COPING... the Alternative Approach
There are several alternative approaches that are beneficial in relieving depression. Some, like acupuncture and mind-body methods, can be used with conventional medications and psychotherapy for additional benefit.
Certainly the most common treatments for depression are antidepressants and psychological counseling. These approaches have been beneficial for most people, but for many others, side effects, lack of success, potential harmful effects on other conditions (such as pregnancy), or only temporary results have caused them to search for alternative treatments.
Do such alternatives exist and are they beneficial? The answer is yes, and some of these alternatives may be very surprising.
The most popular alternative treatment for depression is St. John’s wort, an herb that dates back to the ancient Greeks and was used by Hippocrates. Numerous scientific studies have documented its benefits for mild to moderate depression, but not severe depression. It has been shown to be equivalent in effectiveness to most antidepressants, including SSRI’s.
The main problem with St. John’s wort is that it can interfere with other medications such as HIV drugs, digoxin, blood thinners, anti-seizure drugs, some contraceptives and potentially many drugs used for acid reflux and ulcers. You should not take it along with other antidepressants or anxiety medications because there might be an increase of side effects. If you take other medications, you should check with your doctor before taking St. John’s wort and more closely monitor your other conditions if you do take it. Because many herbal products vary in quality, you should look for a product that is standardized to contain 0.3% hypericin; dosage is 300 mg daily. Although it may take up to three weeks to be effective, most people start obtaining benefits in 3-7 days.
Another popular herb for depression is SAMe, which has been used as a prescription drug in Italy, Spain and Germany. The studies are not as complete as for St. John’s wort, but it seems safer in terms of drug interactions. Its main downfall is that it is extremely expensive when taken in the necessary doses for depression, so other natural products are much more cost-effective. If you take it, use the butanedisulfonate form. Dosage is 1600 mg daily for the best results.
Several studies suggest that omega-3 fatty acids (found in fish oils) can further reduce depressive symptoms as an additive effect if your conventional medications have not completely resolved your depression. However, you must take 3-4 grams a day of regular fish oil, which may cause GI side effects. I recommend taking Krill oil, which is the most potent fish oil known and requires only 500 mg daily, yet does not have the side effects of other fish oils. It may take two to six weeks to observe a benefit.
Western herbs are not the only herbs that can be beneficial for depression. There are several Chinese herbal formulations that have been used for depression during the last 3000 years. The most common is called Gui Pi Wan, which is also helpful for treating anxiety and phobias as well as depression. The advantage of Chinese formulations is that they contain a variety of herbs which act in concert to decrease symptoms while minimizing side effects. The disadvantage is that you must take larger doses to have a beneficial effect (usually 9 pills a day initially). Gui Pi Wan can be combined with St. John’s wort for faster and often better results.
What if you want to avoid taking a pill, either antidepressants or herbs? After all, if you are pregnant or breast feeding, or you are concerned with side effects from either conventional medications or herbs, or they don’t completely help, you need further options. Fortunately, there are other effective approaches.
Acupuncture is one. Surprising to most Americans, acupuncture is very beneficial for depression and can provide long term relief. Although it is not known exactly how acupuncture combats depression, it is known that acupuncture can affect the release of neurotransmitters in the brain, so it is reasonable to assume that it can re-balance serotonin and other neurotransmitters that cause depression, much like the conventional antidepressants do.
The advantage to acupuncture is that it can be performed on anyone, even children and pregnant women, and benefits appear to be long lasting (even lasting several years). Acupuncture uses very thin needles, the size of a hair, and usually 5-6 points are used. You should observe benefits within one to six treatments, although more sessions may be necessary to obtain maximum benefit. However, be sure to find a certified acupuncturist who has experience with depression because many acupuncturists do not commonly treat, or know how to treat, depression.
Finally, there are two mind-body methods that can treat depression. Several studies have proven that thoughts, feelings and images are able to alter the balance of neurotransmitters in the brain, so the mind can directly affect depression.
The first method is meditation, (just 15 minutes a day) has been shown in numerous studies to decrease depression and improve quality of life. There are two main types of meditation, concentrative (concentrating on a mantra such as a word or sound) and mindfulness (being an “observer” of your own feelings, sensations and thoughts). Both are equally effective.
The second is a form of psychotherapy of which few are aware. It is called Interactive Imagery and involves mental dialogues with images that represent your emotions. It is like having a dream while you’re awake, but you are able to explore and understand the images and use them to release your emotions. Unlike “talk” therapy, which works externally to change your internal emotions, Interactive Imagery works internally to change what you feel and do externally. This type of imagery is very powerful and significant benefits are seen very quickly, often within just a few sessions. The downside is that there are not many therapists trained in the technique.
In conclusion, there are several alternative approaches that are beneficial in relieving depression. Some, like acupuncture and mind-body methods, can be used with conventional medications and psychotherapy for additional benefit. So don’t despair if the usual methods don’t work: there are other options for conquering depression.
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"COPING... the Alternative Approach"
authored by:
Dr. Altshuler graduated magna cum laude from Duke University in 1972, and received his medical degree from the University of Oklahoma School of Medicine in 1976. A board certified Internist since 1979, he founded the Balanced Healing Medical Center,...
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