Preventative Guide: Depression
Depression is described as a mental and emotional disorder that affects how you feel, the way you think and how you act. This state of mind is quite common and can be experienced at any age, though is prevalent in younger adults and elders. Though feelings of sadness as we grow older should be recognized as normal, lasting depression is not and should be approached with care.
There is a wide range of possible causes related to elderly depression, including other medical illnesses, specific medication, family history of depression, fear of death, damage to body image, home relocation, presence of chronic or severe pain, loss of a spouse or loved one and lack of social engagement. It is also important to note that being female significantly increases your chances of developing depression in old age, so prevention through holistic lifestyle is crucial. A large share of prevention is supporting social and mental states by strengthening outside relationships and the inner relationship with yourself. Implementing herbal, supplemental and nutritional will support the healing process.
Nutrition
Complex Carbohydrates
Consume a diet that includes an abundant variety of vegetables, whole grains, seeds, nuts, legumes and some fruit. A diet too low in complex carbohydrates can cause serotonin depletion and depression. Surprisingly as it may seem, one of the best and most widely applicable and accessible remedy to feed nervous tissue is OATS! We can take oats in tincture form or simply consume a warm bowl of oatmeal. Oats are a high fibre complex carbohydrate source and contain both a variety of B vitamins and tryptophan, both known to directly affect our mood by the production of serotonin. Since it is a complex carbohydrate, it won’t raise blood sugar levels too rapidly, which can also directly affect our mood.
Though oatmeal is a great carbohydrate source to include in your diet, some people tend to feel sleepy after due to the tryptophan and melatonin it holds, so play around with the timing to see if you are one of those people! Consume a warm bowl of oatmeal with organic soy or almond milk, chia seeds, ground flaxseeds, fresh or frozen berries, and soaked walnuts or pecans.
Probiotic-Rich Foods
Probiotics are the good bacteria that reside in our digestive tract (the colon, more specifically) that provide a number of beneficial functions to our body, including improving immune system function, synthesis of B vitamins and vitamin K, digestion, improving mental health and depression. Consuming probiotic-rich foods every day can greatly contribute to lowering the incidence and severity of depression. Excellent options include sauerkraut, kefir, kombucha, miso and yogurt. If choosing yogurt, be sure to select a plain, sugar free variety and aim for a non-dairy option (coconut yogurt is fantastic). If you can tolerate dairy well, an organic, unflavoured and unsweetened option is preferable.
Fiber for Bowel Health and Elimination
Proper elimination is critical for digestive and bowel health, as well as mental health. You should be moving your bowels AT LEAST once per day to avoid overburdening your system with toxic accumulation. Constipation, or a sluggish bowel can lead to mental disturbances, including headaches, fatigue, and depression. In addition to consuming a variety and abundance of complex carbohydrates - specifically a rainbow of vegetables - high fiber foods that will keep your bowel moving include flax seeds and chia seeds. Be sure to always drink plenty of fluids when consuming high fiber foods to avoid constipation and allow the stool to become softer and easier to pass.
Omega-3 Fats
The omega-3 fatty acids, in particular, are very necessary for keeping the mind healthy and studies have shown that a deficiency can lead to mood disorders. In particular, EPA, one of the major omega-3 fats obtained from fish, has a protective effect against depression. Good food sources of omega-3 fats are wild caught cold water fish, particularly salmon, mackerel and anchovies, as well as flaxseed oil and hemp seed oil.
Avoid Sugar and Sugar Substitutes
Avoiding all forms of sugar, including normally “good” sweeteners such as honey, molasses and fruit juice, as well as sugar substitutes like NutraSweet, Equal and Sweet & Low, will directly affect your mood. The body reacts more quickly to the presence of sugar than it does to the presence of complex carbohydrates. The increase in energy supplied by the simple carbohydrates is quickly followed by fatigue and depression. High GI foods cause the “sugar crash,” which happens especially after eating high sugar foods. This leads to a too rapid reduction of blood sugar, causing your body to release the hormone adrenaline. This is the “fight or flight” chemical that causes anxiety and irritability. The avoidance of high sugar foods such as baked goods (cookies, cakes, biscuits, brownies, etc.), cereal, ice cream, ketchup, bread, crackers, granola bars, bagels, and soda will directly and positively affect your mood.
You will also want to cut back on fruit consumption, especially in the morning. Fruit in the morning can cause a spike in blood sugar after awakening from your sleep. Stick to berries such as blueberries, blackberries, and raspberries. Avoid high sugar fruit such as bananas, dates and figs, as they contain high fructose levels. Small and consistent meals are best to make sure blood sugar isn’t dropping too low. As a general rule, aim for 6 small meals spread out evenly through the day. Consume a protein source with each meal to control blood sugar, such as beans, nuts, seeds, eggs, fish or white poultry, and occasionally organic tofu.
