There may be hope for hard-to-treat depression as scientists explore novel ways to help people who have the often crippling condition.
21. And when We let mankind
taste of mercy after some adversity has afflicted them, behold! They take to
plotting against Our Ayat (proofs, evidences, verses,
lessons, signs, revelations, etc.)! Say: "Allah is more Swift in
planning!" Certainly, Our Messengers (angels) record all of that which you
plot.
22. He it is Who enables you
to travel through land and sea, till when you are in the ships and they sail
with them with a favourable wind, and they are glad therein, then comes a
stormy wind and the waves come to them from all sides, and they think that they
are encircled therein, they invoke Allah, making their Faith pure for Him
Alone, saying: "If You (Allah) deliver us from this, we shall truly be of
the grateful."
23. But when He delivered
them, behold! They rebel (disobey Allah) in the earth wrongfully. O mankind!
Your rebellion (disobedience to Allah) is only against your ownselves, - a
brief enjoyment of this worldly life, then (in the end) unto Us is your return,
and We shall inform you that which you used to do. 10. Surah Yunus
(Jonah)
Recently, a number of studies have suggested the benefits of Botox, ketamine, and certain sometimes-unexpected means of treating depression.
"I'm excited in general, and I'm curious," says Peter D. Kramer, MD, author of Listening to Prozac and Against Depression.
Each year, around 16 million U.S. adults battle major depression. Many of them benefit from antidepressants. But as many as a third get depressive symptoms despite medication. And side effects, which can include weight gain, nausea, and insomnia, are troublesome for some patients. That leaves many people with depression searching for alternatives.
But if Kramer is hopeful about the newer, novel ways to treat the condition, he's also cautious. The studies backing those treatments aren't conclusive, and none of the approaches have been approved by the FDA to treat depression (though some, such as ketamine, have been approved for other uses).
"Things are merely hopeful until they are demonstrated [safe and effective]," Kramer says. "It's always hard to tell what's going on, but it's a very interesting time, and I think some of them will come through."
Here's a closer look at what might be used to help treat depression in years to come.
Ketamine. Already in use in certain clinics and in some emergency departments around the country, ketamine is an anesthetic most often used during surgery. It's given through an IV, and it quickly eases symptoms of depression, often in a matter of hours. The benefit is temporary, though.
One recent study found it to be very good at helping curb suicidal thoughts in severely depressed people. But it's expensive, still experimental as a depression treatment, and can cause hallucinations and other side effects.
"Some people are very uncomfortable with the side effects," says Alan Manevitz, MD, a psychiatrist who specializes in treatment-resistant depression at Lenox Hill Hospital in New York City.
Nitrous oxide, or laughing gas. This is an anesthetic commonly used by dentists. A small study published last December reports that nitrous oxide improved depression symptoms within less than 2.5 hours.
Unlike ketamine, though, nitrous oxide had few side effects. The benefits lasted from 24 hours to a full week in some of the 10 people in the study. Much more research needs to be done on the safety and effectiveness of nitrous oxide, but Manevitz says it's promising.
"For people who are in suicidal despair or crisis, it may, like ketamine, temporarily relieve that person and act as a bridge until other treatments start working," he says.
Botox. Best known for temporarily erasing frown lines and crow's feet, onabotulinumtoxinA (Botox) has recently attracted interest as a novel means of lifting major depression. The theory is simple: If you can't frown, you won't be sad. And some research has borne this out.
A single Botox injection into the facial "frown muscles" provided lasting relief from depression symptoms, according to a study published last spring in theJournal of Psychiatric Research. Another study found similar effects following Botox injections into frown lines around the eyebrows. Many questions remain, though.
"The Botox is very interesting, and the best evidence [it helps] is as an add-on to antidepressants, but what's going on?" asks Kramer. "Is it really feedback to the brain, that if you can't frown, do you feel more resilient? Or is it that people respond to you differently?"
Anti-inflammatory medications. Inflammation has been linked to depression for several years now, says Brown. A recent review of studies, published in JAMA Psychiatry, further backs up the connection. The researchers found that painkillers such as celecoxib, ibuprofen, andnaproxen reduced depression symptoms. Another class of anti-inflammatory drugs, called cytokine inhibitors, also showed some benefit.
