Best Treatments for DEPRESSION

Yesterday, I went to a school meeting where many moms and dads were chattering away about how the school year has been going in their home. In the corner of a beautiful couch in the school’s living room, an old acquaintance was sitting staring into the distance, not talking to anyone but just wagging her long leg crossed over her other leg with her hand propping her sad, downcast face. She looked so sad and no one it seemed wanted to even talk to her as she looked so sad. She had been so nice to us when we first moved to the area but in the last few years has said they have been too busy to get together despite invitations for dinner and lunch. Gently I sat next to her to talk to her and it was clear that she very depressed. Her husband travels a great deal and she mentioned this fact multiple times in the short time we had to talk before a presentation began. I wanted so much to reach out and share with her some helpful options, but could not in such a public settings. Still even in private, I suspect she may not want to admit to a “semi-stranger” that she is struggling with depression and possibly deep resentments. All I could do is try to talk to her as best as I could and offer her a friendly smile trying to commiserate with the busy husband, busy household so common among women these days.

No one is immune from feeling down from time to time or from full blown depression. In medical school, as part of my 3rd year psychiatric rotation at Dartmouth, I was asked to interview a woman for our whole class who was admitted to the psychiatric ward at Dartmouth Hitchcock Medical Center for “Major Depression.” As I talked to this lovely 56 year old woman, I realized right then that no one was immune. She had lost her husband 5 months prior to a long and painful bout with lung cancer and then 3 months after that her teenage son was killed when a tractor flipped over upon him as it was climbing a gentle hill on their farm. She was completely physically and mentally “normal” aside from her admitting diagnosis.

At the time, all I could do was to offer my condolences. I don’t even think I told her that I would pray for her as that concept was likely not even on my radar screen. But now after years of seeing many people suffer through depression, it is clear that there is a better way.

Below are some great sites that have some good point from the medical perspective. Some treatment options are summarized below on my list as well. But all of them miss a key component which is the spiritual component of every human being which, in my opinion, needs to be addressed in most patients in order to help them presently and more importantly eternally. 

C. G. Jung, an agnostic if not atheist psychiatrist who was a contemporary and colleague of Sigmund Freud noted in a published interview that if everyone went to confession weekly, he would be out of a job. He saw the healing power of confession and studied it for for this reason. 

—–

J Relig Health. 1985 Mar;24(1):39-48. doi: 10.1007/BF01533258.
The value of confession and forgiveness according to Jung.
Todd E.
Author information
Abstract
This article represents a broad survey of the views of C. G. Jung regarding confession and forgiveness. Man, a naturally religious being, has a need to confess his wrong and to gain forgiveness of one sanctioned to absolve. The curative effect of confession has been known for centuries. Without confession, man remains in moral isolation. Priests, ministers, and rabbis, as well as psychotherapists, attest to the universality of this human phenomenon.

——–

Aside from the biases one might have from “rotten apple” priests, which unfortunately in any profession do exist, there is an inherit benefit to weekly confession. If you have not tried it, you should: with a good Catholic priest (a list of favorite confessors of all times is below). A friend once went into a random Catholic confessional and said something to the effect, “Father, forgive me, I don’t believe all this crap.” It changed her life for the better, forever she says.

Why not try it? Is it embarrassing and humiliating? How much more embarrassing is going to a shrink who charges a lot of money? Confession is free. Confession will not cure all types of depression or mental health issues if there is a hormonal or neuro-chemical or brain issue, but it has helped so many people I know personally that I feel compelled to mention it precisely because no physician, especially no surgeon,would publicly mention it or ever prescribe it.  Yet we prescribe billions of dollars worth of prescription medicines which also do not have a 100% guarantee and have numerous potential side effects. Is there a side effect of weekly Confession? Not really. Maybe time could be an issue, but I would not say it is wasted time since going to a wise Catholic priest is priceless. There is reason why thousands would fly all over the world to visit with Padre Pio. Also the time you spend in confession is paid back I would argue 7 fold in getting the wisdom to avoid the traps that lead many into the pit of depression and despair.  

More on Padre Pio Below. But if you want to skip to my list of Best Treatments for DEPRESSION, please scroll down to ***.

in a small, hard to get to town called San Giovanni Rotondo, Italy before his death in 1968.

After his death, millions still flock to see the remains of St. Padre Pio who was an incredible confessor. 

Most of my list may sound like “common sense,” but I would argue that if you follow this list well, you might have many new natural options that might help keep you stay away from prescription drugs which each have a long list of potential side effects. 

Dr. Cremers’ Best Treatments for DEPRESSION

1. Be sure you are getting plenty of sleep: avoid tv, ipads, cell phones after 8pm (ideally earlier); especially avoid tv, ipads, or cell phones in bedroom. Getting enough sleep is essential in getting the right neurotransmitters to work in your brain properly when you wake up. If you do not get enough sleep, your brain cannot be happy! (see references below). Sleep should be sacred in your house unless you are a true saint and can cheerfully offer up a bad night of sleep.

