It’s time for a more holistic approach to depression

Standard disclaimer: I’m not a doctor or a psychologist. I’m a systems administrator by trade and a journalist by training. I write this as a survivor of depression, not as an expert on its treatment. Combined with the experiences of others, I think it’s worth listening to. But it’s no substitute for seeing a specialist.
Earlier this week, after I mentioned my experiences with depression in passing, my mom e-mailed me and asked me a few questions. Thought-provoking questions. Then Dan pointed me to another person’s experience with depression.

It’s been my experience that some people just seem to have a natural tendency towards depression. I don’t think that’s necessarily a bad thing. Some people are moodier than others, and that moodiness can be exceedingly difficult to be around sometimes, but there’s also a gigantic upside to it. Think of the most creative people you know. I’ll bet most of them are also pretty moody. That’s one factor.

While a student at Mizzou in late 1994 or early 1995, I had a conversation with a girl about depression. I knew she’d struggled with it, and I was curious. We had a long talk one day about it. Initially, in the back of my mind, I thought I’d interview a couple of other people who’d battled it, then interview an expert or three, and write a story about it. It was during that first talk that I learned that depression was sometimes caused by a chemical imbalance in the brain. (Interestingly, I don’t remember my lone college psychology class–that’s science of behavior to Dr. Dave McDonald and his students–talking much about depression. Or maybe we did and I just forgot it.)

Over the years I met a lot of people who were put on Prozac or Paxil or any number of other drugs intended to treat a chemical imbalance in the brain. In most cases they didn’t get the dosage right initially. In those cases the adjustment was difficult. In one case, a good friend of mine had been on it in the past and it helped, then he started to feel himself relapse. He called me one day and told me he was going back on treatment. A few months later, I started to hear stories. Stories that were very out of character. My friend, a gentle giant type if there ever was one, was supposedly very detached from reality and sometimes even dangerously violent. His dosage was wrong and it was destroying him. One night he called me, distraught. He was on the brink of losing everything, and it didn’t seem like anyone understood.

I was mad that the stories of his behavior had become public knowledge. I was also a little irritated with him that when his family and friends suggested there was a problem, that he didn’t go back to see his doctor until it reached crisis stage. But I was livid about how the people around him handled the situation. When there’s a problem with your Paxil dosage, it’s a matter between you and your doctor, and you have to be patient about it and so do the people around you. There is no way to measure brain chemistry and figure out exactly the amount of Paxil you need to get the dosage right. (This was news to him and to his family, and when one of his friends, who happens to hold a PhD in psychology, got involved but didn’t mention this, I was more than livid when I found out about it. If I’d known how to call him on the carpet about it, I would have.)

I haven’t been very good about getting to my point here. There’s a lot of guesswork when you get drugs involved. They don’t necessarily kick in right away. Sometimes they kick in too hard. Sometimes they have undesirable side effects. I mentioned the possible psychotic side effects, but they can also increase your sex drive to an uncontrollable level, and they can lead to very excessive weight gain. Those television commercials showing people playing outside on a sunny spring day while extoling the virtues of those drugs don’t mention anything about their dark side. Since brain chemistry isn’t measurable, you’re playing a guesswork game. Hopefully it’s an educated game of guesswork, but unless you manage to get a referral to a psychiatrist, it may not be.

The late, controversial Dr. Atkins took a different approach to treating chemical imbalances. Where do your brain chemicals come from? Your body makes them. What does your body make them from? The nutrients you take in. What happens when your body doesn’t take in the nutrients it needs to make the necessary brain chemicals? Chemical imbalances that lead to depression. What happens when you change your diet and/or start taking supplements that provide those chemicals?

Atkins said, “no more depression,” then moved on to his next topic.

I think there’s something to that. When carpal tunnel syndrome threatened to destroy both of my careers, one of my readers pointed me to Atkins’ vitamin book. I started taking, among other things, Flax Seed Oil or Fish Oil (buy whichever is on sale; chemically, they offer the same benefit) and Vitamin B6 and B complex. I was surprised at the effect they had on my mood. But that combination promotes a generally healthy nervous system. Vitamin B1, Atkins said, is especially effective in treating depression. The B vitamins work best in the presence of each other, so a trip to the local discount store for a bottle of Vitamin B1 and B complex could make a world of difference.

Battling depression via nutrition is imprecise, but the nice thing about that is that you’re not messing directly with brain chemistry. You’re providing your body with the raw materials to make what it needs. Your body knows how to dispose of excess B1. What’s it supposed to do with excess Paxil?

