Depression - 2
Agatha M. Thrash, M.D.
Mental sicknesses fall into two large general categories: neuroses or simple mental discomfort from some kind of emotional or psychological imbalance, and the second, psychosis, or true mental illnesses with varying degrees of incapacitation. Simple depression always has a cause, and it should be searched for. Causes fall under two categories: Situational, Metabolic.
Situational depression may follow bereavement, a physical illness, a financial loss, etc.
Metabolic depression follows a change in the condition of the internal milieu of the body of such a degree as to influence the mind in a depressive way. Fifteen to thirty percent of Americans suffer at least one episode of depression in their lifetime. Only a fraction of these will ever seek professional help. Many depressed persons, particularly youth, may complain only of physical problems, or appear to be insane. The depressed person may complain of a variety of physical symptoms—headache, facial pain, chest pain, skeleton pain, abdominal pain, digestive complaints, constipation, genitourinary or menstrual problems.
Depression has been increasing since 1915. Twenty million cases in the United States are estimated, or about one in every three people who see an internist. About seventy billion dollars are paid out in treatments, or disabilities, or lost productivity each year. It is much more common in those born after 1945, than those born before. The average age of onset is also decreasing, now in the mid-twenties, whereas once the mid-thirties. There is a higher rate of depression in the US than in almost any other country and, as Asian countries westernize, their rates of depression increase correspondingly. These changes are not simply the product of individual biochemistry or biogenetics, but pathology within our culture. One in every four women will have a bout of major depression in their lifetime, and about one in every eight men. Ninety-nine percent of people by the age of seventy have a situational depression, meaning a depression caused by a life situation.
Major depression has no generally accepted cause, but over a hundred possible causes are listed in the medical literature. It is multifactorial. The cause is obviously not some neurochemical deficiency or imbalance that can be cured by a medicine. Antidepressant medications are not curative, as only twenty percent of people on antidepressants stop having depression; and these same ones would have stopped having depression, even if they had not taken the medication. Some of the major associations of conditions and lifestyle are as follows:
- Three neurotransmitters are important in depression: dopamine, serotonin, and nor-epinephrine. A diet that produces no serotonin can cause depression.
- Being a night person (also produces no serotonin).
- Social factors causing continual irritation, disappointment, or moral compromise.
- Heredity (only about half of cases)
- Little or no time outside in the open air.
- No regularity in schedule.
- No fresh air in the house.
- Increased risks come from divorce in parents, drugs as teenagers, sexual abuse in childhood, depression as an adolescent. Excesses in marital relations.
- Early puberty in girls gives two times the risk (excessive animal protein, fats, and sugars in the diet between ages 3-5 brings on early puberty).
- Decrease complex carbohydrate intake and frontal brain lobe activity goes down.
- Increased social activity in teens and increased M-TV viewing also brings reduced frontal lobe function. We suspect, and there is much research to indicate that rock and other stimulatory music increase the risk for depression.
- Undergoing hypnosis gives an increase in depression.
- Reduce the abstract thinking a person is doing, and the result may be depression.
- Going against ones conscience may precipitate a major depression.
Nine Key Symptoms of Depression
If a patient has five or more of the following signs, the condition is called major depression; if patient has only two of these, probably situational depression.
- Deep sadness or emptiness
- Apathy – no interest in the day
- Agitation OR slowing of muscle movements
- Sleep disturbances – being a night person is a sign of not making brain serotonin
- Weight or appetite change
- Lack of concentration or inability to make a decision
- Feelings of worthlessness or failure
- Morbid thoughts
- Loss of energy
Signs and Symptoms
Since fatigue is the most common presenting symptom in any patient with depression, it should always be considered in chronic fatigue. The fatigue of depression usually begins on awakening, when the person is unable to drag out of bed, but gradually feels better as the day progresses. Conversely, the physically ill person usually feels better in the morning, but gets worse and worse as the day progresses. The depressed person may wish to be alone, but the sick person more likely desires companionship. The person feels sad, hopeless, and sometimes irritable. Symptoms may include poor appetite with significant weight loss, or an increased appetite with significant weight gain; inability to sleep or sleeping all the time; anxiety or extreme sedation, restlessness or extreme motionlessness; agitation or retardation, reduced interest in sex, loss of energy, feelings of guilt, morbid thoughts, apathy, indecisiveness, and inability to think rapidly. The depression may express itself as the onset of the use of alcohol or drugs. Alertness, sharing of experiences, and interests in outside affairs wanes. Gestures disappear. Sleep is not satisfying; dreams are disturbing. Work becomes impossible. Preoccupation with regrets about the past, disease, ruin, and death grips the person. Delusion about ill health or financial calamity may occur.
