Advice Column

I am a 41-year-old father of four and husband of one very
special lady. I have a business which, fortunately, is able to run
fairly well while I am so sick with depression. I have a 20-year
history of depression/anxiety. I have been in inpatient treatment a
couple of times and in some psychotherapy at crisis times and am now
trying to avoid having to go into a hospital again. I desperately need
help as I cannot stomach taking my life on one hand, and continuing
with life as it is on the other. I have been on various medications
over the past year.

I don't know what your depression is about, but medications
obviously haven't addressed it; neither has hospitalization. That doesn't
mean these approaches won't be helpful in the future, but you'll have to
be smart about the way you approach things, and strive to do it
differently than before. (Doing what didn't work before in the same way
makes no sense.)

A crisis is usually the worst time to address your problems
sensibly and effectively. Crisis-level pressure encourages a focus on
immediate relief. Too often decisions made during a crisis turn out to be
bad for life beyond it. It's also much more difficult to go beyond mere
symptom management to try to address and reduce depressive risk factors.
A good depression expert will want to see you--and you should get
help--before things become a crisis. Therapy is about learning your
unique vulnerabilities and how to strengthen and manage them. No amount
of medication can help you do that.

I urge you to read my book,
Breaking the Patterns of Depression(Random
House/Doubleday). It provides realistic perspective and opportunities to
develop the life management skills known to reduce depression and
relapses. I'd also encourage you to find a depression expert who
practices cognitive-behavioral therapy who can help you through the
crisis and strive to prevent future ones. Depression is manageable with
the right tools. Take the time to learn about depression and how people
recover; work with someone knowledgeable and skilled who won't divert you
into irrelevant territory, and you'll likely do well.

Q: Our mother was diagnosed manic-depressive over 35 years
ago. My brother and I have grown to adulthood symptom-free. After
seeing the years of suffering our mother has endured, we wonder if
there is anything we can do to help our children avoid this
debilitating disease. The September 2002 issue of Blues Buster
discusses an omega-3 fatty acid theory and it made us wonder if giving
our children (ages 6, 9 and 12) a daily supplement might be
beneficial.

To answer this question, I turned to two experts on mood and
nutritional supplements: Ross Pelton, Ph.D., pharmacist, clinical
nutritionist and health educator, and Taffy Clarke-Pelton, M..A.,
marriage, family therapist. Together they wrote
Mind Food and Smart Pills(Doubleday). Here is their
reply:

Although omega-3 fatty acids have not yet been specifically studied
for prevention of bipolar disorder, some recent studies suggest that
fatty acids play a role in this condition, which further suggests they
might also be useful in prevention. In a landmark double-blind
placebo-controlled study published in the
Archives of General Psychiatry, omega-3 fatty acids
provided bipolar patients such significant benefits that the study was
shortened from nine to four months.

This preliminary research utilized high-dose omega-3 fatty acids
(EPA and DHA) obtained from fish oils, and reported that most patients
experienced highly effective mood stabilizing and antidepressant effects.
The omega-3 patients were doing better on virtually every outcome measure
compared to the placebo controls, and the differences in the rates of
relapse were especially remarkable. Principal researcher Andrew Stoll,
M.D., is now conducting a much larger three-year study, and other
scientists are initiating trials to confirm the results.

The success of the trial suggests that fatty acids, which are an
important part of the architecture of cellular membranes, may play
critical roles in regulating thought, emotion and mood. The fatty acids
may stabilize mood by "calming" nerve cells that are continually
over-stimulated. Last March, a study, published in
European Neuropsychopharmacologyreported that people
with bipolar disorder have a significant deficiency of fatty acids,
including omega-3s, in their cellular membranes.

At this point it is too early to know exactly which fatty acids may
be deficient in a person with bipolar disorder or a genetic
predisposition to it.

Deficiency of omega-3 fatty acids in the diet is widespread in our
culture, and most people could benefit from fatty acid supplementation.
Supplements containing fish oils are generally safe and well tolerated. A
common dosage for adults is 2-5 grams provided as a combination of EPA
and DHA.

Fish oils can contain toxins and become rancid easily, so be sure
to choose a brand of certifiable purity and integrity. Some manufacturers
have also developed palatable products specifically for children. When
taking fish oils as supplements, it is also important to take natural
vitamin E daily for antioxidant protection. People on blood-thinning
medications should check with their doctor before taking omega-3
supplements.