Why Are We Depressed?

• An 80 year old woman who just lost her husband to cancer

• A 55 year old man who just lost his job

• A 22 year old who just broke up with his girlfriend

• A 70 year old woman whose dog just died

• A 42 year old in the midst of a divorce

• A 51 year old man 2 weeks after his heart attack

• A 45 year old woman whose hormones are out of balance

In all of these examples, grief or depression would be a normal and healthy result of these losses. Would any of these examples fit the criteria of mental illness, requiring medication, or would their grief and sadness be seen as a normal response to what they had just experienced?

A few days after 9/11/2001, many patients came to see me when they realized they did not feel the emotions others did upon witnessing the devastation surrounding the Twin Towers. They felt numb from being medicated with anti-depressants previously prescribed by their physicians for circumstantial grief and depression that surfaced years ago after experiencing similar life events as those described in the list above. Although the situation that catalyzed their feelings had long passed, they had not received any support or help to process their emotions at that time, nor was it suggested that they wean off their anti-depressants. Their response to the 9/11 devastation made them realize they had unknowingly been emotionally numb for years due to the anti-depressants they were still taking.

This was a powerful sign for me to evaluate how we diagnose and treat depression. I also became acutely aware of the surprising amount of complacency that is normalized in the medical system when prescribing pharmaceuticals for symptoms of depression, anxiety, grief, or sadness. In fact, grief and sadness have been so pathologized in our society that people feel the need for medication if they experience either emotion. For many, feeling numb is preferred over experiencing intense emotions, which are actually a normal part of being human.

Our mental and emotional well-being is intrinsically related to how isolated and alone we feel during times of loss and transition, and whether or not we are a part of a larger community. People who feel their lives do not matter, are more vulnerable to depression and anxiety. People who are emotionally sensitive are vulnerable as well. Never before in the history of the human race have people felt so alone and isolated as they do today. Our connection with one another has been contaminated with technology and the mechanization of our systems. Before cell phones and computers were the norm, we actually spoke with one another. This has been replaced with texting and emailing, a method of communication that lacks heart or emotion. We have sacrificed our emotional and energetic connections with one another for convenience. Feelings of isolation, loneliness, and grief are the consequence of these choices.

When feelings of isolation, loneliness, or sadness arise, neurotransmitter levels (that regulate our moods) fall. Some important ones are serotonin, gamma-amino-butyric acid, L-Dopa, acetylcholine, and norepinephrine. Neurotransmitter levels are also directly affected by diet and exercise, our perceptions, and attitudes. It has also been well established that one of the most effective anti-depressants is regular exercise, as it affects neurotransmitter levels that regulate our mood. These levels are also affected by a sense of belonging. In fact, several studies have shown that women with breast cancer who were part of a support group lived twice as long as women who were not.

A diet high in Omega-3 and antioxidants and low in sugar and grains supports our nervous system and neurotransmitter levels. A diet high in refined sugar, processed food products, carbohydrates, chemical additives, and food colorings has a negative effect on neurotransmitter levels. When people use addictive substances such as recreational drugs and alcohol to ‘medicate’ their feelings, these can amplify depression and cause a rollercoaster of emotions. Unfortunately, this form of self-medication is normalized and present in epidemic proportions in our society today. In fact, it is a part of how we mark ‘the coming of age’ in our society.

An additional cause for mood disturbances is hormonal shifts in midlife. Between their late thirties and fifties, women experience a drop in levels of the hormone, progesterone, which causes their neurotransmitter levels to decline, intensifying feelings, and amplifying depression and anxiety. Both diet and exercise support the nervous system, as previously mentioned and, along with natural hormone balancing, are extremely effective in healing these symptoms.

Synthetic hormones, both prescribed and those present in non-organic food have the opposite effect, causing serotonin levels to fall, making everyone more vulnerable to depression and anxiety. A lack of sleep can also have this effect on mood and emotional health. Diet, exercise, and hormone balance are highly effective and restorative for sleep disturbance as well.

Processing our emotions and supporting each other during life’s transitions and losses (in addition to a healthy lifestyle) are the most powerful antidotes for depression and anxiety. Compensating for and normalizing our mood to appear unwavering (as expected by society) results in the denial of our very human experience of joy and sorrow. Having our feelings validated can do more for our sense of well-being than any anti-depressant ever can. If we require an anti-depressant for a brief period of time to help move through a window of difficulty, it is important to process our pain and wean off it, under a physician’s guidance, once we are stable enough to do so. When dealing with organic or familial depression or anxiety, prescription medication may be an important intervention. Normalizing the need to medicate our very human feelings is both dangerous and unfulfilling.

Traditional medical thinking is still archaic in its approach to our emotional and mental health. Physicians rarely make the correlations described above or take the time to understand why their patients feel what they do. They are quick to prescribe anti-depressants, the majority of which are unnecessary. It requires discernment to bring awareness to what is a normal emotion and what requires treatment. The medical system has still not normalized the impact that lifestyle can have on mood, despite the strong evidence showing a direct correlation. We must widen the context from which we understand mental and emotional health, and practice courage in exercising our choices for self-care that support it.

In the long run, nurturing, authentic relationships, acknowledging and accepting our emotional sensitivity, and living a lifestyle that optimally supports and optimizes our biology are some of the most effective ways to heal depression, anxiety, and other mood disorders that plague our society.

Ultimately, how we love and treat each other is the most powerful medicine of all.

