes and approaches. I don't want anyone to think that the things I mention here are the only ones which may be helpful, but they are the ones I am reading most research about at the moment. Three more I need to add to this list are 5-HTP, a close relative of the amino acid Tryptophan,  and SAM-e, a relative of the amino acid Methionine. Double-blind clinical trials comparing 5-HTP to Tryptophan, found the former to be clearly superior, and some 1991 studies in Switzerland found 5-HTP to be equal in efficacy to the antidepressant drug fluvoxamine, as well as being better tolerated with fewer side effects. (Psychopathology. 1991,24:53-81)

Lithium Orotate, the safe natural version of the high dosage, toxic prescription medication, has been used for bi-polar disorder, but also aaddresses depression - its mode of action appears to be inhibition of shrinkage of the hippocampus in the brain, such shrinkage being a factor in many neurological and psychological conditions. Recent research has shown that it may also be a factor in preventing Alzheimer's disease.

SAM-e has been the subject of about 75 studies in Europe, dating back to the 1980s, but has only just recently become available in the U.S. Not only do experts claim that (by a process of methylation which detoxifies compounds damaging to the nervous system) SAM-e returns the pleasure to everyday living, it also appears to have the ability to repair and desensitize damaged joints. Interestingly, people with severe liver problems, such as cirrhosis, tend to be deficient in SAM-e, because of problems metabolizing Methionine. It is a leap, I know, but perhaps cleansing the liver, or taking liver-supportive herbs might be helpful, particularly for women taking hormones and suffering from depression. Remember, hormones are deconjugated in the liver, which places a tremendous burden on it. On a practical note - when buying SAM-e, make sure the tablet is enteric coated, otherwise it will break down too soon and not be absorbed at the proper site: it will simply be digested and used as Methionine.  A new study presented in 2000 at the Congress of Neuro Psycho Pharmacology  in Belgium shows SAM-e and imipramine performed equally well for Major Depressive Episodes,  but SAM-e was better tolerated by the 281 participants in the double-blind study.   Slightly fewer of the SAM-e group responded to the supplement.

It is easy to run the risk of forgetting the horses as we look at the zebras! In other words, while there is quite a selection of highfalutin' supplements to help depression, some of the basics should not be ignored. The B vitamins, in particular, are essential to good mental health. In fact, folic acid and B-12 tie into the cycle of Methionine metabolism which produces SAM-e, and B-6 is necessary for supporting the pathways of Tryptophan and 5-HTP metabolism. Calcium and magnesium should not be ignored either, as they have important roles to play in our nervous systems.

I always ask my clients to consider, also, whether they may be suffering from a highly acidic body system: this condition can make it impossible for the cells of the body to unload toxins or absorb nutrients, meaning that no matter what nutrients you take, they will be doing you minimal good until your body is in balance. This can be checked by the use of pH strips, and regulated by dietary adjustment - most proteins are acid-producing, most fruits and vegetables are base. Certain supplements are also buffers, among them green super foods, lecithin, brewer's yeast and calcium.  There are some dietary supplements specifically formulated to adjust pH levels.   We do try to insist that a dietary adjustment be undertaken, for reasons too many to enumerate, but sometimes diet alone is not enough.

Perhaps the most powerful mood elevator is brisk exercise (and for the depressed person, one of the hardest to administer) & those who have forced themselves to begin a program of fitness have benefited enormously. Combined with proper nutrition and supplementation and allergy control (where applicable) many people find their depression totally eliminated.

Last but not least, consider the possibility of long term damage to body systems from prolonged use of anti-depressant drugs:  a recent source of excellent information I have found (you may want to sign up for their newsletter) is www.hsibaltimore.com.   There you will find this information expounded on from the point of view of its effect on digestion and health:

HSI Panelist Richard Cohan, D.D.S., M.S., M.B.A., sent (HSI a comment)  regarding xerostomia (dryness of the mouth), which is a common side effect of pharmaceutical antidepressants. Dr. Cohan says that antidepressants cause more xerostomia than any other group of drugs. He adds, "Xerostomia leads to an increase in caries (cavities), periodontal disease, and candidiasis, a yeast infection in the mouth often referred to as thrush. While not everyone who takes antidepressants experiences these side effects, those who do are often left with serious, permanent damage. For instance, these conditions can lead to irreversible loss of periodontal support of the teeth and the loss of teeth themselves. Just more of the hidden dangers in taking these drugs."

Consider also the possibility that long term treatment with anti-depressants may worsen the course of the condition - more here - and that there may be a connection between heart problems and some anti-depressants:

There is help out there for that Black Cloud, and it isn't always necessary to accept the many risks that come with the use of potent chemical antidepressants: there are many effective natural therapies that can be tried first.
 

Find the recommended supplements here

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