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fered from several symptoms of depression, including poor self-esteem.
She was especially sensitive to innocent joking comments from friends.
On one occasion, the husband of a friend commented that she had an
artist s car a vehicle that had seen better days. Alyssa said nothing
but drove home feeling that she was a total failure because she couldn t
afford a newer car. Eventually, in therapy, she was able to create a more
positive self-perception.
A second helpful therapy is called interpersonal therapy. This
approach focuses on a patient s difficulties with others. It s particularly
helpful with major life transitions, such as a divorce or the death of a
spouse, and afterward redefining a relationship with children. Therapy
focuses on helping the patient better adapt to the inevitable changes
in life.
Exercise. Many studies have found that a regular program of exercise
helps to reduce the severity of depression. How does exercise help?
Some researchers believe that exercise increases levels of endorphins, a
family of natural uppers made by the body. Joggers often refer to a run-
ner s high that is felt after running for a mile or two, and going for a walk
can lift feelings of depression for about an hour. Exercise may help for
other reasons, too. Regular physical activity adds structure to a person s
life, and people with depression often lose some of the organizing struc-
ture of their lives. Exercise also increases muscle mass, which improves
blood sugar and insulin levels.
Get a pet. It s often difficult for depressed people to make new friends
and expand their social support networks. Yet pets are accepting of
DEALING WITH DOWN DAYS, DEPRESSION, AND BIPOLAR DISORDER 229
people who are depressed, seriously ill with cancer, or healthy. Having a
pet helps you to create a bond with another living creature, and the ben-
efits are often described as miraculous. Dogs especially are social
creatures and, when treated with kindness, return loyalty, affection, and
playfulness.
Helpful Supplements
Many supplements described in this section help to elevate levels of
serotonin, a mood-enhancing neurotransmitter. Some of the supple-
ments boost levels of other neurotransmitters, such as dopamine, norep-
inephrine, and phenylethylamine, which may also have antidepressant
benefits. All of these supplements will have collateral benefits because
they further a wide range of normal biochemical activities.
High-potency vitamins. Although I frequently recommend a high-
potency multivitamin or B-complex vitamin supplement, you might find
such supplements of greater benefit in depression if they contain
pyridoxyl-5-phosphate, the more biologically active form of vitamin
B6. (You ll have to look at the fine print on the label where the ingredi-
ents are listed.) If you cannot find a multivitamin or a B-complex supple-
ment with pyridoxyl-5-phosphate, take an additional 50 mg along
with your regular supplement. In addition, I recommend that you
take the high-potency multivitamin or B-complex supplement for at
least two weeks before trying other supplements. The reason is that the
B-complex supplement alone may be beneficial, saving you money.
Antidepressant formulas. Many vitamin companies market specific
supplements for easing depression, although the labels can legally only
hint at this use. One of the best-formulated products is Deproloft,
made by Thorne Research (for more information or to order, visit
www.thorne.com or call 208-263-1337). It contains several key B vita-
mins, plus amino acids and herbs. Follow the label directions for use.
SAMe. The body makes S-adenosylmethionine from B vitamins and the
amino acid methionine and then puts SAMe to use in making serotonin
and other neurotransmitters. As supplements go, SAMe is fairly expen-
sive, but it may boost the effectiveness of B vitamins. By itself, SAMe
often works as well as some antidepressant medications, such as
230 THE FOOD-MOOD SOLUTI ON
imipramine, but it also enhances the benefits of medications in treating
major depression (the most severe type). Take 800 to 1,600 mg daily.
SAMe may be of particular help if you suffer from both osteoarthritis
and depression.
Chromium. This essential dietary mineral plays a crucial role in regulat-
ing blood sugar levels and insulin function. If feelings of depression are
associated with excessive appetite, overeating, or overweight, supple-
ments of chromium picolinate may be of particular benefit. The discov-
ery of chromium s value in atypical depression was first published in
1999 by Malcolm McLeod, M.D., a psychiatrist at the University of
North Carolina School of Medicine, Chapel Hill. Since then, further
studies by McLeod and others have confirmed the effectiveness of
chromium picolinate in depression that involves overeating. Take 400
mcg daily or 200 mcg twice daily with meals.
5-HTP. Technically known as 5-hydroxytryptophan, 5-HTP is the imme-
diate precursor to serotonin. The supplement increases serotonin levels,
whereas antidepressant drugs try to maintain higher levels (which may
be difficult if there is not much serotonin to work with). The 5-HTP
molecule is built around tryptophan, an amino acid found in meats, fowl,
and fish. Pure tryptophan is more difficult to find (to order, visit
www.nokomisnutrition.com), but it may actually work a little better,
because the body can use tryptophan in a wider range of biochemical
reactions. Take 50 to 200 mg of 5-HTP daily, in divided doses, at least
one hour prior to or after eating food. For tryptophan, take 500 to 6,000
mg daily, in divided doses, also at least one hour prior to or after eating
food. If insomnia is associated with depression, take the last dose thirty
minutes before bed.
St. John s wort. Of all the herbal remedies on the market, St. John s wort
has the most substantial scientific research behind it. In Europe, the herb
is often the first choice for treating mild to moderate depression, as well
as dysthymia. Studies have repeatedly shown that St. John s wort works
better than the leading prescription drugs, including Prozac, Zoloft,
Paxil, and imipramine, and that it also poses fewer side effects than the
drugs.
Nutritionally oriented practitioners usually reserve St. John s wort for
DEALING WITH DOWN DAYS, DEPRESSION, AND BIPOLAR DISORDER 231
treating mild to moderate depression but not major depression. Major
depression is difficult to treat with any therapy, and, not surprisingly, one
study questioned the herb s benefits in severe depression. Another study,
however, found that very high doses of the herb were helpful.
St. John s wort can also relieve many of the mood and behavioral
symptoms associated with premenstrual syndrome. In one study, virtu-
ally all PMS symptoms decreased, with the greatest improvements in
anxiety, depression, nervous tension, confusion, and crying.
Take 300 mg of a standardized extract of St. John s wort (such as
Carlson Laboratories St. John s wort, Nature s Way s St. John s wort, or
Lichtwer Pharma s Kira product) three times a day. You can also take a
comparable tincture (such as A. Vogel Bioforce s Hypericum Tincture).
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