Cognitive Behavioral Therapy (CBT) is an important technique in the treatment of depression. Many depressed people have a gener- ally negative outlook on life. They see anything and everything that happens to them during the day in a negative light. They are pessi- mistic and expect everything to go south or sour. CBT teaches them to change the way they perceive things by using a technique called Cognitive Reframing. For example, imagine you are walking down the corridor at
work and a colleague passes you by, ignoring your “good morning” salute. If you are depressed, you may take that as a signal that the person doesn’t like you, that you are unpopular at work, friendless and alone. All that from a missed ‘hello’! These types of thoughts are called cognitive distortions. They are a distortion of reality and aren’t useful. With CBT, people are taught to re-frame their perceptions; to look at reality in a more realistic and positive light. Perhaps your work colleague didn’t hear you or was pre-occupied with something important. There is plenty of evidence that CBT helps with depression and
it is now considered a standard of care to use CBT as part of the armamentarium to fight this unfortunate disease. What natural treatments are there to elevate mood? My favorite
natural anti-depressant is S-Adenosyl Methionine or SAM-e. It is derived from an amino acid found naturally in all cells. We think it works by elevating the levels of Serotonin in the brain. Sound famil- iar?
Does it work?
According to the Agency for Healthcare Research and Quality, part of the US Government, 28 studies on SAMe showed a statistical and clinical improvement in depression symptoms. The report also stated that it works as well as the common anti-depressant medica- tions on the market. My own experience with SAMe is that it works about 60-70% of the time, about the same success rate that you see with the prescrip- tion medications. However, before rushing out to stock up on SAMe, a few words
of caution. This supplement needs to be taken under the supervision of a physician because it interacts with certain medications, like anti-
depressants. I find that it can cause anxiety and sleep problems. It also is rather stimulating so I wouldn’t take it at night. In addition, it’s expensive, so don’t be shocked when you reach the cash register! Another botanical often used in the treatment of depression is St
John’s Wort, which has been found in clinical studies to be as effec- tive as the older class of SSRIs like Prozac and Paxil. It is an excel- lent herb with one small but significant drawback; it interacts with many drugs, which makes its use limited to only the most simple of patients.
In a study of 6,500 Japanese teenagers published in the journal
Pediatrics in 2010, researchers found that the group of kids who ate the most fish high in the omega 3 fatty acids EPA (Eicosapentaenoic Acid) and DHA (Docosahexaenoic Acid) had a 27% reduction in the risk of depression compared to the group of kids who consumed the least amount of the fish. This trend was only seen in the boys, for reasons that are not entirely clear. Your brain is full of electric wires called neurons. These neurons, just like the electric wires you find in your kitchen are insulated not with plastic but with a layer of fat called ‘the Myelin Sheath’. There are many different types of fat; saturated fat like those found in cheese and butter, monounsaturated fats like those found in nuts and seeds and polyunsaturated fats that are found in vegetable oils and oily fish. The myelin sheath is composed of a variety of different types of fat. EPA and DHA are two special types of polyunsaturated fats and
studies have suggested that these ‘fish oils’ may play an important role in neurotransmitter activity related to depression. I routinely use omega 3 fish oil with patients suffering from either depression or anxiety. I know an Integrative Psychiatrist who feels that unlike with the dosing of regular fish oil that usually con-
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