NATURAL OPTIONS TO AVOID TAKING PRESCRIPTIVE ANTIDEPRESSANT MEDICATIONS ARE BEING GIVEN A SECOND LOOK.
I had a dinner guest recently, a friend of a friend, who is a dentist with a practice in an upper-income, hipster neighborhood of Chicago. He told me that 100 percent of his patients under the age of 30 are on some type of anti-depression medication.
One hundred percent. Every single patient.
That’s beyond disturbing — particularly when you consider that these are relatively educated, successful people (or at least the children of educated, successful people). It suggests something somewhere in the culture has gone horribly wrong. Are they all truly depressed, or is there something about their social set that naturally leads to becoming depressed? Or do they simply believe they need antidepressants, regardless of the severity of their “blues,” and all have a medical doctor willing to provide them with a prescription? Fully 10 percent of Americans were on some prescriptive antidepressant as of 2005, according to the Archives of General Psychiatry (“Antidepressant Drug Effects and Depression Severity,” Mark Olfson and Steven C. Marcus., 2009).
Depression meds can lead to hair loss and more depression
A dentist wouldn’t necessarily notice this, but presumably some of his patients were also experiencing hair loss — not as a direct result of their anxiety or depression but because many types of medications can lead to hair loss, including some antidepressants. Reportedly, SSRIs (selective serotonin reuptake inhibitors), including citalopram (Celexa), fluoxetine (Prozac), paroxetine (Paxil) and sertraline (Zoloft), may have this effect because they deplete stores of amino acids, which can affect hair health. One might increase protein intake to counter this; however, a patient should always discuss and review options with his or her physician.
As with all medication side effects, hair loss is not necessarily experienced by all individuals taking a particular medication. And sometimes that effect is temporary, something that occurs only when beginning a regimen.
But it all certainly makes a person question whether an antidepressant is worth the cost, in dollars as well as side effects. And certain insurance programs, such as long-term care and disability insurance, can be denied to individuals with a history of depression or mental illness.
Alternative therapies to treat depression
Perhaps all those under-30 dental patients — and the rest of us — should consider other approaches to depression. Here are several, culled from the medical and self-help literature.
Talking cures: Even though the drug industry has supplanted them a bit, mental health counselors still exist and help millions. They go beyond just “talking it out,” although that can go a long way for many people in restoring emotional and mental health. A trained and licensed therapist can help identify other resources and approaches for the patient.
OB-GYN nurse practitioner Marcelle Pick writes about depression, anxiety and mood. She notes that depression might serve an evolutionary purpose as an adaptive response to physical and emotional events. It may be unpleasant — she likens it to how the body fights infection with a fever — but when a patient masks symptoms with medications the benefits of those symptoms may be lost. She suggests the patient consider whether toxic people (friends/“frenemies” or family), behaviors (sedentary lifestyle) or environmental factors (e.g., mold, lack of natural surroundings) are causing the depression and to address those instead.
Socialization: Find people with whom you can relate; get involved in something that is bigger and outside of yourself. Maybe an activity such as card playing or a sport would provide a time, on a set schedule, when you can simply step outside yourself and become something different.
Or perhaps the depression is cause related: A sense of purpose can do a lot, possibly accomplished through working with others (people or animals) who are less fortunate than yourself or who share your passion.
Healthy lifestyle habits: Depression may have an emotional or biochemical cause, but your body is quite capable of combating either with the help of physical activity and smart nutrition. For example, the natural hormones serotonin (what is chemically enhanced with SSRIs) and dopamine can be increased with exercise.
The Web site Mark’s Daily Apple (marksdailyapple.com), which advocates all things Paleolithic for the sake of health, – says, “Don’t think of exercise as a chore to lose weight or prevent heart disease … Realize that 15 or 20 minutes of exercise every day will naturally release these feel-good hormones that are so vital to feeling happy and calm.” The Web site further advocates avoidance of processed sugar, instead eating a good balance of protein (particularly foods that contain tryptophan, such as turkey, fish, chicken, nuts, cottage cheese, eggs and beans) in combination with lesser amounts of brown rice and generous portions of vegetables, as well as good fats: oily cold-water fish such as salmon, herring, sardines, mackerel and tuna plus avocados, flaxseed, vegetable oils and nuts.
Depression can easily result from the abuse of alcohol, other medications (other than antidepression drugs) and recreational drug use. If you’re using any of these habitually, it makes sense to examine why and how to cut down or eliminate them altogether.
Herbs: The herb St. John’s wort (Hypericum perforatum) has been used for centuries for various medical conditions, including depression (melancholia, as it was once known) but has diminished in reception because of recent studies that claim its effectiveness is no greater than that of a placebo. However, the National Center for Complementary and Alternative Medicine acknowledges that while the precise means by which it works is unknown, the herb seems to be effective in some people.
Other herbs that are sometimes used to treat depression are ginger, boswellia and green tea. Data on efficacy is elusive, however.
Environment: Maybe you simply live around too much concrete and unappealing vistas. A study published in the Journal of Epidemiology and Community Health (Jolanda Maas et al, “Evidence Based Public Health Policy and Practice: Green Space, Urbanity, and Health: How Strong Is the Relation?” 2005) found that people living within close proximity of green space (trees, grass, water) had lower rates of anxiety disorders and depression. This effect was even greater for persons of lower income.
Homeopathy: While much maligned by many traditional American medical practitioners, this 200-year-old health practice is readily integrated with modern medicine in Europe, Central and South America and India. It is used to treat chronic conditions, including depression, anxiety and fatigue.
“Patients come to me usually after they tried allopathic (traditional/mainstream Western medical) approaches,” says Chicago chiropractor and homeopathic physician Richard Ezgur.
Homeopathy involves an in-depth interview with the patient, lasting several hours over multiple appointments, from which the homeopath identifies root causes and appropriate remedies.
“The patients are often already on antidepressants, and we encourage them to inform their physicians that they are working on a homeopathic approach. Often they will, under their doctor’s guidance, cut back on their meds by 30 to 50 percent, and gradually reduce medication by 80 to 100 percent.”
Ezgur urges working only with board-certified doctors of medicine, chiropractic, osteopathy or naturopathy when pursuing homeopathic approaches.
Meditation: David Mrazek, M.D., a psychiatrist at the Mayo Clinic, writes that “meditation is a powerful depression treatment tool and you will see results in a short time.” In his blog at MayoClinic.com, several individuals share how meditation worked better than medications for them; however, a psychiatric nurse cautions that different degrees of depression in individuals should temper patients’ expectations on what it can achieve. “It will not magically ‘cure’ your depression,” she writes, “but it is a coping skill that most people who are willing to give it a try find to be a very helpful tool to manage their symptoms.”
Of course, there are many books on the topic. Some people recommend Healing Anger: The Power of Patience from a Buddhist Perspective: The Power of Patience from a Buddhist Perspective, by the Dalai Lama (Snow Lion Publications, 1997).
The fact that the prestigious Journal of the American Medical Association (JAMA) published a meta-study (Fournier, DeRubeis et al., “Antidepressant Drug Effects and Depression Severity,” 2010) strongly challenging the idea of taking antidepressants for milder forms of depression — that the medications had essentially the same results as sugar pills — suggests that all those under-30 dental patients in Chicago might try something else.