Dealing with depression naturally -- can it be done?

[KLynn]

My dearest friend is struggling with what she thinks is a mild case of depression. She has many of the signs, on a fairly low scale, and after wrestling with it for weeks, she is finally ready to admit that maybe it is something more than a string of "bad days." Rather than go straight to meds, she wants to try and handle it through a plan of better nutrition (she is mildly overweight and doesn't have great eating habits), exercise (including yoga) and meditation.

While I applaud her desires to change her life in this way, I wonder if she is setting herself up for failure, trying to make all these changes, then expecting them to "cure" the depression as well. I wonder if she shouldn't go ahead and get ON the meds, assuming they would help her get to a better place, from which she can begin to make all these positive changes in her life.

Any thoughts? If depression (no matter how severe) is a chemical imbalance, can food and exercise really correct it? I am out of my league here, and looking for some advice. BTW, she is going to see a doctor, but not for a couple of weeks.

[ChristineVA]

I have read that there have been studies done that 100% support what your friend is trying to do.

With mild depression, exercise is as effective as medication. I'm not even sure that diet is all that important, though it can't hurt.

In order for it to work, she needs to be totally committed to sticking with and to do the proper types of exercise. I believe that one of the stipulations was that the exercise should be outdoors and in some sunlight.

Also, many people are finding help with supplemental doses of Vitamin D. Apparently, we are very short on that and it seems to help all sorts of mood disturbances.

Christine

[donnamp14]

Aerobic exercise has been used successfully to alleviate the symptoms of depression. I hope she's feeling better soon!
-Donna

[clairea]

I'm glad she is going to see a doctor. I'm fairly vocal about the fact that people should be open to using anti-depressants and other psychiatric medications when necessary. That said, as I understand it, research does show that therapy (specifically cognitive behavioral therapy was used in studies) can be very effective in treating mild to moderate cases of depression, even without medication. The success rate given to me (by a psychopharmacologist, so clearly no vested interest in *not* using medication) were that in these kinds of cases CBT alone or medication alone would have about the same success rate (and that a combination of CBT and medication was generally more successful than either alone).

It's been a while since I looked at this, but I could try to pull out the info on the studies if necessary - I am sure it is in with our medical research somewhere. Note that the therapy used was the specific Cognitive Behavioral Therapy, which is more structured than traditional "talk therapy." IMO "talk therapy" can also be helpful for many people in helping them reframe their thought processes. Think of the negative, unhelpful thought processes kind of like candy bars for a diabetic -- the underlying problem may be chemical (and sometimes you absolutely have to deal with that with a chemical agent) but there are many things you can to help maintain stability, and a diabetic, or someone with depression may have to work harder, or differently, to do so.

To be effective, any type of therapy is really hard work, requires a lot of committment to personal growth and change, and takes time. Depression is painful and dangerous, and the very nature of the disease often hampers someone's ability to effectively participate in therapy without medication. Medication can take several weeks to work, but that is still probably quicker. If your friend's symptoms are getting worse, or if she is at any risk of harming herself or someone else, then it probably isn't wise to avoid medication at this point. If she is just suffering from relatively mild symptoms, and she is willing to wait it out, then that might be okay.

As far as nutrition and exercise -- those are certainly very important. I am convinced (and this is just anecdotal, learned in the school of hard knocks) that the fewer challenges your *entire* system (body and mind) are facing, the better you can address any that do arise. Good nutrition, appropriate exercise, and adequate sleep puts your friend's body in a position to devote resources to helping her heal.

[KLynn]

Thanks for the replies. She is definately not in any danger of hurting herself, and she really has not been getting any worse. I think that is why it has taken her as long as it has to "call" it anything. For weeks, it really did just seem like she was having a lot of bad days. I am a medicine person, and have no problem using meds when appropriate. She isn't so much, and I really hope this works for her. I am mostly confused about the whole nature of depression. You hear all the time it is medical - a chemical imbalance. That makes it seem like meds are truly necessary. I really just don't know much about it.

[Hammster]

Sorry if this has already been mentioned as I only skimmed the responses. I know in areas where there is extended periods of cloudiness (no sun) a form of depression can set it. I understand some UV therapy can alleviate those symptoms. I think it has something to do with a bright UV light and sitting under it for a period of time each day.

[funniegrrl]

Depression -- whether situational or more systemic -- IS a chemical imbalance. However, that does not mean that medication is always needed. The reason is that the other therapies such as exercise do affect chemical changes in the body. Exercise, for example, causes your body to produce substances that can affect mood. It's just that the problem is larger than can be overcome with diet & exercise, and that's when meds are needed. For depression that's more situational -- just a bad patch rather than a clinical problem -- therapy can be helpful as well, because the brain can be "retrained" to some degree. Again, though, sometimes the problem is more entrenched than these methods can alleviate alone, so the medication is needed to jump-start the process or even to keep it at bay over the long haul.

[clairea]

KLynn, I do think depression is absolutely a medical problem -- biological, chemical, etc. In many cases meds and other medical interventions are necessary. However, just because some "natural" treatments may help some people does not mean it is not a medical problem. The diabetes example is always the easy one -- diabetes is clearly a medical problem. Some people have to have medication, but some people can control it with diet and exercise alone. The fact that some people require less aggressive treatment does not diminish the "medical" nature of the illness.

Hammster's post made me think of one other "natural" thing that helps many people. In addition to the light boxes that are for seasonal affective disorder, many people with non-seasonal depression have difficulty either falling asleep or staying awake, and respond well to dawn and dusk simulators. They are a bit pricey (I think around $150) though.

