holistic/non-med treatments for depression

Stephanie said:

Hi all,

Looking for insights on alternate treatments to clinical depression. Once you've gone through standard prescription meds and St. John's Wort, what's left?

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Therapy.

Tom Cruise just announced on a talk show that depression could be cured by Scientology and exercise.

Tish Davidson said:

Tom Cruise just announced on a talk show that depression could be cured by Scientology and exercise.

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lol! Actually, exercise reportedly increases serotonin levels which can improve one's mood. So he wasn't too far off about that. I don't know anything about the Scientology, though. This morning I asked a psychiatrist what she thought about the whole business of Cruise claiming to know the history of psychiatry (because, as we all know, Matt Lauer does not). She remarked that Cruise seemed a little manic these days. I was like, yeah, no kidding.

Both acupuncture and biofeedback, especially in conjunction with therapy, have promising anecdotal results. Homeopathy and Bach flower remedies are also used by some, although that tends to be in cases of mild depression more than moderate to severe cases. One friend found that once her food allergies were identified and under control, her depression cleared up too. Two others report good results from a program involving full-spectrum lights (they probably had depression resulting from Seasonal Affective Disorder). And in at least three cases I know of, being around animals (especially large ones, like horses or cows) really helped, as did gardening in one case. Best results almost always resulted from combining multiple methods, with therapy being one of the methods.

Music for depression

I have worked with a therapist in Chicago, who introduced me to The Listening Program - classical music set to tones, etc that help brain waves to balance - I listened for 10 weeks, 2 times a day for 15 minutes each. It has helped me release emotions, long held. Though I still have some depression after a big change, like moving. Also, acupuncture and Chinese herbs have helped tremendously. I've also read how negative thoughts are often part of the depressive cycles we go through. Still learning about natural ways to work with it.

Stephanie said:

Once you've gone through standard prescription meds and St. John's Wort, what's left?

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You probably wouldn't go in that order--if the person is interested in alternative medicine, they'd probably do St. John's Wort first, and only use prescription meds if nothing else worked. If you went to a holistic doctor (for example an MD who was interested in/trained in alternative medicine), that's the order they would go in. FYI, St. John's Wort can interfere with the way your body absorbs other medications; for example, you're not supposed to take it when you're on birth control pills, since it can make them not work! FYI, St. John's Wort tea is not strong enough to counter depression. Some people drink it when they're not depressed to ward off depression, but it won't get rid of depression once you're already down in the dumps. You need supplements, or maybe a liquid version (one eye-dropper full in a glass of water X times a day...).

Sometimes St. John's Wort is combined with other things for depression. I've heard of it being used along with passiflora for people who are both depressed and anxious/nervous/fearful.

5-HTP (5-hydroxytryptophan) is commonly recommended for depression. I think it's an amino acid. In any case, it's some kind of natural supplement. I hear it works quite well. Here's an article that describes how it works: http://www.smart-drugs.com/JamesSouth-depression.htm

I also hear acupuncture can alleviate depression. And there's a supplement called SAMe or Sam-e (pronounced sammy), short for S-Adenosyl-L-Methionine. Here's something on it: http://www.healthyplace.com/communities/depression/treatment/alternative/sam-e.asp

Stephanie said:

Something else - how can a clinically depressed person (one who doesn't have the energy to get out of bed in the morning) even attempt all of these avenues of treatment?

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Well, the depression you're describing would be severe. You can be clinically depressed and not be severely depressed; clinical depression can be mild, moderate, or severe.

In cases of severe depression (and in others, too), it's not unusual for family or friends to help motivate the depressed person -- to exercise with them, or cook, or whatever. And some severely depressed people have enormous willpower, and get up and do things whether they feel like it or not, because they know they have to.

I'm just really lazy and from all this it seems to me a pill a day would be much easier for a person too impatient to spend time meditating and making other lifestyle changes.

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Medication without lifestyle changes doesn't have nearly the same beneficial effect. That's why a lot of doctors want to know you're working with a therapist before they'll prescribe antidepressants.

Stephanie said:

but I would do the meds first, ideagirl. I'm just really lazy and from all this it seems to me a pill a day would be much easier for a person too impatient to spend time meditating and making other lifestyle changes.

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St John's Wort, SAMe and 5-HTP are all "a pill a day"-type meds (or "a few pills a day," depending on your needs--same as prescription meds). They all come as pills in bottles, they're no more difficult to use than prescription drugs (and they're a lot cheaper--in the US at least, where prescription drugs cost 5 times as much as they do in any other country...). Of course it's better to make the lifestyle changes too, but you don't have to. The herbal stuff works on its own, regardless of whether you meditate or whatever.