The authors of the review call their findings "proof of concept," meaning that their results are strong enough to encourage further research. Another recent study reports that omega-3 fatty acids, which have anti-inflammatory properties, helped treat depression linked to chronic hepatitis C.
"If you could actually treat depression symptoms along these lines, that would be interesting," Kramer says. "Some of the antidepressants are also anti-inflammatories, and some people have thought that maybe it's just coincidence that they work on [the brain chemicals] serotonin and norepinephrine, and that the real effect is anti-inflammatory."
Uncertain Future
The treatments listed above aren't the only ones being tested.
Nasal sprays that have protein peptides or small molecules have shown some promise, Kramer and Manevitz say. A method called transcranial direct current stimulation, which uses electricity to change brain activity, is also being tested.
Mindfulness meditation is another promising addition to depression treatment, and exercise is known to help relieve symptoms, too.
If some of the newer treatments seem far-fetched, Manevitz points out that the same was said just a few years ago about transcranial magnetic stimulation (TMS), a non-invasive therapy that uses magnets to affect parts of the brain linked to mood.
"People looked at me cross-eyed and thought it sounded wacky," he says. "Now, it's an FDA-approved treatment for depression, and it's used around the world."
Which, if any, of these treatments prove effective is anybody's guess at this point. Researchers have a lot of work ahead of them before any make it to patients in the clinic.
"So many medicines get lost in the pipeline," Kramer says. "Either it's hard to engineer them in ways that are not going to harm the kidneys or the liver, or the actual principle under which they are working turns out not to be right. It's hard to give your heart to any one of them because they tend to disappoint."
“Can I recover from depression without antidepressants?”
This is a question that many people ask me. They search the web, talk to their doctors, and seek alternative treatments, hoping that they can recover “on their own.” The answer to this question is both simple and very complicated. It often depends on the severity and persistence of depressive symptoms. Few people, in my experience, recover spontaneously and fully from depression entirely on their own. Reaching out for help is an important part of the recovery process. But getting help can take many forms, and what works for one person may not be the answer for another.
Studies show that psychotherapy can be as effective as medication in improving depressive symptoms, and the benefits tend to persist after treatment ends. Therapy addresses the root causes of depression, such as unresolved grief, anxiety, early childhood trauma,negative thinking, poor self-image, loss of meaning, and relationship difficulties. Therapy can also help to improve coping skills and resilience. But for severe or persistent depression, both therapy and medication may be needed for a complete recovery. This article will talk about what individuals should consider when deciding whether to take antidepressants for treatment of depression or whether another approach might work as well.
1. Severe, debilitating depression warrants a consultation with a doctor.
When a person comes into my office complaining that he or she is depressed, it is important to assess the severity of the depression. Severe depression with suicidal thoughts needs to be taken much more seriously and warrants a consultation with a medical professional regarding possible medication. Severe depression is a life-threatening condition and should be treated as such.
In addition, depression with severe insomnia may require medication. Without adequate sleep, it is extremely difficult to recover from depression. There are strategies that can greatly improve sleep in some cases, but if sleep does not improve quickly, medication may be required to prevent a worsening of depressive symptoms.
2. There are effective non-drug treatment options for mild to moderate depression.
Many people with mild to moderate depression, where sleep is adequate, can recover from depression with talk therapy and adjunctive strategies such as exercise, improved nutrition, mindfulness techniques, sunlight or light therapy, support from friends, family or asupport group, and lifestyle changes. All individuals with depression should rule out a medical issue which may contribute to their depressed mood. Many medical problems, including vitamin deficiencies and hormone imbalances, can contribute to depression. Getting a thorough physical exam to rule out a medical cause is important.
If there is no clear medical cause, psychotherapy which focuses on improving self-care, reengaging in pleasurable and meaningful activities, and managing negative thoughts can be helpful in many cases. Working on issues that are impacting relationships with friends, loved ones, and family can also greatly relieve depression in some individuals. And for some, exploring and resolving unresolved grief or early childhood trauma may be important. Other approaches that can contribute to recovery include bodywork, acupuncture or other alternative medical approaches, meditation, yoga, or spiritual exploration.
