Treating depression without drugs – Part III

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In Part I and Part II of this series, we examined drug-free alternatives to treating depression including exercise, psychotherapy, light therapy, St. John’s Wort and acupuncture. We have learned that all of these treatments are at least as effective as antidepressants in the short term, and some (exercise and psychotherapy) are more effective in the long-term. All of these treatments have far fewer side effects, risks and complications than antidepressants. In fact, the only “side effects” of exercise and psychotherapy are positive ones: improved physiological and mental health!

Today we will look at other lifestyle-based approaches to treating depression without drugs. As I mentioned in the previous article, because 70% of research is funded by drug companies, many of these non-drug approaches have not been studied as extensively as antidepressant medication.

Nevertheless, there is enough data from clinical and epidemiological studies to support the following strategies – especially since they are superior to antidepressants from a “cost/risk – benefit” analysis. In other words, though some of the approaches I will propose in this article have not been exhaustively proven according to the standards of Western science, there are several lines of evidence supporting their effectiveness and without exception they have beneficial side effects and improve the quality of patient’s lives.

What’s more, all of these approaches can be combined together along with the treatments mentioned in the two previous articles to obtain the maximum effect. Based on the available evidence which we have extensively reviewed, these non-drug treatments should without a doubt be the first line of defense (as well as the second, third, fourth, etc.) in treating depression.

Nutrition

At some point in the future, I hope to dedicate an entire post (or perhaps more) to the subject of nutrition and depression. I personally believe that inadequate nutrition is a significant contributing factor to the continuously rising rates of depression in this country. Consequently, I also believe that proper nutrition can be one of the most effective treatments for depression.

For now, I will go over what I feel are the most important aspects of nutritional causes and treatment of depression, and hopefully address the subject in more detail later.

Sugar

Diabetes is correlated with higher rates of depression. In 2005, researchers discovered a positive connection between higher levels of insulin resistance and severity of depressive symptoms in patients with impaired glucose tolerance, before the occurrence of diabetes. Based on these findings, it was suggested that insulin resistance could be the result of an increased release of counter-regulatory hormones linked to depression; however, this has not been confirmed.

Sugar can increase fasting levels of glucose and can cause reactive hypoglycemia. Sugar can also cause a decrease in your insulin sensitivity thereby causing an abnormally high insulin levels and eventually diabetes. Based on the study results above, this is one mechanism by which sugar could contribute to depression.

There is no doubt that increased sugar intake leads to hormonal changes that can lead to emotional instability. Therefore, people who are depressed (and all people, in fact) should significantly decrease their sugar consumption.

Omega-6 : Omega-3 Ratio

Anthropological evidence suggests that the intake of omega-6 (n-6) and omega-3 (n-3) polyunsaturated fatty acids (PUFA) during the Paleolithic era was roughly equal, whereas the present n-6 to n-3 PUFA in western countries has ben estimated to be between 10 and 25 to 1. The n-6 to n-3 PUFA imbalance has been due mainly to the increase in vegetable and seed oil use and the rise in consumption of processed foods (which contain these oils).

Two major studies have provided direct evidence for the role of the n-6 to n-3 PUFA ratio in depression. The studies found that depression is associated with significantly decreased total n-3 PUFA and increased n-6 to n-3 PUFA ratio (Maes et al. 1996; Maes et al. 1999) . A supporting study carried out in 1998 also found a significant depletion in total n-3 PUFA, and in particular DHA, in the erythrocyte membranes of depressed patients.

Epidemiological data show the trend in decreasing dietary n-3 PUFA consumption and the increasing evidence of depression, both over time and between nations (Hibbeln et al. 1995). Further investigation suggests that the significance lies in the increase in n-6 to n-3 ratio, rather than simply low n-3 intake alone, as these two fatty acids compete in binding to enzyme systems that produce chain elongation and further desaturation. A diet high in n-6 fatty acids prevents the incorporation of n-3 PUFA into cell membranes and phospholipids (Spector et al. 1985).

