Treating depression without drugs – Part I

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  1. Mona’s avatar

    I have used both medication and non-medicinal methods for treating my depression.  The first time I went through a depression, it was overwhelming.  I was a full-time student and working part-time in a Biotech lab with grad students so I had to stay focused.  I was a little scared at the ease of actually getting a prescription for antidepressants.  It was a list of questions that qualified me as a candidate (if the patients says yes to any of these then they qualify).  

    I started them at low doses and read the warning label.  (Warning:  if you stop using this medication without doctors consent, you may have suicidal tendencies.)  I did a lot of drugs when I was younger and can honestly say that the first few days were like taking ecstasy but only a bad trip.  I wanted to stop taking it because I felt chittert and high all the time.  Then the effects subdued.  I didn’t care about anything anymore so nothing bothered me.  It was hard to care about studying for test too but I got through my semester.  It was better than trying to study and go to work without sleep and not eating all day.  I was an advocate for antidepressants for that very reason. 

    But my problem was never solved.  After the cause of my depression was a distant memory, the same cycle started again.  I was depressed all over again with the same symptoms.  I was a little older and tired of the cycle so I did some research on my own.  I self-diagnosed myself as codependent and started therapy, exercising, and group therapy.  Exercising was great but the effects are not instantanious like you would expect.  It took time for my adrenaline levels to reach their peak, like weeks.  Then I felt great.  I was strong physically and mentally.  (And I looked great too.)  People started to notice the change which made me feel better .  Likewise, therapy helped me treat the problem, not just the symptoms.  

    I still get sad, angry, and frustrated but each episode is shorter and less intense than the last.  My most frequent lasted only one afternoon.          

  2. Chris’s avatar

    @Mona:

    Thanks for your comment, Mona. I’m glad you’ve learned some non-drug strategies that have helped you to be more resilient.

    Chris

  3. Tam’s avatar

    I am just starting this journey of depression/anxiety treatment. I am seeing a counselor which helps a little. I think therapy would be more effective if the couselor/patient match was better. She recommended that I take antidepressants and scheduled me to see a Nurse Practitioner who gave me sample doses of Lexapro to try for 3 weeks. That was a week ago and I have yet to take the first pill. There is just some sense of apprehension inside me not to do so, even before researching the side effects, which, by the way, the nurse didn’t share with me.
    I am hoping that my condition is temporary and related to a number of major changes I have experienced in the past couple of years and will eventually get better. I am going to try some of the recommendations in this article. I used to practice yoga, meditate and run regularly but stopped doing so once this depression set in. I am going to do my best to start these practices again. I’m also going to try eating healthier as I find I eat lots of junk food in response to stress. That can’t be helping the cause!
    My dad committed suicide 2 years ago. My main fear is that I will end up like him.

  4. Ralph Taite’s avatar

    I know you’re trying to bring healthy skepticism to all branches of medicine, but I think you need to be careful when discussing recent claims that antidepressants are no better than placebo. 

    Remember, prior to SSRIs like Prozac, antidepressants had such a bad side effects profile that only people with true biological depression were being treated.  And we know from that period that the MAO inhibitors and tricyclics did in fact save lives and reduced depression as compared to placebo.

    And that’s with crappy first generation drugs.

    Where we’re running into problems now is SSRIs are being prescribed to people who are just upset about a divorce or a death in the family.  Of course, in that instance, they would be no more effective than placebo since life event depression (without a biological enforcer) typically goes away in 6 months anyway.   

    I have used Prozac and I come from a family which definitely has biological markers for depression and anxiety.  When I first had depression, it did provide relief better than anything I had tried previously.  I have since learned there are natural things (i.e., GABA and its derivatives, valerian root, D-phenylalanine, high omega 3 fish oil, etc), but to say that antidepressants have no role in treating biological depression is simply false.

    The brain and nervous system is a chemical messaging network.  Just as computers use electronic 0’s and 1’s to communicate messages between subsystems, the brain uses messaging chemicals to communicate information between neurons.  In some people, those systems don’t work properly.  I know this because I can see how supplements and drugs affect my moods and my mental state. 

    My depression was made worse by the exercise which you describe as a treatment.  I would have a panic attack after a heavy workout thinking, like you, that I could treat this thing with exercise alone.  It turned out that Prozac helped me get over the panic attacks so I could buy some time to learn other methods of depression management.

    To Tam, I hope you do learn more about depression and don’t simply read blogs which suggest that exercise and psychotherapy will cure it.  For people who have depression in their genetic makeup, drugs can help a lot and may save your life.  I hope you do learn about the major mood neurotransmitters like serotonin, norepinephrine (adrenaline), dopamine and GABA and how drugs which target each system can help you manage your depression.