3. Taking medication for depression, when needed, should not be viewed as a failure.
However, it is important to recognize that depression is an issue as serious as diabetes, epilepsy, or even cancer. Because it involves mood, thoughts, and behavior, it can often be treated through those channels. But there are also genetic and environmental factors that make some individuals susceptible to depression and which may result in a more persistent condition that is more difficult to treat.
Just as other conditions sometimes require medication for their treatment, depression may also require medication to fully resolve. And it is important to recover fully rather than settle for persistent mild depression. Persistent depression can become chronic and more severe over time as the brain becomes accustomed to the depressed state. Therapy and medication combined have the highest success rate in terms of resolving depression, and when therapy alone is not sufficient, it may help to consult with a doctor orpsychiatrist to discuss medication options.
It is important to remember that, when it comes to treating depression, there is no prize for recovering “better” than another person. Recovering without therapy, without medication—literally “on your own”—does not earn you any awards. The prize is being emotionally healthy. It’s important to recognize the impact that our society’s attitudes toward mental health conditions, psychotherapy, and psychotropic medications may have on your decision-making. How you recover is a personal choice, based on your own needs in consultation with trusted professionals. Your choice should be made from a place of compassion and self-love.
Those suffering from severe depression, which the Centers for Disease Control and Prevention estimates is one in 10 adults in the United States, may not be a stranger to antidepressants. What they may be unfamiliar with is the concept their prescription is more effective when paired with cognitive therapy.
As described by the National Alliance on Mental Illness, cognitive therapy is a form of treatment that focuses on the kind of thinking that leads to self-destructive behavior. And a study published in JAMA Psychiatry finds this particular therapy is an important part of the treatment equation.
Study authors worked with 452 outpatients with chronic or recurrent major depressive disorder (MDD), treating half with antidepressants and the other half with antidepressants and therapy over the course of three and a half years. The objective was to treat patients until they were in recovery, or going 26 consecutive weeks without a relapse in symptoms.
The results showed that the combined treatment improved rates of recovery (73 percent) compared to antidepressants-only (63 percent). However, authors noted the impact of this treatment was noticeably different in those with severe MDD. Recovery rates weren’t much different in patients with less severe MDD.
"Our findings suggest that CT engages different mechanisms than ADM but that it likely does so only in some patients,” Dr. Steven Hollon, lead study author of Vanderbilt University in Nashville, Tenn., said in a press release. “Identifying these mechanisms may suggest ways to enhance treatment response. Future combinatorial trials should include comparisons with CT alone to examine the viability of each monotherapy, especially given evidence that CT effects persist beyond the end of treatment."
Hollon’s findings come on the heels of a previous study that found depression treatments are more effective when they focus on the brain more so than a chemical imbalance (the purpose of antidepressants) — specifically, treatments that focus on reducing chronic stress, a condition thought to be a leading cause of depression. The researchers wrote that when stress is maintained for a long period of time, both the brain and body are harmed.
Similarly, research out of the University of Washington found women who received collaborative care, or counseling that focuses on patient engagement, for depression, experienced a 50 percent decrease after just one year. “Collaborative care benefits the community not only by helping women with depression regain function in their lives, but also by lowering health care costs,” Dr. Susan Reed, a professor of obstetrics and gynecology at UW and director of women’s health at Harborview Medical Center, said in a press release.
The theme of cognitive therapy and collaborative care is greater patient care, really taking the time to work through the thought processes and outside risk factors in order to arrive at an effective treatment. The women participating in Reed's study told her they felt it was the first time anyone cared about their mental health.
No, there isn't a universal approach to treating severe depression. But there are so many health care professionals to choose from that it's worth taking the time to meet with more than one. Finding the right psychiatrist, counselor, and/or therapist to work with, who will recommend a variety of treatments, regardless if they're in combination with another or not, makes all the difference.
