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For many susceptible women, the combination of holiday stress and the dark short days of winter trigger a flare-up or first-time appearance of depression. If it happens to you, you’re not alone. Epidemiologists (who chart the incidence of disease) now believe that up to 10% of people suffer from depression, and that after pain, depression is the second most common cause of disability.
The November 27, 2006, issue of Archives of Internal Medicine published what is probably the most important discussion about the treatment of depression in years. After reviewing the care of 12,355 patients all over the US, researchers concluded that the most effective long-term treatment was collaborative care. This approach is exactly what it sounds like: the more individuals involved with treatment, the better.
Some of you with depression may have experienced drawbacks with the current treatment model. Many people get no treatment at all and, often, after several months, the depression just “goes away.” As you may remember from my book, The Triple Whammy Cure, depression is one of the low-serotonin disorders. Serotonin is a brain chemical that serves as your stress-buffer and if you’re low on it, depression occurs because stressful life events have exceeded the capacity of your serotonin buffering system. As time passes, stress can lessen (“time heals all wounds”) and your depression fades.
Another group with depression will see their doctor, who, during the ten-minute visit, may successfully diagnose depression. She may then hand you some antidepressant samples (we receive boxes of them), reschedule you in a month, and renew your prescription at that time if you both think things are better.
A third group will visit a talk therapist, like a psychologist or social worker. This helps, but unfortunately therapists can’t write prescriptions, and the talk therapy may go on longer than if you’d started taking an antidepressant.
What the study in Archives showed was that the more people involved with your care, the better your outcome and the less likely the depression would return. Given that these researchers were conventional physicians, their ideal team was predictable: a primary physician (for medication) + a talk therapist + a case manager (to coordinate care and keep in phone contact). An actual psychiatrist would be available but wasn’t necessarily part of this basic team.
This, to me, is a real step for conventional medicine in the direction of a more holistic approach – that is, taking care of the needs of the whole patient. From our own experience at WholeHealth Chicago, we find that when adding other treatments, results are obtained even faster and for longer durations. We may include bodywork therapies like Healing Touch or traditional Chinese medicine (acupuncture and Chinese herbs), homeopathy, and, if needed, nutritional counseling. I certainly prescribe antidepressants when they’re needed, but try to start first with natural therapies like fish oil, St. John’s wort, 5HTP, SAMe, and light boxes.
The points to remember are simply:
• If you’re depressed, you’re not alone. Every tenth person you see is either being treated for depression or needs treatment.
• The worst treatment is to do nothing. Certain cultures, like the Japanese, are expected to live with it as part of life. They’re not a happy crowd.
• A real bout of depression requires more than just an antidepressant. Ask your doctor for a referral to a therapist for some talk therapy. If she balks, find a therapist on your own. You’ll generally only need a few sessions and most health insurance pays something toward coverage. Conversely, if you’ve been in talk therapy for weeks and you’re making little progress, ask your doctor about medication.
• Take a self-care holistic approach and consider other therapies along with your conventional ones. Use the steps outlined in The Triple Whammy Cure.