    Also, people who have gone through traumatic events may have altered brain function.  They may be overly sensitive to adrenaline — as I believe our family has a genetic tendency toward — and it may take a while for the brain’s receptors to “down regulate” (meaning reduce their sensitivity).  People who have post traumatic stress disorder often have just had too much adrenaline pumped through their systems to the point that their bodies do not react to it properly.  GABA acts like a big stop sign to overactive neurons and supplements which enhance GABA transmission in the brain can help calm the symptoms of PTSD.

    I am a firm believer that we do need chemical intervention at times to deal with depression.  If you get right down to it, food itself is a chemical fuel and we already know our choices of food can affect mood and depression.  The most important thing is to educate yourself about both sides of the issue.

    By the way, I do agree with the blog author that cholesterol appears to not be the big risk factor in coronary heart disease — however, oxidated LDL does — and therefore we must learn how to control oxidation in the body.

    Which, once again, is a chemical process.

    Ralph :)

  5. Tam’s avatar

    First let me say thank you Ralph for your personal response.  I hope you are doing well.
    It’s been 9 months since my previous post on this site. I did not take the SSRI prescribed to me in 07/2009.  I started seeing a new counselor who is a better match for me. She is actually teaching me things which are helping me tremendously.  I have started taking better care of me by doing things I used to love: running, yoga, meditation.  I have been certified in first degree Reiki and am taking the second degree Reiki class tomorrow. Reiki has been wonderful for me; it relaxes and calms me like nothing else. I’ve learned to speak up for myself instead of constantly feeling like a victim. My self-esteem is getting stronger. I’m learning about myself and why I act and react the way that I do and how to change those actions that are less than desireable. I’m learning that it’s okay to feel unhappy, sad, mad, happy, glad, etc. I’d put myself into a spiral of guilt because I thought I should be happy all the time. My life is really good so why would I feel sad? I realized that I was/am grieving the loss of my single life after I got remarried a year and a half ago to a wonderful man with a lot of baggage in the form of an ex-wife, 2 children and an overly involved mother! No wonder I was unhappy! ha!
    Anyway….what I want to say is that I am glad I didn’t go the medication route. For me it was not the best treatment.  I am not even sure that I was really depressed. Yes, I displayed some symptoms of depression but I think I was in mourning. Mourning the “death” of my previous lifestyle.
    I can’t say that I agree or disagree with the treatment of depression with medication. I guess if the disease is debilitating and the person doesn’t respond to any other treatment then okay. I am blessed and grateful that I am not in that situation.
    Peace and blessing to all that are.

  6. Ralph Taite’s avatar

    Tam,

    That’s great news.  I support any therapies which bring you the results you desire.  For me, it must be a combination of psychotherapy and supplements or medication to address the underlying neurological disorder.  If psychotherapy in the form of meditation, Reiki, yoga, etc works for you, then I concur with you that you should utilize them first.

    I think you are correct that your depression was a result of a big life change and not indicative of an underlying psychiatric disorder.  My point to the author of the blog was that some people do have serious psychological issues which won’t be cured by exercise, meditation or diet alone. 

    Ralph

  7. Joan’s avatar

    I am 60 yrs old and have taken SSRI steadily for the past 13 yrs.  My first experience with antidepressants was at age 34 when I took a TCA for 3 months -  I was reluctant to see what I was experiencing as Depression (ie meeting DSM3 (at that time) criteria but was persuaded to try a TCA just for a couple weeks to see if I got any response.  I did, and it started on about the 7th day.  It was like a miracle.  Profoundly helpful.  I had every side effect in the book and successfully went off the medication after 3 months which was what was recommended at the time.
    I continued to be highly reluctant to take medications to treat subsequent episodes of depression.  I have tended, since I have studied pharmacology, and do have a healthy degree of scepticism, to want to avoid drugs when ever possible.  I have suffered through periods of depression without meds but with substantial costs in my family life, and costs in terms of personal suffering.
    I have worried that I  might be doing harm to myself by not treatment depression chemically.   Several years after developing a chronic illness (autoimmune) that i decided to take drugs if they helped.  So now I have taken Celexa for 13 yrs.  At times I have reduced the dose form 40 to 20 mg, but have not done that for at least 6 years.
    There is multigenerational suicide and depression in my family -and I have felt very lucky to live in a time when antidepressants are available.  I have accepted that I do have a genetic tendency toward depression.  I do light therapy in the winter as I do also have SAD.  Aerobic exercize is not a possibility for me.
    I am concerned re long term side effects of Celexa and do want to get off of it.  So,I am planning to do another trial of reduction of dose.  I will of course go slow.
    What suggestions do you have for things I can do to mitigate against the disruption I am bound to experience with a brain that has become accustomed to Celexa for so long?
     
    Thanks,
    Joan
     
     
     

  8. Chris Kresser’s avatar

    Joan,

    All of my recommendations are contained in the “Treating depression without drugs” articles, Part I – Part III. Remember, it’s essential to have qualified medical supervision if you try to reduce the dose of your antidepressant. Diet is crucial, as I point out in the articles.

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