“New Cures for Depression” shouted the 1986 essay in New Woman magazine; “Dramatic Progress against Depression,” blared a New York Times Magazine piece in 1990. Its subtitle was revealing: “The success of new drugs is prompting debate on their overuse—and the value of talk therapy.” That story smugly said that the new wave of antidepressants, including the then two-year old Prozac, which took the country by storm, had “proved to be as effective as the older ones and often safer.” What’s more, the article went on to say that these amazing new drugs worked when old-fashioned talk therapy didn’t. Psychotherapy was relegated to the dustbin of history.
Fast-forward just a couple of years. Suddenly, the manufacturer of Prozac, Eli Lilly, was being sued by families of people who either committed suicide or tried to do so while taking the drug. In the next 15 years, lawsuits for other antidepressants piled up against other manufacturers for the same reason: Forest Pharmaceuticals, maker of Celexa; Lilly (again), maker of Cymbalta; Pfizer, maker of Zoloft; and GlaxoSmith Kline, maker of Paxil.
At the same time, the U.S. Food and Drug Administration started coming down hard on pharmaceutical companies for promoting “off-label” uses of their products, that is, uses that had not been approved by the FDA. To accomplish their goals, big pharmaceutical companies would pay doctors to prescribe various drugs already in use for symptoms not related to the drugs’ stated purpose.
Not only did the drug industry promote off-label uses, but many of the research papers that touted the benefits of the medication were fraudulent. Doctors on the drug makers’ payroll would submit fictitious results to such prestigious journals as the New England Journal of Medicine and the Journal of the American Medical Association. Journals subsequently added to their editorial policies a requirement that all submissions include the funding sources for the research.
And now, the latest blow to the pharmaceutical industry: research shows that not only are dummy pills, called placebos, just as effective in routing out depression as antidepressants, but in some cases they are even more effective! What’s more, the latest technology shows that both the dummy pills (used in scientific research as “controls”) and talk therapy change the brain’s wiring. That means we can take psychotherapy out of the dustbin and restore it to the place of honor—and hope—where it belongs.
When it comes to depression, we need that hope. According to a 2009 study in the Journal of Marital and Family Therapy(JMFT), close to 16% of people will be diagnosed with Major Depression during their lives; in fact, the World Health Organization states that, of all health problems, depression is the second from the top. Of interest, more women than men suffer from depression in marriage.
If depression is that serious, how could psychotherapy work where drugs have given us a bouncy ride (like side effects and how they can just stop working if they had any effect in the first place)? How does talk therapy have the robustness to counteract what pharmaceutical companies have billed as a chemical imbalance in the brain? Most importantly, how could counseling tackle the kind of depression that comes out of strained personal relationships?
The good news is that brain chemistry “imbalances” in depressed people have never been found. That is, there is nothing about the brain of a depressed person that doesn’t work right. When there is less serotonin (a neurotransmitter that signals good feelings) in their brains, it is a reflection of their depression, not a cause of it. More good news is that talk therapy is actually the best solution to the kind of depression that comes out of strained personal relationships. According to JMFT research, both couples counseling and individual therapy can improve depression, but only relationship therapy improves relationships.
Research using functional magnetic resonance imaging (fMRI) demonstrates that drugs, placebos, and talk therapy all can change brain chemistry. But how could drugs have the same effect on the brain as placebos? Scientists hypothesize that these dummy pills work because of the attention and care that the researchers give to the people participating in the experiment. And wouldn’t you know: Psychotherapy research comes down to the same thing. When talk therapy works, it does so because of the quality of the therapeutic relationship. So of course the pharmaceutical will work because it is distributed by researchers who talk to—and listen to—the research volunteers. What we’re saying here is that the way we’re treated changes brain chemistry.
Studies in the animal kingdom shed more light on this. In 1986,Discover Magazine reported research by Jacqueline Crawley with Siberian hamsters, animals that are unusual because, like most humans, they mate for keeps. When a female is taken away from her mate, the male not only acts depressed, but serotonin levels in the brain go down—a sure sign of depression. But look at this: to raise those serotonin levels back to normal, all the researchers had to do was re-introduce that mate!