[cindy47031]

Klynn,

Does your friend already practice yoga? If not, encourage her to try several different teachers out to find the one that works for her. Going to class a couple days a week is a HUGE help to me, and helps guide and motivate my home based practice on the days I don't have class. While I don't always practice every single day, I know I feel better both mentally & physically when I do. And I know that the days i feel least like doing it are the days I need it most and get most benefit from it.

As for depression being a chemical imbalance requiring chemical treatment, I don't think that is necessarily always the case. Even if it is chemical, taking care of one's body through proper exercise & nutrition & rest can cause the parts of the body that manufacture those chemicals to function better, thus naturally restoring the balance.

Yoga Journal's website (http://www.yogajournal.com) has several articles on depression. You (or she) can also search poses to find specific poses that may be helpful to her. On the "poses" page, under "theraputic applications" search on Mild Depression.

Best wishes to your friend. She is already fortunate to have you in her corner!

[cindy47031]

KLynn, I do think depression is absolutely a medical problem -- biological, chemical, etc. In many cases meds and other medical interventions are necessary. However, just because some "natural" treatments may help some people does not mean it is not a medical problem. The diabetes example is always the easy one -- diabetes is clearly a medical problem. Some people have to have medication, but some people can control it with diet and exercise alone. The fact that some people require less aggressive treatment does not diminish the "medical" nature of the illness.

Hammster's post made me think of one other "natural" thing that helps many people. In addition to the light boxes that are for seasonal affective disorder, many people with non-seasonal depression have difficulty either falling asleep or staying awake, and respond well to dawn and dusk simulators. They are a bit pricey (I think around $150) though.

I am not an herbalist, but I have heard St. John's Wort is useful for mood problems. She may be interested in exploring herbal treatments...

[Leslie Ferguson]

First caveat: I'm not a medical person but I have experience with people treating depression with and without medication.

My story: I was diagnosed with mild depression. Because it was mild the psychiatrist treated me with counseling and therapy but no medications. The major cause of my depression was stress related so this was an effective treatment.
My experience with treating significant depression with medication is through my wife. She went for a long time without meds and ultimately ended up on medication which is important for her psychological well being.

So, the best answer I can give: (1) I think mild depression is treatable without medication. (2) It is important at times to treat depressionwith medication. (3) There is no stigma using medication to treat depression (contrary to some philosophy - medicine is a crutch - which is WRONG).

I'm PM if you'd like with some other thoughts if you'd like.
Les

[cookieee]

This may sound too simplistic of an answer, and I don't know all the medical stuff that happens. But take your friend to the funniest movie you can find. Or do anything you can to make her laugh. Laughing outside in the sunshine would be even better.;) If this is mild depression, this should help make her feel better real quick. And listen to her, really listen. Let her talk her head off. Sometimes that is all it really takes. Just knowing that there is someone that gives a da#n.

[KimberlyS]

I think I was mildly depressed when I was going through my divorce. Both my counsellor and doctor said that if I was not having trouble sleeping, and I was able to function well enough to get to work and be reasonably effective, I probably didn't need meds. I think if these are true for your friend, and she acknowledges that she's depressed, it's worth trying excercise, etc. until she sees her doctor. It would be good info for the doctor to have ("I've started excercising and that helped/didn't help".)

You're a good friend!

[Kay Henderson]

It is my limited reading of the research that walking is particularly helpful for depression. If your friend is up to starting a regular program, it's not likely going to hurt to try it.

Kay

[mcgeiger]

I've suffered chronic depression most of my life...
Excercise can and will help depression--as long as you can get out of bed to do it;) --but may not totally fix it.
Funny movies, although sweet, may help her mood, as will friendship, but may not help depression.
St. John's wort has been shown to not effect depression, and like many herbal "remedies" can interact with other medications, ALWAYS check with a doctor before taking any supplements.
I'd still talk to a doctor, just so she can be monitored, and the doctor knows whats going on (often they want to run bloodwork to make sure it's not some underlying change).
Counseling may also help, even if it is "just stress"

It's great that you are concerned and wanting to help!

[TKay]

I, too, have experience with this subject. It's been my experience that exercise helps greatly. I mean regular exercise. It needs to be a consistent routine--at least for me it does. If your friend's depression truly is mild, exercise alone may do the trick. Endorphins are a wonderful thing.

I have taken anti-depressants off and on for several years. I have had some good experience with mild doses--and that may be all your friend needs (if she does indeed require medication). You might warn your friend that it sometimes takes trial and error to find just the right med for you.

My thoughts on St. John's wart and the like are that because it's not regulated by the FDA, it's sort of a hit and miss thing. I did try it briefly while waiting to go in to see my doc (like your friend). I can't say that it helped me. I will say I stopped it immediately when the doc told me about how you're not always sure what you're getting. I know some people have great experiences with herbal solutions, so I'm not ruling it out. It just wasn't for me.

I would also mention that people who are depressed are notorious for self-treating. We like to take meds for a while, feel better, and then go off of them. For some reason, we feel like we can (and should) handle all this stuff ourselves. If you can help your friend understand this is indeed a medical condition, she may be less tempted to treat her body like a lab experiment (as I've done for years).

On a personal note, the worst depression I had (outside of the one following my divorce) was post partum. I've taken meds regularly since then. I guess that bout was enough for me to say I give up and just let the meds do their work.

Good luck to your friend. I would suggest she try the exercise routine first. If that doens't work, at least there is medical help out there. Oh, one more thing. A therapist told me years ago that sometimes the treatment of drepession can be a short-term thing. The meds help balance everything out, get you back on track, and then you can take over from there. With luck, that will be your friend's experience. Just because she tries meds now (if she does) doesn't mean she'll be on them forever.