 The Big
"D" - Depression Therapy - Both Western & Alternative
By Michelle McLaughlin of On Site Acu-Health
What is depression? The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV)
describes depression as a mood disorder. This mood disorder can be a single episode
disorder or a recurring depressive disorder, as in chronic depression. According to the
DSM-IV the following symptoms must be present during the same two week period, with at
least one being depressed mood or loss of interest to fit the major depression criteria:
- Depressed mood for most of the day
- Decreased interest or pleasure in daily activities
- Significant weight loss or gain, changes in appetite daily
- Changes in sleep patterns - insomnia or hyposomina
- Psychomotor agitation or retardation observed by others
- Fatigue
- Sense of worthlessness or excessive guilt
- Loss of concentration or indecisiveness
- Recurrent thoughts of death or suicide
“Have you ever felt sad, low, down, or hopeless and lost interest
or pleasure in normal activities?” “Has this been going on for a while?”
These questions are a standard set developed by the Canadian Network for Mood and Anxiety
Treatments (CANMAT). The questions above are accompanied by a series of screening
questions involving sleep, appetite, energy level, concentration, sense of worthlessness,
agitation and suicidal thoughts. According to CANMAT there are six types of major
depressive disorders: Typical, Anxious, Atypical, Seasonal Affective Disorder, Melancholic
and Psychotic. The following gives a brief description of each and the Western drug
therapy most often prescribed.
Popular antidepressants used in the treatment of Typical depression are
Selective Serotonin Reuptake Inhibitors (SSRI’s): Fluoxetine (Prozac), Fluvoxamine
(Luvox), Paroxetine (Paxil), Sertraline (Zoloft), and Venlafaxine (Effexor). Anxious
depression is a major depressive episode with a prominent anxiety. It is treated with the
same popular anti-depressants used for Typical depression, with the exception of Luvox,
which moves to a second choice treatment when anxiety is present.
Atypical depression is characterized by meeting the DSM-IV criteria
above, plus exhibiting symptoms of overeating, weight gain, excessive sleep, extreme
fatigue and a long standing pattern of real or imagined rejection. Drug therapy consists
of Prozac & Zoloft, Phenelzine (Nardil), Tricyclic Antidepressant (TCA) and Imipramine
(Tofranil). A Monoamine Oxidase Inhibitor (MAOI) may also be used, but are prescribed less
often due to side effects, drug interactions and dietary constraints.
Seasonal Affective Disorder is considered a major depressive disorder
with the onset coinciding with a particular season, mainly fall or winter and recurs
during the same season for two or more years. Each episode meets the DSM-IV criteria and
symptoms disappear during other seasons, particularly summer. Light therapy is the first
choice of treatment when the episode is mild or moderate and the patient is not suicidal.
If the episode is severe and there are suicidal tendencies, the patient is placed on
Prozac in combination with light therapy. Light therapy consists of the use of a
commercial fluorescent light box for 30-45 minutes per day, usually in the morning.
Melancholic depression is considered a depressive state that meets the
DSM-IV criteria, plus a loss of emotional reactivity to pleasant events and at least three
of the following: early morning waking, pronounced depressive mood, psychomotor
retardation, marked weight loss and inappropriate feelings of guilt. The therapy of choice
is electro-convulsive therapy. Other first choice therapies include the SSRI’s
Nefazodone (Serzone) and Venlafaxine (Effexor).
Psychotic depression meets the DSM-IV criteria and experiences
delusions and/or hallucinations. A combination of electro-convulsive therapy, psychiatric
referral and anti-psychotic drugs are the treatment of choice.
Treatment of depressive disorders involves extensive use of
prescription drugs in the Western world. With drug therapy comes the risk of side effects
and the longer the patient is on antidepressants, the greater the risk of adverse effects
and/or dependency in order to function normally. Side effects of the various SSRI drugs
include nausea, anorexia, diarrhea, anxiety, agitation, insomnia and nervousness. TCAs
have a more significant occurrence of dry mouth, constipation, blurred vision and
dizziness.
So how does one cope with or prevent depression? That’s an age-old
question asked by researchers and patients alike. Your best defense is to temper excessive
emotions. Emotions are a normal occurrence in everyday life and are not normally
considered a cause of disease. It is when emotions become excessive or prolonged that they
become causes of disease.
A natural remedy to combat mild depression is to eat a well-balanced
diet, low in heat and damp-producing foods. It would be advisable to avoid consumption of
alcohol, meats, eggs and tofu and to increase the amount of brown rice, cucumbers, apples,
wheat germ, wild blue-green micro algae, and apple-cider vinegar in the diet. Other
aspects to consider are sexual over-indulgence, overstress or overstrain. Excessive
activity depletes certain energies within the body and should therefore be practiced in
moderation.
Alternative treatments for depression include acupuncture, naturopathy
and various forms of stress relief including massage therapy, meditation, yoga and
physical activity.
In summary, a life of moderation will produce a happy, healthy
individual with a peaceful heart and a calm spirit, allowing the individual to better cope
with the emotions of daily life.
Michele McLaughlin, owner of On Site Acu-Health, is a Registered
Acupuncturist & DTCM, practicing Acupuncture, Chinese Diet & Herbal Therapy.
Contact: 403.538.4830 |