In other words, how you feel about your relationship really is in your head, but that doesn’t mean it started there. Sometimes correcting external factors is all that is needed to correct what’s not right in the brain.
There’s another external factor that has a powerful effect besides the care and attention mentioned above. Another JMFT article noted that more women than men initiate separation and that when they do, if they started out depressed, their depression lifts. One conclusion you should not draw is that a separation from the s.o.b. was the right move. It doesn’t prove that at all.
The authors speculate that the person who initiates separation has more control over events at that moment and that is why the depression lifts. One of the hallmarks of depression is the hopelessness that comes from being out of control of the situation. The real solution is for the therapist to work with the controlling partner to relinquish control, be a listener, and behave respectfully—in addition to being caring and attentive. Then, just as in the case with the Siberian hamsters whose depression lifted simply by changing external circumstances, a partner’s depression can lift, too.
There’s a huge bonus to therapy. Partners in a relationship can be taught how to make each other happy rather than fight over why the other person was making them unhappy. In other words, partners can learn how to inject serotonin into each other’s brains with just a well-placed smile and a thoughtful gesture. That’s so much more powerful than drugs, isn’t it?
One in 10 American adults suffers from depression.1
Standard care is prescription drugs that are laden with side effects.2-7 For many patients, the effectiveness of these drugs can diminish over the course of treatment,8 forcing depressed individuals to learn to live with their mood disorder.
Researchers have found that a specialized complex of curcumin fights the crippling effects of depression9 by attacking multiple underlying targets.10
A team of internationally recognized scientists has published an impressive clinical trial on the antidepressant benefits of a superior-absorbing curcumin that Life Extension® members have used for many years.9
In this 2013 study of depressed human subjects, curcumin’s effectiveness was similar to that of a standard antidepressant medication. However, curcumin contains none of the side effects associated with commonly used drug therapies9 and provides additional health benefits as well.
These results are in keeping with earlier research showing that curcumin increases levels of “feel good” neurotransmitters such as serotonin and dopamine.10
Landmark Clinical Trial On Curcumin
A breakthrough clinical study recently published in Phytotherapy Research should be welcome news to anyone afflicted with depression, which by 2020 is expected to become the world’s second-leading cause of disability.11
Depression continues to escalate despite “more than half a century of modern psychopharmacology, with billions of dollars spent on antidepressants annually world-wide.”12 And about 63% of patients who take antidepressants experience at least one of the numerous potential side effects,2 which include anxiety, thoughts of suicide, insomnia, weight gain, and sexual dysfunction.2-7 And the payoff for all these risks? Many depressed patients do not respond at all to drug antidepressants and most patients fail to achieve complete remission!13 Some evidence indicates response rates as low as 17% after taking specific antidepressants.14
Scientists have been seeking safer and effective alternatives to pharmaceutical medications.
The antidepressant activity of curcumin was initially suggested by various animal models of depression.10,15-19 But no evidence had been found on the clinical effectiveness of curcumin against depression.
So researchers designed a clinical experiment that was randomized and observer-masked. This means the observers were not told what treatment had been allotted to the patients, and the patients were instructed not to discuss their treatment regimens with the observers.9
The researchers randomly divided volunteers diagnosed with major depressive disorder into three study groups of 20 patients each. The first group took 20 mg of the antidepressant Prozac®(fluoxetine) every morning. The second group took a total of 1,000 mg of absorption-enhanced curcumin in two divided doses of 500 mg each. And the third group took both the once-daily fluoxetine and the twice-daily curcumin.9
The results were measured using the Hamilton Rating Scale for Depression (HAM-D scale).20 This scale provides a way to rate the severity of depression by assessing mood, anxiety, feelings of guilt, suicidal ideation, insomnia, agitation or motor retardation, weight loss, and other body symptoms.9
Efficacy and safety were evaluated after two, four, and six weeks. The HAM-D scale showed that the proportion of patients responding well to treatment was 62.5% in the curcumin group of the study, 64.7% in the fluoxetine group, and 77.8% in the combination group.9
The study team concluded that there was no statistically significant difference in the improvements among the three treatment arms.9 In other words, there was no difference in the effectiveness of the enhanced curcumin formulation compared to the prescription antidepressant fluoxetine in improving symptoms of depression between baseline and six weeks of treatment.9
The study team concluded that this “is the first randomized clinical trial that clearly highlights that curcumin may be an effective and safe agent when used as a modality of treatment in patients of MDD [major depressive disorder].”9
The advantage of curcumin as an antidepressant is its benign profile of adverse events as compared to other antidepressants.9 Curcumin is known to be safe—even in a huge dose of 8 grams (8,000 mg) a day.9
This remarkable clinical trial used a unique formulation—as we’ll learn next—one that overcomes a longstanding problem with curcumin: limited absorption.
