Shown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by SLS on January 23, 2009, at 5:14:33
A friend of mine is a 52 year old woman who has had double depression for most of her life. Double depression is the superimposition of major depression episodes over chronic dysthymia. Right now, she is in a terrible depressive episode. She refuses to try any drugs at this point, and she has tried most of them.
She asked me for non-drug recommendations. I don't feel educated enough in alternative medicine to be able to counsel her, so I was hoping to get a few ideas here. Her depression includes a great deal of anxiety. Otherwise, she lacks motivation and energy. Everyday is a push for her.
Thanks much.
- Scott
Posted by Lao Tzu on January 23, 2009, at 15:41:28
In reply to Woman with double-depression: Alternatives sought., posted by SLS on January 23, 2009, at 5:14:33
I'm just asking, but do you think she could have bipolar depression? Anxiety, lack of motivation and energy are key components of bipolar depression. I have the same symptoms, but I'm not a manic bipolar. Has she been formally diagnosed by a psychiatrist? That might be the first step. If she's willing, I'd ask her to see a psychiatrist first, preferably one that is open to natural solutions to complement medication. She may definitely need some medication, but addressing her nutritional needs is also paramount. If she refuses to see a psychiatrist, then try and find her a naturopathic doctor and ask her if she would go. If she's very anxious about it, some medication to calm her anxiety might be necessary in the beginning until she feels more comfortable about seeing a doctor. The anxiety can definitely be helped with medication. From my experience, the motivation and energy problems may take longer to treat, but she definitely could be made to feel more comfortable with the proper attention. However, she must be willing to try it. I'd try and gently explain the options to her. Let her think it over. There are a lot of organizations out there that will run tests and treat people with nutrients. I don't know enough about them to recommend any particular one, but some of them supposedly have solid reputations. The Brain Bio Center in Princeton is one I've heard about, as well as Dr. Amen's clinic in California. I don't have a lot of faith in treating people with just nutrients, especially if they have severe bipolar symptoms. Some medication is usually necessary. These are just some suggestions. I am NOT a naturopathic doctor, so if she's willing, then talking to one might be an option. Addressing her anxiety should be first and foremost; otherwise, she may find excuses not to do anything that might benefit her. It's difficult to get someone to seek help if they are unwilling. A lot of times, people get hospitalized before they are formally treated. I would first try and gently reassure her that there is help out there for her and that she can start to feel much better. Even offer to accompany her to the doctor because a supportive friend is almost essential for someone in her condition.
Posted by Sigismund on January 23, 2009, at 16:45:03
In reply to Re: Woman with double-depression: Alternatives sou, posted by Lao Tzu on January 23, 2009, at 15:41:28
My nutritional doctor's approach would be, if necessary, to use (minimal quantities of) drugs to bring the brain (?) into some kind of balance, along with all sorts of general things to try to improve basic health.
I have had some success with this over a 10 year period, which is to say that everyone says I look 10 years younger 10 years down the track. I still don't feel that great, but it is a real improvement.
So what are the chances of getting your friend to see a good nutritional doctor who has a good understanding of metabolism and human biochem generally?
Posted by SLS on January 24, 2009, at 9:49:42
In reply to Re: Woman with double-depression: Alternatives sou, posted by Lao Tzu on January 23, 2009, at 15:41:28
> I'm just asking, but do you think she could have bipolar depression?
Yes. Definitely.
> Anxiety, lack of motivation and energy are key components of bipolar depression.
That's me, too.
> I have the same symptoms, but I'm not a manic bipolar.
That's me, too. The only times I have ever displayed a manic episode were as a reaction to drug intervention. In 25 years, this has happened 5 times.
> Has she been formally diagnosed by a psychiatrist?
Yes. Her sister becomes floridly manic.
We met as research patients (guinea pigs) at the NIMH, NIH in the US. She has been seeing psychiatrists all along. She just has a belief system that modern antidepressants will not help her and that she refuses to take the risk that one will make her feel worse. Wellbutrin and Ritalin help when she is in her dysthymic state.
I might suggest that she look into Dr. Amen's clinic. Don't they choose drugs based upon the results of fSPECT imaging?