I'm actually speaking from experience here--my doctor is an MD who's also licensed in holistic medicine, and this is always her approach: try the alternative stuff first, and only turn to prescription drugs if it doesn't work (or doesn't work as well as you'd hoped--for example, if it turned out that the depression was too deep for herbs to snap you out of it). Aside from the lower cost of herbs, etc., the two main reasons for starting with herbs and only moving to prescription drugs if they don't help enough are:

(1) Side effects--the herbal/vitamin/etc. treatments for depression have zero side effects (with the exception of the fact that St. John's Wort can affect how you absorb other medication), but the prescription antidepressants all have side effects, ranging all the way from sexual dysfunction to suicidal thoughts (!). So you would always try the thing with no side effects first, and only risk the side effects if the herbal stuff didn't work.

(2) Withdrawal and drug interactions--many prescription antidepressants include warnings about interactions; for example, with several of them, you can't safely drink alcohol AT ALL (not even wine with dinner) while you're taking them. The combination can destroy your kidneys, or make you so drowsy you can't even function, etc. Also, once you're taking a prescription antidepressant, with several of them you can't stop cold turkey: if you decide it's not working or the side effects are so bad you don't want to continue, you have to taper off gradually under a doctor's supervision. This makes it more complicated to take prescription antidepressants than herbal ones--another reason that doctors will start with the herbal stuff first.

Stephanie said:

Also, you'd have to experiment with the alternative approaches to see which worked for you - if any. So you might just possibly be depressed for a very long time before you came up with the right combination of techniques.

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The same is true for prescription antidepressants. *shrug* Depression isn't a simple thing, it's not like an infection where you can just give 500mg of antibiotics and kill the infection in all patients. It's very subjective, and in addition to the different ways a given substance (herb, drug, etc.) affects different people, side effects are different for everyone. For example, I know millions of women take Ortho-Cept birth control pills, but when I tried them, I was immediately slammed with a depression so intense I could not get out of bed for three days. Obviously, I had to change which brand of pill I took. Antidepressants are the same--a drug that works great for millions of people might whack you hard with an unbearable side effect.

Stephanie said:

Something else - how can a clinically depressed person (one who doesn't have the energy to get out of bed in the morning) even attempt all of these avenues of treatment?

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Not being able to get out of bed = severe depression. Most clinical depression is not that debilitating. In any event, getting herbs is no more difficult than getting prescription antidepressants--if they can do one, they can do the other. Oftentimes the person's spouse or best friend or whatever will drag them to the doctor.

Stephanie said:

And I wonder if anyone's done just that reverse order you mentioned - gone from the holistic/homeopathic route to better results with prescription medication like Zoloft et al?

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Oh, I'm sure they have. And vice versa. Just because different substances affect people different ways--Zoloft might literally save one person's life but not help another person at all, and the same is true of the herbal antidepressants. One rule of thumb is that really, really severe depression generally can't be cured by herbal/natural remedies alone; you have to catch the depression earlier, before it gets that bad, for the natural stuff to work. Sometimes people are so depressed that prescription meds don't work and they have to get electroshock therapy (yes, they still use that!). A friend of mine who's bipolar (manic-depressive) tells me that she's using something called cranial-magnetic therapy, or something to that effect, which sounds a bit like electroshock, but milder. She can't take any medication right now, including herbal remedies, because she's breastfeeding.

But basically, just as depression can run the gamut between feeling down and trying to commit suicide, depression treatments run the gamut between St. John's Wort tea (which helps if you're just slightly down, or want to avoid depression), to concentrated St. John's Wort or SAMe or 5-HTP in pills, to Zoloft, Wellbutrin, etc., to electroshock therapy!

ideagirl said:

(1) Side effects--the herbal/vitamin/etc. treatments for depression have zero side effects

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*banging head on desk* This. is. not. true.

I hear that all the time, and it drives me crazy. When you are using these substances as medicine, you are using them at levels and in dosages that damned well can and do have side effects. St. John's Wort, for instance, increases sensitivity to sunlight, to the extent that users can blister badly from mild exposure. High dosages of certain vitamins can be toxic. Natural remedies as a group have fewer and milder side effects than most conventional meds, but they are not universally free from side effects simply because they're natural.

Aconite said:

St. John's Wort, for instance, increases sensitivity to sunlight, to the extent that users can blister badly from mild exposure.

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I think we're both exaggerating here... yes, many natural remedies have side effects (almost always quite mild). But after looking around the web a bit, the only reference I found to severe sun reaction in people using St John's Wort were three cases in Australia (home of high melanoma rates due to the hole in the ozone layer) and it's possible they had taken too much ("Severe phototoxicity has been reported in cattle and sheep grazing on the plant... but not in humans taking therapeutic (antidepressant) doses." http://www.mja.com.au/public/issues/xmas98/rey/rey.html). People who are already photosensitive for some other reason, e.g. because they have lupus, should be very cautious with St John's Wort (and the Pill, and anything else that can increase sun sensitivity), but in normal people taking normal doses, the usual warnings (wear sunscreen, don't lay out on the beach) apparently suffice.