A few years back, Harvard conducted a study to reiterate what many in the psych professionals already know – Americans are addicted to anti-depression meds. We (though not myself) pop Prozac, Celexa, Effexor, Paxil, and Zoloft pills like they are candy in an attempt to boost mood and feel better. The increase in sales of anti-depressants is up a startling 400%. This pill-popping became the norm, even though clinical studies suggest there are numerous natural remedies that can help us feel better, without the pricey and life altering side-effects that many of these drugs can cause.
Indeed, many individuals can find relief from depression with simple lifestyle changes, even just dietary changes. Even the spice turmeric has been shown to treat depression better than Prozac, one of the best selling, yet least effective anti-depressants of all time. Phytotherapy Research said that not only is turmericeffective at treating depression, but it is likely more effective than some of the most common anti-depressant drugs currently on the market.
Additionally, there are several things people can do to boost their happiness levels without ever popping a pharmaceutical pill. Here are 5 potential solutions:
5 Ways To Boost Happiness Naturally
- 1. The Easiest Way to Feel Better, by Far, is to Exercise. In study after study, scientists have proven that just moving your body makes you feel better. Exercise boosts dopamine levels and oxytocin levels – two hormones responsible for happiness and love; one dampens pain, the other makes you feel ‘bliss.’ Why take a pharmaceutical drug that might cause you to have migraines or become suicidal when you can just spend 10 minutes throwing a Frisbee with your dog, or walking along a path in nature? (Spending time with your dog and being in nature also happen to boost your happiness hormones, so you can get two for the price of one!)
- 2. Spend Time with Friends and Family - Spending time with friends and family or even interacting with social media friends across cyber space can boost levels of seratonin and oxytocin, and even help you to live longer. We are social creatures. If you’ve been hiding in your house and not interacting with other people, consider volunteering, attending a social gathering, or even going on a date. Your better mood is waiting on this action.
- 3. Get Outside - New York-based naturopathic doctor Alan Logan, co-author (with Dr. Eva Selhub, an internal medicine physician) of Your Brain on Nature: The Science of Nature’s Influence on Your Health, Happiness and Vitality, believes thatthe energy from mountains, trees, plants and water can improve your sleep and mental outlook. You don’t have to abandon city life, but try to find trees, natural reservoirs of water, birds, flowers – anything that is natural. Your health and happiness depends on it.
- 4. Sleep More - Our circadian rhythms are absolutely vital to good mental health. Circadian cycles are our bodies’ way of regulating a host of hormones that are responsible for everything from keeping us alert when we should be to helping us to relax in stressful situations. Lost sleep can even age your brain significantly over time, while more sleep will improve mood just about every single time. Try it. You look tired.
- 5. Improve Your Diet - Foods for depression can be much more effective than a bottle of junk made by Big Pharma. That saying – you are what you eat – is true. If you eat tons of refined sugar, unhealthy fats, and no ‘living foods’ like organic fruits and vegetables, you will look and feel…not so great! You need high levels of B12, found in fish and eggs, to increase neuronal communication between ‘good’ brain pathways, fiber to avoid spikes in blood sugar and insulin which can lead to depression, folate to keep your brain bathed in cerebrospinal fluid, iron to make sure your blood can transport oxygen, iodine to lower depression and increase memory, calcium to lower anxiety and curb depression, and much more. Try leafy greens, nuts, and foods high in Omega 3s to get an immediate happiness boost.
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