All polyunsaturated fatty acids – including n-3 PUFA – have been shown to make lipoproteins more vulnerable to oxidative damage (Reaven et al. 1991), and oxidative damage is a significant risk factor for heart disease, cancer and many other conditions. As mentioned above, n-6 consumption actually prevents the incorporation of n-3 into our cells. Therefore, rather than increasing our consumption of n-3 PUFA to treat depression, as is often suggested, it makes more sense to dramatically decrease our consumption of n-6 PUFA. This will help our bodies to incorporate the small, but adequate amount of n-3 PUFA we get in a whole-foods based diet. Avoiding n-6 PUFA (primarily found in vegetable and seed oils, and in animals fed vegetables high in n-6 like pigs and chickens) will not only alleviate depression, but also benefit our health in many other ways.

Vitamin D

In a 1998 controlled experiment, Australian researchers found that vitamin D (400 and 800 IU), significantly enhanced positive affect when given to healthy individuals. Forty-four subjects were given 400 IU cholecalciferol, 800 IU cholecalciferol, or placebo for 5 days during late winter in a random double-blind study. Results on a self-report measure showed that vitamin D3 enhanced positive affect a full standard deviation and there was some evidence of a reduction in negative affect. The authors concluded: “vitamin D3 deficiency provides a compelling and parsimonious explanation for seasonal variations in mood” (Landsdowne & Provost, 1998).

In another study in 1999, the vitamin D scientist, Bruce Hollis, teamed up with Michael Gloth and Wasif Alam to find that 100,000 IU of vitamin D given as a one time oral dose improved depression scales better than light therapy in a small group of patients with seasonal affective disorder. All subjects in the vitamin D group improved in all measures and, more importantly, improvement in 25(OH)D levels levels was significantly associated with the degree of improvement (Gloth et al. 1999).

According to the Vitamin D Council:

To further strengthen the case that vitamin D deficiency causes some cases of depression, evidence should exist that the incidence of depression has increased over the last century. During that time, humans have reduced their sunlight exposure via urbanization (tall buildings and pollution reduce UVB ), industrialization (working inside reduces UVB exposure), cars (glass totally blocks UVB), clothes (even light clothing blocks UVB), sunblock and misguided medical advice to never let sunlight strike you unprotected skin.All these factors contribute to reduce circulating 25(OH)D levels.

Klerman and Weissman’s claim that major depression has increased dramatically over the last 80 years is one of the most famous (and controversial) findings in modern psychiatry. Something called recall bias (a type of selective remembering) may explain some of the reported increase, but does it explain it all?

If you suffer from depression, get your 25(OH)D level checked and, if it is lower than 35 ng/mL (87 nM/L), you are vitamin D deficient and should begin treatment. If you are not depressed, get your 25(OH)D level checked anyway. If it is lower than 35 ng/mL (87 nM/L), you are vitamin D deficient and should begin treatment.

Recommended intake is up to 5,000 IU per day of vitamin D through exposure to sunshine and/or supplementation. See this article on vitamin D to learn to calculate how much vitamin D is produced given a certain amount of exposure to sunlight, and to learn more about vitamin D supplementation. It is important to remember that D works synergistically with A & K2, so if you increase your intake of D you must also increase your intake of A & K2 to avoid D toxicity.

Finally, I’d like to share with you a comment I received from a reader about how he/she has cured depression with nutritional intervention. Note that I endorse just about every suggested step, with the exception of the significant increase in n-3 intake. Based on the evidence above, I suspect that his/her improvement was a result of the decrease in n-6 PUFA more than it was the increase in n-3 PUFA.

I suffered from depression, for many years–it was so bad that often I thought that the only answer for my life would be to end it. Thoughts of suicide danced through my mind frequently.

