As the morning sunlight hits our eyes, we reach across to turn off the alarm clock before it can sing its annoying tune. we then bounce out of bed with enthusiasm and energy to face our day… or do we? for many people, the morning brings a desire to climb under the blankets for a few more hours of sleep. Upon rising, their body complains with stiff or sore muscles; and as far as energy is concerned, that usually comes in the form of several strong cups of coffee. Enthusiasm, joy, creativity and motivation are elements of a happy day; but for many, depression has robbed them of these feelings.

For the most part medical doctors address depression with a group of antidepressant drugs called selective serotonin reuptake inhibitors (SSRI), such as Prozac, Paxil and Zoloft. this type of drug helps to keep serotonin from leaving select areas of the brain where it is needed to regulate moods, sleep, and appetite, among other things. new classes of antidepressants are steadily being developed and brought to market. one of these newer classes, the SNRI’s (serotonin/norepinephrine reuptake inhibitors) like Effexor, work in a similar manor but seem to have less side effects. I have found that although these types of drugs often help in the beginning with depression, after a period of six months or more, they seem to lose their effectiveness and side effects often set in. I am often asked about natural alternatives for lifting depression. When you take a natural approach to healing, the first question you want to ask yourself is why did a symptom manifest itself? In the case of low serotonin levels, why did they get so low? one of the first places to look is stress.

Stress is a big trouble maker for our health. As our schedules get busier, more demands are put on our systems. In addition to a busy lifestyle, people are often faced with additional stressors such as children leaving the home, family illness, changes in career or relationships and caring for aging parents. As stress builds we begin to feel out of control and irritable, we find we can’t fall asleep at night, and depression or mood swings start to set in. Even if we take a good multi-vitamin and eat a good diet, it would be very hard to get enough of what we need to sustain us through excessively stressful times without additional supplements. In response to the stress, our bodies put out chemicals that help to balance our emotions. GABA (#1823-6) is one of the first to come to the rescue. GABA is an amino acid that is used to make a neurotransmitter (brain chemical) that calms excessive brain activity and promotes a state of greater relaxation and peace. If stress is ongoing and excessive, the body quickly depletes the GABA needed to make this chemical. The resulting low GABA levels will cause one to feel irritable, easily angered, and short tempered. A lack of GABA also causes excessive brain activity such as, lying in bed as our mind races through all the thoughts of the day. this adds to an inability to fall asleep which will add to poor moods. The next chemical to be depleted when under stress is 5HTP (#2806-4) the precursor to serotonin. When serotonin levels become depleted a whole list of symptoms quickly follow: Cravings for carbohydrates (they help to form 5HTP), vague muscle aches and pains, insomnia, depression, binge eating, tension headaches, migraine headaches, PMS headaches, mood swings, body aches, generalized fatigue, joint swellings, numbness and tingling, fibromyalgia, obsessive compulsive behavior and addictions (alcohol, smoking, and stimulants). I can understand the desire at this point to run to the doctor for medications; but before trying a prescription, discuss with him the alternative of first using GABA and 5HTP. see if the underlying cause can be corrected naturally without medications. In addition to these supplements, support stress with B-complex vitamins so that these neurotransmitters do not burn up so quickly. I love the formula Nutri-Calm (#1617-3) which combines B-vitamins and Vitamin C in a base of herbs that support stress and nourish the nervous system.

Question: can I take 5HTP with Prozac or other SSRI drugs? It is not recommended to take 5HTP and GABA while on an SSRI anti-depressant drug because the 5HTP will increase your serotonin levels and the anti-depressant causes the serotonin to stay in the brain. an over abundance can quickly build-up. If you would like to replace your anti-depressant drug with 5HTP, talk with your doctor and have him advise you on a program to fade off of the medication. these drugs cannot be stopped suddenly and need to be decreased slowly.

What do we do if we want to get off these types of medications?

