Depression and Homeopathy

I didn't go to a homeopath to have depression treated. Homeopathy doesn't really work that way, despite what the labels on the remedies at the health food store may lead you to believe.
Homeopathy is based on the principle that like cures like, but the word "like" can be complicated here. Remedies are created out of substances that are known to have effects on healthy humans (ranging from mercury and arsenic to lion's milk and wind flower), diluting them down again and again until they're theoretically unable to do much of anything. However, homeopathic theory states that these dilute forms will trigger an immune response the same as if the actual symptoms are present, and kick start the body into healing the causes of those symptoms.
Remedies are "proven" by being given to healthy adults, who track what symptoms manifest after they take them. This is how a given remedy gets the little bullet points on the bottle, like "runny nose" and "arthritis." In fact, though, a remedy may effect quite a few symptoms, and a trained homeopath will identify the remedy that addresses the largest number of symptoms her or she can.
When a remedy is the correct one for a patient, it will even address symptoms you didn't talk about with the homeopath, or that have been suppressed. You can tell this is happening because you may experience little flare-ups ("aggravations,: in the homeopathic vernacular), generally not as strong as the actual symptom and lasting only a day or two. I had what appeared to be poison ivy show up on my knuckle - it was where I got a really bad case about ten years ago, one that spread all over my body.
So I didn't go to a homeopath for depression, but I discovered a couple weeks later that my remedy was addressing suppressed depression. It was a remedy I was taking daily, and after a couple of days of short temper, lack of focus, and mood swings, I consulted with her and she reduced the frequency. The symptoms went away (thankfully), and I know that the little kernel of depression inside me is being chipped away at by my own immune system.
The real point here is that homeopathy is a powerful medicine, and should not be used by people suffering from depression without professional supervision! Taking a remedy for headaches could lead to a lot of problems for a depressed person. On the other hand, undergoing treatment by a trained homeopath could be the solution after long years of suffering.

Migraines and Depression

I suffered from migraines as a child, and I became depressed as an adolescent. I would have thought it just bad luck, but a study suggests migraines and depression may both be linked to serotonin levels. I suppose I should have seen it coming, since it's kind of a dummy smack. My own anecdotal experience, now that I look at it, suggests a link between the worst headache ever invented and depression.

SSRIs are being prescribed as migraine preventatives in response to this area of research. The research suggests a link (47% of Migraineurs experience clinical depression as opposed to just 17% of the general population), but is not yet clear on whether one causes the other or not, or perhaps both are caused by the serotonin levels. I wouldn't be surprised if the serotonin imbalance itself was eventually proven to be a symptom only; however, I don't anticipate that being proven easily by science because of the difficulty of the scientific community in overcoming the body/mind link that depression and related illnesses straddle.

Solutions for SAD sufferers

I found this amazing article about SAD suffering, which is reaching its peak now as the stress and joy of the holidays falls away, leaving us with cold, dark, and dreary (or, if you live in the Northeast, unseasonably warm, dark, and dreary). I was particularly interested in the supplement SAM-e, which I have heard of in passing only. It's refreshing when a medical site recognizes that non-drug treatments can be useful for addressing depression. This particular post gave me the impression that there was some commercial reason for the supplement's promotion, but I am going to do more research on my own and see if the research bears out the claims from this article.

My misgivings notwithstanding, I'm glad to see real research on treatments that may have less side effects. Of course not all options will work for all victims, but that's why I advocate for a variety of treatment options being made available, so the best ones can be found for the individual.

As I side note, I really hate the term "feeling blue" in this context. I think it minimizes the seriousness of depression and sends a message that it's a disease that is not taken seriously.

Fish Oil is not Snake Oil

Studies have not shown if fish liver oil helps with depression. Science sometimes fails to be like the thing that it studies; that is, slow-moving and focused. I have not the slightest idea if fish oil has any impact on depression (although it is probably as effective a placebo as anything else out there), but I'm pretty sure that you aren't going to get fast results out of a natural phenomenon.