Early March 2008 I changed my diet completely:

–eliminated all processed foods

–eliminated all white foods; most important, eliminated sugar, which is the “white devil”

–eliminated all foods containing soy and corn; so I don’t eat the meat of animals that have been fed grains

–two years prior to March 2008 I stopped drinking sodas/soft drinks

–only meats that have been traditionally raised; meat from ruminants that have been grass fed; chickens that have been pastured (I get them with the head and feet); meat from pigs that have not been raised in confinement (I know the people who “produce” the pork that I eat–they feed their pigs food that is in season and local, and they allow their pigs to be pigs, and never slaughter them before their time)

–eliminated all the bad fats

–added good fats: coconut oil, palm kernel oil, [raw] butter from grass fed cows, lard (from the pigs described above), beef bone marrow fat (from grass fed and pastured cows), olive oil

–eat a tin of sardines (with the skin and bones) weekly

–eat wild Alaskan salmon weekly

–cut out grains; although, occassionally, I have a jones for those carbs, so I’ll eat some brown rice; sometimes I’ll have a bowl of steel-cut oats, which I have soaked overnight, and when I eat it, I add lots of butter and raw cream to it

–stopped eating out; I cook all of the meals that I eat

–only eat raw milk cheeses

–eggs from hens that have been pastured

–drink this mixture daily: raw milk, raw cream, 4-6 raw egg yolks, some unsulphured organic blackstrap molasses

–daily supplements of: cod liver oil, evening primrose oil, wheat germ oil, kelp powder, dessicated liver

–vegetables and fruit

–drink only when thirsty

–stopped wearing sunblock/sunscreen lotions; get out in the sun daily for 20-plus minutes

–exercise daily; I ride my bike everywhere (I live in San Francisco) or I walk

Following the reader’s advice will not only relieve depression, it will dramatically improve all aspects of your physical, emotional and mental health.

Adequate sleep and rest

Recent studies have definitively linked insomnia with depression and increased suicidal behavior. A research abstract that was presented on June 12 at SLEEP 2008, the annual meeting of the Associated Professional Sleep Societies, found a link between poor sleep and suicidal behavior among children and adolescents with depressive episodes. 83.8% of the depressed patients in the study had sleep disturbances, and there was a significant association between suicidal behavior and the presence of sleep complaints.

Another recent study confirmed the persistent nature of insomnia and the increased risk of subsequent depression among individuals with insomnia. According to the study, 17% – 50% of subjects with insomnia lasting just two weeks or longer developed a major depressive episode reported in a later interview.

Other research has indicated that insomnia can cause depressed mood and adversely affect endocrine function (Banks 2007).

Most Americans are chronically sleep deprived. The foundation’s 2001 national “Sleep in America” poll reported that almost seven out of 10 Americans experienced frequent sleep problems, and that most were undiagnosed. The same poll in 2003 found that 67 percent of older adults had frequent sleep problems and only one in eight had been diagnosed.

This alone could explain the epidemic increase in depression over the last several decades. But when sleep deprivation is added to other factors such as increased intake of n-6 PUFA, increased stress, the use of antidepressant drugs, the breakdown of family, community and other social support structures, it isn’t difficult at all to understand why so many of us are depressed.

The American Academy of Sleep Medicine (AASM) offers the following tips on how to get a good night’s sleep:

  • Follow a consistent bedtime routine.
  • Establish a relaxing setting at bedtime.
  • Get a full night’s sleep every night.
  • Avoid foods or drinks that contain caffeine, as well as any medicine that has a stimulant, prior to bedtime.
  • Keep computers and TVs out of the bedroom.
  • Do not go to bed hungry, but don’t eat a big meal before bedtime either.
  • Avoid any rigorous exercise within six hours of your bedtime.
  • Make your bedroom quiet, dark and a little bit cool.
  • Get up at the same time every morning.

Stress Management

An increasing amount of evidence (along with common sense) indicates that chronic stress directly contributes to depression. Please see my recent article for more information about this.

