Bah humbug: Dealing with depression at Christmas

It has been estimated by the World Health Organization that about $1 trillion per year is spent around the globe because of lost productivity related to depression, with the condition affecting about 264 million people per year, worldwide. A number of studies have demonstrated that one in five people will experience depression at some stage in their lives for at least one month but typically longer.

Grief vs depression

It is, however, very important to distinguish between grief and depression. If you don’t get on with your partner, you detest your job and your children are problematic, you probably will feel depressed. But this is, in fact, usually grief. Or in other words, a reasonable reaction to a very difficult situation. Anti-depressants may make you feel slightly better but they certainly will not change your situation.

Endogenous depression

The medical condition endogenous depression is due to an alteration in brain chemicals, typically serotonin, but a number of other chemicals may be intricately involved. The cardinal symptoms of endogenous depression are a loss of interest in activities you typically look forward to, fatigue and waking in the early hours of the morning finding it very difficult to get back to sleep. If depression plunges into its severe depths, it may also be characterised by a sense of hopelessness and suicidal thoughts.

Unfortunately, for many years there has been a stigma around the diagnosis of depression, with inferences that the person with this condition is a lesser human being and should be able to pull themselves out of the situation. Nothing is further from the truth. Endogenous depression is a medical condition that requires medical therapy, along with supportive psychotherapy to create awareness around the illness.

Effective treatments: medication and lifestyle

Standard, modern-day therapies such as the SSRI-anti-depressant medications are highly effective, in most cases with minimal side effects, for most people.

Many lifestyle factors may also improve endogenous depression, such as a high-quality protein diet containing the amino acid tryptophan, which is the precursor for serotonin. Since the suggestion many years ago that low-fat diets were healthy, the consumption of foods containing fat declined. But typically, foods containing fat also contain proteins and this meant many people on low-fat diets weren’t getting enough tryptophan in their diet to produce the serotonin necessary for normal brain function.

A regular exercise habit of three to five hours per week has also been shown to improve the symptoms of endogenous depression. In some studies, exercise was as effective as standard antidepressants.

Electroconvulsive therapy is still an option for people with severe, refractory depression. There is also an emerging technique known as direct cranial stimulation, which is showing some very promising benefits in the management of endogenous depression.

New drug therapies

Over the past decade, there has also been a number of novel therapies suggested for depression including medical cannabis, therapeutically controlled ecstasy and the South American psychodelic, psilocybin. There have also been reports of the use of the horse anaesthetic and illegal recreational drug, ketamine. A recent study published in Cell Reports from Vanderbilt University in the US has found a particular type of receptor in the brain allows ketamine to rapidly act and improve the symptoms of depression.

I’m certainly not suggesting that we should rush out and obtain a supply of ketamine, but this research allows for the development of specific drugs targeted at these receptors, which may offer another pathway for the management of depression.

Conclusion

If you are suffering from any of the symptoms I have mentioned, it is vital you consult your doctor, firstly to make a diagnosis and secondly to receive proper therapy, if necessary. Depression is certainly not a condition that should carry any stigma nor should it be something where you suffer in silence. Please seek help if you feel you need it.

To read more articles by Dr Ross Walker, click here.

IMPORTANT LEGAL INFO This article is of a general nature and FYI only, because it doesn’t take into account your personal health requirements or existing medical conditions. That means it’s not personalised health advice and shouldn’t be relied upon as if it is. Before making a health-related decision, you should work out if the info is appropriate for your situation and get professional medical advice.