Avoid “Bad” Fats
Avoid fried foods and damaged/rancid oils from foods such as french fries, deep fried foods and margarine, which can lead to sluggishness, slow thinking and fatigue. Further, they interfere with blood circulation, especially to the brain, by causing arteries and small blood vessels to become blocked and blood cells to become sticky and clump together.
Determine Food Allergies
Depression and fatigue have been directly linked to food allergies for more than 65 years. Conducting an elimination diet is suggested in order to understand if food may be directly linked to your depression. The most common single food that has been linked to mental health is wheat, which is a rich source of gluten. Other common suspects include milk products, eggs, shellfish, and foods with yeast, though any food could be a potential culprit. Remove food colouring such as tartrazine and other chemical additives from your diet, as these can cause you to have a reaction as well. You may also look into conducting a quantitative IgA ELISA allergy test, which involves using a simple home test kit. It also involves a pinprick of blood from which you can be tested for allergy to over 100 different foods and chemicals.
Lifestyle
Regular Movement
Regular daily movement is necessary for all functions in the body and can increase your mood almost instantaneously. Exercise and other physical activity produce endorphins—chemicals in the brain that act as natural painkillers—and also improve the ability to sleep, which in turn reduces stress. Certain endorphins and other brain chemicals released in response to exercise produce a natural high; most people who exercise regularly say they feel extremely good afterwards. 30 minutes of movement at least 3x/week will help you feel more refreshed and enhance your mood like no other. You can do this through walking in nature, running, yoga, tai chi, strength training (will depend on capability and age!) and stretching.
Communication
Seeing a therapist or mentor and expressing how you feel to them is an amazing strategy to use when dealing with depression. Especially for the elderly, whom may feel they have lost those they trust most with their feelings or don’t have anyone close to them in their lives, developing a relationship with a therapist or qualified professional to change ingrained habits can be rewarding.
The use of daily meditation has been shown to significantly increase mood and relax the mind, diminishing feelings of depression over time. Below is a step-by-step guide on how to practice mindfulness meditation:
1. Sit upright in a straight-backed chair, lie in your bed, or be present in an area and position you feel most comfortable.
2. Close your eyes. Use your mind to watch your breath as it flows in and out. Observe your sensations without judgment. Do not try to alter your breathing.
3. After a while your mind will wander. Gently bring your attention back to your breath. The act of realizing that your mind has wandered - and bringing your attention back - is the key thing.
4. Your mind will eventually become calm. Repeat every day for 20-30 minutes. You can also use guided imagery after or before meditating by closing your eyes and envisioning your best and authentic self, doing what you are passionate about, being truly happy with people who truly love and care about you. Think about what you wish for yourself and where you want to be in life, emotionally, physically, mentally and spiritually.
Social Engagement
Lack of social engagement is an extreme issue when it comes to elderly depression. A new study suggests that the mental health benefits of regular face-to-face social interactions—especially among older adults—can reduce the risk of depression. The research shows that having limited face-to-face social contact nearly doubles someone's risk of having depression. Study participants who met in person regularly with family and friends were less likely to report symptoms of depression, compared with participants who emailed or spoke on the telephone, or worse; neither. It is important to spend as much time with family and friends as possible, having at least one day out of the week where you look forward to gathering and having conversation and spending time with loved ones. Social groups are also available to the elderly, as this has become an evident issue and there is higher demand for group formation. Gathering with people who directly are going through similar issues as you (difficulty dealing with aging, the loss of a loved one, etc.) helps you to relate and feel comfort with your issues.
“Re-route” Negative Thinking Patters
Learn to recognize and “re-route” negative thoughts. Working with a qualified professional, such as a cognitive behavioural therapist, psychiatrist or psychologist, to change ingrained habits can improve depressive thought patterns and lift the mood. Try keeping a daily log to help you recognize distorted thoughts and develop a more positive way of thinking.
Light Therapy
Exposing yourself to a light of a certain frequency from a specially designed light box for 15 minutes to two hours daily can improve mood and lift depression. The hormone melatonin, is produced at a greater amount by the pineal gland in the brain in the dark or on darker days. At certain levels, melatonin appears to trigger the onset of depression in some people. Being exposed to sunlight for at least 30 minutes per day or a specialized light box can reduce the amount of melatonin produced during the day, thereby reducing depressive symptoms.
Listen to Music
Music can have a powerful effect on mood and may be useful in alleviating depression. Listen to music that you enjoy that brings you contentment, joy and inner peace.