The best thing you can do for your mental health may very well be to visit a nutritionist. Get a copy of
Dr. Atkins’ Vita-Nutrient Solution
, make yourself a shopping list, get a nutritionist’s opinion, then buy. And avoid processed, commercial food if at all possible. I know my moods are much more consistent when I buy fresh fruits and vegetables and actually cook than when I eat tons of fast food or buy heat-up instant meals from the grocery store. Highly processed foods lose most of their nutritional value. They hurt your mood, they hurt your waistline, they hurt your energy level, they rot your teeth, and who knows what else. And when you’re not happy about how you look and you don’t have a lot of energy, and your teeth are falling apart, none of that helps your mood. Nice vicious cycle, eh?

You hear a lot more now about depression than you did in the 1970s and early 1980s. But there were a fraction of the number of fast-food restaurants and grocery stores were much smaller because they were catering to people who cook, whereas today grocery stores seem to cater to people who heat stuff up because everybody’s too busy to cook. I’m thoroughly convinced that these factors are related.

And cooking isn’t as hard as people make it out to be. I can stir up some mean dishes in about half an hour. Trust me, if I can learn how to cook, anyone can. I’m impatient and clumsy and accident-prone. But I’ve still learned how to cook well enough to impress a girl. Not counting my mother and sister, but I’ve impressed them too.

Remember that most doctors have no special training in nutrition. A lot of people are distressed to hear that and think it’s a conspiracy. It’s not. Medicine and nutrition are related, but they’re too complex for most people to be good at both. Asking your regular doctor to be a nutritionist is like asking him or her to be proficient at surgery. He or she is certainly capable of understanding it, but there are so many things a doctor would like to understand, and there are only 24 hours in a day to learn it all.

I believe that counselling and self-help are overrated, but both helped me to a limited degree. I found
I Ain’t Much Baby, But I’m All I’ve Got
by self-help pioneer Jess Lair to be helpful. It’s sadly out of print but widely available used. The biggest gem out of Lair’s book is a question: Do you have five friends? Lair said that if you have more than that, your friendships aren’t very deep. If you have fewer than that, you’re putting too much burden on them. With an inner circle of five or so, the burden seems to be about right.

But when that’s not enough, counselling helps. The problem with counselling is that sometimes people rely too much on it, or solely on it. Often people have issues they need help resolving. Sometimes that means just listening and offering a few suggestions and sometimes it means re-enacting traumatic experiences in order to finish up some unfinished business. It’s work. But it can be helpful, if you’re willing to do the work. But depression is a complex, multifaceted problem, so a one-pronged attack won’t be very effective. Remember the basic difference between a psychologist and a psychiatrist: Psychologists can’t prescribe medicine, and psychiatrists don’t do a whole lot of counseling. Both are aware of the work of the other, and an honest practitioner of either profession ought to know the limits and know when you need the other. But you may have to ask when it’s time to see the other. Human beings tend to get overconfident in the abilities of the tools they have.

Finally, there’s a spiritual aspect. Virtually everything I’ve ever read says you should believe in something. If you’ve ever had any exposure to Christianity, read the books of Luke and John (they’re not terribly long–read a chapter a day and you’ll be through both of them in two months) in a modern, readable translation. You can read them for free at bible.crosswalk.com. For readability, I recommend the New Living Translation. It plays really fast and loose with the translation sometimes, but the point isn’t to make you a Bible scholar–it’s to present the words of Jesus in understandable fashion. Or you can read an out-of-print modern blending of the four Gospels by Charles Templeton titled simply Jesus, online, for free.

Last night I told someone it’s healthier to be an atheist than it is to be in a cult, but it’s healthier to believe in something than nothing. I’m a Christian and make no bones about it. If you’re a not a Christian and you believe something else and you’re struggling with depression, then my advice to you if you’re not really practicing is to get serious. And if you find it’s not helping you, try Christianity.

No single thing will conquer depression for you. But the combination of diet and nutrition, counseling, and spirituality can be potent. Pills are a brute-force approach, and after watching my friend’s bad experience, frankly I believe they ought to be the thing you go to when the other things don’t work, not the thing you go to before trying the others. I know they work because I’ve seen them work, but if anything, the other things can make them more effective, and if you can get by without pumping man-made chemicals into your system, that’s a very good thing, and I don’t think anyone will disagree with that.

9 thoughts on “It’s time for a more holistic approach to depression

  • May 3, 2003 at 11:27 am
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    Nice coverage, Dave. I’ll add something from another angle in a bit over at my place.