I am not aware of any well-designed clinical trials examining the effects of stress reduction on depression. However, logic dictates that since stress is a cause of and contributing factor to depression, managing stress is an important aspect of treating depression.

One study published in 1995 showed that meditation can improve mood. Another small study demonstrated that mindfulness-based cognitive therapy (MBCT) significantly improved depression and reduced relapse. A series of studies and case studies have shown that biofeedback can also be effective for depression and mood disorders.

The reality is that there are many ways to manage and reduce stress, from yoga to meditation to mindfulness-based stress reduction to progressive relaxation techniques. The important thing is not which method you choose, but that you commit to something and do it on a regular basis.

Prayer & Spiritual Practice

You’re not going to see much scientific research into the role of prayer and spiritual practice in treating depression. Nevertheless, for as long as people have been “depressed” they have used their relationship with God, nature, a “higher power” or whatever guiding principles they embrace to get through difficult times.

People who are depressed often feel isolated, alienated or alone. A strong faith in God or in the interconnectedness of all life can re-establish a sense of belonging and support. Prayer and spirituality can also re-frame the depression one is experiencing in a larger and less “personal” context.

In my previous article called The Heart of Depression, we examined how cultural, religious and spiritual beliefs in these traditional societies provide a context in which symptoms of depression and other mental illness can be understood outside of the label of medical disease or pathology. Possession and rites of passage are two examples of such contexts.

The words and labels we use to “frame” our experience have tremendous power. In the U.S. today, depression is viewed as a sickness that must be cured, as a pathology, as a “biological disease”. There is little doubt that the people who seek treatment for depression are suffering. But should psychological and emotional suffering always be viewed as “something to get rid of”?

Great religious and spiritual traditions from around the world view suffering as an avenue to greater understanding of oneself, life and God. Suffering can be viewed as a signal drawing our attention to issues in our life that need to be addressed.

Spirituality and prayer can help people who are suffering to understand their experience in a more empowering and self-validating context than what is offered by mainstream medicine. When one views their suffering as an opportunity for growth and evolution, rather than as a disease requiring treatment with drugs, it is far more likely that lasting, positive change will occur.

In the next and final article (for a while, at least) in my series on depression and antidepressants, I will summarize everything we’ve covered so far and offer my recommendations for treating depression holistically.

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Comments Join the Conversation

    • Laurel says

      Note to Alice: I have vastly reduced/eliminated depression via a paleo/primal and gluten free diet. The gluten free aspect is only about 5 weeks in, but the change for me has been fantastic and fast.

  1. Laurel says

    Great articles! SO much rings true in my experience so far.

    I am looking for the article Chris mentions at the end of the article, where he says: “In the next and final article (for a while, at least) in my series on depression and antidepressants, I will summarize everything we’ve covered so far and offer my recommendations for treating depression holistically.”

    The link to “my series” doesn’t work, and I can’t find the summary article he references. I am very interested in reading it! Can anyone help?

  2. Michelle says

    Taking control of your own heath is a great idea, but impossible to do if you have severe depression. Zoloft, an SSRI, saved my life and gave me the opportunity to find out that my USDA Food Guide Pyramid diet (which I thought was healthy) may be causing nutrient deficiencies that led to anxiety/depression. But you can’t expect someone who is suicidal to start learning how to make their own mayonaise, find suppliers of grass-fed beef, stop eating out, exercise, etc. Your recommendations are great for someone who has minor/occasional depression, or someone like myself who is depression-free right now (because I’m not pregnant), but is hoping to solve the root problem and avoid SSRIs the next time I’m pregnant.

