Clinical depression can make work and daily life almost impossible; an individual may lose their ability to see the positives in life and begin to feel utterly alone. It may affect between 20% and 25% of the population. The good news, however, is that a depressive episode is treatable and, more importantly, it is preventable. A functional medicine approach to dealing with this mental health problem is often very effective.
For major depression to be diagnosed the majority of the following symptoms must be present most of the day nearly every day (over at least a two-week period):
- Depressed mood (e.g., feeling sad or empty) or appearing tearful to others. (In children and adolescents, an irritable mood is more common.), and/or
- Loss of interest or pleasure in most activities, including hobbies
- Change in appetite or a significant weight loss or gain
- Fatigue or loss of energy
- Change in sleep patterns, e.g insomnia
- Psycho-motor agitation/retardation
- Diminished ability to think or concentrate,
- Diminished short-term memory
- Negative thinking
- Recurrent thoughts of death or of committing suicide
- Feelings of worthlessness
- Excessive or inappropriate guilt
Alternative “male-type” symptoms of depression include irritability, anger attacks/aggression, sleep disturbance, alcohol or drug abuse, risk-taking behaviour, hyperactivity, stress, and loss of interest in pleasurable activities.
2. Causes of Depression
It is really important to ask oneself the question: What are the factors causing my clinical depression? Some, or all, of the following may be important for you to consider:
Recent research suggests that chronic, systemic (i.e. whole body) **inflammation **generally plays a key role in causing depression. Both a poor diet and chronic stress are known causes of causes of such inflammation. Chronic stress causes the stress hormone cortisol to continually circulate throughout one’s body and brain. This eventually results in inflammation of brain tissue which, in turn, limits the availability of certain important brain chemicals (neurotransmitters) ... which stops the brain from doing what it normally does, e.g. controlling one’s mood. Crucially, a diet that regularly includes refined carbohydrates, processed food and added sugar will also often trigger a very similar chronic, systemic inflammatory process.
Not all people who eat a diet that is high in refined and/or processed food, as described above, and/or who experience chronic stress will fall into major depression, however. Those people who are negatively affected are likely to have a ‘predisposition’ for depression which is caused by one or more of the following factors:
Genetics. If depression runs in the depressed person’s family, s/he has a higher chance of becoming depressed, i.e. s/he has a genetic vulnerability or predisposition.
Unmet emotional needs during childhood. If a depressed person did not have all or most of his or her emotional needs met as a child, either at home or at school, then s//he may have a psychological vulnerability for depression.
Age. People who are elderly are at higher risk of depression. That can be compounded by other factors, such as living alone and having a lack of social support.
Hospital procedures. Going under general anaesthetic will cause many individuals to experience a depressed mood. This may turn into a major depressive episode for those who are sensitive to the chemicals used and/or are vulnerable to depression.
Health conditions. Chronic conditions such as cancer, heart disease, pain, etc. increase the risk of depression.
Trauma and grief. Trauma, such as physical or emotional abuse can trigger depression. Grief after the death of a friend is “normal” but can sometimes lead to depression.
Change. People often become depressed during times of change, such as during a divorce. Yet even positive changes, like getting married, can trigger depression.
Medications and substances. Many prescription drugs can cause symptoms of depression. Alcohol or substance (ab)use makes the condition worse.
The key thing to remember is that depression is not the afflicted individual’s fault. It's a disease that can affect anyone, and regardless of the cause, there are many ways to treat it.
3. Treating and Preventing Depression
In treating depression, a combination of medicine and psychotherapy is often most beneficial to begin with. For optimal mental health that is sustainable, however, it is critical to improve one’s lifestyle. In this regard, many studies show that gradual changes in diet, movement and exercise, sleep habits, social connections and one’s approach to dealing with stress are more important.
Psychotherapy or Talk Therapy for Depression
Scientific research indicates that talking with a psychologist is one of the best treatments for depression. Some people choose to be in therapy for a few weeks / months to work on a few key issues. Others stay in therapy for years, gradually working through larger problems.
Medicines for Depression
Medicines are another important treatment for depression. If one antidepressant doesn't work well, one’s doctor might try a different class of depression medicines or change the dose. There are dozens of anti-depressants available, including the selective serotonin reuptake inhibitors (SSRIs) amongst many others. In general, these drugs improve symptoms of depression by increasing the availability of the neurotransmitters in one’s brain.
Stress reduction training
As it is ongoing stress that tips many individuals into a major depressive episode, learning how to cope effectively with stress, and the often-underlying negative habits of thinking (e.g. ruminating), is critical to ensuring that relapse into depression does not occur. Mindfulness-Based Stress Reduction (MBSR) training is one of the most beneficial training options currently available.
Diet and Exercise
Diet and exercise are proving to be crucial for recovery and, especially, for prevention. Cutting out refined carbohydrates, processed foods, sugar and seed oils (e.g. sunflower oil) is critical. And as little as 15 minutes of cardio-vascular exercise causes the release of endorphins which has a positive effect on brain functioning. 40 minutes of such exercise three times a week is optimal and has been shown to have a neuroprotective effect.
Between 7 and 9 hours of unbroken sleep is optimal. At the very least, keep your bedroom as dark as possible and ensure that the temperature in your bedroom is cool, around 18°C. Also, turn off or stop using all electronic devices that have an LED screen two to three hours before you put your head on your pillow. LED light prevents the production and release of melatonin, the sleep hormone, which causes us to feel drowsy and fall asleep quickly.
A strong network of social support
Regularly interacting with emotionally supportive friends and family is critical in preventing mental health problems.