    One of the more interesting lessons of how depression used to be treated came during a continuing education lecture in my early years as a medic. Someone had asked the ER MD running the show why we seemed to have so many overdoses from tricyclic anti-depressants; his (much paraphrased) response:

    “The most effective med we have in our arsenal right now doesn’t take effect until the patient’s had it on board for thirty days. So we give them this med that will take away their suicidal tendencies and tell them that it won’t help them for a month. …and then we warn them to be careful with it since overdosing is fatal.”

    Yeah, like that. I’ll also mention from the dietary side of things that sugar tends to bring out the worst in me.

  • May 3, 2003 at 7:55 pm
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    don’t ever take depression for granted,I’v know very smart,accomplished people who have taken their lives.modern meds is the best antidote,and should be taken without guilt.

  • May 4, 2003 at 3:30 pm
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    It’s not about guilt, it’s about effectiveness. If the person’s not in a crisis situation, if you have the choice between vitamins that will do the job and won’t overshoot or drugs that probably will, a holistic approach makes a lot more sense. Unfortunately the pharmaceutical companies have lulled us into a blind faith that drugs are always the only answer. Often it’s not, sometimes it’s not even the best answer, and rarely is it the entirety of the answer.

  • May 5, 2003 at 4:55 pm
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    I think guilt does figure greatly in depression. So may depressed people are told to “just pull yourself together”, that there are many people “worse off than you”. The clear message is that depressed person is being self-indulgent in feeling dpressed. Friends and family lose patience with the person who won’t/can’t take all their helpful advice “don’t they want to help themself?”. I believe this is seperate from the whole issue of the stigma around mental illness. How does one ask for help when one is just lazy and selfish?

  • May 5, 2003 at 4:58 pm
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    The one other thing I would suggest, is to ask your Doc to take a look at your Thyroid levels. I had mild depression in my early 20’s and (kinda) got out of it through trying to live better….then I started to feel worse and worse until I found out I have low thyroid numbers. I’m on meds for that now, and my depression hasn’t been back.

    My mom was worse than I was, and she had severely low levels. She was at a point to where she couldn’t function, but once she was diagnosed she can function again.

  • May 5, 2003 at 8:58 pm
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    I second the thyroid check.

    And you guys, get your testosterone checked! I went through close to 20 years of the Beast, the last ten nicely stable on an MAOI — an “old-fashioned” anti-depressant.

    A few years ago my hard drive failed and I asked the doc to check my hormones, figuring they’d be fine and “it was all in my head”. Turns out they weren’t and it wasn’t… Started testosterone therapy and felt better than I had in years. Weaned off the AD’s and have been clearheaded, MORE creative, lively and social on a consistent basis than any time in the last two decades.

    That sounds like hyperbole, but it’s not. I wish some psychiatrist had checked 20 years ago!

    Thanks Dave and Dan for bringing this up.

  • July 13, 2003 at 3:26 pm
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    Does anyone know the correct dosage to take of the vitamin B1 and vitamin b complex??

  • July 16, 2003 at 10:29 am
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    How wonderful, someone I can talk to about my work and my God and my health! Re lethargic behavior, yes, checking thyroid levels is a priority. I found this to be true in my case and now take five grains of thyroid replacement each day. Also, for depression (a long time problem for me) I was advised by my physician to follow the diet for candida yeast allergies (there are progressive suggestions from severe to moderate changes). This also proved to be a life saver. As long as I control my diet, I am fine. The minute I go off and eat sugar or white flour products I am in deep depression again, unable to study or function. There is a book, I think the author is Dr. Cook, on the candida yeast. You don’t have to be diagnosed with allergies to follow the diet. In fact, if you wait for a diagnosis for anything you could be hanging a long time. I have just completed a 60 credit masters in forensic psychology with an emphasis on children in the court system. I work full time as a Paralegal. I am also 75 years old. Also, I just found a sometimes works, sometimes not home remedy for a spot of depression that shows up. Take a quarter teaspoon of baking soda- yes the kind you buy for cooking- add eight ounces of water, and drink down. Almost immediate light heartedness will occur. Good luck. Blessed be to all.

  • July 16, 2003 at 10:42 am
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    The philobuf is because I majored in philosophy-love that stuff. Anyway, just a sign off. I believe that we are led in our lives by God to do certain things. I signed on this morning in a state of unease over my computer refusing to do stuff (note I don’t even know how to identify it!) and found you all. Now, how could that possible have happened to me if it wasn’t help from my Lord. I have been really downhearted and am now uplifted with the knowledge that you are all out there. Thank you. Katherine

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