Effects of Depression
Some of the effects of depression are headache, osteoporosis, asthma, reduced physical drive, reduced sex hormones, poor memory and immediate recall, nervous thoughts, and mental illness developing in the offspring. There is an increased risk of sudden death from heart attacks, and two-and-a-half times increased risk of death from cancer, pneumonia, and suicide. Sex hormones are reduced. For every homicide there are two suicides. Suicide is often done on an impulse, and if the person survives they may freely tell you they have no idea why they did it. They do not usually think of the implications for family, or for their own future immortal life. PET scans show low activity in the gray matter.
Determining the Cause
Among the first things to look for in depression is a physical cause. Check all matters dealing with lifestyle and the physical health—the diet, the exercise program, whether regularity is observed in sleep time, mealtime, whether fresh air and pure water are used, etc. Unhealthful lifestyle habits are a major cause of depression. Unhealthful habits affect the frontal lobe of the brain, and when this part of the brain is impaired, it can cause depression and emotional problems.
When depression occurs due to a situation that is recognizable, either the situation itself can be dealt with or the mind adjusted to deal with it in the most positive way possible. Do not allow chronic depression to take hold of the mind, as it can injure not only the mind but also the immune system and reduce the resistance against disease.
Once being depressed becomes a habit, the mind defaults into a depression about things over which there should be no cause for depression, such as a beautiful sunset, or a newborn baby. Individuals who attend religious services are both less depressed, and are physically healthier than those who worship at home or are not religious. Depression increases one's likelihood of having heart disease.
Information overload is another of those factors leading to depression. Americans watch between four and seven hours of television every day, having an insidious effect on our culture, one of which is our reduced tolerance for frustration; after all, in “TV-land” any major problem can be resolved in about 30 minutes. TV devotees can lose perspective as to what is reality, and their lives must be inferior since their own problems are not solved in 30 minutes.
Adrenal exhaustion from stress may represent a portion of the cause of major depression and suicidal behavior. A study done on suicide victims showed a hypertrophy of the cortex of the adrenals in suicide victims compared to those dying of other causes.—American Journal of Natural Medicine 2(3):14;1995
For individuals under extreme stress, the use of licorice root tea might be very helpful, as it improves the functioning of the adrenals.
Certain medical conditions are known to increase the risk of depression as cerebrovascular insufficiency, senile dementia or Alzheimer’s, impotence, vertigo, tinnitus, peripheral vascular insufficiency, Raynaud’s syndrome, premenstrual syndrome, macular degeneration, diabetic retinopathy, vascular fragility, lupus, AIDS, stroke, heart disease, Parkinson’s disease, diabetes, PMS, sleep disorders, thyroid disease, cancer, parathyroid disease, and head injuries from sports or accidents.
The use of legal or illegal drugs can also cause depression. Over two hundred drugs have been reported to cause depression including some that were prescribed for depression. If you are taking any kind of medication, be aware that drugs are a very common source of depression. The antidepressant drugs can have very adverse side effects including liver damage, dry mouth, constipation, blurred vision, sweating, rapid heartbeat, impotence, etc.
Blood Supply to the Brain
Depression in people over 50 could be from silent strokes due to blockage in the small blood vessels in the brain. These people have no numbness, weakness, or paralysis, but may develop depression.—AARP Bulletin May 2,2000
Men lose brain tissue at almost three times the rate of women, and the brain loss may account for the grumpiness in some older men. The loss of brain tissue in the left frontal region of the brain seems to be connected to the development of depression in the elderly.
