D is for Depression, or perhaps for DON’T GO THERE!
Well, I’m going there: The big D.
Why am I going there? Well, interestingly when I recently asked in a facebook group about feeling demotivated and flat – the response from people who felt the same was MASSIVE. So I think we need to cut the proverbial and talk about it. Lots. Why are people suffering so much from this? And why do they do it at home in silence?
Sucking it up in Silence
To go to the latter first, I think there are a few reasons people tend to suffer in relative silence. Firstly, depression still has a stigma that’s lingering like a bad smell. Perhaps just continued fear of something we can’t quite understand? And it is hard to understand – it’s complicated and there is still so much unknown. Research has come a long way however and I’ll get to that in a second.
Another reason we do it alone, and I think this is where some of the misunderstanding arises: If you’re really, really depressed, you can’t move. Period. You struggle to find a reason to get out of bed. If you do get out of bed you sit on the lounge and just exist. You might go out to hang the washing but you stand there staring, mostly doing nothing or working on autopilot. You can’t reach out to people cause you can’t switch on those muscles in your face. You can’t reach out cause you forget how to function. Your mind has somehow collapsed in on itself, so it’s this little tiny speck of activity deep in your brain and you’re just stuck in there – nothing is reaching the surface – you literally can’t move, let alone find the energy to connect.
If you do manage to shake it off momentarily, feel something, realise that this just can’t go on and you finally, finally muster the nerve to reach out; in my experience you are faced with a few possibilities: 1. there’s noone there; 2. there’s noone there who actually gets it or 3. noone feels they can do much so they tend to do nothing. In the end you get tired of hearing yourself talk about it so you figure everyone else must be well bored by now and next time you have one less reason to get out of bed.
Models of Depression
The current view of depression is that there are underlying factors that might predispose a person to be more vulnerable, such as genetic factors and neurochemical imbalances. However these don’t determine on their own if a person will develop depression (identical twins will both have depression about 70% of the time). So beyond your biology, there are psychological and social stressors that may act as triggers. These include: lack of sleep (me), isolation (yep), lack of exercise (un-huh), hormone imbalances, death/divorce and infection, just to name a few.
There is also an emerging view that systemic inflammation is a cause of depression. This can be a “stress” on the body that is enough to make you feel exhausted and miserable – enough of a trigger to tip the balance.
Things Research has Demonstrated
I don’t want to make it complicated, but depression is complicated – there are many, many factors that can play a role and noone really knows which are chickens and which are eggs. What we do know:
- The Ventromedial Cortex (VMC) of depressed people is smaller – this is a part of the brain involved in being able to emotionally regulate, including switching between moods and being able to experience pleasure. Activity in the Pre-frontal Cortex is reduced (where the VMC is located) and is believed to inhibit the ability to filter inappropriate or incapacitating emotions.
- Neurotransmittors serotonin, norepinephrine, dopamine and glutamate are all involved but it’s not a simple picture. There is a relationship between the number of neuronal receptors, the amount of each neurotransmittor available and also a neccesary rest and reset between neronal signalling. Serotonin is important for sleep, mood, aggression and eating. Some models show a link from low serotonin causing low norepinephrine linked with depression, so often the links aren’t direct. Dopamine is linked with reward seeking and obtaining a sense of pleasure which is reduced in depressed people and may explain why they aren’t inclined to get out and do what other people would do to feel better.
- There are links to hormonal imbalances: the hypothalamus regulates stress hormones, the immune system, Circadian rhythms. High cortisol (your “stress” hormone) is linked with increased depression. Decreases in oestrogen are also linked with disruption to serotonin and norepinephrin balance = depression.
- Taking anti-inflammatories with anti-depressants increases the effectiveness of treatment, so the inflammation hypothesis is definitely holding water. Stress causes persistent inflammation, as does infection and/or a diet high in sugar and trans-fats (hello western diet).
- There are more synthetic chemicals, toxins and electrical polllutants in our environments than ever before and these are all having some impact on our health, including depression.
- There is a link between gut health and mental health. There was a great doco on SBS a while back called Life on Us – there were many conditions linked with gut health, even those never suspected. Whilst trying to cure Crohn’s and other gut issues by recolonising the gut with healthy bacteria, one patient reported his depression was gone. The researchers asked him how he knew it was gone. “After 25years with depression, you know when it’s not there anymore.”
What to do?
I’m obviously not a big advocate for pharmaceuticals, however if you’re facing serious depression you may need a kick-start. Anti-depressants tend to have a limited timeframe you can use them before you desensitise, so my advice is to talk to your GP and make a plan – a really solid plan for all the different interventions you can use to help you so that you can wean or reduce your meds as soon as possible.