For research purposes, this link is a quick way to get an overview of the uses, dosage, and side effects of various natural remedies. There's a link at the bottom of each page (e.g., the St John's Wort page, etc.) that displays the references, so you can read the medical literature directly if you want:

http://www.gnc.com/healthnotes/Default.aspx?lang=en

I guess I thought it went without saying that you should follow directions and take no more of any herbal medicine than your doctor (and/or the label) suggest, but for the record, yes, you can overdose on almost anything (including water), with unpleasant or even fatal results.Hence the directions on the label...

Stephanie said:

Also, you'd have to experiment with the alternative approaches to see which worked for you - if any. So you might just possibly be depressed for a very long time before you came up with the right combination of techniques.

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Another factor to take into account:

To the best of my knowledge, some types of depression recede without any type of treatment in about six months' time, give or take. Others, like Bipolar Disorder, may be with a person for a lifetime and require years of medication management (whatever the medication or treatment).

You might want to look at this clinical trial

[font=&quot]Study of a Repetitive Transcranial Magnetic Stimulation (rTMS) Device for the Treatment of Major Depressive Disorder[/font]


http://www.clinicaltrials.gov/ct/show/NCT00104611?order=2

Tish Davidson said:

[font=&quot]Study of a Repetitive Transcranial Magnetic Stimulation (rTMS) Device for the Treatment of Major Depressive Disorder[/font]

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I wonder if that's the same thing as this:
http://alpha-stim.com/Information/Technology/Research/Index/Kennerly03/kennerly03.html

This is what my bipolar friend is using.

ideagirl said:

But after looking around the web a bit, the only reference I found to severe sun reaction in people using St John's Wort were three cases in Australia (home of high melanoma rates due to the hole in the ozone layer) and it's possible they had taken too much ("Severe phototoxicity has been reported in cattle and sheep grazing on the plant... but not in humans taking therapeutic (antidepressant) doses." http://www.mja.com.au/public/issues/xmas98/rey/rey.html).

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Huh. I definitely remember reading about the extreme photosensitivity, but a quick Web search doesn't turn up the articles I remember. I don't know if that's because I don't have access to the same subscription medical databases that I used to, or because I confused this research with other research I was doing at the same time. Of course, it's possible I was reading a print source that isn't on the Web at all. Argh! I hate it when I can't cite something.

ideagirl said:

I wonder if that's the same thing as this:
http://alpha-stim.com/Information/Technology/Research/Index/Kennerly03/kennerly03.html

This is what my bipolar friend is using.

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I don't think so. From what I read, I think your friend is getting some sort of low level direct electrical stimuatiion to the brain.

Here is part of the blurb from the clinical trial I mentioned. I thought the stats on chronic depression after treatment were interesting.
Despite major advances in the treatment of depression in the last three decades, further improvements are needed. For instance, with respect to antidepressant pharmacotherapy, only 1/3 of patients are estimated to have a nearly full resolution of their clinical symptoms with their first medication trial. Indeed, partial remission or lack of response to treatment is experienced by the majority of patients. Even with serial trials of antidepressant medication, at least 10 to 15% of patients with major depression are estimated to experience limited benefit and remain chronically depressed with significant psychosocial morbidity. Some patients cannot tolerate the dosage and duration of antidepressant treatments required for treatment trials to be considered adequate. In such patients, intolerance of somatic treatments for major depression leads to chronicity and impaired function, and likely hinders long-term compliance with treatments. For many patients with treatment resistant depression (TRD), more complex regimens of polypharmacotherapy, or the use of electroconvulsive therapy (ECT) are the only currently available treatment options.

Repetitive transcranial magnetic stimulation (rTMS) is a promising alternative to treatments such as ECT or pharmacotherapy for patients presenting with MDD. An rTMS procedure is non-invasive, does not require anesthesia, and may be delivered in an appropriately staffed outpatient setting.

By creating a time-varying magnetic field that is unimpeded by the scalp and skull, TMS can focally and painlessly stimulate the cortex of awake individuals. Through the principle of magnetic induction, the localized pulsed magnetic field generated in the coil at the surface of the head induces an electrical current that depolarizes underlying superficial neurons. It is widely thought that rTMS produces its behavioral effects solely through the induction of current flow in cortex.

There's evidence that long enough use of St. John's wort causes cataracts. No, I don't know how long is long enough.

Stephanie said:

Can you direct me to an article or site concerning that evidence, reph?

