When I think about depression and its treatment I often liken it to diabetes, specifically, Type II diabetes. Treatment of the two illnesses has a lot in common. How can that be?
Let's take a patient who has been diagnosed with Type II diabetes. They are placed on medication and their blood sugar monitored. If the patient takes their medication but gets no exercise, eats a very poor diet, does not lose the extra 50 pounds they are carrying around, gets too little sleep and does not eliminate the stressors from their life, the medication is only going to be minimally effective. Therefore, a good doctor will also make some strong recommendations about necessary lifestyle changes for the patient. If this same patient loses the extra weight, eats a healthy diet, gets regular exercise, reduces stressors and gets a good night's sleep every night they have a much better chance of the medication controlling their blood sugar. It may also require less medication or they may be able to eliminate the medication all together.
Likewise, a patient with clinical depression who is placed on medication is much the same. The medication can only do so much if you don't make some serious lifestyle changes. However, most doctors do not discuss these changes with patients. What are they?
1. Exercise
Research has consistently shown that just 30 minutes of moderate exercise 4-5 times per week can lift your mood.
2. Diet
Many people with depression live on a diet of, what I call, "caffeine and carbs" in an attempt to give themselves the energy they desperately need to function. The carbs are typically simple carbs and simple sugars. Caffeine, simple carbs and simple sugars dump sugar or caffeine into the bloodstream and provide that "rush" of energy. But this is a double-edged sword. When these sugars hit your system, your body responds by dumping large amounts of insulin into the bloodstream to remove the excess sugar from the system. This may result in you having lower blood sugar. You now crave an instant hit of sugar to elevate your low blood sugar, so you eat a spoonful of ice cream, a candy bar, drink a can of soda or a glass of juice. This shoots your blood sugar back up, the body dumps insulin, your blood sugar lowers and crave more sugars. See the problem? This roller coaster energy is not good for a mood disorder, your waistline or your poor pancreas. The solution? Complex carbs.
Complex carbs like whole grain foods (brown rice, whole grain pasta, whole grain breads), oatmeal, legumes (beans) or vegetables break down slowly in your body. When your body breaks down these foods they are stored as energy in the muscles and the liver. This provides a consistent warehouse of energy for your system to call upon all day long rather than the "rush and crash" of sugars. Be sure to read labels. "Wheat bread" is usually no better than processed white bread. Make sure it says "whole grain" and the main ingredient is "whole grain wheat flour".
Another important factor in a "depression diet" is quality proteins. Antidepressants work to make more neurotransmitters in your brain available, thereby elevating your mood. Neurotransmitters like Serotonin, Dopamine, Norepinephrine, Epinephrine and even GABA are important to stabilizing mood. Neurotransmitters are made from amino acids. Proteins are long chains of amino acids. The body requires about 28 different amino acids in order to function properly. The "caffeine and carbs" diet will not provide these amino acids. Your diet must include quality proteins so that your body has the nutrients it needs to make the neurotransmitters your brain needs to lift your mood. Eggs, dairy products (yogurt, milk, cheese), poultry, fish, beef, tofu, beans and nuts are high in proteins. Proteins from animal sources (meat, milk, eggs) are called "complete proteins" because they contain all the amino acids needed to break down proteins. Non animal sources are not complete proteins, but can be combined with other foods to contain all the amino acids required, you just have to be much more conscious of your protein choices and what you are combining them with.
It is also essential that your body contain all of the vitamins and minerals required to produce neurotransmitters. So it is important that people fighting depression be especially aware of eating healthy, balanced meals with complex carbs, quality proteins, fruits, vegetables and healthy forms of fat.
3. Sunshine
Get out of the house, stop isolating and get some sun and fresh air. Research has consistently shown that exposure to sunshine lifts the mood.
4. Socialize
People with depression tend to isolate and this leads to a depressed mood. Extroverts should go out and be among other people. Introverts may want to invite a few close friends or just one friend over for a quiet evening. Whatever your style, it's important to have contact with other people.
5. Sleep
Getting a good night's sleep is crucial to mental health. During sleep your body repairs itself. When you don't get good sleep your physical and mental health are compromised.
6. Drink water
I recently read a research article which showed that dehydration can cause or exacerbate depression.
7. Monitor your input
Computer programmers have a saying, GIGO, "garbage in = garbage out". Monitor what you are feeding your brain everyday. Depressing movies? An endless parade of negative news stories? Tragic books? If you are exposing your brain to an endless stream of negativity, odds are your mood will suffer. Insert laughter into your life. Rent a comedy. Go to a comedy club. Attend a sports event. Go to a concert. Read a humorous book.
8. Change your friends
"Birds of a feather flock together" and people with depression tend to be attracted to other people with depression, which can be, well, depressing. Imagine a group of depressed people sitting around, eating caffeine and carbs, talking about how awful they feel. You may have to change who you hang around with in order to lift your mood.
9. Lower stress
Stress compromises your system and can lead to depression. Rearrange your schedule. Eliminate unnecessary burdens and obligations. Stop taking care of everyone else. Prioritize. Get some peace and quiet in your life, then fill that time with something from this list.
10. Express yourself
Suppressed anger turns into depression. Unfortunately our culture views anger as a "negative" or "bad" emotion. It is neither good or bad. Emotions simply are. All humans have them. Anger is simply a feeling. What matters is how you express it. Anger can be expressed in a healthy way, a way in which you stand up and say, "I have had enough". It does not have to be loud, aggressive or violent. It can be quiet, but firm. If you hold in your anger, it may be exacerbating your depressed mood. Find a way to get it out in a healthy manner.