Depression: What the Science Says


– With depression affecting
more than one in 10 adults in the United States, how
can we help our patients with this daunting mental disorder? Well, here’s what the science says. (cheerful folk music) According to the National
Institute of Mental Health, an individual may have depression or a major depressive disorder
if they suffer from just some of the following signs and
symptoms almost every day for a period of at least two weeks. The type and severity of symptoms can vary from person to person. There is persistent sadness,
anxiety, or numbness, feelings of hopelessness,
guilt, or worthlessness, mood swings, irritability,
loss of interest in activities that used to bring pleasure, appetite, or changes in weight, restlessness, decreased energy, fatigue, moving or talking more slowly. There could be difficulty
sleeping or oversleeping. Difficulty concentrating,
remembering, or making decisions. And then there’s aches or
pains, or headaches and cramps, or digestive problems
without a physical cause and not solved with treatment. And finally, there can
be suicidal thoughts and suicidal attempts. In addition to major depressive disorder, there are various types of
depression differentiated by the symptoms, the
severity, and the triggers. I just wanna review a few. First, there’s persistent
depressive disorder, or something called dysthymia. This form of depression is characterized by a depressed mood lasting
more than two consecutive years, although, the severity of those symptoms may vary during this time. Postpartum depression is major depression occurring during pregnancy
or following a delivery. There’s psychotic depression. Individuals with psychotic
depression experience symptoms of severe depression and psychosis such as delusions or hallucinations. Seasonal affective disorder
is a seasonal depression usually occurring during the winter months with individuals typically
experiencing improved moods in the spring and summertime. Premenstrual dysphoric disorder, or PMDD, can occur in women at the
beginning of their period. And finally, there’s bipolar disorder. While bipolar disorder is
not a type of depression, its condition is characterized
by experiencing periods of depression and mania,
or highs and lows. Now some form of depressions
are linked to specific triggers such as postpartum depression and seasonal affective disorder. But depression is believed to be caused by a combination of factors. And these can be genetic,
biological, environmental, nutritional, or psychological. And risk factors include things like personal history of depression, a family history of depression, trauma, or extreme stress, diagnosis with an illness
such as diabetes, cancer, Parkinson’s disease, or heart disease, use of certain medications. And conventional treatments for depression typically involve
antidepressant medications. Other things could involve psychotherapy or modalities such as
electroconvulsive therapy. However, there are also a number of evidence-based dietary
supplements effective in the treatment of depression. First of all, there’s St. John’s wort. Several studies have noted
the antidepressant effects of St. John’s wort. In fact, there was a
2016 systematic review examining the safety and effectiveness of St. John’s wort treatment
for major depressive disorder. And this found that the
effectiveness of St. John’s wort was comparable to an
antidepressant medication for both mild to moderate depression and had fewer side effects. Remember, when prescribing
St. John’s wort, it’s important to account for any pharmaceuticals
your patient may be taking due to the potential
drug-nutrient interaction. There’s also been some
studies on omega fatty acids. There was a meta-analysis
conducted in 2011 and also 2014 examining
the antidepressant effects of omega-3 polyunsaturated
fatty acids supplementation. And it found that omega-3
treatment was effective in patients with both diagnosed
and undiagnosed depression. And research showed that
supplements containing 60% or more of the EPA compared to DHA were effective against primary depression. Another 2012 meta-analysis
found that adjunctive treatment with omega-3s improved
symptoms of bipolar depression. And then there’s exciting
research on curcumin. A 2014 randomized, double-blind,
placebo-controlled study compared the use of 500
milligrams twice daily of curcumin or a placebo for eight weeks in 56 participants with
major depressive disorder. And the results demonstrated that curcumin had antidepressant effects
with benefits occurring four to eight weeks after treatment. Another study compared the effectiveness of curcumin, fluoxetine,
and their combination found that all three groups
had comparable effectiveness, indicating that curcumin
alone may be an effective and safe treatment for
major depressive disorder. Another botanical, saffron. A six-week, double-blind,
placebo-controlled, and randomized trial found
that compared to a placebo, Crocus sativus, or saffron treatment, produces significantly better outcome on the Hamilton Depression Rating Scale, basically supporting the use of saffron in mild to moderate depression. Another eight-week, pilot double-blind, randomized trial supporting
the antidepressant effects of saffron was similar
to fluoxetine treatment in the treatment of mild
to moderate depression. And finally, there’s SAMe. Several studies have been conducted which support the use
of SAMe supplementation in the treatment of depression, and that SAMe may be an
effective alternative for serotonin reuptake inhibitor treatment-resistant individuals. For example, there was one
double-blind, randomized study of 73 serotonin reuptake
inhibitor non-responders, and they found that 800 milligrams of adjunctive SAMe administration
twice daily for six weeks resulted in greater improvements
compared to a placebo. And preliminary evidence also suggests that SAMe may be a safe
and effective alternative to antidepressant medications for individuals with Parkinson’s disease. If you have experience
with treating patients with depression, by all
means, like our post and comment below so we can
keep the conversation going. And for more information about depression and a depression protocol, visit Fullscript’s practitioner
medical education hub at www.fullscript.com/hcp. (cheerful folk music)

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