    SSRIs work very well for some people (like Zoloft did for me) and not at all for others. You can’t take a study where some people were helped a lot and some not at all and then average the results and say the drug doesn’t work any better than placebo. That just doesn’t make sense. There are lots of different causes of depression, and we need to use all the solutions that work. People take anti-depressants because they work. If they couldn’t tell the difference between SSRIs and placebo, the people in the study must not have had very serious depression. I have a hard time believing that SSRIs are as ineffective as you say because the side effects are VERY common. Think about it: if you couldn’t really tell whether your depression was alleviated, or it was only better on some days, would you keep taking a drug that prevented orgasm and caused wicked constipation? That would be really silly.

    For me, the side effects were a tiny price to pay for my life and for the relief from the pain of depression — the suffering which you can only understand if you have been there. The pain of losing my sister in an accident or miscarrying pale in comparison.

    St. Johns Wort is not recommended during pregnancy (which is a huge segment of the depressed population). If you have morning sickness all day, exercise is not going to happen. Not to mention, if you are nutritionally deficient, strenuous exercise is only going to make it worse. My depression was caused by sleep deprivation which was caused by anxiety, so getting a good nights sleep is a great a idea, but, again, not possible. (It is very common to have sleep disturbances as a RESULT of depression.)

    I’m just saying, be careful what you recommend. There are people reading this who need to get help and fast, and telling them that drugs are ineffective is an exageration that might result in disaster.

    • Veronica says

      I’m not denying or believe that SSRI’s didn’t help you, but you are evidently proven to be a small minority thanks to those meta-analyses. But I TOTALLY agree that instead of conglomerating studies to see if something works is rather silly, and we should instead subdivide studies and figure out why some drugs work and some don’t. (Unfortunately, that’s not how drug studies often work…I’ve read too many papers were there’re a couple outliers skewing data and the authors present the drug as an overall moderate success when in reality, it’s a huge success for like 5% of participants, and totally ineffective for the other 95%.) Furthermore, the amount of data hidden by drug companies who make SSRI’s that has only come to light recently, show that SSRI’s can basically backfire and make someone commit suicide.
      http://www.youtube.com/watch?v=ksJXaqx6Gag

      People don’t have to take SSRI’s because they work. They take them out of desperation and because they have been told there’s medical reasons to take them, and they’ll wait the necessary month to see if they work, maybe wait longer or then up the dosage, have some sort of up or lessening of symptoms during the following months, think they might be working, until they feel worse again and then they up the dose more or then try another one. If they try another one, they get withdrawal that makes them feel worse and understandably, they see that as the drug was actually doing something, so they are anxious to start up a different one. And there are, what, a dozen of these drugs to cycle through? That’s quite a long time of trying different drugs. And they’re basically the only treatment a medical professional is going to give you. Of course you’ll keep taking them. Besides which, billions of people use folk medicine that does absolutely nothing medical because they feel better doing it.

      ” If they couldn’t tell the difference between SSRIs and placebo, the people in the study must not have had very serious depression” Why why why do you assume that YOU are the standard? Yes, you can have serious depression and not show improvement on an SSRI. I am one of them, or was when I started anti-depressants. Besides which, how you DO you know you weren’t yourself experiencing a placebo? Oh of course you weren’t, you’re a smart person, you wouldn’t be fooled by that, you had clear, noticeable changes that made you better…but nevertheless that’s exactly how a placebo works.

      As someone who has been depressed for over a decade in varying degrees of severity, and who was then, finally, diagnosed with celiac disease, I had to change my diet and cook all my own foods and be incredibly careful what I eat…far more cautious than the recommendations on this site. All celiacs go through this, and many of them are very, very sick, not just emotionally and mentally, but physically too. The difference is that we KNOW that we can get better by changing our diets is what makes you eat better, so people do it. (I will say I haven’t been suicidal while changing my diet, but that’s because the only times I’ve ever attempted suicide were when I was in SSRI’s or withdrawing from them. I was 18 when I started antidepressants, not a child or even an adolescent.)

  3. Paul says

    Hi Chris,

    People with my condition (OCD) usually take evening primrose oil, but given that I avoid omega 6 like the plague, I never gave it a shot. I see that you use (or used to have) it. Why do you think it’s ok to take it?