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Re St John's Wort and cataracts, this is part of the photosensitivity thing. It's obviously really rare, and it doesn't happen all by itself--you have to combine St John's Wort use with extended exposure to intense UV rays without eye protection (anti-UV sunglasses). If you get a lot of direct eye exposure to UV rays while taking St John's Wort, and you do this regularly over a period of 5-10 years, your eye proteins can change and form cataracts. Some recommendations I've heard include: if you have Seasonal Affective Disorder, use EITHER light-box therapy OR St John's Wort, but not both (SJW works for SAD all by itself, and so does light therapy--so people with SAD should choose one or the other); don't use tanning beds while using SJW (of course, doctors universally recommend against using tanning beds at all, regardless of what meds you're taking); and so on.

The basic factors are (1) extended, intense UV exposure; (2) unprotected eyes; and (3) long periods of time. I would guess that, since massive overdoses of St John's Wort can induce phototoxicity all by themselves, you could also add (4), using extremely high dosages of SJW, as a factor. And if you have a condition that makes you photosensitive, like lupus, that would presumably aggravate this. Try googling st john's wort, phototoxicity, and cataracts for more info.

Is depression sometimes the symptom rather than the problem?

Sleep disorders can pervasively deteriorate the good health of mind, body and spirit. There are many types and causes of sleep problems. This will address only one: sleep apnea.

Sleep apnea is caused by an obstruction of the airway during sleep. The obstruction can be the result of facial structure type, excess tissue around the airway (usually due to being overweight), as well as other causes. If you feel that habitually, you do not get restful sleep, if you think you have insomnia, if find yourself waking up frequently for bathroom (particularly if you know you snore when you do sleep), you may have sleep apnea. Any habitual sleep disruptions, whether they are caused by sleep apnea or some other sleep disorder, can contribute to depression. The test for sleep apnea is non-invasive, and being diagnosed means that you can be treated and maybe change your life - for the better.

With sleep apnea, a person literally stops breathing when the airway closes, and the person will rouse slightly each time to readjust the body to resume breathing. These rousings may occur hundreds of times a night, most often without the the person noticing or remembering. As such, the person is habitually deprived of the last three of the five stages of sleep, all of which are crucial to the body's rejuvination and restoration on a daily basis. Clearly, this deprivation creates exhaustion that impacts energy levels and may ultimately adversely impact mood.

Sleep apnea also causes undue strain on the heart and body systems. This adds to exhaustion and the inability to achieve restorative sleep that is crucial to mind/body health. One of the things that happens with sleep apnea is that the overworking of the heart causes excess fluid production, and this can lead to extra nighttime bathroom trips. A person may think they are having problems with frequent nighttime urination and that this problem is interfering with their sleep, when in fact, the real problem is sleep apnea. In either case, the person does not get the benefits of the continuous, multi-stage sleep we need for our bodies to restore every day.

While sometimes surgery is recommended to remove the airway obstruction related to sleep apnea, most often, a non-invasive solution is recommended. This solution involves the introdution of continuous positive air pressure (C-PAP) during sleep to keep the airway open. For many, with this treatment, all snoring ends, and more restful sleep begins. Treat the sleep apnea, and you may find that your mood will improve, as may your vitality, your exercise levels (which will also benefit your mood), and that your life will be changed for the better!

Sleep disorders are not the only problem that can cause or exacerbate depression. Anyone struggling with depression should examine their overall health and consider whether there are other physical problems that may be contributing to the depression. If so, those problems also may be treatable holistically or non-invasively, meaning without surgery or manufactured drugs. This is not to suggest that there are not times when surgical or pharmecutical treatments are appropriate, but in non-crisis situations, there is usually time to explore alternatives.

The bottom line is, depression is sometimes a symptom, and in those cases, if you treat the cause, the depression may well improve or resolve itself.

An amusing note on Tom Cruise and Scientology:

According to some Internet subculture news sources I've read, Scientologists believe that eons ago, billions of aliens, due to overpopulation of their own planet, were sent to inhabit the Earth. Scientologists believe that their resulting billions of alien spirits are still with us today. They believe that human bodies are sometimes riddled with these pesky alien spirits, called "Body Thetans". They also believe that some Scientologists achieve spiritual levels such that they are able to detect and, in essence, "exorcise" these Body Thetans from inhabited Earthlings. Scientologists who have this special ability to detect and purge these spirits are Operating Thetans. Tom Cruise belives himself to be an Operating Thetan 6. Apparently, John Travolta is an Operating Thetan 7.

Do you think I'm kidding? These are NOT conventional news media links, but they make interesting and amusing reading anyway: http://cultnews.com/archives/000790.html
http://www.churchofcriticalthinking.com/images/church_topArch.gif

If you are looking to Scientology to cure depression, you might want to look at some other alternatives, as well.

By the way, who thinks it's interesting that all this Thetan stuff comes out about Tom Cruise just in time for the release of War of the Worlds?

Believe none of what you read, and half of what you see . . .

Thanks to advances in digital graphics, now you can believe none of what you see, either, unless you see it in person!