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Many Paths to Healing Depression James Strohecker and Nancy Shaw Strohecker
- Albert Schweitzer
There is no shortage today of media stories on depression. Newspaper headlines from this year cover a wide range of issues surrounding depression: "Herb is Found to Aid Mild Depression," "Researchers Probe Heart Disease-Depression Link," "Millions of American Teenagers Suffer from Depression," "A Hidden Epidemic of Male Depression," "Feeling Blue? Check your Thyroid," "Medicating Kids: A Pacifier for Depression," and of course, "Prozac Keeps Drug maker Feeling Good After 10 Years." Why this sudden fascination with depression? Is it because depression is rapidly becoming recognized as the one of the biggest health problems facing our society, not only affecting adults, but teens and children? This current climate is a far cry from the amount of public interest and media coverage of depression just four years ago in 1994 when we produced a conference called "Healing Depression" in Santa Monica, California that inspired this book. At that time, depression was still a taboo subject socially, a frightening and mysterious condition that was treated medically with powerful psychotropic antidepressants which had disturbing side effects. The controversial antidepressant drug, Prozac, had been on the market for several years and was just penetrating the public consciousness and beginning to make headlines. There was little or no interest in, nor knowledge of natural alternatives to treating depression. Today, thanks to the barrage of media stories and a number of well known public figures who have disclosed their battles with depression, including television journalist Mike Wallace, actor Rod Steiger and novelist William Styron, much of the social stigma surrounding depression has been removed. Discussion of depression in our culture has become more commonplace, and it can now be mentioned in the same breath as being "anxious" or "stressed out." Concurrently, there is an increasing public interest in natural approaches to dealing with this health condition. Even conventional medical doctors who have historically been known to only prescribe antidepressants, are now responding to the public demand and are beginning to recommend natural remedies like St. John's wort for mild to moderate depression.
A National Health Problem All told, it is estimated that depression will cost our economy more than forty-four billion dollars, and an annual loss of two hundred million work hours. These numbers may be deceiving, however, given people's reticence in the past to talk to their physician about depression. Today over 17 million people, including teens and children, are currently on Prozac, the second most commonly prescribed drug in America. Pharmaceutical giant Eli Lilly, the maker of Prozac, is now engaged in a major media campaign to raise public awareness about depression and Prozac. With the rising tide of awareness of depression, many who would have never considered themselves depressed will be taking Prozac, or some other antidote, pushing the statistics even higher. And it appears we are bringing our children along for the ride. It is estimated that close to 13% of teenagers and approximately 3% of children under thirteen suffer from depression according to the Center for Mental Health Services. Until recently, no one has wanted to recognize that teens and children suffer from depression. To make matters more difficult, childhood depression is hard to identify and diagnose because it is so easily confused with other health conditions, and because children lack the verbal skills to explain what they are experiencing. As a result they act out their depression in the only way they know how--what we commonly describe as moodiness irritability, anger and even rage. Are we becoming a "Prozac nation?" Prozac, despite its ability to transform personality, appears to be a short-term solution to a long-term problem. FDA statistics reveal unsettling reports of adverse side-effects ranging from loss of sexual appetite to suicide and death. These serious shortcomings, the rising incidence of depression, and the growing popularity of natural health care, clearly demonstrates the need for safe and reliable drug-free treatments. It is no surprise then that the antidepressant herb St. John's wort, despite having been successfully used for centuries, was barely on the radar screen in the United States four years ago, but is now the number four-selling herb in the U.S. and is outselling Prozac in Germany.
