9781579542320

Chapter One

Braving

the Storm

Have we lost our heads, writing a home remedies book for depression? Although experts consider depression the "common cold" of mental health, we realize that this topic is far more challenging than the sniffles and aches for which our famous home remedy gurus give quick and natural solutions.

Depression affects nearly 10 percent of adult Americans, and major depression is the leading cause of disability in the United States and worldwide. It can be wrenching to your relationships; disrupt your eating and sleeping habits; impair your reasoning, memory, concentration, and sexual ability; and increase your risk for heart disease, accidents, substance abuse, and death. Without proper treatment, painful symptoms can endure for months, years, or a lifetime.

Actually, the frequency and severity of the problem is all the more reason that we wanted to write a home remedies book on depression--when you have it, you need to take better care of yourself than ever. What could be more appropriate than a book that will help you clear up what's stressful in your lifestyle, power up your diet, and offer positive ways to resolve problems?

Whether you are struggling your way out of the grief of a recent loss, have seasonal or occasional bouts of the blues, or have a clinically diagnosed depressive illness, we believe that you will find it refreshing to know how you can take a proactive approach, using hundreds of proven and practical methods.

What's more, you can and will feel better. Experts will tell you that once properly diagnosed , even the most severe forms of depression are highly manageable and very treatable.

The first steps are to determine if you need a doctor's help and find out how to get a diagnosis. If you are diagnosed with depressive illness, you will find that many of the 100-plus techniques in this book can ingeniously enhance the treatment prescribed by your doctor. If your blues are temporary or mild, this book is loaded with nondrug strategies to facilitate a speedy and full recovery.

Know the Signs

Depression can come on suddenly, seemingly for no reason or as the result of a stressful or life-altering event. It can also grow slowly over months and years, gradually draining away happiness and hope.

"The illness creates the same kinds of painful feelings that you'd experience after a death in the family, a failed romance, a lost job, a serious illness, or any other life crisis that leaves you feeling sad, lonely, or `down' for a period of time," explains Jonathan Alpert, M.D., Ph.D., assistant professor of psychology at Harvard Medical School and associate director of the Depression Clinical and Research Program at Massachusetts General Hospital in Boston. "The difference is that while you generally recover from most stressful events like a death or other serious loss within a period of months, depression often refuses to go away on its own." Instead it persists, getting in the way of your job or relationships with family and friends, and basically prevents you from getting on with your life.

Although it can take many forms, here are some common symptoms of depression.

· Persistent sadness

· Loss of self-confidence

· Feelings of hopelessness or helplessness

· Numbness (lack of feelings or emotions)

· Lethargy or increased lack of energy or drive

· Insomnia or problems getting up in the morning

· Persistent headaches, stomachaches, backaches, or muscle or joint pain

· Increased difficulty making decisions

· Problems remembering things or concentrating

· Loss of interest in pleasurable activities, including hobbies, sports, and sex

· Increased isolation from friends and family members

· Eating disturbances (weight gain or weight loss)

· Panic attacks

· Overwhelming feelings of guilt or fear

· Frequent crying

· Increased arguments with friends or coworkers

· Loss of interest in saving money or controlling how much you spend

· Dangerous or compulsive risk taking

· Thoughts of your own death or suicide

To be clinically diagnosed as having depression, you have to have a depressed mood or loss of interest in ordinary activities for at least 2 weeks, plus four or more of the symptoms of depression listed above. If you fit this description, see your primary care doctor as soon as possible.

Before making an official diagnosis, your doctor will want to rule out any illness that may cause similar symptoms, such as thyroid conditions, lupus, multiple sclerosis, or diabetes. Hidden Mood Benders on page 11 will help you identify, other possible underlying causes of your discontent.

Depression may be missed because its complex and varied symptoms often confuse family doctors who aren't in the practice of looking for it. So, if you suspect depression, ask your family doctor to do a specific evaluation for it.

If you can't get the help that you may feel you need, search your telephone directory under "mental health," "social services," "crisis prevention," or "hotlines" for a psychiatrist, psychologist, or counselor who can give you immediate attention. Hospital emergency rooms can also provide temporary help for an emotional problem, and their staff can tell you how and where to get further help.