  4. VanessaL says

    I’m wondering if Chris Kresser believes depression has a physiological basis, even if it’s not a chemical imbalance. I have a moderately, but not overly, stressful life. I’m a no-sugar, paleo, high-fiber, balanced diet with a good omega-3/omega-6 ratio, enough Vitamin D and exercise but still experience ongoing mild depression (dysthymia). I have a very hard time believing depression is all psychological. I’ve had counselors say they have run out of things to talk about with me because I seem psychologically healthy. I don’t believe antidepressants work at all. I’ve tried them and they basically have zero positive effect with icky side effects.

  5. Julien says

    Thanks Chris for putting together this series – it is great to have all this information synthesized in one place, and thoroughly analyzed. Your conclusions match the experience I have had so far with depression and bipolar disorder (as a witness).
    In particular, someone very close to me healed from bipolar disorder after being on about all existing drugs for over 10 years, several hospitalizations and suicide attempts. He (1) ended an abusive relationship, (2) started a positive relationship based on respect and understanding and (3) has been taking 2-3 g of EPA (now moving to DHA based on your n-3 advice…) per day plus large amounts of B complex, Vit. C, D (only recently), and probiotics. He quit all drugs (including lithium and anti-psychotics) abruptly – against my advice – with no issue.
    His diet has always been pretty decent (vegetarian/organic) though his n-6 intake is hard to assess. Of course, not so good when he was deeply depressed or manic… in particular, little protein (now taking whey protein regularly, as a precaution).
    He’s been close to anemia for years, with a depressed immune system. Now both are normal.
    He’s been doing psychotherapy for years, which has offered him some relief -but the psychologist he was seeing didn’t even figure his relationship was abusive (nor did he for a long time!)
    My sense is that his ‘sadness’ originated from childhood trauma (emotionally immature parents + having to raise his siblings while a teenager himself) and was compounded by a abusive relationship (in which he stayed because of the above-mentioned trauma). So a lot of stress…
    I suspect healing is very personal and situation-specific, takes a combination of all methods you describe and requires non-judgmental, loving and accepting support.

  6. Cassandra Quandt says

    “When one views their suffering as an opportunity for growth and evolution, rather than as a disease requiring treatment with drugs, it is far more likely that lasting, positive change will occur.”
    I could not agree with you more. It took me many years of battling bouts of severe depression to realize this. Dietary shifts, movement (hot yoga and dancing), becoming an observer of my thought patterns and internal “scripts”, and reconnecting with nature in a scared and spiritual way has resolved my issues. I was placed on Prozac at age 14 and stopped taking it in my early twenties after my doctor at the time upped my dosage and placed me on anti-psychotics to alleviate the side effects created by the high dose. I still remember how intense emotions felt to me when I stopped, being on the Prozac truly did feel like I was lobotomized. I still to this day, some 6 years later feel a bit off some days and I often wonder if I have permanent damage. Thanks for posting some great information about depression and “anti”-depressants. It’s nice to know some sanity still exists in the world.

  7. Gisela says

    “When one views their suffering as an opportunity for growth and evolution, rather than as a disease requiring treatment with drugs, it is far more likely that lasting, positive change will occur.”
    Speaking as a person who suffered depression and who was treated successfully with Prozac, this statement just seems like bs.  In my experience, personal growth and evolution could only happen after the depression was removed, not while it was eating up my life.
    I see this like the platitude that “whatever evil doesn’t kill me will make me stronger.”  That’s bs, too, as whatever evil doesn’t kill you makes you damaged and lame, and less strong than you were before.   It takes a LOT of rehab to get beyond that fact, and many never do.
    I’m not suggesting that we should idealize stress-free lives, nor that we should avoid challenges.  I’m also not suggesting that non-pharmaceutical approaches aren’t worthwhile.
    I’m saying that hardship and disaster maim us more often than not, even if we do sometimes manage to squeeze a little lemonade out of them, and that it’s insulting to people struggling with serious mental illness to tell them they won’t need pills if they just change their attitude.

