The blues are depressingly com mon - but serious all the same. Toughing it out on your own is just not a solution. We speak here not of a streak of sadness but of a persistent dark mood accompanied by appetite changes, sleep disturbance, loss of interest in whatever usually gives you joy, social withdrawal, hopelessness, feelings of worthlessness or, god forbid, thoughts of suicide. Your first trip is to a doctor to rule out hypothyroidism, chronic hepatitis and anemia, illnesses that can cause a symptom picture very similar to depression. If your condition is severe, you need antidepressants and counselling.
Don't let a doctor just hand you a prescription. If you've got mild or moderate depression, a referral to a therapist might be all you need.
Some anti-blues drugs have been found to be possible carcinogens; know that there are safer holistic options.
No matter how sad you are, you can help yourself by cutting sugar, coffee and junk from your diet and adding more omega-3 fatty acids from flax oil, nuts and cold-water fish, more veggies and whole grains. Take a walk in the fresh air and sunshine daily, and make time for your soul's desires. Then book an appointment with a nutrition-oriented MD, herbalist, homeopath, naturopath or TCM expert.
People often try St. John's wort. Be aware that this herb can interact with antidepressants, HIV drugs, oral contraceptives, chemotherapy and other meds. It takes a couple of months to kick in (if it does). Use under professional care.
what the experts say
"Severe unremitting stress and food allergies (e.g. to milk, sugar, coffee) are very common causes of depression. (So are) deficiencies in one or more nutrients, chronic illness or fatigue. I ask my patients to eliminate sugar. For mood disorders I prescribe lots of vitamin C, vitamin B3 and a vitamin B complex. My formula includes folic acid. There's a lot of research showing it's as good as the drugs. Essential fatty acids (flax oil, fish oil) are extremely important. Chromium is a (blood) sugar stabilizer and a good antidepressant. Once people are well, I try to get them off medication. It's a shame so many patients are exposed to these toxic drugs when the therapeutic advantages have been exaggerated and the major side effects downplayed."
ABRAM HOFFER, orthomolecular psychiatrist, president, International Schizophrenia Foundation, Victoria
"I use interactive guided imagery to help people figure out what they want in life. Sometimes people (don't realize that) underlying their depression is the fact that they're not getting what they want out of life. If they don't want to come off antidepressants, I support their liver. Coming off has to go slowly. You start taking supportive herbs, then gradually decrease the drug dosage. We don't give St. John's wort with antidepressants; it has an additive effect. We've never used St. John's wort for severe depression. One of the indicators is thoughts of committing suicide. We wouldn't touch that with herbs."
SUSAN EAGLES, medical herbalist, Lindsay
"Cognitive therapy is as effective as medication for moderate depression. For more severe depression, a combination of cognitive therapy and medication is superior to either approach delivered singly. We have people pay attention to what goes through their minds when they notice themselves having a strong emotional reaction to an event. Over time, therapist and patient recognize certain thinking patterns that might point to a depressive way of interpreting the meaning of events. Homework assignments then allow the person to generate alternative ways of understanding these events.'
ZINDEL SEGAL, Morgan Firestone chair in psychotherapy, U of T
"The reason for this person's depression is different than that one's, and we treat them differently. Acupuncture and herbs definitely help mild and moderate depression. Traditional Chinese medicine can work well in combination with Western medicine. Other times we can completely eliminate Western drugs. When people choose to be victims in their own lives, sometimes that resignation can take the shape of depression. Sometimes subconsciously people choose depression to get attention. Sometimes it's genetic."
MARY WONG, practitioner, traditional Chinese medicine
"In Ontario, naturopaths aren't allowed to diagnose depression. We can say "depression-like symptoms.' We look at serotonin as a major brain chemistry balancer and give the body the building blocks it needs to produce more serotonin. We commonly use 5-hydroxytryptophan (5-HTP). Don't self-treat. There can be side effects. We also treat with phosphatidylcholine, which is found in lecithin. Those who have always been put down or shut down perceive that they can't do anything about the situation and give up. I help them find places in their life where they can get some control.' DENIS MARIER, naturopath
"Depression is like arthritis in that it has a chronic, recurrent pattern. The challenge is to find medicines you hardly know you're taking. The side effect profile with second- and third- generation drugs is much more user-friendly. St. John's wort did not perform better than a placebo in two large trials. On the other hand, in Germany and France there are some smaller trials where the active ingredient appears to be effective. Fatty acids found in fish oils, used in combination with antidepressants, are particularly helpful."
SIDNEY KENNEDY, professor of psychiatry, U of T, psychiatrist in chief, University Health Network