Any scientific study must be funded, and most funding comes from the companies that profit from research - the ones making products that they can sell. Sunlight, plants you can pick from your own garden, and air just aren't going to be studied as serious treatments for anything since they're free and plentiful (unless a marketing person can find a way to sell us what we already have, a la pet rocks); things like fish oil and cow pies and cat hair are all common enough that it would be tough to charge a lot for treatments derived from them, also discouraging the really big research bucks. We aren't likely to see long-term studies on depression treatments that nobody can make money from.

There have been some amazing breakthroughs for treatments of all manner of diseases through new drugs. That doesn't mean that every drug is wonderful, nor does it mean that every disease's cure is in pill form. Well-trained pharmaceutical representatives earn a great living convincing doctors to prescribe their products, and no one is out there equally passionately pitching St. John's wort, taking a walk every day, fish oil, getting a puppy, copper bracelets, and believing in God (at least in doctor's offices). Plenty of alternative therapies may be effective, but the medical community isn't designed to find out.

Of course, I can't say that I would like the idea of being accosted by fish-oil salesmen.

Placebo: What Your Brain Can Do for You

The placebo effect is the measurable, observable, or felt improvement in health not attributable to treatment. This effect is believed by many people to be due to the placebo itself in some mysterious way.

So states this article on placebos and depression from the Skeptic's Dictionary, and appropriate resource. Like this UCLA article about placebo usage, it discusses how, when a patient is told they are receiving a placebo, the effectiveness often goes away. Is this because the treatment was all in their heads? Or that the depression was?

Many studies try to compensate for the "placebo effect." Others, more recently, have specifically studied this factor as a healing process. A study by Dr. Arif Khan showed, according to the New York Times, that:

It turns out that the more severely depressed people are, the less likely they are to respond to a placebo. And people with more mild depressions get better with just about all treatments, including placebos. Since most clinical trials enroll less severely depressed patients, the observed difference between the response to an antidepressant and a placebo can be misleadingly small.

Other studies, including one by Dr. Irving Kirsch, suggest that medications are nearly useless because the placebo effect is so high in depression treatment. Meanwhile, doctors wrestle with the ethics of "tricking" patients with placebos.

I think the point is not quite being realized by the scientific community. Depression is a disease that is has an effect upon the body as well, because the brain controls all things. Placebo is the brain's natural ability to repair damage to all the human systems. This process is easily interrupted by doubts and limiting beliefs. At this point in our development we have identified the process, and we recognize that it can be encouraged by presenting patients with a physical talisman, if you will, of healing; the pill. More severely depressed people need more than a sugar pill because they are so very sick their limiting beliefs extend deep into the unconscious, metastasizing like cancer. They need medications to bring them to the point where the placebo process can recover enough to even try to work.

I foresee a time when the scientific community will focus serious research on placebos, not to remove them as a variable or identify what is "in a patient's mind," but to determine how to harness our own healing ability and hone it. This research will not be conducted by drug companies, because it would not be advantageous to cure such a lucrative market for maintenance medications. It will be research into areas currently sidelined as psychology or superstition, and will tap into the true potential of the human brain.

The lucky depression patients have found other avenues to unlock these secrets, either through sugar pills or prayer or exercise or therapy, and they have been given a chance at true healing, y allowing their brains to overcome depression naturally. It's time the scientific community figures out a way to give the rest of the victims that opportunity.

Self-Care Options

This article reinforces my position on the paradox of depression: you aren't going to get better if you can't learn to do it yourself, but depression keeps you from believing that this is possible. Drugs and therapy can be important tools for recovery, but neither of them will succeed without your help, and neither of them should be considered for a lifetime. If you plan for a day when you won't need them you're much more likely to reach that day.