Is “Alternative” a Swear Word?
There are some really powerful alternatives that have success beyond mainstream meds and let’s be honest, anything is worth a try at this point right?
- Gut Health: GAPS diet is a great way to help restore gut health. Bone broth. I know of an essential oil protocol that will help provide a natural cleanse to the gut – follow it up with some really good probiotics, kombucha, kefir.
- Exercise: really important obviously – it balances hormones and neurotransmitters and helps detox chemicals from your body. Doing it outside in the sunshine and fresh air will obviously add benefit to benefit.
- Diet: A diet rich in fruits, veg and fish oils has been shown to help reduce inflammation. Grains, sugar and trans-fats are highly inflammatory. I recommend looking into the GAPS diet or at least taking a Paleo approach. Include lots of your good nourishing fats and green veg. Curcumin (from tumeric) has also been suggested to help – pretty easy to sprinkle on an omlette. Foods high in tryptophan, which is needed to make serotonin are worth considering also.
- Essential oils:
- Frankincense promotes feelings of peace and wellness. There are also mood-boosting blends which promote a positive mood and energised mind and body; citruses in particular help reduce stress and uplift mood.
- Detoxing/Gut Health – there are oil blends to support the detoxification process, for gut cleansing. Be sure to include a highly bioavailable vitamin, mineral and Omega-oil supplements that will help maintain good health through the detox process. For more info please get in touch and I can help you find what you need.
- Hormone Balance – there are amazing essential oil blends that can support your natural hormone balance
- You may want to keep something for supporting your innate immune system on hand – infection can be a trigger to inflammation and/or feeling low, which can be enough to trigger another downward spiral.
- Environment: There are some aspects of your environment you can control and some you can’t – reduce the synthetic chemicals in your food and your house because there are plenty of them and I can guarantee many are messing with your hormone balance and adding toxic burden to your body that you just don’t need. Reduce the electrical pollution you’re surrounding yourself with as much as you can.
- Herbs/naturopathy: St John’s Wort has a tried and true history of use however it is always worth consulting a naturopath for options. Some do online/skype consults now which makes life easier if you’re house-bound.
- Social support: If you can’t get out of the house, get online – try and connect with someone, somewhere. Talk, reach out, offload.
- Self-support: Try and get out the door, if only to your gate – fresh air and sunshine can really help. If you can’t manage that, try shutting yourself in your room and scream, vent, cry – just try to connect, even if it’s with misery. This may not apply to you, but I personally think that emotions go in cycles – from crying and screaming you can work on turning it around. From nothingness…there’s nowhere to go.
- Read Louise Hay – write yourself some positive affirmations. I highly recommend starting with something like this: I am enough. I am loved, loving and lovable. I am love. Make yourself a vision board – just stick something positive on your wall you can talk to when you need to regroup and find a reason …
I’m not going to add meditate, do yoga, acupuncture, look after yourself, love yourself. Sometimes it’s just not that easy. Sometimes you’ve got 2 kids who don’t sleep and you’re too damn tired to do more than scrape together breakfast, let alone meditate. And you can’t just head off to the gym for some good ole exercise cause they only have creches open when your toddler naps (thanks EVERY gym in a 200km radius)…oh, and you’re too damn depressed. But in your brief motivated moments there has to be a care plan – there have to be things on this list you can do and have ready. Have them as a note in your phone you can refer to. A vision board doesn’t have to be a work of art – copy a few images off google and print them out. Get your meal plan with your paleo recipes and shopping list ready to go. (Or one big casserole recipe you can live off for a week if you need to!) Get your oils. Get 5 minutes of exercise if you can’t get 10. Sit in the sun if even 5 min seems beyond you.
Finally, I want you to remember one word: CYCLES. Everything moves in swings and roundabouts as my mother would say. You have to know that there will be bad days, just do everything you can to make sure they don’t turn into bad weeks, or months…have a plan that works for you to turn it around as soon as you can and just hang in there – sometimes you just have to ride it out.
You are soooo not alone my friend. Keep reaching out and you will find someone who gets it and can at least listen without judgement, without fear. And maybe they’ll check in with you from time to time. Or maybe you can do that for them.
References
A couple of sites I found really interesting while reading up on all this:
http://info.emergencehealthnetwork.org/
http://www.theguardian.com/lifeandstyle/2015/jan/04/depression-allergic-reaction-inflammation-immune-system