It's Not in Your Head

Whatever you do, don't avoid treatment because of someone else's ignorance. The fact is, we live in a culture that harbors unfair misconceptions, such as the belief that depression is a sign of weakness or that the depressed person should "just snap out of it." Nothing could be further from the truth.

The first idea to hold on to is that it's not your fault.

For starters, the hormonal system that regulates the body's responses to stress is often persistently overactive in many patients with depression, which may explain classic symptoms like edginess, moodiness, or sexual impairment. The mood-altering hormonal fluctuations of the menstrual cycle, pregnancy, childbirth, menopause, and oral contraceptives help explain why women experience depression almost twice as often as men do. Shifts in hormone levels also are also a suspected factor in depression being a common problem for teenagers, since major depression typically begins between the ages of 15 and 30.

Modern brain-imaging technology offers a visual picture of how the neural circuits responsible for moods, thinking, sleep, appetite, and behavior may not function properly in depressed people, or it may show that chemical messengers called neurotransmitters are impaired.

Although there are more than 80 different types of neurotransmitters in the human brain, a select few of these chemicals seem to have more control than others over mental functioning. They include epinephrine, histamine, dopamine, endorphins, and serotonin, which work together in a delicate balance to help you concentrate, remember, and perform other mental tasks. Many of the most popular antidepressant drugs are targeted to regulate those neurotransmitters.

As far as how biological irregularities develop in the first place, experts believe that both genetics and certain lifestyle factors make people more vulnerable. "Some people are genetically predisposed through family history to be depressed," says Fred Straussburger, Ph.D., a clinical psychologist based in McLean, Virginia. "It can be the result of an abnormality in the family's biology that might make them more susceptible to the disease, or it could be something environmental about the way your family operates or conditions in which children were raised." If you come from a family with a history of mental illness, you are about two times more likely than someone else to suffer from depression.

The environmental factors suspected of breeding depression include how much day-to-day conflict we experience and how we react to it. Stress is one of the primary causes of depression in the United States, says Susan Nolan-Hoeksema, Ph.D., professor of psychology at the University of Michigan in Ann Arbor.

Major depression is more common in cities than in rural areas, partly due to the increased agitation of dealing with traffic, crime, and high-pressure lifestyles. "Most people with depression don't have to look very far into their personal lives to find that they feel overwhelmed by events and situations that they think are controlling them," says Dr. Nolan-Hoeksema.

Social isolation is another liability. This is illustrated in the high incidence of depression among elderly people who are "shut in" and teens who consider themselves unable to "fit in."

Hope lies in the promise that the more we understand the factors that contribute to an emotional disorder, the more control we can have over reducing or preventing our vulnerability to depression. For example, research shows that people who exercise regularly over a long period of time have far fewer bouts of depression than people who exercise infrequently or not at all. It is highly likely that this physical release is beneficial because it lessens some of the stress factors mentioned above.

Treatment and Self-Help

Traditional treatment for clinical depression combines talk therapy, peer support groups, and prescriptions for antidepressant drugs like fluoxetine (Prozac), sertraline (Zoloft), and paroxetine (Paxil), although medication is increasingly becoming the primary if not the sole thrust of mainstream treatment.

The most popular medications are designed to compensate for the imbalance of neurotransmitters in the brain. Since different drugs are suitable for different people, it is not uncommon to test six or more medications in the first year of treatment. Each drug may take 8 weeks to produce any therapeutic benefit. As with all treatment options, you can expect your mood to improve gradually, not immediately. Feeling better takes time, so experts strongly encourage you to stay on your medication and not stop taking prescribed drugs on your own.

A nondrug approach . Herbs can support you in battling depression by increasing energy, bringing calm, and working similarly to antidepressant drugs by regulating neurotransmitters. Natural supplements like SAM-e, 5-HTP, and St. John's wort are gaining popularity for providing a gentle mood lift, but unlike antidepressants, they have few side effects such as drowsiness, nausea, or sexual impairment. In Germany, prescriptions are written for St. John's wort 20 times more frequently than for Prozac.

Nowadays, you can pick up a bottle of supplements just about anywhere, from the supermarket to the spa, but doctors urge you not to experiment without their blessing.

"Certain supplements may interact with the medications your doctor has prescribed, or, if you avoid seeing a physician, you may not find out if your depression symptoms have another cause, such as thyroid disease," points out Lauren Marangell, M.D., director of the center for mood disorders at Baylor College of Medicine in Houston.