Either of those treatment options may give you the needed push to get to a point where you can do something for yourself, crawl just far enough out of your own personal pit that you can take at least a small amount of responsibility for your own recovery. If they can't get you to that level, and you aren't functional enough to make it there without further help, you should find that help. Never forget that the worst symptom you have is the belief that you are going to stay this way, that nothing you do can change it, that it's pointless to even try. Don't give in to that crap, because if you expect the worst you're rarely disappointed. Do you have anything to lose by trying for more? Can it really get worse than it is? Really?

Some thoughts on the five suggestions given:

• Keep Active: yep, I've mentioned how important even a little bit of exercise can be. Don't want to get out of bed? Consider having a friend drag you out if necessary.
• Eat well. A well-balanced eating strategy will help you feel better now and later. Good thought. I've had comments here from depression victims that eat like crap, and it shows in the writing that they're just making things worse. Your body needs good fuel to do a good job.
• Get adequate sleep. I would modify this to say, "Get appropriate sleep." Insomnia is a symptom of depression, but I was more prone to the fourteen-to-sixteen-hour power nap. I psychiatrist I knew said that the best way to regulate sleep is to get up at the same time, every day, without fail. Your body will take care of the rest.
• Control stress. Coping with depression is stressful enough, so try to limit other sources of stress. And depression does a marvelous job of amplifying the other stress, doesn't it?
• Stay connected. Make relationships a priority. Social ties give you a sense of purpose and meaning in life. I can't emphasize this more. You need to be around people, even if you don't feel like it, because even if you believe you're alone in a crowd it is better than being alone alone. Do it even if you don't want to.
  

Giving Perspective

One of the ways that depression works to gain control of a person's life is to instill a perception of changelessness. You always felt this way; it's not a disease so much as it is who you are. Nobody ever cared and you should not waste anybody's time by telling them your problems. Happiness is not meant for your life. The dark cloud that surrounds a depression victim makes it impossible to see things that are positive, helpful, promising.

Now comes a tool from the Families for Depression Awareness that can help remove that metaphorical blindness. It allows a victim to see progress that is made in treatment by carefully tracking it. It's a simple concept but a very important one. It breaks that perception that nothing has ever changed and nothing ever will change by showing, in the victim's own words, what things were like yesterday, last week, last month.

By involving family it also helps break down the belief that you're alone in this journey. Solitude is depression's friend, and it withers if you convince the victim that they are not alone. Mind you it takes a consistent effort to make that point, and even minor setbacks can bring you all the way to Square One, but this tool is a good way to involve the people that care about the victim and help them reinforce that fact.

Medical Reinforcement (sort of)

Dr. Neubauer has located some studies that support what I have stated previously, namely that there are steps you can take to improve your mood and your sense of accomplishment, including caring for pets and exercise. I understand that his training is scientific and so he will only support any treatment option so far as the scientific method can document its success, but I take exception of his downplaying the value of these treatments, as well as herbal remedies like St. John's Wort, which I will discuss more in detail in a future post. For now, suffice it to say that there have been studies that demonstrate this herb's efficacy, just not, apparently, published in any journal the doctor respects.

I'm also not surprised that he does not include such vehicles as prayer and self-affirmation, as these are exceedingly difficult to document in a laboratory. Being unverifiable is not the same is being unsuccessful, however. Expectation is often half the battle.

Will Employers Actually Help?

This is an interesting study - careful tracking of employees through screening and treatment, even accounting for various levels of quality of treatment, to see how much productivity could be improved by working to overcome the depression. I'm more amazed with the process than with the results. The keys to such an enhanced depression screening program working would be twofold:

First, the employers must recognize that the cost of replacing an employee with another, which would not include the cost of depression treatment, would still be higher. Training and development, even for a relatively low-challenge job like fast food, can amount to thousands of dollars. The investment would be a crap shoot if you consider that a lack of depression screening could land another underperforming individual on the payroll.

Second, it must be mandatory, or it will be a failure. Nobody submits themselves for depression screening, or nearly nobody. Half of the depression victims don't realize they have a problem and the other half are too ashamed to admit it. Most of the people with a need would never be identified, so the cost would have no offset in value.