2. Drink plenty of water: at least 64oz per day. Eat plenty of green leafy vegetables ideally 2-3x per day to increase the antioxidants and vitamins needed to produce “happy feeling” hormones such as oxytocin. 

3. Get some direct sunlight safely at least 2 hrs per day. Natural sunlight increases one’s Vitamin D levels which are the backbone to key hormones in our body which we need to have the feeling of “happiness” or “contentment.”

4. Get more exercise: yes, this it seems is on any list having to do with any health issue. But it is true. Even standing at an elevated desk instead of sitting can help improve the stress hormone/ relaxation hormone ration in the long run. Park farther away from the entrance. Take 1 flight of stairs a day and increase it each week. Talking the long way around the 1st floor kitchen island and picking more things off the floor can build your “happy hormones” especially when done with love and purpose. In the Christian relm, we say to sincerely “Offer Up” that little inconvenience of that extra exercise or effort for someone you love or for a soul in purgatory. Science is now finally showing that these little “Oferrings” actually help the person doing the “Offering Up” chemically as well.

5. Learn to say “I am sorry” and “I forgive you” at least 7 times a day with a sincere heart and mind. This might be the hardest thing on the list. One has to start small: saying “I am sorry” to your dog for stepping on his tail may be much easier than saying “I am sorry” to your spouse who you have a mountain of resentments towards. But learning to say you are sorry and also learning to FORGIVE your enemy and saying you FORGIVE your enemy has been proven to decrease stress hormones in the body and increase happy hormones. At the base of this is an act of humility which the body is pre-programmed to help us physically if done with gentle charity and cheerfulness. An “I forgive you” or “I am sorry” while gritting one’s teeth with anger at the max, does not have this effect. Thus taking this “I am sorry” and “I forgive you.”slowly but surely is worth the effort and pain it takes. This point is the bases for the next:

5. Weekly confession. Find a great Catholic priest who walks the walk & lives a virtuous life. A wise, holy priest is worth more than 1million psychiatrists. It is not easy to find a holy, wise priest in some locations, but there are thousands around the world and well worth a plane ticket.

6. Daily Mass: this takes a leap of faith, it is true, but just going to daily mass even as someone who does not believe God at all, likely would prove to decrease stress levels in an NIH sponsored study. Mass is a very peaceful place and time in most cases and a time to reflect on one’s life and decisions at the very least. It is “mindfulness” on steroids. And if you believe all that is purported to occur at Mass: if you could even imagine a world where such was possible, then the power of Daily Mass, has the power to cure eternally. A friend used to sit in the very back pew at Daily Mass for months, criticizing all he herd and saw: the old women & men there. “Likely on death’s door anyway. What do THEY have to loose. They have nothing better to do anyway. What a waste of time, this nonsense.”  Yet, he found a peace there that he could not explain and kept returning. He soon was blown away by “something” (he now recognizes it as the Holy Spirit) and he was transformed into a new man who goest to Daily Mass out of pure love of God. 

Similarly we have a friend who was a world-touring executive for a big TV network in LA. He found himself one day waking up and finding no real meaning in his life: “what’s all this money and power for anyway?” He started feeling called to stroll at a nearby cemetery near his work frequently during lunch when his colleagues would go out for drinks. There he was faced with his mortality and that he would die someday and wondered what he would have to show for his life. Soon he felt called to go to Daily Mass at a nearby Catholic Church. He says he was drawn to it but could not explain why initially. Now he is able to explain that he found a meaning and peace there he could not find any where else in the world. He is now in the seminary to become a priest. 

Give it a try for 2 weeks: Daily Mass. It takes about 20-30 minutes in most good parishes. Just ask God to help you see if you should be going to Daily Mass. Just try it.

7. Pray frequently throughout the day. My favorite prayers are the Rosary and the Angelus. Since many may have stopped reading this “religious stuff” already, I’ll leave it at that. But prayer and meditation has been proven in scientific studies to increase oxytocin levels in the brain and decrease stress hormone levels.

8. Call a friend at least once per week. Ideally once per day if you can. This is often the hardest thing to do when you are in the pit of despair. There has been many papers reporting that the reason women are happier than men over time is because women in general at better at making and maintaining friendships. Still I have many friends who begin to isolate themselves in their resentments and depression and will not answer a friend’s call because they are so deeply depressed. By getting into the habit of calling a good friend frequently when things are stable or not too bad, this good habit will help you in the end conquer the turning in of depression and help you reach out for help.

9. Find a trusted, wise mentor, spiritual director. This is a must for everyone. In the professional world, many of the most successful people have a trusted advisor or mentor. The same should be true in the mental health world and I would say in the spiritual world as well. Find someone who lives a life of virtue and ideally practices the above 7 points and is a happy, cheerful, deep person. Wise mentors are priceless.

10. Follow a Plan of Life: have a schedule that keeps you busy and focused on serving others and not serving yourself. Thinking about yourself is a recipe for disaster and despair. Here is a sample Plan of Life of a friend who is trying to be a saint.

