Strategies for Depression

There are many well-known triggers for depression such as trauma, grief, financial difficulties, unemployment, divorce, etc.  But if you are depressed and there are no correlating stressors, there may be a more obscure and less obvious origin for your condition. The roots of depression can be deep, difficult to identify, and highly individualized. Here are some potential causational factors you may want to consider:

GENETICS: There is a great deal of evidence that certain genetic changes can affect brain development in subtle ways.  It is increasingly likely that genetics may determine how sensitive we are to stimuli and stressors. An ancestral propensity towards depression may make you more prone to develop the condition than people without a family history. People with a family history of depression may want to be more proactive in seeking out both treatment and information. 

BRAIN CHEMISTRY:  Depressed people have a different brain chemistry than those without the illness.

INFLAMMATION:  A new and interesting theory suggests that inflammation in the brain and body may contribute to the emergence of depression. The Inflammatory Theory of Depression embraces the idea that mood disorders may be caused by enhanced levels of inflammatory signaling.  Certainly many clinically depressed patients manifest higher levels of inflammatory markers.

 

Below is a checklist of things you can do to enhance your ability to treat depression.

Consider Genetic Testing

  1. We are still in the pioneering stages of this fascinating field. Clinicians can now offer patients a saliva-based genetic test and use the results to formulate superior treatment methods and prescribe more effective medications. The tests enable providers to use a client’s genetic makeup to customize the type of medications most likely to lead to success, and to mitigate negative side effects. These tests will minimize the usual trial-and-error prescribing practices which delay relief and result in wasted time and resources. Genesight looks at a panel of biomarkers commonly associated with psychiatric illness.  You will receive an analytic report from the company based on your results as well as a telephone consultation with a psychopharmacologist.
  2. It has been shown that up to 70% of people with depression have a genetic error called the MTHFR polymorphism that limits the body’s ability to reduce dietary folate or folic acid into L-methylfolate.  Many people with depression have low folate levels in their bodies. Folate (or prescription L-methylfolate, known as Deplin) may be helpful for depression and anxiety. Deplin claims to be the only active form of folate that can cross the blood brain barrier. It works by helping the L-methylfolate deficient brain create the neurotransmitters that affect mood.

Normalize your sleep cycle

1.  Set a routine wake-up time and get 7-8 hours of sleep each night.
2.  Bedtime can vary but prepare with a “bedtime ritual.”
3.  Practice sleep restriction therapy.
4.  Maintain a normal weight to reduce the risk of sleep apnea.
5.  Consider a sleep study by a specialist.
6.  Limit use of alcohol.
7.  Use a medication sparingly and only as prescribed.
8.  Exercise regularly.
9.  Consider supplements such as melatonin which sends sends a signal to the body that it’s time to sleep. As we age, our bodies produce less melatonin. Theanine is a compound found in green tea and is known for its stress relieving properties. GABA (Gamma-aminobutyric acid) is an amino acid and neurotransmitter that works to support relaxation and restful sleep patterns. Vitamin B6 is critical for healthy production of GABA and melatonin in the brain. Magnesium and calcium are both sleep boosters,
 and when taken together, they become even more effective.  Finally, Chamomile tea is an herb known for its calming properties.

 

 Antidepressant Medication

1.  May see positive results within the first two weeks.
2.  Antidepressants generally require 4-6 weeks to be effective, with maximum effectiveness at 12 weeks. 

 

Psychotherapy 

1.  Education and counseling to address your identified distressing issues.
2.  Generally psychotherapy is time limited.
3.  Shown to be as effective as antidepressant medications. 
4.  Consider Rumination-Focused Cognitive Behavioral Therapy to reduce negative thinking (see handout HERE).

 

Increase Physical Activity 

1.  Moderate exercise lasting at least 20-40 minutes, 4-5 days a week can be as effective as an antidepressant (click on link HERE).
2.  Exercise reduces anxiety.
3.  Yoga is generally thought to reduce depressive symptoms, tension, and improve chronic pain. 