Where Does the Answer Lie? Two things are clear. The human suffering resulting from depression is real and impacts every aspect of one's life--family, work, and relationships. Secondly, depression is not an illness that can be reduced to a single cause or a single cure, as demonstrated by the problems associated with the succession of antidepressant drugs produced over the years. There are no magic bullets for depression. Where then does the answer lie to relieving the toll of human suffering brought on by depression? We have discovered that there are many answers to solving this complex malady. The key is in understanding the many underlying causes of depression, and becoming aware of the variety of natural approaches to its treatment. Many of the solutions come from the world's great systems of traditional health care. Some have ancient roots such as herbal medicine, the oldest form of health care on the planet, and the Greek medicine of Hippocrates. Chinese medicine and Ayurveda, both of which have both been practiced continuously for five thousand years, can rightly be called the original systems of holistic medicine. Other systems of traditional health care have more modern origins, such as homeopathy and naturopathic medicine, each of which originated in early- to mid-19th century Germany before taking root in the U.S. After having fallen into obscurity for most of the 20th century due to the advent of miracle drugs, both are now enjoying a major renaissance. What all of these systems of traditional health care have in common is a focus on health maintenance, prevention, treating the whole person, reliance on natural therapies, and taking a more integrative, multi-disciplinary approach to treatment in order to restore health and internal balance. These systems also share another commonality--for most of this century, each has remained outside the accepted standards of conventional Western medicine, but are now becoming increasingly in demand by people like yourself in search of solutions to their health problems. In order to prevent illness and achieve optimum level of personal health, it is important to be familiar with the tools that can help build a wellness-based lifestyle, and become aware of all of your treatment options. The approaches in this book represent the collective wisdom of thousands of years of the great healing traditions as well as the best of the emerging field of integrative medicine--nutrition, healthy lifestyles, mind/body therapies, and spiritual practices. We have brought together a team of nine leading experts from each of these fields to present, for the first time, a comprehensive and integrated picture of depression, including an understanding of its many causes, prevention and time-tested natural approaches to its treatment. This team of health professionals will provide an in-depth understanding of the following primary systems of natural medicine:
(For a complete list of therapies covered in this book see Appendix B: "Quick Reference to Therapies" in Natural Healing for Depression.)
Many Perspectives on the Causes of Depression From an overall systems perspective, depression can be viewed as a "warning sign" that the body-mind is off-course in some manner--whether it be biochemical, physiological, psychological, energetic or spiritual--and is signaling that there is a need to make some change in your life.
Psychological/Emotional Causes of Depression
Biochemical/Physiological Causes of Depression
Energetic Basis of Depression: According to Traditional Chinese Medicine (TCM) illness results from an energetic imbalance of qi or life force in the body's meridians and internal organs. TCM views depression as resulting from a blockage or stagnation of emotional qi. Similarly, the Chinese system of energy training known as qigong and the Indian system of yoga, both recognize the link between the mind and life force (qi or prana), while utilizing breathing and awareness practices to help regulate the flow of life energy in the body/mind. Spiritual Basis of Depression: According to the "perennial philosophy" found in the world's great spiritual traditions, we have essentially forgotten who we are--our true nature and divine heritage--and feel disconnected from our spiritual source. This disconnectedness or separation is viewed as the primary source of unhappiness. Many sacred traditions view mental illness and conditions such as depression not as a disease of the mind, but as a lack of connection to and awareness of soul. It is when we lose touch with our essential spiritual nature, and forget our true purpose in life that we become subject to depression and other illnesses.
"The doctor of the future will give no medicine, but will interest his patients in the care of the human frame, in diet, and in the cause and prevention of disease." Thomas Edison When looking at the many faces of depression, the logical question arises: is depression preventable? In many cases the answer is, "yes" if we can learn to minimize or avoid the previously mentioned causes by living a balanced, wellness-based lifestyle, and maintaining a healthy psychological and spiritual perspective. Until recently, however, prevention has been a hard sell in America, as our system of health care has actually been a "sickcare" system focused on treating disease, not in preventing illness and maintaining health. In this book, each of the health traditions discussed by our team of health experts offer secrets to not just treating, but preventing depression through a healthy lifestyle and having tools and resources at hand to help deal with depression at its onset.
