One in 10 United States residents aged 18 or older has a depressive disorder.1 Pharmaceutical antidepressant medications are not as effective as once believed, especially for many patients with less severe forms of depression.2 Most clinicians have a working knowledge of such antidepressants and prescribe them on a daily basis, but are not as well versed in integrative medical treatments.3
The exact cause of depression is not entirely understood. There is a theory that the interplay of social/environmental factors overlaid on genetic vulnerabilities places one at risk of entering a downward cycle towards depression.
For example, repeated episodes of an illness may lead to chronically elevated levels of stress hormones, which at the microscopic level, determine which genes get turned on. This leads to alteration in levels of serotonin, norepinephrine, GABA, dopamine, etc. At the level of the organism, this cocktail of messengers lead to a feeling of chronic uneasiness. At the level of the community, it affects how the individual interacts with others in the environment, which feeds back onto one's self perception, nutrition, hormonal and genetic makeup, and so on.
In terms of therapy, numerous studies have shown that regularly performed exercise is as effective as antidepressants or psychotherapy.4,5 Oftentimes, it's very difficult to begin exercising however, especially if one’s diet is suboptimal and there’s an element of being overweight.
As far as diet is concerned, numerous studies have suggested a correlation between sugar intake and major depression.6 On the other hand, protective effects of foods such as vegetables, fruits, fish, whole grains, olive oil, multivitamins have also been well documented.7,8 Oftentimes, it is easier to start by optimizing diet while keeping exercise intensity to a minimum. Once dietary changes are fully enacted and resultant changes appreciated, exercise intensity can then by increased.
We offer various packages to our clients. These can involve dietary modification, supplements, specific exercise recommendations, means of tracking progress via thorough lab testing, all depending on the extent to which clients prefer involvement from us. We also work with physical therapists, acupuncturists, chiropractors, therapists, and other specialists in the community. There is no maze to navigate for our clients, we do the leg work for you so the only thing for you to focus on is your health.
Finally, the only pharmaceutical that we believe has been promising towards treating depression has been ketamine.9 It is something we employ at our office and dispense on an as-needed basis until satisfactory results are achieved.
- O.B. Gonzalez, J.T. McKnight-Eily, L.R. Strine, et al.: Current depression among adults: United States, 2006 and 2008. Morb Mortal Wkly Rep Surveill Summ. 59:1229-12352010
- J.C. Fournier, R.J. DeRubeis, S.D. Hollon, et al.: Antidepressant drug effects and depression severity: a patient-level meta-analysis. JAMA. 303:47-53 2010
- J. Mitchell, M. Trangle, B. Degnan, et al.: Adult depression in primary care. 2013 Institute for Clinical Systems Improvement (ICSI) Bloomington, MN 129
- S. Kirby: The positive effect of exercise as a therapy for clinical depression. Nurs Times. 101:28-29 2005
- D.A. Lawlor, S.W. Hopker: The effectiveness of exercise as an intervention in the management of depression: systematic review and meta-regression analysis of randomised controlled trials. BMJ. 322:763-767 2001
- A.N. Westover, L.B. Marangell: A cross-national relationship between sugar consumption and major depression?. Depress Anxiety. 16:118-120 2002
- T.N. Akbaraly, E.J. Brunner, J.E. Ferrie, M.G. Marmot, M. Kivimaki, A. Singh-Manoux: Dietary pattern and depressive symptoms in middle age. Br J Psychiatry. 195(5):408-413 2009
- F.N. Jacka, J.A. Pasco, A. Mykletun, et al.: Association of Western and traditional diets with depression and anxiety in women. Am J Psychiatry. 167:305-311 2010
- CG Abdallah, LA Averill: Ketamine as a promising prototype for a new generation of rapid‐acting antidepressants. Annals of the New York Academy of Sciences. 1344: 66-77 2015
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