Natural Approaches to Depression

Although depression is in many ways a baffling and poorly understood disorder, there is growing recognition that it involves many body systems. That makes a powerful case for measures, most of them deceptively simple, that target one or more facets of depression. For example, depression is in part a disorder of social connection; the only remedy for that is social activity.

Studies consistently show that, by virtue of biology or early life experience, people differ in the degree to which distressing experiences can stress or overwhelm individual resources, disrupt functioning, and result in the system-wide shutdown know as depression. From learning to tolerate negative feelings to taking a walk in the park, there is an array of strategies that effectively interrupt or blunt the myriad effects of stress, and they can literally foster the growth of new nerve pathways that enable renewed interest in life and the ability to engage in it.

Depression is a holistic disorder, a complex condition that afflicts the whole person, manifesting in many disturbances of mind and body function. It disrupts sleep as much as it impedes social interest. It fixates thinking on past failures as much as it keeps people from wanting to get out of bed. There is an array of measures that can counter the multiple ways depression disables so many systems of body and mind. Addressing cognitive distortions, disconnection from others, fatigue, a sense of purpose, a nutritious diet—and above all allowing the emotional time-out that depression demands—each addresses some facet of depression and all together provide an integrated way to restore health to the whole person.

Inflammation plays a significant role in bringing on and perpetuating depression. Many studies show that depressed patients have higher levels of inflammatory compounds circulating in their blood. Inflammation is part of the body’s natural response to injury, and there are many ways of injury. So too are there many ways of curbing the processes of inflammation. Because one effect of stress is to increase inflammatory compounds in the body, finding effective ways of coping with stress—such as reframing difficulties as challenges or doing some exercise—lowers the body burden of inflammation.

Diet is another way to lessen inflammation. There are popular foods (such as fatty meats) that foster inflammatory processes, and there are common foods (such as strawberries) and nutrients (curcumin in the spice turmeric) that have anti-inflammatory properties, making healthy eating a sensible everyday approach to curbing inflammation.

Any exercise is activating and promotes a sense of accomplishment. Studies show that moderate-intensity aerobic exercise, such as walking for 20 to 40 minutes three times per week for six weeks, significantly alleviates many symptoms of depression, including self-concept, but is especially effective at relieving somatic symptoms, including sleep disturbance. What’s more, the benefits of exercise are long-lasting.

There are many explanations for the effects. Exercise raises core body temperature, which in turn crates feelings of relaxation and tension-relief. Exercise also promotes the release of endorphins, neurochemicals that have a direct mood-boosting effect. In addition, exercise counters depression by fostering a sense of self-efficacy. But the most enduring effect of exercise may be that it stimulates the release of nerve growth factors in the brain, leading to the growth of new nerve cells and new connections—literally opening new channels for thinking and acting.

One of the most studied sources of depression relief is walking. Research consistently finds that walking for 20 to 40 minutes three times a week significantly improves mood and relieves other symptoms of the disorder. Walking alone has benefits, but walking with a partner or a group is even better, because the social interaction also lifts mood and adds to the motivation to continue the activity. Any activity that requires movement is beneficial, including stretching. Research shows that resistance exercise, such as lifting weights, is also effective against depression.

The B vitamins —and especially folate (B9), pyridoxine (B6), and cobalamin (B12)—are crucial for nervous system function and play multiple roles in maintaining brain health. All the B vitamins are cofactors for enzymes involved in production of neurotransmitters that influence mood. Fish oil, rich in omega-3 fats, particularly the component fat eicosapentaenoic acid (EPA), curbs inflammations, enhances neuroplasticity, and protects brain cells against the degenerative effects of depression.

The spice turmeric contains curcumin, which has also been shown to improve symptoms in patients with depression. It not only has anti-inflammatory effects, it helps moderate the effects of the stress hormone cortisol. The mineral magnesium also reduces inflammatory substances in the body; additionally it stabilizes the levels of some neurotransmitters linked to depression.

Found in fatty cold-water fish like salmon and mackerel, omega-3 polyunsaturated fatty acids contribute to general and brain health in a variety of ways. They maintain cardiovascular integrity and counter inflammation. They also play huge direct roles in brain function and are normally found in the brain in high concentrations; they make up the membrane of nerve cells and insulate the long arms so that nerve cells can efficiently relay signals.

Omega-3s also are neuroprotective, reversing the nerve cell degeneration that is an effect of depression. Studies show that omega-3 fats containing at least 60 percent eicosapentaenoic acid (EPA) are especially effective in relieving depression symptoms, likely because EPA has significant anti-inflammatory activity.

