The experience of depression is different for each person, but overwhelmingly it is marked by intense hopelessness, emptiness and despondency. Natural medicine can help, writes Tania Flack.

The author J.K Rowling has described depression as the most unpleasant thing she has ever experienced. “It is that absence of being able to envisage that you will ever be cheerful again. The absence of hope. That very deadened feeling, which is so very different from feeling sad. Sad hurts but it’s a healthy feeling. It is a necessary thing to feel. Depression is very different.”

Unless you have first-hand experience of this disease it is difficult to fathom the depth of its reaches and its ability to change every aspect of a person’s life. For some people, these feelings develop slowly over time, while for others depression can strike like a bolt out of the blue. Some people live with a low level of mood disturbance for many years, while others can become paralysed by its effects and are unable to work, maintain relationships or even care for themselves.

Depression is common in Australia, affecting approximately one in every seven people at some point in their life. It is the primary cause of non-fatal disability, costing the economy approximately $12.6 billion per year, and accounting for up to six million working days of lost productivity. Sadly, in severe cases, depression can lead to suicide and every day at least six Australians die and a further 30 people will attempt to take their own life. In fact, Australians are more likely to die from suicide than skin cancer, and it is the leading cause of death for young people aged 15-24.

Thanks to the bravery of high-profile Australians such as Magda Szubanski, Ian Thorpe, Jessica Rowe and Buddy Franklin and the fantastic work of organisations such as Beyond Blue, The Black Dog Institute, Headspace and RU OK day, we are starting to raise awareness and decrease the stigma associated with mental health problems, such as depression.

Understanding the causes

It’s important to note that there are many different types of depression and they each have their own unique set of contributing factors. We know that genetics and stress increase the risk of developing depression, but this is only part of the story. Fundamentally, depression is a brain disease caused by significant shifts in neurochemistry, which is partly influenced by complex changes in other systems.

MRI imaging has identified changes in the hippocampus, an area of the brain involved in emotion and memory. The hippocampus in depressed people tends to be much smaller than average, especially in people who have had depression over many years. Stress is thought to be a major trigger for neuronal loss in this area of the brain. As people recover from depression, this area of the brain regenerates back to normal volume.

Other contributing factors include inflammation, neurotoxicity, methylation problems and nutritional deficiencies. Hormonal factors at puberty, childbirth and menopause can increase the risk for women. As the brain ages we are less resilient to biochemical changes and depression can be common amongst the elderly. Personality type can also be a predisposing factor and traits such as perfectionism can increase stress, which can in turn lead to depression.

Seeking treatment

People with depression often delay seeking help due to the perceived stigma attached to mental health problems. Research shows that early intervention can speed recovery, so if you feel that depression is setting in the message is – get help early. Natural medicines are most effective during the early stages of depression; it really equates to “a pinch of prevention is worth a pound of cure’.

Just as there is a complex array of contributing factors in the development of depression, there must be a broad range of supports in place to assist full recovery. It is crucial that people with depression seek assistance from a team of health professionals, including a doctor, psychologist and natural therapist. A coordinated approach to treatment will ensure that every aspect of depression recovery is being addressed.

Some people have a great response to natural antidepressant therapy while others may require extra medical treatment. In this case, natural therapies can be used alongside pharmaceutical medicines, but it is very important that these are professionally prescribed, as some natural medicines cannot be taken with antidepressants.

Natural antidepressants

St John’s wort: This herb is best known for its potent antidepressant activity, which has been demonstrated in numerous clinical trials to be as effective as pharmaceutical antidepressants in the treatment of mild to moderate depression, with a lower risk of adverse effects. It also exerts anti-anxiety effects and is especially useful for depressed patients suffering from anxiety.

St John’s wort has a unique range of actions and its constituents act as non-selective reuptake inhibitors for various neurotransmitters including serotonin, noradrenaline, dopamine, gamma-aminobutyric acid (GABA) and l-glutamate. St John’s Wort should be professionally prescribed; it cannot be taken with standard antidepressants and may interact with other medications.

5-Hydroxy tryptophan (5HTP): Problems with the production or activity of the neurotransmitter serotonin is thought to be a major cause of depression. In the 1970s, scientists began experimenting with the amino acid precursors to serotonin, nutritional building blocks that the body uses to produce the neurotransmitter. Repeated clinical trials have demonstrated that 5HTP, a direct precursor to serotonin, has significant antidepressant activity. Several studies have shown it to be as effective as standard selective serotonin reuptake inhibitors (SSRI) antidepressants, without any of the usual side effects.

5HTP remains one of the front line depression treatments for natural therapists today. It is generally well tolerated and can produce significant antidepressant effects. It is contraindicated for use with standard antidepressants and must be professionally prescribed.

S-Adenosylmethionine (SAMe): SAMe is an amino acid that is required for the production and maintenance of several neurotransmitters including serotonin, noradrenalin and dopamine. Routinely prescribed in Europe for nearly 30 years, many randomised controlled clinical trials show that SAMe is a safe and effective antidepressant.

Under professional supervision, SAMe can be used in conjunction with standard medication to enhance antidepressant effects. It can minimise common side effects, such as sexual dysfunction, and has been shown to improve libido and erectile function in men taking antidepressant medication. SAMe can also improve memory related cognitive symptoms in people with depression.

A varied wholefood diet is also essential for your mental health, as certain nutritional deficiencies are linked to depression and diminished tolerance to stress.

READ: Nutrition essentials for mental health

Support and resources

If you, or someone you love are suffering from depression, help is available:
Lifeline – 131114, www.lifeline.org.au
Beyond Blue – 1300 224 636, www.beyondblue.org.au
Black Dog Institute – www.blackdoginstitute.org.au
RUOK – www.ruok.org.au
Headspace (youth mental health) – www.headspace.org.au

This article first appeared in Nature & Health magazine.
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