Several studies have shown an association between severe depression and an increased risk of fatal heart disease. Now it has been shown that even a mild depression could eventually harm the heart. The Centers for Disease Control recruited 28,000 people, ages 45-77, none of whom had heart disease when the study began. After twelve years, the rate of heart disease and death was significantly higher among depressed people, about double the rate of those with the most buoyant health. Prolonged depression encourages blood clots, and thicken the artery walls.—Consumer Reports on Health, June, 1995, page 69
A manic-depressive psychosis may attack at any age, but is more prevalent between the ages of 20-60, women comprising about two-thirds of all cases. In the manic phase the person may have overabundant energy, incessant activity, and exaggerated sense of well-being. Impulsiveness and incessant talking may be pronounced. The judgment is disordered, and the decisions are weak. Moods may suddenly change to irritability and extreme anger. This is often followed by a painful emotional condition of deep despondency, a sense of guilt over illusory misdeeds and sins. He may consider suicide. Symptoms such as sluggishness, inability to make decisions, and lack of concentration are pronounced. There may be physical signs such as constipation, sleeplessness or sleepiness, loss of weight, and suppressed intellectual activity almost to the point of stupor.
Manic-depressive (bipolar) disease often runs in families. Persons who are rigid, obsessional, perfectionistic, are far more likely to be involved. Diagnosis is by history, but laboratory tests should be obtained for diabetes, hypothyroidism and uremia (kidney disease), as these diseases may have symptoms similar to bipolar disease. Do laboratory tests for blood sugar, blood urea, hematocrit, thyroid, and a battery of chemical tests to determine if a metabolic problem is a factor in the depression. These may be corrected by appropriate dietary and physical means.
Depressed children and children with bipolar illnesses are more likely than non-depressed children to have alcoholic parents. Children with bipolar disorder are about three times more likely to have alcoholic mothers, whereas depressed children without bipolarity were more likely to have alcoholic fathers.—Journal of American Academy of Child and Adolescent Psychiatry 35:716;1996
No treatment known brings immediate cure. There is a 90 percent chance of getting off medication, without collapse, when the underlying causes are treated. Depression can usually be cured within five months or less with treatment in the following categories.
- Strict regularity in schedules. For partum or postpartum depression prescribe regularity.
- Bright lights within ten minutes after waking up using 10,000 watts of bright lights 30 to 60 minutes per day. Bright lights early in the morning increase LH, regularity of menstrual cycles, and an increase in muscle size and strength.
- Hourlong walks, seven per week is minimal. If walking is impossible, upper body exercises with gymnasium equipment may be substituted, but are not as effective.
- Diet is important: High in tryptophan rich foods (black-eyed cowpeas, black walnuts, almonds, sesame seed, flaxseed), high folate (parsnips, okra, lentils, black-eyed cowpeas, spinach)
- Avoid pessimism and negative thinking. “It is a duty to resist melancholia.” MH:251
Wet Sheet Pack
Cold, wet sheet packs can be very helpful for agitated depression. The single layer wet sheet is laid on a plastic shower curtain on a bed and wrapped around the patient, trying to cover every inch of skin from the collar bones down. (See the book Home Remedies by Agatha M. Thrash, M.D. for the method.) This treatment can be effective when all other treatment modalities are ineffectual.—Hospital and Community Psychiatry 37(3):287;1986. Sometimes a wet sheet pack can offer sufficient physical restraint and enough sedation to avoid the use of medications.
A continuous neutral bath at about 97-98 degrees, being sure to keep the head nicely cool, will calm many an agitated patient.
Whole body hot baths can cause a significant improvement in depression.—International Journal of Hyperthermia 8(3):305;1992
Perform the bath daily for five days, skip two days, and give a second and then a third series of five baths. Try to get the mouth temperature up to 102 degrees.
Use skin stimulation with a stiff brush before the daily cool shower. See “Brush Massage” in the book Home Remedies by Agatha M. Thrash, M.D. for the technique.
Regular exercise is one of the most important and powerful natural antidepressants we have. Getting plenty of exercise reduces anxiety and tension. Exercise may be done several times daily, quite strenuously for about 10-15 minutes. These should be done both indoors as well as outdoors, as some of the exercises need to be done first thing in the morning before it is light, and last thing at night after it is dark outside.
