Depression

Depression is a mental health disorder characterized by persistent feelings of sadness, hopelessness, and a loss of interest or pleasure in activities. Depression can significantly affect a person’s thoughts, feelings, behavior, and overall well-being.

Depression is more than just being sad, down, or having a ‘rough patch’. When depression is prolonged and interferes with daily functioning and quality of life, seeking help can be critical.

Although several kinds of depression exist, the two most common as categorized by the Diagnostic and Statistical Manual of Mental Disorders (DSM) published by the American Psychiatric Association are Major Depressive Disorder and Persistent Depression.

Major Depressive Disorder is diagnosed when an individual has 5 or more of the following symptoms during the same 2 week period, representing a change from previous functioning and at least one symptom must be either depressed mood or loss of interest or pleasure:

• Depressed mood most of the day, nearly every day.
• Markedly diminished interest or pleasure in almost all activities most of the day, nearly every day.
• Significant weight loss or gain, or decrease or increase in appetite.
• Insomnia or hypersomnia nearly every day.Psychomotor agitation or retardation nearly every day.
• Fatigue or loss of energy nearly every day.
• Feelings of worthlessness or excessive guilt.
• Diminished ability to think or concentrate, or indecisiveness.
• Recurrent thoughts of death, suicidal ideation, or suicide attempt.

Persistent Depressive Disorder, otherwise known as Dysthymia involves depression most of the day, for more days than not, for at least two years in adults (one year in children and adolescents), along with two or more additional symptoms such as; poor appetite or overeating, insomnia or hypersomnia, low energy or fatigue, low self-esteem, poor concentration or difficulty making decisions, and feelings of hopelessness.

Depression is often categorized as mild, moderate, or severe, depending on the degree of symptomatology.

How Naturopathic Medicine Can Help:

A Naturopathic Doctor can help in the assessment and treatment of depressive disorders, often in conjunction with talk therapy and/or Psychiatric care.

Naturopathic Doctors in some states, like Washington, can diagnose and assist in the treatment of mild to moderate depression, while investigating the route biological

drivers in its presentation. Depending on the individual, medication and additional therapies may be required.

For some, relief may be found through evidence based natural therapies and lifestyle changes, while others may need to pursue complementary health options in conjunction with pharmacological treatments.

Along with the psychological factors playing a role in depression, the Bio-Psycho-Social model can be a helpful framework to keep in mind when treating depression and other mental health concerns.

Below are some examples of the implementation of the Bio-Psycho-Social Model in the treatment of depression:

Treating the Biological Routes Depression

While depression is thought of as primarily a mental disorder and has often been treated as strictly a disease of the mind or brain, physical health factors can play a significant role in both driving the symptoms and in its treatment.

Labwork investigation for depression:

• Thyroid function tests
• Complete blood count
• Inflammatory markers
• Vitamin D
• Glucose levels

Urinary neurotransmitter testing assessing for neurotransmitters such as dopamine and serotonin, while in its infancy, can be helpful in guiding treatment plans in the treatment of depression

Genetic Testing for depression:

While depression is complex in its etiology, heritability is a predisposing factor in depression and genetic associations do exist in predisposing an individual to depression.

Examples include dopamine binding genes such as DRD2 or DRD4, or BDNF, a gene that encodes for Brain Derived Neurotropic Factor, which plays a role in neuroplasticity and resilience to stress.

Complementary Health Interventions:

Diet

Generally speaking, an anti-inflammatory, low glycemic diet can be helpful in reducing symptoms of depression.

This can look different for each individual however, and a Naturopathic Doctor can work with you to tailor your diet and assess if food sensitivities may place a role in your symptoms.

Lifestyle

Addressing sleep issues, and incorporating movement therapies such as cardiovascular exercise and yoga, have been shown to be effective in addressing mild to moderate depression.

Other lifestyle practices that can play a part in the treatment of depression may include; pursuing more fun, meditation and breathing exercises, and Emotional Freedom Technique (EFT/tapping), to name a few.

Nutritional Supplements

Taking the right quality nutritional supplements, at the right dose and frequency, can play an important role in the treatment of mild to moderate depression.

High dose EPA fish oil, vitamin B12, and SAMe, a cofactor in the methylation cycle which helps to reduce inflammation in the body, are examples of supplements that have been shown to be helpful in managing symptoms of depression.

Psychological Factors at Play in Depression:

While a Naturopathic Doctor tends to focus on the biological factors at play in symptoms of depression, they can also offer lifestyle counseling and guidance in practices such as Behavioral Activation.

Behavioral Activation is an evidence based Therapeutic Technique which involves tracking and monitoring of daily activities, particularly including those that promote a sense of pleasure or accomplishment.

Through lifestyle counselling, a Naturopathic Doctor can guide you to resources for Psychotherapy, Meditation and Mindfulness, support groups, and books to help in the management of symptoms of depression.

Social Contributors in Depression:

Social support remains an important factor in the management of depression, while social isolation, an increasingly prevalent social issue, can be a significant social driver of depression.

Other social factors such as inequality and social comparison can also play a significant role in the development of depression.

While some factors in depression like heritability and stressful life events can play a role in depression, a Naturopathic Doctor with a background in mental health can help you identify the factors you can control and help you with a treatment plan that works for you.

What to do if you or someone you know is struggling with Depression:

If you or someone you care about is struggling with depression that interferes with your quality of life, relationships, or ability to work effectively at your job, reaching out for help is critical.

In addition to Talk Therapy and Psychiatric Assessment, booking a consult with a Naturopathic Physician with a background in Mental Health and Depression, can be a great place to start.

*Disclaimer: The information provided in this article is intended for educational and informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. If you or someone you know is experiencing severe symptoms of depression or a mental health crisis, including thoughts of self-harm, harm to others, or thoughts of suicide, please seek immediate assistance from a qualified mental health professional or emergency services in your area