Finding Joy: A Mind-Body-Spirit Guide
A Western psychiatrist draws on Eastern traditions to guide us out of depression.
Step 1: Your Brain's Health
From Western medicine, we have gained great insights into brain chemistry -- the balance of chemicals in the brain that determine, to a great extent, our mood, energy level, even our outlook on life, Emmons writes. An imbalance of these brain chemicals -- serotonin, dopamine, and norepinephrine -- results in depression.
A "brain-healthy" program involves specific nutrients that will help boost specific brain chemicals, depending on the type of depression you have - anxious depression, agitated depression, or sluggish depression, he explains.
"Many patients who try to eat well, exercise frequently, and live a healthy life remain ignorant of the specific diet and lifestyle choices that might cure their insomnia, lift their mood, soothe their anxiety, and generally ease their depression," he writes.
Emmons' term for Rachel's condition is "anxious depression," which he says indicates that her serotonin levels are low. He identifies two other types of depression: "agitated depression" (high levels of norepinephrine and dopamine, with low serotonin levels) and "sluggish depression" (norepinephrine and dopamine levels are low).
To increase her serotonin levels, Rachel needs a diet high in complex carbohydrates -- root vegetables (like sweet potatoes), whole grains, beans, legumes -- plus a little protein with every meal, he says. She should eat several small meals during the day or three meals plus a couple of snacks. She should also eat foods high in omega-3 fatty acids, like salmon.
Emmons advised her to take these supplements: B-6, B-12, folate, omega-3, vitamins C and E, beta-carotene, and selenium. A multimineral supplement with calcium, magnesium, chromium, copper, zinc, and manganese is also important (although most good multivitamins contain these minerals), he says.
The Case for Supplements
Over the last decade, a growing number of studies have shown that these supplements can help with depression, says Gordon. "I've looked at the evidence, and there's enough evidence that these may be helpful. We don't know for sure -- but I prescribe them because there's no downside, if they're taken in reasonable doses. And there's enough evidence to suggest that they might be helpful," he tells WebMD.
Published studies have shown a relationship between B vitamins and depression, Gordon says. "Whether it causes depression, we don't know. But studies show that increasing levels of B vitamins -- particularly when taking antidepressants -- improves mood. The evidence is not ironclad, but enough is there that I feel very comfortable prescribing it."
Omega-3s are known to reduce inflammation, protect against heart disease and cancer, and help with arthritis, he says. "It stands to reason that if there is any inflammatory process going on in depression -- and there may be -- omega-3s might help. Studies suggest that omega-3s help with bipolar disorder, but the evidence is not as strong about whether it helps depression alone."
Rachel's symptoms improved very quickly -- with a low-dose antidepressant, nutritional supplements, and counseling to help her deal with pressing family issues, Emmons reports. She was willing to try Ayurvedic medicine and Buddhism to gain better balance in her life -- to gain control over her thoughts and quiet her mind, he says.
"With antidepressants, there's always a point at which the drug just doesn't seem to work well anymore and when side effects begin appearing," he says. "For the vast majority of people, they are not an adequate long-term solution. Over time, if you're living as stressfully as before, if your diet hasn't changed, you're still overresponding to stress, you're going to get depressed again."