Seventy-five percent of persons with depression in a large study showed improvement with jogging. They approached life more optimistically and reported that running gave them more control over their lives. Dr. Keith Johnsgard, Professor of Psychology at San Jose University, made the report. Even deep breathing exercise carried out twice daily can lift a gloom from the spirits. Too much exercise can be harmful. Moderate exercise such as walking briskly, cycling, swimming, golf, while pulling a cart or carrying clubs, general housekeeping, and mowing a lawn with a power mower provide enough benefits to reduce risks of disease. At least 30 minutes seven days a week is preferable. The exercise can be done in ten-minute segments, if desired.
Lifestyle and dietary factors are important in depression. A high protein diet increases one's likelihood of being irritable, having mood changes, and depression.—Medical Tribune April 4, 1996
The most favorable diet for depression is a totally plant-based diet, using whole foods, low in free sugars and free fats, but containing foods daily from four basic food groups: fruits, vegetables, whole grains, and nuts or seeds.
Depression may result because of the wrong kind of fatty acids comprising the cell membranes of nerve cells in the brain. All cells throughout the body are enveloped in membranes composed chiefly of essential fatty acids in the form of phospholipids. The type of phospholipid in the cell membranes of the brain is determined by the kind of fat eaten in one's food. If the phospholipid is composed of saturated fat or trans-fatty acids, the structure of the cell will be markedly different than if the membrane contains omega-3 and omega-6 oils. If the cell membranes are stiff, the brain is less likely to function properly; therefore, the diet can impact behavior, mood, mental function, etc. The following foods are high in omega-3 fatty acids: flaxseed, walnuts, green soybeans, spinach, avocado, and almonds. Evening primrose oil is a rich source of omega-6, also sunflower seeds, pumpkin seeds, safflower, hemp, soybeans, walnuts, and flaxseed.
Supplementation with essential fatty acids can dramatically improve both the behavior and the intelligence of children. These fatty acids can also be found in abundance in nuts, seeds, whole grains, beans and peas. This research was reported in Medical Hypotheses. Both omega-6 fatty acids and omega-3 fatty acids are required for proper development of all tissues, but they are especially important for the brain and nervous system. Omega-6 fatty acids are essential for the normal growth of infant brains and omega-3 fatty acids are needed for the brain's normal functioning. Both of these groups of fatty acids must be converted from the form they are found in vegetable oils and dark green vegetables to other tongue-twister fatty acids, which have been abbreviated GLA, DGLA, EPA, and DHA. Breast milk is the primary source of essential fatty acids for infants.
It may be worth a trial to give a diet high in ground flaxseed, walnuts and ground unsweetened coconut, along with a totally plant-based diet, especially no milk products or eggs. Use about two tablespoons each of the flaxseed and coconut with each meal.
A case of depression treated with pumpkin seeds was reported in the British Journal of Psychiatry in 1990. One and one half grams of L-tryptophan per day can often abolish depression. Pumpkin seed, a good source of natural L-tryptophan, may help those where depression is controlled by this treatment. About 3/4 cup of pumpkin seed will contain about one gram of L-tryptophan.—British Journal of Psychiatry 157:937-938, December 1990
Phenylalanine can convert into tyrosine, which improves brain function. For depression, try a phenylalanine intake sufficient to provide 30 milligrams. The following foods in the serving sizes suggested should yield about 30 milligrams:
Coffee is an important cause of depression with an estimated 450,000,000 cups of coffee each day consumed in America. About half of the population between 30 and 60 call themselves coffee drinkers. About 30 percent of Americans smoke at least half a pack of cigarettes daily. Cigarettes are also known to be associated with depression. Around ten percent of Americans are addicted to alcohol, also strongly associated with depression. Up to 33 percent of our population consumes more than four alcoholic drinks daily; and one-third of high school seniors are binge drinkers. Thus we can urge that coffee, tea, colas, chocolate, tobacco, and alcohol be omitted in the treatment of depression.
Nutritional deficiencies and related factors are also important causes of depression; for example: hypoglycemia is a common condition among depressed individuals.