  8. Bruce says

    Diet obviously affects beliefs, thoughts, and behaviors. Having a stressful environment can enhance those effects. Sitting all day (in work or school) is stultifying and depressing. Basing your life on shopping and mindless consumption is equally meaningless, un-fulfilling, and empty. To quote Eric Hoffer, “You can never get enough of what you don’t need to make you happy.” True happiness can only come from within. The root of the discontent, IMO, is wanting things you don’t need. To reword Socrates a little, “Contentment is natural wealth. DESIRE is artificial poverty.”

    • Veronica says

      Being depressed, the thing I feel that I’m missing the most is wanting. When I have no desire is absolutely when I’m at my worst. Working towards goals, be it wanting a sports car or growing a pretty flower or making a delicious meal are all desires, and are absolutely necessary for happiness. Of course setting goals outside possibility is going to make you unhappier. And many people find that it is the struggle itself that is better than the achievement of the goal, which is where we get glimpses of the futility. Eg: You bought the car, you drive it, you made someone jealous, now what? Now you make a new goal, or else you stew and become unhappy.
      On the flip side, if you are happy doing nothing, it’s like the difference between soma (if you get the reference) and living. It’s lazy and frowned upon and doesn’t advance society and to most people, it’s incredibly dystopian; it’s what we want to avoid. Most people don’t want to become the guitar-playing pothead living in their parents basement, no matter how much spiritual fulfillment they might have.

      Personally, being happy is ultimately a physiological state that my sick body might not even be capable of reaching. Yes, circumstances and controllable thought patterns and actions can prevent that happiness from occurring. However, depression is sooo much more than just not being happy. I enjoy it when I can cry or get upset about something. Pain, unless constant, is better than nothing. Even my dreams are devoid of emotion, although certainly not of activity or events.
      The root of my problems are NOT because I want things I don’t need, rather, my physiological problems make me desire nothing. And it pisses me off no end that people like you haven’t the faintest idea or acceptance that emotions require a proper functioning body to function properly. But I suppose I should thank you at the same time…I’d rather for a moment be pissed at your ignorance than be depressed.

  9. says

    @Bruce:

    In my own considerable experience working with my own depression and that of others, I have found that understanding what is at the root of the discontent is essential to lasting healing. Sometimes the answer is nutritional, but that is not always the case. To deny that our beliefs, thoughts and behavior play a role in the suffering we experience, or that seeking the source of this suffering and then responding appropriately is an important part of healing is to ignore perhaps the most essential aspect of healing from depression.

    One need not be “religious” or even “spiritual” to embrace this. It is simply a matter of being willing to examine oneself and one’s choices, to ask questions, and to be willing to hear and act on the answers. I simply mentioned spirituality and religion because these are two contexts in which these questions have been asked historically. But they could just as effectively be asked on one’s own, by a psychotherapist or by a concerned friend or family member. There is nothing inherently religious about the process.

    Chris

  10. says

    Gordon,

    Such a baseless and obviously ill-informed personal attack doesn’t deserve a response. But on the off chance that you are actually capable of thinking rationally about this, please feel free to provide evidence to support your claims and I will gladly reply.

    I have provided several citatations from major peer-reviewed scientific journals to support my arguments. You have not. You have provided your opinion, which, unless supported by evidence or years of direct clinical experience is not worth much in this debate.

    Your comment seems to suggest that modern treatment of depression (with antidepressant drugs) has saved lives. I challenge you to show me proof of that assumption. On the contrary, I have presented several studies which show that:

    – There is no evidence that antidepressants reduce the risk of suicide or suicide attempts in comparison with a placebo in clinical trials (Kahn et al. 2000).