If you're having trouble locating a doctor who is knowledgeable about both pharmaceutical medications and natural supplements, contact the American Holistic Medical Association at 6728 Old McLean Village Drive, McLean, VA 22101, or log on to its Web site at www.holisticmedicine.org.

Nutritional therapy . A healthy diet is vital for more than keeping up your immunity and energy during times of stress. With depression, as with any other illness, you can count on food (and nutritional supplements) to support healing. Fresh greens and sunflower seeds, for example, are rich in compounds like tryptophan, lithium, omega-3 fatty acids, and phenylalanine--compounds that have a direct impact on mood. Solid evidence shows that taking nutrients such as vitamins B ₆ , [B.sub.12], and C as well as zinc, magnesium, thiamin, and folic acid has relieved depression. In fact, some doctors prescribe vitamins and minerals for their psychiatric patients to enhance the effects of pharmaceutical treatments. See Diet, Herbs, and Supplements on page 33 for guidance in making wise food and nutrition choices for your specific needs.

Emotional disclosure . According to research at Duke University in Durham, North Carolina, talking with friends, confiding in a therapist, praying, and writing about your thoughts are all highly beneficial physically and mentally.

"There are several reasons why emotional disclosure is so effective," explains Daniel L. Segal, Ph.D., assistant professor of psychology at the University of Colorado at Colorado Springs. "When you have something distressing on your mind and you try to not think about it, that takes physiological work and causes stress on your body." If you can let out those thoughts in a structured way, you can reduce stress on your body and often put the distressing thoughts in a context where it's easier to see solutions, he says.

You will find many writing exercises throughout this book, along with specific steps to open the lines of communication with loved ones and strangers and even how to rediscover your spiritual side.

Cognitive therapy . Cognitive therapies help a person to change the negative styles of thinking and behaving that are associated with depression. Researchers at the University of British Columbia in Vancouver analyzed 28 separate studies to determine how people fared after different types of mental health therapy. Those who used cognitive therapy did better than 98 percent of those who had no other therapy, better than 70 percent of those who took antidepressant drugs, and better than 70 percent of those who tried traditional talk therapy.

You don't necessarily need to pay a cognitive therapist to get results. Support groups will probably catch your negative thinking patterns, and Change Your Mood by Changing Your Mind on page 71 provides exercises to examine and empower your attitude.

Get physical . Nothing is more widely agreed upon among health care practitioners than the value of regular exercise for emotional health. Whether you consult a psychologist, a family physician, or an alternative health practitioner, you will likely find a workout program high on your treatment list. We could go into elaborate explanations of how exercise releases feel-good chemicals or improves blood circulation to the brain, but you already know the most common and most valuable denominator--it makes you feel good. Walking is a favored activity among the experts interviewed for this book, but all agree that the sport or activity should be whatever appeals to you the most. See Relax and Enjoy Life on page 91 to motivate you to start moving, and for other tips for a good-mood lifestyle.

Self-nurturing . Alternative health techniques like music therapy and aromatherapy are not only safe and easy, they are also fun to experiment with. Better yet, science is beginning to recognize the value of these more "touchy-feely" approaches to well-being.

In a Japanese study, 12 depressed men who were treated with citrus fragrance (aromatherapy) for 11 weeks were able to dramatically decrease their doses of antidepressants. Researchers say that massage can release beneficial chemicals like serotonin, which antidepressants work to enhance, and reduce levels of norepinephrine and cortisol, which anxiety medications attempt to lower. Treat yourself to some of the suggestions for relaxation and nurturing in Relax and Enjoy Life, or check Alternative Options on page 119 to find a holistic health practitioner who aims to soothe your psyche in the spirit of love and hope.

"When diagnosed accurately and treated with either antidepressant medication or one of the many nondrug therapies, there is virtually no one who cannot be helped," says John McIntyre, M.D., past president of the American Psychiatric Association. "Feel free to try as many things as you can, because while depression can be a debilitating illness, if it is properly treated, your chances of making a complete recovery from the condition are very good."

Excerpted from The Doctors Book of Home Remedies for DEPRESSION by . Copyright © 2001 by Rodale Inc.. Excerpted by permission. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.

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The Doctors Book of Home Remedies for Depression

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