Thank you for your kind advice.
- Scott
Posted by SLS on January 24, 2009, at 9:53:29
In reply to Re: Woman with double-depression: Alternatives sou, posted by Sigismund on January 23, 2009, at 16:45:03
> So what are the chances of getting your friend to see a good nutritional doctor who has a good understanding of metabolism and human biochem generally?
Hmm. You know, I never suggested that to her. It would certainly be consistent with her desire to stay away from more medication. I'll mention it to her.
Thanks.
* 10 years younger is a good deal. Actually, I guess you really saved 20 years!
- Scott
Posted by Sigismund on January 24, 2009, at 17:12:50
In reply to Re: Woman with double-depression: Alternatives sou » Sigismund, posted by SLS on January 24, 2009, at 9:53:29
I have these interesting conversations in my infrequent appointments with this doctor.
He only sees a few patients a day.
You never know if he *will* see you (unless you are first in the day) because people come from all over and he might spend the whole day with them going over all the tests, ordering more and trying to figure out what the problem is and what interventions can be usefully made.
Some of these people have cancer or out of control diabetes.
A lot of it is metabolic biochem, way above my head of course, but very interesting all the same.
Hormones are difficult too.
Posted by fairn on January 25, 2009, at 1:32:10
In reply to Woman with double-depression: Alternatives sought., posted by SLS on January 23, 2009, at 5:14:33
im no expert but i would suggest d- phenylalanine in case of endogenous opiod problems which can cause chronic low moods with low energy. Also anything which might help boost mitochondria eg quercetin, resveratrol, d ribose along with antioxidants. There is something called forskolin which effects the second messenger system first messenger being serotonin dopamine etc. rhodiola and sam-E can be helpful too, but be careful in case it is bipolar ive found lots of natural substances can induce mania.
Good luck i hope she gets better life can get so bad sometimes shes lucky to have someone like you on her side!-Clayton
Posted by SLS on January 25, 2009, at 6:54:15
In reply to Re: Woman with double-depression: Alternatives sought., posted by fairn on January 25, 2009, at 1:32:10
What's coenzyme q10 all about?
- Scott
Posted by desolationrower on January 25, 2009, at 16:23:11
In reply to Woman with double-depression: Alternatives sought., posted by SLS on January 23, 2009, at 5:14:33
the bipoal makes it trickyy, 'natural' ADs seems to exacerbate it in many cases. you probably have thought of all htese, and not sure just what she thinks of as 'natural', but things i can think of that aren't at least known to induce switching:
magnolia bark
rhodiola
ashwagandha
vitamin d3
folate
minerals (mag, zinc especially, 'natural' lithium orotate)
gotu kola
inositol
NAC
cold water induction
bright lights
NSAIDs
valerian (i think it contains valproate analogue. unknown effect.)
melatonin if insomnia, although i'd guess tahts more likely on the manic side-d/r
Posted by desolationrower on January 25, 2009, at 16:25:32
In reply to Re: Woman with double-depression: Alternatives sought., posted by desolationrower on January 25, 2009, at 16:23:11
oh and lots of fish oil, dur.
and soy lecithin too just remembered, more evidence vs. mania for that.
-d/r
Posted by Sigismund on January 25, 2009, at 18:37:51
In reply to Re: Woman with double-depression: Alternatives sought., posted by desolationrower on January 25, 2009, at 16:25:32
A really good Traditional Chinese Medicine practitioner is another potentially useful angle.....for herbal medicine.
Posted by SLS on January 26, 2009, at 17:48:13
In reply to Re: Woman with double-depression: Alternatives sought., posted by Sigismund on January 25, 2009, at 18:37:51
Posted by SLS on February 6, 2009, at 8:48:49
In reply to Woman with double-depression: Alternatives sought., posted by SLS on January 23, 2009, at 5:14:33
Well, my friend finally relented and started taking lithium 600mg. She has experienced a significant improvment, and is no longer in the pit of deep despair.
Thanks to every one for their sincere and well thought-out advice.
- Scott
This is the end of the thread.
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