    – In fact, rates have actually increased in some age groups and in some countries despite increased antidepressant prescribing (Moncrieff & Kirsch 2006), and when antidepressant trials have been re-analyzed to compensate for erroneous methodologies, the SSRIs have consistently revealed a risk of suicide (completed or attempted) of between two to four times higher than placebo (Jackson 2005).

    – Sharply rising levels of antidepressant prescribing since the 1990s have been accompanied by increased prevalence of depressive episodes (Patten 2004) and by rising levels of sickness absence for depression (Moncrieff & Pomerleau 2000).

    – Longitudinal follow-up studies (which study the effects of antidepresants over the long term – not just the 6-8 week periods the clinical trials look at) show very poor outcomes for people treated for depression both in the hospital and in the community, and the overall prevalence of depression is rising despite increased use of antidepressants (Moncrieff & Kirsch, 2006).

    – Over the long-term, people prescribed antidepressants have a worse outcome than those not prescribed them, even after baseline severity had been taken into account (Brugha TS et al, 1992; Ronalds C et al., 1997). No comparable studies exist that show a better outcome in people prescribed antidepressants.

    As I said, if you have evidence or objective information which supports your viewpoint, I’d be more than willing to engage in a debate with you. However, if all you have to offer are personal attacks based only on your opinion or dogma, I see no reason to waste time responding to them.

    Chris

  11. Bruce says

    I don’t agree with the religious content, but what is upsetting about taking control of your own health? Treating problems with drugs and supplements is dumb, IMO. I think it’s smarter to change your diet and lifestyle than use drugs or supplements with potentially toxic effects. Companies don’t make drugs and supplements out of the goodness of their hearts. They sell them for money. Most of the problems wouldn’t exist if people stopped eating an awful diet, sitting indoors all day, and subjecting themselves to chronic stress (including sleep deprivation).

  12. Gordon Farmer says

    “Great religious and spiritual traditions from around the world view suffering as an avenue to greater understanding of oneself, life and God. Suffering can be viewed as a signal drawing our attention to issues in our life that need to be addressed.”
    “Spirituality and prayer can help people who are suffering to understand their experience in a more empowering and self-validating context than what is offered by mainstream medicine. When one views their suffering as an opportunity for growth and evolution, rather than as a disease requiring treatment with drugs, it is far more likely that lasting, positive change will occur.”

    I wonder how many people you folks will kill with these two paragraphs. This is not 2008 BC. How dumb can you get.
    You make me sick to my stomach.

  13. says

    Thanks for your comment, Bruce.  I agree that diet is one of the most significant – if not the most significant – contributors to depression.

  14. Bruce says

    I don’t think grain-fed meat has anything to do with depression. I have had depression back when I was eating junk food loaded with PUFA oils, refined sugars, and bleached enriched flour. I think it’s the amount of PUFAs that is the problem, not the ratio. Omega-3 fats are more prone to oxidation than omega-6, so a little goes a long way. (Only the oxidized derivatives have an effect anyway.) Beyond that, I think there are other problems with the modern diet, like the lack of protein and fat and the excess of highly refined carbohydrates. We need to remove variables not add them. I would want to see a study that removed all PUFA oils, trans fats, refined sugars, and bleached / enriched grains. Then see if there is any depression in that group. I doubt there will be, since most depressed people I know eat all of those foods.

    I would never eat flax oil, canola oil, wheat germ oil, safflower oil, corn & soybean oil, sunflower oil, sesame oil, cottonseed oil, rapeseed oil, large amounts olive oil, large amounts of avocados, nuts, or seeds in general. I don’t care for the strong taste of olive oil – macadamia is better. The total amount of PUFAs matters more than the ratio, IMO. A high ratio will cause disease ONLY if it comes with a high amount of PUFAs (e.g. safflower oil). Coconut oil has no omega-3 and it won’t cause any disease, unless it has been partially or fully hydrogenated perhaps.

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