What Do the World's Systems of Traditional Health Care
Offer?
and not merely the absence of disease or infirmity." The World Health Organization (WHO) uses the term "traditional medicine" to describe established systems of health care worldwide considered "unconventional" by modern, standardized western medicine. Most people are surprised to learn that according to the WHO, 80% of the world's population receives their health care from the various forms of traditional medicine considered to be "alternative" or "unconventional" in the U.S. These systems include Ayurveda, Chinese medicine, herbal medicine, unani (Graeco-Arab medicine), native American medicine, traditional African medicine, naturopathic medicine, homeopathy, chiropractic and osteopathy, among others. The maintenance of health and the prevention of disease form the basis of Ayurveda, Chinese medicine, naturopathic medicine and other forms of traditional health care. The therapeutic protocols in these systems are intended to restore balance to the body systems in order to reestablish health. Samuel Hahnemann, the late 18th/early 19th century founder of homeopathy wrote volumes on hygiene, health maintenance, mental health, as well as the prevention of disease. These systems all understood the connection between diet and mental health, the influence of lifestyle factors, the strong connection of mind and body, and finally the importance of the spiritual dimension in physical and mental health. Yoga and qigong are psychospiritual practices aimed at integrating body, mind and spirit. Meditation, now regularly prescribed by many physicians, is one of the eight limbs of classical yoga. In fact, the basis of much of today's mind/body medicine, including guided imagery, biofeedback and other relaxation techniques, have strong ties to the practices of yoga and meditation. The following poetic passage written thousands of years ago in the Yoga Vasistha, a Sanskrit text of yoga and spiritual philosophy, demonstrates a profound and time-less understanding of how illness can originate in the mind--an understanding that is now weaving itself into the fabric of today's medicine:
"When the mind is agitated, then the body also follows in its wake. And when the body is agitated, then there is no proper perception of the things that are in one's way and prana (vital force) flies from its even path onto the bad road, staggering like an animal wounded by an arrow. Through such agitation's, prana, instead of pervading the whole body steadily and equally, vibrates everywhere at an unequal rate. Therefore, the nadis (subtle channels for circulation of prana) do not maintain a steady position, but quiver. Then to the body, which is the receptacle of partially or completely digested food, the nadis are simply death, because of the fluctuations of the pranas. The food which settles down in this body amidst such commotion is transformed into incurable diseases. Thus through the primary cause (of the mind) the disease of the body is generated. If this primary cause be annihilated at its root, then all diseases will be destroyed."4 The formation of a truly global medicine in the spirit of the World Health Organization's vision of integrating modern western medicine with the world's traditional medicines, is more and more becoming a reality. This process involves a revitalization of medicine, inspiring the evolution of even greater numbers of safe and effective forms of naturally-based approaches to health care, side by side with the cutting edge developments in the field of mind/body medicine and energy medicine.
Alternative, Complementary or Integrative Medicine? What's in a Name? Alternative medicine is a relative term that refers in large part to the systems of traditional medicine that until recently were considered to be outside of the mainstream of western medicine. Today, courses on many of these systems are now being taught in over fifty U.S. medical schools, including Chinese medicine, acupuncture and qigong, Ayurveda, herbal medicine, mind/body medicine, nutritional medicine, homeopathy, naturopathy and chiropractic. There is a growing number of traditional patient-care organizations who now offer alternative medicine services in their clinics as well as insurance reimbursements. Many in conventional medical circles, however, still refer to "alternative" as unproven therapies which purport to replace or act as alternatives to conventional medical treatment. The issue as to what constitutes proof, conventional double-blind studies as opposed to hundreds or even thousands of years of favorable or successful outcomes, remains a contentious issue in conventional medicine. We often see conventional medical experts erroneously stating that there is no research on herbal or nutritional medicine. The German Commission E Reports, probably the single most important collection of botanical research in the world, have been publicly available in Germany for over ten years. Few in this country were aware of its existence and many who were, discounted it significance as it was not "American" research. However, the German Commission E Reports2 have now been translated into English (1998) in a project spearheaded by the American Botanical Council, and beginning to gain its due respect. Similarly, Dr. Melvin Werbach's classic book, Nutritional Influences on Illness3, now a CD Rom containing over four thousand pages of nutritional research on over one hundred health conditions, was until recently little known outside of alternative medicine circles. Two other terms coming into greater use are "complementary" medicine and "integrative" medicine. Complementary medicine means that it complements, but does not