Depression

Depression is classically defined as a psychiatric mood disorder characterized by feelings of extreme sadness or guilt, an inability to concentrate, helplessness, hopelessness, and thoughts of death that can lead to some degree of impairment—whether mild, moderate, or severe. It can appear as a result of life changes such as divorce, loss of a job, or death of a loved one. Or depression may also come about gradually for no apparent reason at all.

Statistically, depression is the second most common medical condition observed in general medical practice today—behind hypertension alone. An estimated 16% of adults in Western countries suffer from major depression at some point in their lives, and of these, only 25% receive adequate treatment.

Like most chronic conditions and their symptoms, there is not one single cause for depression. Rather, there are several different factors which can contribute to and cause depression. When depression is not a by-product of external events, it is called endogenous, meaning “originating from within.” This kind of depression is believed to be fundamentally due to biochemical abnormalities specifically an altered balance of the neurotransmitters serotonin, norepinephrine, and dopamine.

Lifestyle and Dietary Modifications

Exercise increases the body’s production of endorphins—chemical substances that can relieve depression. This makes exercise one of the most powerful antidepressants available. The best exercise is aerobic activities such as walking, swimming, bicycling or dance; as well as strength training such as weight lifting.

Alcohol abuse or dependence on alcohol is associated with depression, especially if used with other drugs or if the individual has a history of antisocial behavior. Reducing alcohol dependency or abuse can reduce the feeling of depression, improve memory and well being.

Getting enough sleep is very important for mental health, as many people with a problem with depression may also have insomnia. One way to improve sleep is to go to bed at the same time every night, only use your bed for sleeping (or being intimate with your partner but not reading or working in bed), and doing breathing exercises or relaxation therapy before bed.

Food sensitivities may play a part in depression, as when chronic exposure to a food or compound that the body regards as foreign can induce an altered, lethargic state that may be confused for depression, or may even cause depression. Identification of food sensitivities and avoiding them can significantly help in a persons well being and mood.

The type of dietary fat may also play a role in depression, as the balance of fats in the diet can have an effect on brain function. The lack of omega 3 fatty acids (from fish) has been associated with increased levels of depression. People who eat diets high in omega-3 fatty acids from fish have a lower incidence of depression and suicide.

Certain nutrient deficiencies are directly related to depression. Some examples of these are iron and iron deficiency anemia, vitamin B12 deficiency (which can also cause pernicious anemia), folic acid and other B vitamins, Some medications are known to create depression for instance oral contraceptives can deplete Vitamin B6, a nutrient needed for normal mental functioning. Other substances are oral steroids, alcohol and some mind altering drugs such as marijuana.

Nutritional Factors Shown to be Beneficial

Omega 3 Fatty acids

Omega 3 fatty acids from fish oils, specifically DHA, has a beneficial effect on the functioning of the nervous system.
Dose: 3-6 grams of fish oil a day, or 2 grams of DHA a day

5-HTP

5- hydroxytryptophan is a precursor the neurotransmitter serotonin, and can act in a similar fashon as some of the antidepressant medication but with fewer side effects.
Dose: 50-300 mg three times a day

St John’s wort (Hypericum perforatum)

St John’s wort has been studied for the treatment of disease in over 20 studies and with over 1,500 people. It is best used for mild to moderate depression. St. John’s wort should not be used with other antidepressant medications that have an activity on the serotonin pathway. St. John’s wort may also reduce levels of other prescription medications including birth control pills and some antimicrobial medications.
Dose: 500-1000 mg twice or three times a day

Vitamin B6

Vitamin B6 or pyridoxine, acts as a coenzyme in energy7 producing pathways, and is also involved in the bodys conversion of amino acids to serotonin, one of the main neurotransmitters involved in mood.
Dose: 50-200 mg a day

Vitamin B12

Vitamin B12 or cobalamin is required for a healthy nervous system and can help in the treatment of sleep disorders, which many people with depression may suffer from.
Dose: 1000-5000 mcg

Inositol

Inositol is member of the B vitamin complex and work as a messenger in the central nervous system. It is useful in the treatment of depression and anxiety.
Dose: 1-5 grams a day

Ginkgo biloba

The herb Ginkgo improves the health of the brain by increasing blood flow to the head. It is also an antioxidant.
Dose: 120 – 240 mg of standardized extract a day

Phosphatidylserine

Phosphatidylserine, a natural substance derived from serine, affects the levels of neurotransmitters in the brain related to mood. It is found in high amounts in brain tissue.
Dose: 200–500 mg per day

Theanine

Theanine is an amino acid that is found in the tea plant. It increase neurotransmitter activity and has been shown to help the brain achieve a state of relaxation
Dose: 200 mg two to three times a day

Diagnosis and Pharmaceutical Interventions

Diagnosis of depression is usually done with a counselor, therapist, a psychologist or some other medical practitioner. A through psychological evaluation should be performed before the diagnosis is given. Most people with depression respond to a combination of therapies, which includes supplementation and ‘talk’ therapy with a counselor, therapist or psychologist.

Laboratory testing may be done to evaluate neurotransmitter levels, for example to check for levels of serotonin. Most often these tests are done when an individual is being monitored with therapies that specifically act on the neurotransmitter pathways, such as serotonin reuptake inhibitors (SSRI’s) or 5-Hydroxy-Tryptophan (5-HTP).

Medications for depression

Conventional medicines can be prescribed by medical doctors or psychiatrists to treat depression.

Following is a list of common conventional medicines that may be used for depression.

Serotonin Selective Reuptake Inhibitors (SSRIs)

The most commonly prescribed antidepressants. These include: Citalopram (Celapram), Fluoxetine (Prozac), Paroxetine (Aropax), Sertraline (Zoloft). These medications increase the neurotransmitter serotonin in the brain, which elevates mood and energy. These medications at times can increase the level of serotonin so much that a serotonin syndrome presents, especially when used in conjuction with other medications that act in a similar fashion, or with the use of other mind altering drugs. The symptoms of the serotonin syndrome include tremor, changes in mental affect and cognition. In addt6ion SSRI’s can cause irritation and bleeding of the stomach and gastrointestinal tract, and cause lower libido as a sexual side effect.

The second most common class of medications prescribed is tricylic antidepressants.

These include: Amitriptyline (Amitrip), Clomipramine (Clopress), and Imipramine (Tofranil). Monoamine Oxidase Inhibitors (MAOIs) are rarely prescribed. They include Tranylcypromine (Parnate). Some other types of medication that may be used are Bupropion (Zyban), and Venlafaxine (Efexor).

A host of potential side-effects (or symptoms of withdrawal) accompany the use of many if not all of these drugs. Some of the most serious of these are: anxiety, asthenia – loss of bodily strength, blurred vision, constipation , decreased ability to think clearly, development of drug dependency, development or worsening of suicidal tendencies, dizziness, dry mouth, insomnia , loss of libido and other sexual side effects, nausea , nervousness, rash , somnolence – sleepiness or a lack of energy and activity, and sustained increase in blood pressure (hypertension).

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