Mild
Depression May Be Reduced with Lifestyle Choices
A brisk run, a friendly game of chess, a soothing massage:
All of these pursuits can help ease mild depression, experts say.
 "These are all things that are certainly worth trying and
are generally healthy, anyway," says Dr. Nadia Marsh, an expert in treating
depression and chief of the division of geriatrics at Cabrini Medical Center
in New York City. Dr. Marsh stresses, however, that alternative or complementary
therapies probably will not do much to ease really serious depression.
"For any form of mild depression, all of these things can
help when added together," she notes. "But, even then, it's not a form of treatment
in and of itself."
Each year millions of Americans are diagnosed with depression,
and many turn to their physicians for either professional psychotherapy or
an antidepressant medication - usually widely used selective serotonin reuptake
inhibitors (SSRIs) such as Prozac® or Zoloft®.
But increasingly, individuals are also looking for non-pharmacologic
relief of illness, including depression.
Unfortunately, according to Dr. Marsh, the evidence to support
the effectiveness of alternative therapies against depression is not strong.
"The studies for non-pharmacologic interventions have not
been great," explains Dr. Marsh. "There are relatively few randomized controlled
trials, and the ones that have been done are plagued by problems such as too-short
follow-up or small sample size."
However, some research has shown promising results.
Researcher James Blumenthal, Ph.D., a professor at Duke
University, says, "Exercise, at least when performed in a group setting, seems
to be at least as effective as standard antidepressant medications in reducing
symptoms in patients with major depression."
His team's study found that 10 months of regular, moderate
exercise reduced depressive symptoms at a rate equal to that of Zoloft.
Another study, this time by researchers at the University
of Texas Southwestern Medical Center, found that 30-minute workouts done three
to five times a week could cut depressive symptoms in half in young adults.
Even less vigorous activities, such as Tai chi or yoga,
may help lower blood pressure and ease stress, adds Dr. Marsh. "People who
exercise also tend to feel that they have more control over their life. That's
important, since a persistent feeling of helplessness is a hallmark of depression.”
According to Dr. Marsh, the science is much less clear when
it comes to the effectiveness of supplements and herbal medicines.
For example, there is little good data to support the use
of either folate or the B vitamins in warding off the blues, she says.
Perhaps the most talked-about herbal therapy for depression
is St. John's wort, but "the evidence that it can help moderate-to-severe depression
is very poor," points out Dr. Marsh. "Even for mild depression, it's unclear
what the correct dose should be - the studies have been all over the map."
Dr. Marsh also warns that both St. John's wort and prescription
SSRIs get metabolized through the liver. "They both affect the liver, and it
affects the metabolism of the antidepressant.”
"A lot of people combine antidepressants and alternative
medicines - we see that all the time," says Dr. Marsh.
It is a dangerous mix, however, because adding St. John's
wort to an antidepressant might boost the risk for side effects, says Dr. Marsh.
The herbal can also trigger photosensitivity in users, causing their skin to
quickly turn "beet-red" if they go out in the sun, she adds.
"It shouldn't be given during chemotherapy, either, that
can be very dangerous," says Dr. Marsh.
The bottom line is to always let your physician know what
over-the-counter medications - herbal or otherwise - you might be taking.
Finally, non-pharmacologic interventions such as massage
therapy, acupuncture, or aromatherapy are great at easing short-term stress, "but
the real issue, when it comes to depression, is what is the effect over the
long term?" asks Dr. Marsh.
One thing the science does show, however, is that contact
with others such as friends, family, clubs, and group activities can boost
mood and help ease depression.
"If you're socially isolated, especially, just reaching
out can help," says Dr. Marsh.
Dr. Marsh stresses that most of the interventions listed
above certainly will not hurt, and taken together, probably will help boost
mood.
Always consult your physician for more information.
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