 

Eat an Anti-Inflammatory Diet

1.  Dietary choices are perhaps the most important way to keep excessive inflammation in check.
2.  You may benefit from a diet low in processed foods and simple carbohydrates.  
3.  Enjoy a diet high in antioxidants including fresh fruits and vegetables, wild fish, and grass fed meat. (see Dr. Weil’s Anti-Inflammatory Food Pyramid HERE). 
4.  Eat breakfast

 

Social Support 

1.  Cultivate lots of significant relationships and avoid negative or unhappy people. 
2.  Be service-oriented and generous, foster an attitude of giving.
3.  Stay busy and try not to spend too much time alone as it may lead to worry and negative rumination.  

 

Meditation or Relaxation Techniques

1.  Relaxation techniques have been shown to improve immune response (see handout HERE).
2.  Reduction in overall anxiety.
3.  Reduces psychosomatic disorders like headaches, migraines, asthma, ulcers, etc. 
4.  Increases energy levels and productivity.
5.  Improves concentration and memory.
6.  Reduces fatigue and insomnia.

 

Limit Alcohol Intake 

1.  Alcohol can make depression worse.
2.  Alcohol can disrupt sleep.

 

 Manage Your Weight 

1.  Being overweight can cause sleep disturbance, depression, and reduced energy. 
2.  Obesity is related to increased inflammation in the body.

 

Address Relationship Problems 

1.  An unhappy marriage or relationship can lead to depression.
2.  Consider couple counseling.

 

Balance Your Work Responsibilities 

1.  Enjoy regular vacations
2.  Work no more than 45 hours weekly.
3.  Take regular breaks throughout the day.
4.  Regularly engage in hobbies you enjoy.

 

Enhance Spirituality 

1.  Spirituality is a belief system that focuses on intangible elements that add meaning and vitality to life’s experiences. Studies  show that highly spiritual people are twice as happy as people who are not.
2.  Consider engaging in regular prayer or meditation.
3.  Think about establishing connections in a place of worship.

 

Over-the-Counter Nutritional Supplements Helpful for Depression 

1. Essential fatty acids, such as omega-3 (found in fish such as salmon and tuna), and omega-6 fatty acids (found in vegetable oils, nuts and seeds) play a crucial role in the function of serotonin and dopamine.  Regularly enjoying foods rich in omega-3 and omega-6 fatty acids can be helpful for reducing inflammation and depression. 

2. N-acetylcysteine (NAC) can enhance the production of glutathione (GSH), a powerful antioxidant that protects the brain from stress.

3. B Vitamins: Vitamin B-1 (thiamine) converts glucose into energy.  Deficiency of this natural supplement can cause depression, anxiety and fatigue. Vitamin B-3 (niacin) supplements may also be beneficial for depression. Deficiency in niacin produces anxiety along with fatigue and overall slowness.  Deficiency in Vitamin B-5 (pantothenic acid) may cause fatigue and depression. Vitamin B-6 (pyridoxine) is a source of serotonin, melatonin, and dopamine. A deficiency in Vitamin B-6 may cause mental confusion. Vitamin B-12 (Methylcobalamin) plays a key role in the normal functioning of the brain and nervous system. Research shows that those who suffer from depression may respond better to treatment if they have high levels of vitamin B-12 in their blood.  Methylcobalamin is available over-the-counter at Costco.

4. Saffron is a spice that is used in cooking and also in traditional Persian medicine as a natural supplement for depression. It has shown to be effective only in mild cases of depression. 

5. S-Adenosinemethionine (SAMe):  Some studies suggest that the dietary supplement SAMe may be effective as a supplement for depression as it appears to boost serotonin levels in the brain. Although research studies appear promising, it is best to avoid using SAMe in conjunction with antidepressants.

 

Bright Light Exposure 

1.  Effective for those who notice a seasonal (fall/winter) component of depressed mood. 
2.  May benefit from exposure to at least 30 minutes per day of a special light box.

 

Bibliotherapy

1.  Reading self-help books may assist you in your recovery.