A Holistic Approach to Treating Depression

From the WebMD Archives

If you’re depressed, taking medication is only one of many treatment options. A holistic approach focuses on treating your whole being -- body and mind -- to help you feel better. A healthy diet, exercise, and talk therapy are a few of the holistic approaches you can use, along with your medication, to help speed recovery from depression.

In a given year, nearly 15 million adults in the U.S. suffer from depression. Those with depression often have another medical condition such as diabetes, heart disease, stroke, or cancer, which makes treating the whole body even more important. This article looks at the benefits of diet, exercise, and therapy, and how you can use them alone, or with medication, to help treat depression.

A Diet for Depression: Eating Well for Your Whole Body

Lisa Brennan has experienced the effect that diet can have on depression. She was first diagnosed with depression as a teenager and has had several bouts of depression as an adult.

“I’d often eat unhealthy food because it was easy, and sugary foods would boost my mood for a while,” she says. “But after a few hours, my energy level and mood would plummet and I’d feel really lousy. Now that I eat mostly vegetables, beans, and whole grains, I feel better and I have a lot more energy. I don’t think I could have gotten over my depression if I didn’t change my diet.”

Many specialists agree that a healthy diet of whole foods -- such as whole grains, vegetables, fruits, beans, fish, and lean meats -- is best for people with depression. “We know that diet can have a strong influence on mood,” says Eric Endlich, PhD, a Boston-based clinical psychologist. “And eating a balanced diet can keep your blood sugars stable throughout the day and help calm your mood. This stability is especially important if you’re depressed.”

Researchers are studying specific vitamins and nutrients in foods to see if they have a positive effect on depression. Omega-3 fatty acids, folate, and vitamin B12 show some promise. Experts aren’t certain of the role these substances play in boosting mental health but believe they may help with brain function. However, some experts caution that one of the greatest risks of these treatments is that people who use them may delay in seeking well-established treatments.

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Depression and Diet: Should You Avoid Some Foods?

Healthy eating when you have depression may also mean avoiding certain foods and beverages. For example, foods and drinks that are high in added sugars, such as processed foods, soft drinks, and sugary snack foods, may cause blood sugar levels to go up and down dramatically during the day. This may have a negative effect on mood and energy levels. It’s also a good idea to avoid alcohol, which can make depression worse. For some people, caffeine may also contribute to depression.

“I’ve found that sugar and caffeine are the two biggest dietary culprits in depression,” says Larry Christensen, PhD, professor of psychology at the University of South Alabama in Mobile. “About 20% to 25% of my patients find relief from depression when they cut caffeine and added sugar from their diet.”

Christensen recommends that patients remove caffeine and sugar from their diet for two weeks to see if these substances are making their depression worse. “The results can be really remarkable. I often see a huge difference in patients’ depression simply from making these changes,” he tells WebMD.

The Benefits of Exercise for Depression

Exercise can also have a positive effect on your mood and energy level. “Not only does exercise reduce depression, but it gives people a sense of self-mastery and empowerment,” says Keith Johnsgard, PhD, emeritus professor of psychology at San Jose State University and author of Conquering Depression & Anxiety through Exercise.

“I first discovered the benefits of exercise on my own mood,” Johnsgard says. “I started exercising on my lunch break three times a week and was surprised at my increased level of energy and reduced stress.”

As a result, Johnsgard began prescribing exercise to his depressed patients and found that many of them experienced positive results as well. In some cases, Johnsgard started taking therapy sessions out of the office and walking with his patients. “Because exercise is a tool people can learn to use on their own, the results are often more effective and longer lasting than taking a medication,” he says.

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Indeed, a study published in Psychosomatic Medicine in 2007 found that exercise was as effective as medication in treating depression in some people. Research has shown that exercise causes biochemical changes in the brain that are similar to those produced by medication, including an increase in serotonin levels.

Exercise may also be a good option for those who are unable to take medication, including some older adults, pregnant and postpartum women, and children. Studies have shown that exercise can reduce symptoms of depression in all of these groups. And those who exercise are less likely to have a relapse of their depression.

Another benefit of exercise for depression: It has no side effects. “Because exercise is good for your whole body, there’s really no downside to adding some kind of exercise to your treatment regimen,” Johnsgard says.

What Talk Therapy Can Do for Depression

Talk therapy, or psychotherapy, is another valuable tool to combat depression. Two kinds of therapy -- cognitive-behavioral therapy and interpersonal therapy -- have been found to be especially useful in treating depression. Cognitive-behavioral therapy (CBT) helps you look at how negative thoughts and behaviors may be contributing to your depression. CBT teaches you how to make positive changes in how you think. Interpersonal therapy can help you improve your relationships with family and friends, so you feel better.

Talk therapy can last anywhere from several weeks to several years and can be one-on-one with a therapist or in a group. Many people combine therapy with other treatments, such as medication or exercise.

“Talk therapy gives you skills to help deal with your depression long term,” says Christensen. “A therapist can work with you to give you strategies to help fight your depression and ways of handling your depression so you have more control. This helps you stay feeling better in the long run.”

Sticking With Your Depression Treatment

Whatever treatment plan you choose, it’s important to stick with it to give it enough time to work. It may take up to several weeks or longer before you start to feel a benefit from any depression treatment, including antidepressants. Make sure to keep your doctor involved in the process and let her know how you’re doing.

If your treatment plan isn’t working after a few weeks, don’t give up. There are many different medications and treatment options you can try. Often, people find that if one type of treatment or medication doesn’t work, something else will.

“I just kept trying different things until I found the combination that worked for me,” Brennan says. “It takes a little bit of work, but the end result -- getting over my depression -- has definitely been worth it.”

WebMD Feature Reviewed by Brunilda Nazario, MD on July 06, 2010

Sources

SOURCES:

Freeman, M. Journal of Clinical Psychiatry, March 2010; vol 71(6): pp 669-681.

Greer, T. Current Psychiatry Reports, 2009; vol 11: pp 466-472.

Rao, T. Indian Journal of Psychiatry, April-June 2008; vol 50(2): pp 77-82.

National Mental Health Information Center: “Alternative Approaches to Mental Health Care,” “Depression.”

Eric Endlich, PhD, clinical psychologist, Newton, Mass.

Lisa Brennan, Oakland, Calif.

Larry Christensen, PhD, professor of psychology, University of South Alabama, Mobile.

Keith Johnsgard, PhD, emeritus professor of psychology, San Jose State University, Calif.

Rosa Schnyer, DAOM, LAc, clinical assistant professor, University of Texas College of Pharmacy, Austin.

Depression and Bipolar Support Alliance: “Food and Mood.”

National Institute of Mental Health: “Questions and Answers about the NIMH Sequenced Treatment Alternatives to Relieve Depression (STAR*D) Study -- Background,” “The Numbers Count: Mental Disorders in America.”

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