replace conventional health care, such as the use of acupuncture for pain control in the treatment of diabetic neuropathy. The Office of Alternative Medicine (OAM) at the National Institutes of Health now promotes the use of the term Complementary and Alternative Medicine (CAM). Integrative medicine refers to a form of health care that integrates both alternative/traditional and conventional medicine. Whatever name you choose, the strengths of this approach to health care are in maintaining a high level of health and well-being, treating the whole person, preventing illness, and offering safe and non-toxic natural therapies for treating illness, particularly chronic illness. The public demand for alternative medicine is very strong. A national survey conducted in1998 by Stanford Center for Research in Disease Prevention showed that the public does not differentiate between alternative and conventional medicines. Those polled wanted the options of going to both conventional and alternative health practitioners, and using those medicines and services that proved most effective without being restricted by arbitrary definitions. Over 69% of the respondents had used some form of complementary and alternative medicine in the past year. Clearly, consumers want choice in the forms of treatments they pursue --they want the best of both worlds.
How to Get the Most Out of This Book Choosing a specific program or approach for any health condition can be a very personal process. For healing depression, some of you may choose to work primarily with an acupuncturist or Doctor of Oriental Medicine, while others may prefer to work with a homeopathic or naturopathic physician. Still others will choose a psychiatrist or a physician who is knowledgeable of both alternative and conventional therapies. Some of you may find that taking a more multi-dimensional approach in designing a program that utilizes several different health practitioners and forms of therapy including exercise, massage, meditation, a healthy diet, nutritional supplements and herbs, is the right solution for your condition. Look over each chapter and see if the approach is relevant to your situation, and whether or not its basic principles resonate with your own philosophy and belief system. Each of these approaches has been effectively used for treating depression, and can work if it is the appropriate approach for you. With the broader acceptance of alternative/ complementary therapies we are no longer restricted to standardized, conventional medicine which looks for one solution to each health problem as if physicians were treating "disease units" rather than a whole person with both biochemical and psychological individuality. As the various systems of traditional medicine and the more modern systems of alternative medicine share a common perspective--a holistic focus on prevention, health maintenance, the use of natural therapies, and a comprehensive treatment plan--you will find throughout the various chapters some of the same therapies as part of an overall treatment plan. For example, St. John's wort is included in the chapters on herbal medicine, naturopathic medicine as well as an integrated approach to women's depression. This overlapping is not only because of this herb's high success rate with depression, but because the description of each approach would be incomplete without a discussion of this herb. Finally, you can use this book to help increase your general level of health and well-being by incorporating the dietary, lifestyle, and stress management guidelines. Every chapter provides tools to help you develop a wellness-based lifestyle and to address imbalances that may occur in your physical and mental health. We have provided additional resources in the appendices for each specific therapy included in the book: recommended reading, national organizations and educational institutes, professional referral sources, as well as Internet resources. The Internet has played a strong role in disseminating information and resources about alternative medicine to consumers, health professionals and health care organization. More importantly, as a global delivery system it supports the formation of an integrated global system of health care which can utilize the best of traditional and modern medicine.
"The next major advance in the health of the American people will be
determined by what the individual is willing to do for himself."
- John Knowles, Former President of the Rockefeller Foundation With the current direction of managed care, it is vital for the individual to take more control over their own health care. The abundance of information about medical options and alternatives necessitates that we become educated brokers of our own health care. Consumers are doing much of their own medical research today and assessing alternative treatments before conferring with their health professional. The accessibility and wealth of information on the Internet, has only accelerated thisprocess. The philosophy of Self-Managed Care emphasizes maintaining health and well-being, consumer empowerment, partnership with one's health care provider, and increased utilization of natural remedies and alternative medicine services. The demanding baby-boomer population, many of whom are now managing their own health as well as that of their children and aging parents, are opting for less-invasive and more cost-effective natural approaches as their primary strategy, tending to avoid the medical system when possible in non-emergent cases. Savvy health consumers today want a full range of treatment options from both conventional and alternative medicine. More than ever the key word is choice.