There’s no one specific diet that combats depression but there are a number of nutrient-rich foods that positively affect mental health and counter the effects of depression on the brain. Numerous studies link traditional Mediterranean-type and Japanese-style diets with low risk of depression. Both eating patterns involve lots of fruits and vegetables, fish more than meat, oils rather than solid fats, and moderate to minimal dairy consumption.

Most fruits and vegetables contain nutrients needed for brain health. In particular, studies show that berries—strawberries, blueberries, raspberries, blackberries, cranberries—with their high antioxidant content, contribute to brain efficiency and protect against neurodegeneration. Olive oil is another food that aids brain function. Fish, especially wild-caught, contain fats that help the brain. Whole grains, nuts and seeds, and low-fat dairy products similarly supply nutrients that boost brain health.

There are groups of food that have negative effects on metabolism and general body health, and virtually all of them are linked in one way or another to increased risk of depression or worsening of already existing depressive symptoms. Red and processed meats, for example, contribute to adiposity because they generally contain high amounts of fat, and especially saturated fat; adiposity raises the level of inflammation in the body, a contributor to depression risk. Sugars and refined grains impair glucose and insulin regulation, both important to brain energy. In addition, they contribute to inflammation and increase the production of free radicals of oxygen, which especially degrade brain cells.

The sun is not only the timekeeper of the universe but also of the human body, and all body functions are synchronized to a roughly 24-hour cycle set by patterns of light and dark. Even subtle disruptions of circadian rhythms, from sustained lack of sun exposure, dysregulate production of hormones such as melatonin and serotonin that affect nerve function and cognitive processes. Sunlight exposure resets the body clock, begets healthy blood flow in the brain, and triggers body production of vitamin D. Studies show that vitamin D plays important roles in maintaining brain health, stimulating the growth of nerve cells to preserve memory and executive function and sustaining mood..

Talking about thoughts and feelings under the guidance of a trained therapist can help people gain control of their mental life and find a healthy perspective. Studies document that the patient-therapist relationship adds to the curative power of therapy. Specific types of talk therapy target the major ways the mind goes off-track in depression. Cognitive behavioral therapy (CBT), the best-studied therapy, is a structured treatment that helps people change the thinking styles and beliefs that limit them, mire them in negativity and guilt, lead to pessimism, and destroy their mental energy. Behavioral activation is a variation of CBT that helps people take baby steps of activity that bring pleasure, which in turn motivates continued activity, a growing sense of pleasure, and a renewed sense of self.

Meditation provides a way of reducing negative reactivity to the stressful thoughts, feelings, and situations that are a major precipitant of depression. There are many styles of meditation, long a tradition in Eastern cultures, and meditation in some form has been incorporated into many behavioral therapies for depression.

Most forms of meditation are ways of recognizing the transience of thoughts and feelings, acknowledging them without giving them undue attention, and allowing them to pass without feeling the need to act on them. Mindfulness, a popular form of meditation that is often combined with CBT, teaches people to focus on the rhythm of their breathing while letting thoughts come and go. The goal is to detach people from their thoughts so that they can choose what to pay attention to, rather than be dragged down automatically by negative thoughts.

Acupuncture involves the insertion of fine needles (or a laser beam) into specific points on the body. and the manipulation of those needles by hand or a small current of electricity to produce a therapeutic effect, such as relief of pain.

There is evidence that many of those points, particularly on the external ear, tap into branches of the autonomic nervous system (ANS), including the vagus nerve, and the manipulation of those points stimulates the ANS. One of the key functions of the ANS is regulation of the stress response, a major player in the onset and maintenance of major depression. The relatively small number of high-quality studies of acupuncture, as well as significant clinical experience, show that acupuncture reduces the severity of depression symptoms. Because he benefits tend to be short-lived, a series of treatment sessions is usually needed.

Social activity is a natural buffer against depression. It breeds a sense of belonging and a sense of safety, both of which mitigate feelings of distress, promote a sense of well-being, and affect physiology to curb the output of stress hormones. Staying socially active also counters the effects of depression symptoms. It takes direct aim at the disconnection so many of the depressed feel.

One of the many consequences of depression is a heightened perception of —and reactivity to— social rejection. Feeling connected to others, whether to individuals or groups, boosts recovery in people with depressive symptoms, providing a particularly large dose of satisfaction and encouragement.