When is it Depression?

Over the years, prescriptions for antidepressants have multiplied. According to Statistics Canada 10 percent of the population age 18 to 24, nine percent age 25 to 44, 6.3 percent age 45 to 64, and three percent 65 years of age and older suffer from some form of depression.

Recently Health Canada released a public advisory alert about the most commonly prescribed drugs in the country, selective serotonin reuptake inhibitors (SSRIs). The advisory warned that doctors should be on the look out for signs of suicidal thoughts or worsening depression, hostility, anxiety, or insomnia in patients taking SSRIs. The list includes Prozac (fluoxetine), Paxil (paroxetine), Zoloft (sertraline), Effexor (venlafaxine), Celexa (citalopram), Luvox (fluvoxamine), Remeron (mirtazapine), and Wellbutrin and the antismoking drug Zyban (bupropion).

Many of these drugs are given to children SSRIs are among the top five classes of drugs recommended to patients 12 to 17 years even though Health Canada has not approved the drugs for use in patients under 18). The National Mental Health Association reports that as many as one in 10 young people suffer from anxiety disorders and one in 33 children may have clinical depression. Although Canada does not have statistics on the number of prescriptions given for antidepressants in children, the U.S. Federal government states that 250,000 antidepressant prescriptions were issued for children and adolescents last year.

Symptoms of depression include:

• feelings of sadness
• apathy
• weight loss
• increase or decrease in appetite
• physical restlessness or lack of motivation
• exhaustion
• insomnia
• anxiety or panic attacks
• feelings of worthlessness or guilt
• difficulty in making decisions or concentrating
• recurrent thoughts of death or suicide

The causes of depression vary. Biochemical depression is caused by brain chemistry imbalances such as changes in hormones or epinephrine (adrenaline). General clinical depression is caused by such factors as genetics, emotional distress, or as a side-effect of an underlying illness such as cancer or Alzheimer's. Other easily reversable causes include diet and lifestyle, overuse of alcohol or other stimulants, hormonal imbalances such as clinical or sub-clinical hypothyroidism, and stress-related burnout.

Is it Depression or Burnout?

Burnout is a state of mental, emotional, and physical exhaustion that leaves us feeling depressed with feelings of despair and hopelessness most of the time. Over the years I have had many patients come to me with a pre-diagnosed condition of depression. On further questioning, though, it usually becomes apparent that exhaustion is the underlying cause. Imbalances in the function of the adrenal glands stress adaptive organs can lead to the same symptoms as clinical depression.

Perhaps it's Thyroid Disease

Thyroid hormone has a prominent role in the development and homeostasis of the central nervous system and prolonged stress can affect thyroid gland function. Symptoms of thyroid disorders are similar to those of depression.

Even if your thyroid test comes back normal, you may be suffering from sub-clinical hypothyroidism. If you suspect you have a thyroid problem, consult a naturopathic or alternative-minded MD.

Eating the Blues Away

Diet and lifestyle have a profound impact on our emotional well being as well, no matter what our age. Junk food and particularly white sugar can cause dramatic mood changes as a result of rapid increases and decreases in blood sugar (hypoglycemia). One of the main effects of hypoglycemia is biochemical depression.

Eating three meals a day with a good protein base, taking stress-formula B vitamins, and 200 mcg of chromium daily provides some nutritional keys to treating depression. Essential fatty acids found in supplements such as evening primrose oil or flaxseed oil can increase prostaglandin levels. These hormones raise serotonin levels, a key to elevating mood.

I strongly encourage people to treat the underlying cause of their problem, whether it is depression or some other disease. Medications often offer life-saving, short-term answers but unless we choose to review why we are depressed, we cannot address the root of the problem. It takes courage and patience to look at our lives and to make the necessary changes for our mental, emotional, physical, and spiritual well-being.

Natural Treatments for Depression

• St. John's wort has been used successfully in the treatment of mild to moderate depression. Take 300 mg daily, standardized to contain 0.3 percent hypericin.
• Inositol, part of the B vitamin complex, has been reported to be effective in the treatment of depression and anxiety at a dosage of up to 12 to 18 grams per day.
• 5-Hydroxytryptophan (5-HTP) is a precursor for serotonin and some studies show a 60 percent reduction in depressive symptoms based on a dosage of 200 to 3,000 mg per day.
• Flower essence therapy offers a different approach to the treatment of depression by impacting the psyche rather than body chemistry. Consult a Bach flower therapist for help matching the 38 different flowers to individual symptoms.

A Sugar Pill is Hard to Beat

After thousands of studies and tens of billions of dollars, researchers found that sugar pills (placebo) treated depression more effectively than a common antidepressant. In fact, a 2002 study published in the American Journal of Psychiatry compared St. John's wort against Zoloft, finding that St. John's wort fully cured 24 percent in patients; Zoloft, 25 percent; and placebo, 32 percent. The sugar pills caused profound changes in the same areas of the brain affected by antidepressants, proving that drugs aren't always the answer. The greatest benefit may come from the care and concern shown to the patients during treatment.