Many Paths to Healing Depression In reading this book you will witness the true art of medicine as you are intelligently and compassionately guided by dedicated health professionals who look beyond the apparent symptoms to address the deeper, underlying causes of depression through natural and humane approaches. Reading each chapter will take you on a journey of hope and discovery. You will be exposed to healing secrets, both ancient and modern, that will expand your view of the nature of depression and illness as well as educate you in the many paths to healing this condition. The following summaries of the nine chapters of this book will give you a sense for each healing system or approach, and help you or your loved one begin developing the options for an effective treatment plan.
Depression as Emotional Pain: A Mind/Body Approach -- David Bresler,
Ph.D., L.Ac. Guided imagery can help us learn to "focus attention on the part of the nervous system that may have answers to our questions and solutions to our problems," according to Dr. Bresler. Most of us are unaware of the powerful inner resources we have at our disposal, and guided imagery techniques can help us to discover these resources and use them to provide new insights and creative solutions to our problems. The reader is guided through an evocative imagery experience which is designed to identify the particular qualities that are needed right now to help get one through a current challenge or difficulty. Additional imagery tools are given for dealing with depression: exploring the origin and meaning of symptoms, encountering the Inner Critic, and accessing yourInner Intelligence or Inner Advisor. According to Bresler, of vital importance in healing depression is keeping the human spirit alive through hope and faith. "When we lose hope, we lose the very thing that offers the greatest help in healing our problem."
Natural Medicine and Depression: A Naturopathic Approach -- Joseph
Pizzorno, N.D. This approach has many advantages. Stressing prevention and honoring the healing power of nature, Naturopathic medicine relies upon natural therapies including diet, nutritional medicine, herbs, homeopathy, acupuncture, massage and bodywork as well as psychological and lifestyle counseling. The patient is able to utilize a combination of therapies determined by the naturopath at very safe dosages, rather than a using a single therapy at a higher, toxic dosage. Naturopathy also views the role of the physician to be an educator, teaching and motivating people to take more personal responsibility in maintaining good health and a state of wellness. All of these factors allow the patient to be highly involved in the treatment process. Dr. Pizzorno's naturopathic approach to treating depression identifies five primary determinants of mood: physical factors; social factors (family and social patterns), mental factors (a person's thinking patterns), emotional factors and spiritual factors. For example, on the physical level we may need to eliminate toxins, normalize endocrine function and neurotransmitter metabolism, increase exercise and light exposure, and utilize natural mood elevators. On the mental and emotional levels we may need to deal with family of origin issues, employ psychodynamic approaches when necessary, or even follow a prescription for having fun if we are in need of lightening up our lives. Dr. Pizzorno offers a fascinating case study to illustrate naturopathic medicine's comprehensive and effective approach to dealing with depression that first provides the necessary and immediate symptomatic relief while treating the primary causes.
Women's Depression: An Integrative Approach -- Hyla Cass,
M.D. Her integrative approach to treating depression and mood disorders in women utilizes a wide range of therapies depending upon the specific history and biochemistry of the patient as determined by laboratory tests. These therapies include dietary therapy and nutritional medicine, amino acid therapy, herbal medicine, and natural hormone therapy, as well as mind/body therapies, leading-edge forms of psychotherapy including Voice Dialogue, and when necessary, conventional antidepressant medications. Dr. Cass' integrative approach to treating depression and its underlying metabolic causes is also relevant to men, with the exception of the specific hormonal imbalances.