This article was written in memory of Robin Williams, who brought joy and laughter to so many. He compensated for his depression with his gift of comedy. In death, he awakened us to the importance of honest, self-awareness of our emotional world.

May he find peace as he returns to the Light.

How to Get a Good Night's Sleep

Sleep is essential for health.  The lack of sleep stresses the adrenals and reduces vitality. It causes an acceleration of the aging process.  The three most powerful ways to promote health and slow down aging are:
1. A plant based wholesome diet rich in antioxidants
2. 6 – 8 hours of sleep per night
3. Regular aerobic exercise (at least 20 minutes 5 to 6 times per week)

Studies show that 8 hours of sleep per night are needed to produce enough melatonin and healthy neurotrasmitters to maintain health. Hormonal changes in women in midlife, particularly a reduction in progesterone can disrupt the sleep cycle. The lack of sleep has become a chronic problem of our time.  The stress of our fast paced life and constant busyness, coupled with fast food, brain stimulation with computers, texting and television, all contribute to insomnia and disturbed sleep.  The brain has a hard time shutting off and resting at the end of the day with all the over-stimulation it experiences.  The brain needs energy to function and needs a good 8 hours of sleep to replenish its circuits before another day of activity begins.  Deep breathing and meditation help immensely but most people do not take the time to do this.  Doing 10 minutes of abdominal breathing every night, or alternate nostril breathing (Pranayama), relaxes the brain enough to allow for its rest and rejeuvination.
The regular intake of alcohol, inflammatory fast foods (nutrient poor), caffeine and regular tv or computer use have an additive effect in overstimulating the brain.  I advise my patients who have difficulty sleeping when they first come to see me, to eliminate or minimize alcohol and wheat,  increase their intake of whole, plant based foods, omega -3 and exercise.  With these changes, the vast majority begin sleeping better.  Not watching television or using the computer before bed also helps as the glare from the screens has deleterious effects on brain activity before bed.

Supplements:

1. Magnesium 250 mg before bed.

2. Lavender oil pills, Lavela, which have shown similar efficacy as prescription sleep aids (available at The Ommani Center)

3. Melatonin 5mg.  No more than 5mg should be used as a sleep aid, only on an as needed basis as melatonin is a hormone.  Any hormone taken by mouth regularly will suppress the production of the body’s natural hormone production.  It has been shown to help people that work night shift as melatonin production is reduced with lack of darkness during night hours (even a night light in the bedroom at night will reduce the brains production of melatonin).  A decrease in melatonin production by the body has been correlated with increase in the incidence of cancer. The data on melatonin supplementation is mixed and this should not be taken on a long term basis as a sleep aid until conclusive evidence demonstrates its safety.

4. Valerian is an herb that is commonly used for insomnia.  The data on its effectiveness and my experience of it with my patients remains mixed.

5. Omega-3 Fish oil. Omega 3 and the amino acid tryptophan together increase serotonin in the brain.  Seratonin is a precursor to melatonin which aids in sleep.  Salmon, sardines, oily cold water fish and eggs all increase serotonin in the brain.  Make sure your omega-3 supplement is of pharmaceutical grade, mercury free, micro-distilled and supplies at least 300 mg of DHA and 300 mg of EPA per capsule.  2 to 3 capsules per day are needed for a therapeutic effect.

6. Bio-identical progesterone is extremely effective to restore sleep in midlife women whose hormones are out of balance.  This must be done with the aid of a physician skilled in hormone balancing, who also monitors blood levels of hormones to ensure safety.


Foods:

Bananas, almonds, warm milk, cherries, decaf green tea, oatmeal, salmon, cold water fish and eggs are all recommended to enhance sleep.

I always tell my patients to try eliminating the unhealthy foods and behaviors they are engaged in for a few weeks and then resume them.  See what happens.  Experimenting in this way releases the pressure that they may feel of ‘being deprived.’  Instead, they approach this experiment with curiosity and take cues from their body instead of my directive.  The majority of patients who have approached it in this way have successfully resumed a healthy sleep pattern.

Complementary Medicine:

1. Acupuncture is a very successful modality in restoring sleep patterns.

2. Massage relaxes the muscles and produces serotonin in the brain and body.

It takes time to develop an unhealthy sleep pattern so it takes some time to develop a healthy one.  Food takes time to restructure the cells and re-calibrate the good chemicals in the brain and body that promote health.

Food is Medicine.  It is not a quick fix.  It is however a lasting one.  Supplements are just that – supplements to our diet and lifestyle, not substitutes for healthy food and exercise.

Nature has everything within it we need to support our health.  If we live a balanced life from its basic principles, we can minimize disease and maximize our body’s regenerative potential.  The good news is that we always have a choice to do this.  The fun of trying healthy behaviors and see how our body responds. This is the basic premise of any scientific study.  We can do our own study and learn from our body’s wisdom at any time.

The choice is always ours.

http://www.elephantjournal.com/2013/03/5-ways-to-get-old-fast/

http://www.yogajournal.com/practice/220

http://www.tatianasadak.com/userfiles/2607091/file/LavelaBrochureFull.pdf

http://www.ncbi.nlm.nih.gov/pubmed/16162447

http://www.cbn.com/health/naturalhealth/drsears_depression.aspx

http://www.ommanicenter.com/bookstore - Becoming Real by Rose Kumar M.D.

http://www.ommanicenter.com/womens-health