Supportive Herbs
Passionflower is an herbal remedy that contains methanol, a compound that is extracted from the leaves, stems and flowers and has an effect on our mood. It can also be used for insomnia or sleep troubles (usually associated with geriatric depression), better blood flow, muscle relaxation, nervousness and GI related trouble. This herb will help calm the mind when overthinking is present.
Use: Passionflower is best in infusion, tea or tincture form. Try drinking tea just before bed.
Ginkgo Biloba has been used for centuries, specifically in Europe, for a wide variety of issues related to depression. This herbal remedy contains constituents that have extremely strong antioxidant power, which is believed to slow down the progression of age-related disease. For ages, ginkgo has been used to increase circulation and platelet formation. Coronary issues such as atherosclerosis have been linked to depression, as it has been shown to directly affect the brain. That being said, making sure to keep your heart healthy through herbal remedies such as ginkgo will be beneficial. Ginkgo also benefits cognitive function, increased energy, improved memory and mood.
Use: Ginkgo is best used in tincture form. Take 2-3 x per day.
Caution: Do not take ginkgo if you have a bleeding disorder or are scheduled for surgery/dental procedure. Consult a physician before taking, as ginkgo can often interact with specific medications such as antidepressants.
Damiana leaf has that typically grows in the West Indies and Central America that can be used as an antidepressant herb. In general, damiana can help to reduce symptoms of depression such as sadness and to lift your overall mood. When taken daily over an extended period of time, it will help you feel more consistently relaxed and help you feel more positive on a day-to-day basis.
Use: Damiana is best in tincture or capsule form. Taken as needed.
Skullcap can be used as a natural antidepressant for people suffering from chronic depression. Skullcap is extremely beneficial when used with other dried herbs and taken as tea. It can also be taken in form of capsules and do you believe that seasonal affective disorder exists. With its calming yet strengthening effects on the nervous system, skullcap is a great option for helping to relieve depression, as it can also poor sleep, poor concentration and headaches.
Use: Skullcap is best used in tincture form. Take 2-3x per day as needed.
Consult with a nutritionist prior to taking or combining herbs or supplements or if you are taking any medications.
Supportive Supplements
Omega-3 An insufficiency of the long-chain omega-3 fatty acids (EPA and DHA) has been linked to depression, so making sure to supply your body with enough through supplementation and diet is essential. It can be hard to get enough through diet, so supplementation is often beneficial for some. Because the brain is the richest source of fats in the human body and proper nerve cell function is dependent on proper membrane fluidity, alterations in the fluidity can cause decreased mood and mental function. By consuming enough omega-3 fatty acids, we are making sure the cells keep their fluidity.
Dosage: 1,000mg EPA + DHA/day. You can purchase a good quality omega-3 supplement at your local health food store or through a reputable online supplement store.
B vitamins are essential for proper functioning of the brain and nervous system. Vitamins B6 and B3 specifically allow the body to convert the amino acid tryptophan into serotonin. Serotonin, as stated earlier is a chemical that enhances mood significantly and low levels have been linked to depression. B vitamins are also necessary for energy production in the body, which is important, as we often feel extremely fatigued and tired when experiencing depressive episodes. Caution: Do not take B3 (Niacin) if you have liver disorder, gout, or high blood pressure. GENERAL DOSAGE: B complex dosages will vary. Look for B5, B6 and B12 and larger quantities. You can purchase a good quality B complex at your local health food store.
Probiotics are live bacteria that balance our gut flora, ultimately creating a healthy digestive environment. Gut health is extremely correlated to the brain and our mind body connection. Stress and our overall mood directly link to how we assimilate and digest our food, so making sure to take care of our gut is vital when it comes to adrenal health. Probiotics also help the body absorb antioxidants, which can boost the body’s immune system. 70% of our immune system is in our gut, so taking care of our GI tract is vital.
Dosage: 10 billion CFU’s/day. You can purchase a good quality probiotic supplement at your local health food store.
SAMe is an amino acid derivative that appears naturally in all body cells. It plays a significant role in many biological responses by transporting its methyl group to DNA, proteins, phospholipids and biogenic amines. Many studies indicate that SAMe may be useful in the treatment of depression, as it works in the body just like an antidepressant. It has been shown to be very useful for Parkinson’s disease patients with depression, and some studies suggest it may be most beneficial in the senior population.
Dosage: 200mg twice per day on an empty stomach. You can purchase a good quality SAMe supplement at your local health food store or through a reputable online supplement store.
5-HTP is a supplement that some people use in an effort to support their mental health and immune system. It is a naturally occurring amino acid and chemical precursor of the neurotransmitter serotonin, which we know is heavily related to and responsible for our mood. 5-HTP increases the body’s production of serotonin, but should not be used with other antidepressants.
Dosage: 500mg/day with a meal. You can purchase a good quality 5-HTP supplement at your local health food store or through a reputable online supplement store.