Friday, September 1, 2017

Nondrug Remedies for Depression


I’ve just come across an article “Nondrug Remedies for Depression”. Let’s have a closer look at the different tips [1].

Exercise 
“Exercise can relieve depression” – yes, exercise should be part of any therapy.

Light therapy
“During the short, dark days of winter, some people are prone to a type of depression called seasonal affective disorder.” Are we talking about seasonal affective disorder or depression? But I’d agree that light can play a role in symptom control.

Mood diary
“A mood diary keeps negative events in perspective and serves as a reminder that good days do happen.” That’s also a good idea. Limits are based in the severity of the disease.

Acupuncture
“As with many alternative therapies, there isn’t a heap of data that proves acupuncture relieves depression.” Then, why mention it? There has been one good study by J.J. Allen and colleagues [2]: “Acupuncture for depression: a randomized controlled trial.” ClinicalTrials.gov identifier NCT00010517. The authors concluded: “Although TCM manual acupuncture is a well-tolerated intervention, results fail to support its efficacy as a monotherapy for MDD. …”
And the text goes on [1]: “In a second study in the Journal of Affective Disorders, 70 patients with a major depressive disorder who were already taking an antidepressant seemed to show more improvement if they had acupuncture, compared to those who did not.” The study isn’t named, but you can see that the intervention wasn’t blinded.

Support groups
“Support groups … are an excellent way to help treat mild forms of depression.” I agree with a caveat – not all group support. You have to look carefully if the group supports or is a stage for neuroticism.

Cognitive behavioral therapy
Cognitive behavioral therapy is very effective therapy.

Fish oil
“In areas where consumption of foods with omega-3 is high, people tend to have lower rates of depression.” The authors of the text do not fall into the trap of cherry picking and keep an eye on not exaggerating. A Cockrane review concluded [3]: “At present, we do not have sufficient evidence to determine the effects of n-3 PUFAs as a treatment for MDD.” I agree that a deficiency in n-3 fatty acids could be substituted with benefit. Linseed oil and oil of algae are good alternatives for vegetarians.

Meditation
“Promising research suggests that meditation may play a role in preventing depression relapse.” Yes, but lots of people cannot meditate.

Saffron
The authors cite a small study, “which looked at 38 people over six weeks, found that saffron was as effective as fluoxetine (Prozac) in reducing symptoms of depression.” A systematic review in 2014 sees it [4]: “Research conducted so far provides initial support for the use of saffron for the treatment of mild-to-moderate depression.” Here in Germany saffron would be less expensive that fluoxetine. But as saffron isn’t sold as a drug, all side effects would be at the risk of the patient.

Yoga
“Striking a pose may alleviate stress and symptoms of depression.” Yes. And have a look at the link [5]!

St. John’s wort
“One of the most studied supplements for depression is St. John’s wort, a yellow-flowered plant used in teas, pills, and extracts.” Yes, St. John wort is working but in anti-depressive dosages St. John’s worth has a high rate of liver toxicity. And it might “diminish the effectiveness of some prescription medications”.

All in all I’m really not disappointed with the text. I cannot agree with all the tips, but the text has been written without exaggerations and a sense of proportion.  


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