Our first step, as I mentioned above, is to support stress with B-complex vitamins and adaptogen herbs like those found in the formula Nutri-Calm. this can be done even while on the medications. Secondly, we will look to the wisdom of Chinese medicine for another alternative to lifting the moods. Mood Elevator TCM (#1035-7) is a Traditional Chinese Medicine herbal blend that relieves sagging chi and disperses stagnant chi. this formula increases something called shen in the body. Chi and shen are poetic descriptive names for the invisible energies which are created in the body when we are healthy and vibrant. When we don’t take care of our health and push our bodies too much, our chi and shen energy gets depleted. Think of this as your life force inside your body. When your life force gets depleted, you will suffer from sagging spirits, lack of motivation and illness. Unlike modern medicine’s approach to depression, which focuses on the neurotransmitter serotonin, Mood Elevator works in a holistic manner to relieve depression and sadness by balancing the liver, digestive, intestinal and nervous system functions. this result is restored vitality and life force energy in the body. within a few days of trying this formula, I remember the distinct feeling of being in a good mood – “like the birds were singing all around me.” besides depression, this formula is helpful for sadness, fatigue, insomnia, neurosis, hysteria, hypersensitivity and anxiety. It may be helpful for restless dreams and nightmares and for people who have hypochondriac tendencies. It is amazing the symptoms the body will exhibit when the liver and digestive functions are out of balance –disrupting harmony throughout the body. by restoring balance in the body, moods and a sense of well being increase. Chinese Mood Elevator formula can safely be taken while taking a prescribed anti-depressant. this formula is my choice to help people who want to get off their prescribed anti-depressant drugs. I have had people report very good success by taking one Mood Elevator in the TCM form (concentrate) twice daily for a couple weeks, along with Nutri-Calm to support stress. we would then ask the doctor’s suggestion for reducing the antidepressant dose slowly. Once the medication is decreased in half or more, ask the doctor to retest serotonin levels. If the levels are still low, discuss adding in the 5HTP and/or GABA in place of raising the medication. often just balancing the body with Mood Elevator will be enough to lift the moods. this is primarily because the depression was caused by poor lifestyle habits more than low serotonin levels.

Another area to consider is the changes in the hormones estrogen and progesterone that women experience monthly. A woman’s monthly menstrual cycle, as well as entering peri-menopause and menopause, are accompanied by ever changing hormone levels. The ups and downs of hormone levels have to be balanced with the help of the liver. Problems arise when high stress, poor diet choices and lack of adequate water and exercise congest the liver and its ability to break down excess hormones each month. To further overload the liver, we are often bombarded with chemicals and toxins in our work place or home environment. According to Traditional Chinese Medicine, when the liver gets overloaded and fails to do its job properly, we develop symptoms which include feeling depressed. The first warning signs come when the liver begins to get stressed such as “Flu-like” symptoms, nausea, diarrhea, stiff & aching muscles, cold hands and feet, headaches, gallbladder attacks, tenderness or swelling under the right rib cage, dizziness, puffy eyelids , skin eruptions, difficulty falling asleep (late night energy) followed by difficulty awaking in the morning. If we continue with a high-paced lifestyle and poor diet, the liver becomes more congested resulting in symptoms becoming more chronic in nature; such as chronic fatigue, blood sugar imbalances, hormonal swings, food allergies, immune system weakness, poor bowel elimination, gas and indigestion, feelings of depression and despair. Chinese Mood Elevator is a good choice to support these issues. In addition I would consider adding digestive enzymes with your meals, drastically improving your diet and lifestyle and adding in formulas to either cleanse or strengthen your liver function such as Chinese Liver Balance TCM (#1008-8) or Chinese Blood Build TCM(#1005-9).

To help balance the female hormones and support stress at the same time consider the herb MACA (#1117-2). Maca is a hearty root vegetable plant which grows in the high Andean plateaus of Peru. Maca contains substantial amounts of minerals such as calcium, magnesium, phosphorus, iron, zinc, vitamin B1, B2, B12, C, E, riboflavin, thiamin and ascorbic acid. MACA’s reputed positive effect on hormonal balancing issues such as hot flashes, memory problems, fatigue, mood swings and male impotence A chemical analysis shows the presence of biologically active aromatics which have unique aphrodisiac properties as well. Henry Camponile, M.D., of St. Petersburg, Florida states that his first menopausal patient “started to feel better four days after she began taking Maca”, and finds that it promotes energy unlike any other herb he has used. Dr. Richard Brown, M.D. author of STOP DEPRESSION NOW, says that Maca holds great promise for the health and well being of men and women. Dr.mark Smith , M.D. has said “I have noticed a significant level of more balanced energy, stamina & endurance markedly during cardio vascular workouts using MACA”. Aguila Calderon, M.D., is the former Dean of the Faculty of Human Medicine at the National University of Federico Villarreal in Lima. He says, “Maca has a lot of easily absorbable calcium, plus magnesium and a fair amount of silica. we are finding it very useful in treating the decalcification of bones in children and adults.” In his practice, Dr. Calderon uses maca for male impotence, erectile dysfunction, menopausal symptoms, and general fatigue. Maca is a wonderful hidden treasure in the herb kingdom as so few people know about the wonderful benefits it supplies.

