Rachel can't sleep, can't eat. She is in the midst of a family health crisis, marriage problems, and other issues. She's faced bouts of mild depression all her life, but this is suddenly much worse -- a severe case of anxious depression.
Rachel needs an antidepressant, most psychiatrists would say. And they're right, says Henry Emmons, MD, a general and holistic psychiatrist in Minneapolis-St. Paul, Minn. "An antidepressant can quickly and potently address her depression. But all too often, the treatment stops there."
Antidepressants, especially when combined with talk therapy, generally help
people recover from depression. Symptoms begin to improve within weeks for the
majority of people taking antidepressants. And people who take antidepressants
long-term -- up to 36 months -- have a relapse rate of only 18% compared to 40%
for those who do not.
But if they work so well, why do so many people stop taking antidepressants
within a few weeks of starting them? Or skip doses when they start to feel
If she'd had a heart attack, her cardiologist wouldn't just prescribe pills for cholesterol and blood pressure and leave it at that, Emmons notes. She'd get advice -- on stopping smoking, eating better, getting more exercise, learning how to cope with stress.
"Even well-meaning psychiatrists tend to see depressed patients as brain chemistry gone awry rather than as a complex integration of mind, body, and spirit," Emmons writes in his newly published book, The Chemistry of Joy. "Even responsible, caring physicians -- psychiatrists as well as general practitioners -- are unaware that depression requires a 'brain-healthy' diet and lifestyle."
The chemistry of joy, Emmons says, is built on a foundation of specific nutrients -- like B-vitamins, omega-3 fatty acids, and antioxidants that affect brain chemicals involved in depression. It is the cornerstone of the three-part program he describes in his book.
Blending Western and Eastern Medicine
Emmons believes in mind-body medicine, so he also draws on wisdom from two ancient Eastern systems -- Ayurvedic medicine and Buddhist philosophy.
Through Ayurvedic medicine, we discover our specific mind-body type, which offers clues to finding balance in our lives, he explains. Through study of Buddhist philosophy, we learn how to rein in thoughts, quell our fears, open our hearts, and practice forgiveness, which provides the path to joy.
Depression is more than a brain chemical crisis -- it is very much a spiritual crisis, says James S. Gordon, MD, a psychiatrist and founder of the Center for Mind-Body Medicine in Washington, D.C.
"Depression and anxiety develop from how one feels and looks at the world, at one's own life," he tells WebMD. "Treating depression isn't just about getting it under control with antidepressants. It's often a matter of transforming your whole life. As we deal with any difficulty in our lives, we can look at depression as an opportunity for profound change."
Buddhism and Ayurvedic medicine "have been used for centuries, and people may find them useful," says Gordon. "There's really no research data on those approaches, but it's obviously something that [Emmons] has found useful in his clinical practice. My sense is that these traditional approaches can help people."
Charles L. Raison, MD, a professor of psychiatry at Emory University School of Medicine in Atlanta, is "agnostic about traditional systems like Ayurvedic medicine," he tells WebMD. "But they point the way to something we've really gotten wrong in the West -- that just because our bodies work like machines, we shouldn't be treated as machines."