A Comprehensive Approach to Depression: Nutritional Medicine and
Biofeedback -- Melvyn Werbach, M.D. Dr. Werbach, an internationally recognized authority in nutritional medicine, an early pioneer in biofeedback research at UCLA, and Assistant Clinical Professor at the UCLA School of Medicine, provides a clear and in-depth explanation of the nutritional treatment of depression through diet and nutritional supplementation, based on solid scientific research. Dietary factors and common foods associated with depression are examined such as caffeine, sugar and alcohol, as well as specific nutrient deficiencies including vitamin B-Complex, folic acid, vitamin B6, vitamin B12, and vitamin C, as is neurotransmitter precursor therapy to raise serotonin levels. A case study emphasizes the importance of integrating therapies such as biofeedback and relaxation response training into a more comprehensive model of treating depression.
The Natural Pharmacy: Herbal Medicine and Depression -- Janet Zand,
O.M.D., L.Ac. Dr. Zand profiles the Western and Chinese herbs herbs that have proven effective in treating depression, anxiety and mood disorders, including St. John's wort, kava, Siberian ginseng, Ginkgo biloba, astragalus, Dong quai, bupleurum, milk thistle, ginger root, and valerian. She also provides a list of essential oils that are helpful in alleviating depression as well as a useful herbal chart for quick reference. This chart lists the herbs and the corresponding symptoms of depression that it addresses, along with how the herb is taken, plus any possible side effects.
Homeopathy and Depression -- Jacquelyn Wilson, M.D. The most important homeopathic remedies for depression are described in this chapter, along with the appropriate Bach Flower remedies and cell salts, including each remedy's matching symptom profile. Dr. Wilson also distinguishes between the advantages and disadvantages of the two primary forms of homeopathy--classical single remedy prescribing, and complex homeopathy which uses combination remedies. She provides a fascinating account of a serious depressed woman who did not respond to antidepresssants and conventional medicine, but significantly benefited from a specific homeopathic remedy.
Qigong, Chinese Medicine and Depression: Roger Hirsh, O.M.D. Dr. Hirsh, a respected doctor of Chinese herbal medicine, acupuncture, and a longtime teacher of Qigong and taiji (tai chi), leads the reader in a journey into the secrets of Qigong, an ancient Chinese art of energy training and rejuvenation. Qigong is increasingly utilized in health care settings worldwide, and is used in both the prevention and treatment of depression. For those experiencing either acute or deep-seated depression, Hirsh provides some simple Qigong exercises which involves breathing, visualization and movement to stimulate and energize. The first set of Qigong exercises are warm-ups that can be performed either individually or as a group to help deal with mild to moderate depression. The second group, "The Eight Silken Brocades" is a set of ancient exercises that help to stimulate and tonify the whole biomechanical system of the body in order to relieve stress, maintain youthfulness, and promote general well-being.
Ayurveda for Depression and Mental Health -- Shri Kant Mishra, M.D.,
M.S., Doctor of Ayurveda This ancient system of natural medicine has a long history in the areas of mental health, rejuvenation, and longevity through the use of diet and lifestyle practices, herbs, massage, yoga, and meditation. Dr. Mishra explores the Ayurvedic approach to attaining a balanced state of mental health and focuses on specific approaches to treating vata, pitta and kapha forms of depression. He also provides yogic practices such as pranayama (breathing practices) and meditation to help promote optimal health and mental clarity and balance.
The Spiritual Dimension of Depression -- Carlos Warter, M.D.,
Ph.D. The solution, according to Warter, is to help the individual to move from the small, contracted story where depression is able to develop, to the awareness of a larger dimension of one's being, the large or big story of human life. This elevation in awareness entails a fundamental shift in the very notion of who one is, thereby undercutting very basis of the existing depression. In this final chapter, Dr. Warter charts out the spiritual terrain of healing, by combining both eastern and western spiritual traditions, and providing many practical tools and exercises to help us reclaim our wholeness and spiritual birthright.
Where Do I Go From Here? Treat this book like a treasure chest of healing approaches to depression and mood disorders. Open and examine its unique and valuable contents. Discover and take with you the map to healthier living.
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