NEW YORK (Reuters Health) — People with long-lasting depression may benefit from talk therapy when other treatment methods such as antidepressant drugs alone aren't working, suggests a new study. But the topic needs more research, the authors say – and they also point out that talk therapy isn't accessible or affordable for everyone.

About 15 million adults in America suffer from major depressive disorder – serious cases of depression that last more than two weeks – in any given year, according to the National Institute of Mental Health. Most people who are diagnosed with major depressive disorder get prescribed an antidepressant rather than going straight into talk therapy, explained Dr. Ranak Trivedi, the lead author on the current study from the University of Washington School of Public Health.

But up to half of those people might not feel any better after they start taking the medication, she said.

Guidelines point doctors to a few different options for treating patients who don't respond to their first antidepressant drug. the doctor can add a new antidepressant to the first one, or switch drugs completely. Sometimes it takes several attempts to find the drug or drugs that will help the patient feel better. They can also refer the patient to talk therapy, either in addition to medication or instead of medication.

However, "though the guidelines seem to suggest there are four ways to approach treating people who don't respond to (the first) treatment, we tend to gravitate toward giving medication," Trivedi told Reuters Health.

To see if patients could be getting more out of talk therapy instead of switching between different antidepressants, Trivedi and her colleagues reviewed a series of seven studies involving nearly 600 adults with major depressive disorder who hadn't been helped by medication.

In each of the studies, researchers either took patients off antidepressant medications and substituted talk therapy, or they added therapy on top of patients' usual medication routine. then they compared those patients to others who stayed on their antidepressant drug, switched to a new drug, or had another drug added to their original medication – but didn't have any talk therapy.

Each of the studies was a "randomized" trial, meaning participants and doctors didn't get to choose which treatment the patients got; instead, the assignments were made by chance. This type of study is the most reliable.

Taken together, the results published in the Journal of General Internal Medicine were generally favorable. Some of the studies suggested that patients improved more when they were in therapy and on medication than when they were only taking medication. others showed that adding or switching to talk therapy was beneficial, but not any more so than changing a patient's prescription or having the patient take additional drugs.

Researchers say the results show that talk therapy may be promising for people who don't get better on medication – but they also reflect the fact that many more studies are needed.

As it becomes clearer that the first try at an antidepressant doesn't work for many people, "it's apparent that greater attention needs to be paid to this whole other avenue of treatment for people who aren't responding to first and second and third choice medications," Dr. Michael Thase told Reuters Health. Thase, a psychiatrist at the University of Pennsylvania School of Medicine, has participated in some of the research that suggests that talk therapy can be beneficial. (He wasn't involved in Trivedi's study, however.)

For some patients, however, getting access to talk therapy is more difficult and costly than taking medications, which have gotten cheaper as generic versions became available. As of August 2010, according to data from Wolters Kluwer Pharma Solutions reported by Consumer Reports, average monthly costs for antidepressants were as low, for example, as $19 for fluoxetine (the generic form of Prozac), $26 for sertraline (Zoloft), and $35 for citalopram (Celexa).

Talk therapy costs more than medication, at least in the short term. And insurance companies often put limits on reimbursements (although new rules issued by the Obama administration are intended to improve coverage of mental health care for people whose insurance comes through their employers).

But Trivedi said that in the long run, talk therapy may well be worth it. "People who take antidepressants often end up taking them for life," she said. with talk therapy, patients often go for a few months, or sometimes a few years, and then stop when their symptoms have gone away.

The bottom line is, treatment choices should come down to what the patient prefers, Thase said. In the early stages of chronic depression, "you should pick the (treatment) that you want, or the combination, and go with that. then consider the alternative if three months into it you're no better."

Trivedi agreed that people with depression should try to be attuned to the kind of help they want and need, while not losing hope of getting better. for those with chronic depression, she said, "keep at it. If you don't respond to the first treatment, you're not alone."

SOURCE: bit.ly/dMfUcd Journal of General Internal Medicine, online December 24, 2010.