Employers are very results-oriented, so hard data such as these are promising. It is still likely only to be implemented by employers that are independent enough not to have to answer to stakeholders that are so shortsighted that they resist anything without an immediate benefit, and only in industries where employees are likely to stay more than the five years projected by the study as the point at which savings develop.

Wellbutrin and SAD

I think the most promising thing about this discussion of Wellbutrin is that it's only recommended to be taken during the dark months. It's very easy to get into a maintenance program with depression, and it's often not necessary. Long-term medication creates a dependence in a way that isn't defined by the scientific community; it's a belief that develops that one cannot be well without a drug, which becomes a self-fulfilling prophecy. If you're depressed you're already extremely susceptible to the belief that you are simply not a strong person, and drugs can easily reinforce that by becoming a security blanket. Properly used, a medication for most depression victims should be a trainer, showing their minds what health looks like so that they can reproduce it in themselves.

That being said, I'm glad that Wellbutrin might be useful for SAD sufferers. If it gets you through the darkest times, and allows you enough energy and motivation to modify your behavior for health (exercising, exposing yourself to more sunlight), then it could be a godsend for many. Only for a very small percentage of depression victims is a permanent drug solution logical. And I know how you think if you're depressed, so let me make this clear: you're not one of that small percentage. Don't believe it. The light is inside you, and the drug is only a tool that can bring you back to the level where you can find and use what you've had all along.

Maybe it's the fur?

RemedyFind has an extensive amount of information on depression, ranging from details on the various kinds of depression, to a regular newsletter on new research, to an extensive list of treatments rated by members. Only the top ten best-rated treatments with at least one hundred ratings are displayed on the front page, but the complete list is really quite instructive. Sortable alphabetically, by average rating or number of ratings, it goes through so many options that I realize I have a lot more research to do just to understand them all. For example, I did not know that a gluten-free diet has been proposed for treating depression. Apparently none of the RemedyFind members have tried it yet, but it's interesting to see that an alternative like that, or contraceptives, or even just reading blogs and email newsletters are included as potential alternatives.

I think some of the therapies that have not yet been sufficiently evaluated to be included in the top ten are quite instructive. Only 36 members have tried prayer, and it scores an 8.1. More amazing still is the emotional support of pets, scoring an impressive 8.9 with 63 votes in. I'm going to keep an eye on the list to see how those two, in particular, do as more ratings come in. I've spoken a bit about prayer already, so I'm going to speculate a bit about pets, in particular mammals, since that's where my own experience lies.

I have had cats as companions all my life. They are incredibly empathic creatures, sensitive to your moods and able to sense when you're about to go to the bathroom, settling on your lap just moments before the pressure in your bladder builds to a climax. Granted, they have a sadistic sense of humor, but they also use this sensitivity to know when you need to be reminded of the nature of love. I have only had one dog, but he and the others I have known have made it obvious that, although they may be slightly less sensitive to the shifting moods of the human, they are even moreso a vehicle of unconditional love. Love is, in my opinion, the vital tool that pets wield, both innocently and adeptly.

Your pet does not judge you if you can't get out of bed one day. Their eyes do not accuse if you forget their birthday. They don't laugh at you when you try and fail, or give up without trying. This raw emotion of love that they project is in its most primitive form, unrefined by the nuance of human behavior. It is easy to understand, and it is easy to accept that there are no motivations for it. If depression has led to anhedonia then that love may be the first form of pleasure the victim is again able to feel. In turn, the victim will be more likely to take care of basic tasks, such as feeding, walking, and litter cleaning, for the pet than they are for themselves in some cases.

Feeling love. Completing basic tasks. For some serious sufferers, this marks amazing progress.

Other animals, rodents and fish and reptiles, probably can achieve similar results. However, insidious as it is, depression can turn that love into responsibility, and responsibility into guilt. There is no magic bullet, but the right pet can make a wonderful impact.