When depression and anxiety are quite severe and hospitalization appears imminent, it is often possible to avoid hospitalization by injection every other day, ½ cc of vitamin B12 and 1½ cc of vitamin B complex. In addition to the injection, certain herb teas for sleep should be given such as hops, St, John's wort, and chamomile, one cup of tea, or comparable amount in capsules or tablets, two to three times daily, valerian, and passionflower, in double strength. Pray earnestly with the patient. The deficiency of several vitamins is also known to cause depression. These include thiamin, riboflavin, niacin, biotin, pantothenic acid, B6, folic acid, B12, and vitamin C. These vitamins can all be obtained from fruits and vegetables, particularly when fresh or when cooked nicely so as not to damage the tender vitamins such as thiamin and riboflavin. In elderly people, a deficiency of folic acid may be a part of the whole picture that results in depression. Many patients with psychiatric disorders are low in folic acid.—Nutrition. 16:544, 2000
Vitamin B12 must be taken as a supplement from a pill, preferably one that can be chewed for two minutes (there is a salivary factor, which activates the B12).—American Journal of Natural Medicine 2(10):10-15
Lithium, magnesium, iodine and selenium may be low in persons suffering from bipolar states. These minerals should be emphasized by eating foods high in them. Many have found selenium supplementation to be helpful for the manic-depressive states.
Lithium is a mineral essential to the body, and it may be that you are taking wrong foods, or overworking and under-sleeping, factors that can cause you to have a malabsorption of lithium. I believe nobody yet understands why lithium helps in certain persons who have a type of depression. My theory is that it is truly a deficiency in neurologic tissue. One may have a difficulty in absorbing lithium, or in transporting it, once it is absorbed. Your body may require more than the average person.
Foods high in magnesium include whole grains, cashews, almonds, seeds, soy and black beans, fresh green leafy vegetables, corn, avocados, butternut squash, carob flour, figs, cantaloupe, bananas, apples, peaches, pineapple, and lemons.
Iodine deficiency can also cause fatigue. Vegetarians need to be careful about that point. Seafood and seaweed products are good sources of iodine, as is sea salt. Up to 80 percent of vegans can become iodine deficient, compared to 9 percent of people on a mixed diet.
Many have found selenium supplementation to be helpful for the manic-depressive states.
Tyrosine, an amine acid (an appropriate dosage for the patient), can elevate the mood of elderly people, relieve dizziness, normalize blood pressure, and improve the appetite.—Pharmacology, Biochemistry, and Behavior, 47(4):935-41;1994
Also called L-tyrosine, it converts into dopamine and norepinephrine, neurotransmitters in the brain. Although the daily value is not clearly established, probably from 50-200 mg should be used, the person deciding how much is needed to feel good.
Even the plant-based diet must be checked for foods to which one may be sensitive, as food sensitivities are more commonly involved in depression than has been formerly recognized. Carefully perform an Elimination and Challenge diet.
Never eat between meals, not even an apple or glass of fruit juice.
Avoid crash diets for weight reduction. Depression often follows such programs.
Control sexuality. Many have no extra strength to use in this direction. Masturbation must be strictly avoided.
Some persons with manic-depressive psychosis may require some form of restraint, either physical restraint or chemical restraint.
The use of oats in any way will usually help in depression: oat or oatmeal cereal; oatmeal gruel, broth or tea.
A program of detoxification should be instituted. First use a cleansing diet of fruit and whole grains only. Maintain this diet for one week. During this time take one clove of finely minced garlic with each of two meals. Take one sprig of cilantro with each meal, and one tablespoon of spirulina daily. This routine will encourage the excretion of any toxic substance, including heavy metals, present in the blood or tissues.
St. John's wort and ginkgo have been researched for help with memory impairment, depression, and anxiety. The research has generally revealed good results. These two herbs we have found to be quite effective in the treatment of these and other common psychiatric disorders.—Archives of General Psychiatry, 55:1033;1998
St. John's wort is used for depression the world over. One cup of the tea four times a day, can be most effective in treating depression. It should be kept up, as its effects grow as time goes by.
Ginkgo biloba can be very helpful in treating depression, particularly in the elderly, but also in younger patients. Ginkgo biloba extract or tea contains flavone glycosides and terpenoids, which are very useful not only in depression but also in cerebrovascular insufficiency, senility, Alzheimer’s disease, impotence, vertigo, tinnitus, peripheral vascular insufficiency, Raynaud’s syndrome, premenstrual syndrome, macular degeneration, diabetic retinopathy, and vascular fragility. Many of these diseases are associated with depression, and ginkgo would be the herb of choice.
