Unlike a passing ‘case of the blues’, depression is a real psychological illness that disrupts every aspect of daily life. To qualify as actual depression, it needs to have lasted for more than two weeks.
Sufferers present with varying degrees of psycho-emotional, behavioural and somatic symptoms (1). These typically consist of:
According to the World Health Organization (WHO), depression is thought to affect 3.8% of the global population, including 5% of adults and 5.7% of those over 60, making it one of the most common mental health problems (2). It’s thought to have a greater impact on women (3), and also affects children and adolescents (4).
Due to their interrelationship, the causes of depression are difficult to pinpoint, but are likely to be the result of a combination of life event, genetic and neurobiological factors.
Traumatic events, such as separation, bereavement, job loss, abandonment, physical or psychological aggression – sometimes dating back to childhood – can all trigger the onset of depression (5), as can chronic illness or disability, which mobilises physical and mental resources. Alcohol dependence is also known to create the right conditions for depression (6).
Genetic predisposition may also be a factor (7). An individual with at least one parent who has had depression may be 2-4 times more likely to suffer an episode themselves at some point in their life, though this predisposition would really only be expressed against a backdrop of a difficult experience. This partly explains why two individuals faced with the same situation react very differently.
People with depression have been identified as having abnormalities in the transmission of nerve impulses between areas of the brain involved in emotional and cognitive control and self-reference. This may be the result of inadequate production of three neurotransmitters: serotonin, dopamine and noradrenaline (8).
Since depression creates a vicious circle from which it’s difficult to emerge unaided, sufferers need support from those around them as well as from the medical profession. In the first instance, they need to consult their GP, who will be able to refer them on to a psychiatrist if need be.
For episodes of mild depression, psychotherapy alone may be enough (9). Short-duration treatments, such as behavioural and cognitive therapy, focus more on managing the crisis in question by correcting cognitive biases. Longer-term therapies, such as psychoanalysis, aim to identify the ‘origins of the illness’ by revealing past breakdowns that may have led to current negative patterns.
For moderate to severe depression, antidepressant drugs (such as selective serotonin reuptake inhibitors or tricyclic antidepressants) will be prescribed to reduce symptoms and prevent a relapse (10).
With shorter days comes less exposure to natural light and disruption to our body clocks… as well as our mood! The more sensitive among us may go on to develop seasonal depression, or Seasonal Affective Disorder (SAD) which manifests in a lack of energy and low mood in winter (11). How can this be addressed?
By diffusing a white light that mimics the sun, light therapy boxes help to combat the winter blues (12). The dose normally recommended is 100,000 lux in the morning for a period of 30 minutes. Even when the depression is not related to the change in season, light therapy may be effective as an adjunct to conventional treatment (13). Discuss it with your doctor, psychiatrist or psychologist.
In addition, certain practices can boost the production of ‘feelgood’ hormones in the brain: taking regular exercise, eating a diet rich in tyrosine (animal source products) and omega-3 (oily fish, nuts, rapeseed oil), meditation and positive visualisation exercises (14-16)…
St John’s Wort (present in the product St John Wort Extract) supports a healthy psychological state and regulation of mood (17). Though it has long been thought to have an inhibitory effect on monoamine-oxidase, this theory has now been rejected: its benefits are now believed to be due to its dual content of hypericin and hyperforin. However, this plant has a number of known interactions with drugs and should only be taken under medical supervision.
Some compounds are directly related to the ‘happiness’ neurotransmitters. 5-HTP is, in particular, involved with the synthesis of serotonin (it can be found in the 98% standardised supplement 5-HTP), while PEA (isolated from the algae Aphanizomenon flos-aquae in AFA Extract) is a precursor of dopamine (18-19).
Levels of SAM-e or S-adenosylmethionine, a compound naturally present in our cells, fall when we’re suffering from low mood. It’s thought to play a pivotal role in the three-way functioning of dopamine-serotonin-noradrenalin (the best form for helping to beat the blues is the higher-dose SAM-e 400 mg) (20).
If you’re feeling hyper-sensitive, GABA is an inhibitory neurotransmitter which tends to curb nerve impulses and have a calming effect (21). When low mood is accompanied by a state of stress, it can be helpful to take it as a supplement (such as via the product PharmaGABA, the quality and safety profile of which has been approved by the US Food and Drug Administration).
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