St. John's wort can cause photosensitivity in fair skin individuals and the skin can become very sensitive to sunlight. When using it, be careful of the sun.—Jude's Herbal Home Remedies by Jude C. Williams, M.H. 1996, Llewellyn Publications, P.O. Box 64383-869, St. Paul, MN 55164-0383
For postpartum depression use chaste berry, raspberry leaf, nettles, motherwort, and dandelion leaf and root.The clinical condition of ten patients with major depressive episodes was improved through the application of citrus fragrances. A reduced dose of antidepressants could be used, and a normalization was found of the immune functions (natural killer cell activity and cortisol levels in the urine).—Japanese Journal of Psychiatry and Neurology 48(3):671;1994
Some of the herbal teas such as sage, catnip, mint, or alfalfa can be helpful. Use one cup in the morning and one at night.
Skullcap and valerian are very useful on a daily basis. For the acute phase, or for severe symptoms, use blue verbena and European mistletoe. The recipe for blue verbena is one tablespoon of the root, boiled gently in two cups of water for five minutes; for the mistletoe, use one teaspoon in one cup of boiling water and steep for 20 minutes (do not boil). Use half a cup of the verbena, and one cup of the mistletoe every two hours as needed for control of symptoms.CoQ-10 is good for depressed patients.
Ashwaganda - This fine herb is good for anxiety, depression, to increase alertness, to boost the immune system, to treat insomnia, to decrease cancer risks, to improve thyroid function, and to increase energy. It is a much underused herb.
6. Other Therapies
Bright lights were used for 30 patients of whom 12 experienced improvement of mood during the bright light therapy, while 18 did not improve. The results of an experiment showed a subgroup of patients with major depression making a more pronounced light-associated improvement in heart functions than other depressed patients and controls.—Journal of Affective Disorders 34:131;1995
A large part of depression is a sickness of the brain center controlling the circadian rhythm or biologic time clock. The depressed person should be put to bed two to three hours earlier than the usual bedtime, and seven or eight o'clock in the evening is probably ideal. The house must be made quiet and dark, and all activity cease. Arise seven to nine hours later and begin some preplanned activity, the best being purposeful labor. This activity should be in very bright light. If labor is not available or practicable, use gymnasium exercising. Regularity in all things must become a study. Adjusting the hour of bedtime in this way has cured many cases of depression. Get plenty of sunshine, generally while fully clothed. During the day, keep bright lights blazing in the portion of the house the depressed person stays in.
Three to five million Americans suffer from seasonal affective disorders (SAD). Reduced availability of sunlight leads to an imbalance of brain chemicals resulting in depression. Exposure to high levels of artificial light can restore the balance of brain chemicals in many of these people. Women are three or four times more likely to get this disorder than men. It usually starts after puberty, and diminishes after menopause.
Depression in both children and adults can be treated with daily massage. It can be curative in some cases. Take a full body massage frequently, at least once a week.
Check the transit time by using three tablespoons of moistened sesame seeds. It should be less than 30 hours from the time the sesame seeds are taken until the last of the seeds appear in the stool. The average American has a transit time of more than 80 hours. If the transit time is prolonged, take the measures discussed under Constipation.
Eleven manic depressed persons had their amalgams removed and nine subjects with amalgams were told they were being given a placebo or a sealant. Depression and hypomania scores improved significantly as did anxiety, anger, schizophrenia, paranoia, and many others with amalgam removal, compared to the sealant-placebo group. There was a 42 percent decrease in the number of physical health problems after amalgam removal compared to an 8 percent increase in physical symptoms in the placebo-sealant group.—Journal of Ortho-molecular Medicine 13(1):31-41, 1998
Works of charity have a marvelous effect on gloomy spirits. Seek out the widow and orphan, the lonely or bereaved, or the homesick student. Give a backrub to a weary shut-in. Spiritual defenses can be made strong by Bible study and prayer. Develop a program of guided Bible study and daily prayer. Learn to control the thoughts and to dwell on heavenly themes. A Bible correspondence course can be obtained from Amazing Facts, P.O. Box 1058, Roseville, CA 95678-8058, phone 916-624-3500.
Control talking carefully. Not too much and not too little, and only about cheerful subjects. Courage, hope, faith, sympathy, love, and patience promote health and prolong life.September 2007
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