1) Wake up, saying a prayer called the Morning Offering, and pray to God thanking Him for your life and happiness you have had and will have.

2) Bit of exercise, jumping, high steps, stationary bike riding or climbing up stairs.

3) Daily Mass before breakfast ideally.

4) Wash hands & have Breakfast: full of Omega 3, anti-oxidants; limit carbs as much as possible. Don’t over-eat. 

5) Start the day: ie, Get kids off to school. Get off to work. Help spouse get off to work. Start home-school. Clean house. Do chores, errands. Plan meals. Start cooking. Delegate when can. Call friends. Go out for coffee with friend. Exercise. Frequently imagine you are the child of God who loves you. Try to say “I am sorry” and “I forgive you” at least once a day to start with cheerful affection.

6) Say Angelus Prayer at noon

7) Wash hands & Have lunch

8) Wrap up work day: ie Pick up kids from school. Get home from work. 

9) Make a visit at a tabernacle to pray. Say aspirations of love to God” “I love you, God Almighty.”

10) Read a few minutes of the bible and another good book.

11) Get a bit more exercise in. Go for a walk & call a friend.

12) Wash hands and have dinner: full of green leafy veggies; low carbohydrate best; high Omega 3s

Pray rosary after dinner or as everyone helps clean up. 

13) Start winding down: ie, help kids with homework, finish chores after dinner, get kids to bed, hug your kids, hug your spouse; many hugs and kisses increase Oxytocin which makes brains happy!

14) End of evening: get more exercise in if possible; Attend a stimulating talk or take a course on something new. Do cross word puzzles or brain teasers to keep your mind fit and off your problems until you can process them together with a wise mentor. 

15) Say evening prayers. Finish the rosary if have not already. 

16) Avoid computers in bedroom. 

11. Read good books: there are hundreds of good books out there on how to get one out of depression. Here are my favorites.

a. Hell and How to Avoid It. Still a miracle working- book for me. Usually takes me a few pages to read but after that I am cured of all anger, resentment, depression…at least for a few days.

b. Fascinating Womanhood: a must read for all women: just don’t read the Amazon reviews until after you have read the book and have implemented at least 15 points. 

For Men: If He Only Knew: a must read for all men!

c. The New Testament: just read a couple of lines a day going through the New Testament slowly but surely. Jesus did cure many people and I believe He has the power to cure us to TODAY.

d. The Way, by St. Josemaria. So simple but can be helpful.

12. A Personal Diary: this has many benefits but also some risks. If one feels they cannot talk to anyone, not even a priest about very painful, depressing issues, then writing in a diary is a good idea. Throwing it all out there can be very cathartic. But re-reading a diary or ruminating on past hurts has been shown to create a viscous cycle of stress hormones in the brain that can physically lead to despair. Write it all down & then chuck it out! It is like trash that you have to get rid of from your brain, heart, mind, and soul! Get rid of it.

13. Consider Natural Lithium Water: few risks and helps in some patients. 

http://www.nytimes.com/2014/09/14/opinion/sunday/should-we-all-take-a-bit-of-lithium.html?_r=0

14. Over the counter vitamin D and other herbs and roots may help.

 15. Lastly, prescription medications: more below. List of possible risks is high. 

References.

1.

1.  Dr. Donald Jacobson answered:
From Healthtap MD: 

Why is Abilify (aripiprazole) a $6+billion per year #1 blockbuster drug? Is it worth $25 each for the lowest strength pill? And why so heavily used?
Depression &  disability

Depression is one of the most disabling conditions there is. The total economic loss due to loss of productivity, loss of life, work disability, and presenteeism is virtually impossible to establish. Once a person goes on disability from depression which happens in approximately 50% of major depression recurrent cases, it is very difficult to ever get them off of the disability rolls. Having treated over 200 people with Abilify and having the great pleasure of watching them stabilize, normalize, going to full remission, and return to work has been nothing short of amazing and something that i never expected to see during my career working with particularly depressed individuals.While the cost is high, the company is generous in samples, it’s co-pay cards, and it’s patient assistance programs.I have had the pleasure of watching Abilify prevent marital breakup, child abuse, verbal and physical abuse, and a tremendous number of hospitalizations. It is on this basis that i feel it’s cost is justified.Having previously suffered subdural hematoma, i don’t know that i would’ve been able to rehabilitate to return to work without the addition of Abilify to my medication regimen. It has also saved lives of several very close friends and relatives as well. It’s contribution should not be underestimated.

2. http://www.webmd.com/depression/features/natural-treatments?page=2
10 Natural Depression Treatments
By R. Morgan Griffin
WebMD Feature
Reviewed by Joseph Goldberg, MD
http://www.webmd.com/depression/news/20050915/best-depression-treatment-one-you-want?page=2
Best Depression Treatment: The One You Want
Antidepressants or Therapy? Patient’s Preference Most Effective
By Daniel J. DeNoon
WebMD Health News
Reviewed by Michael W. Smith, MD
WebMD News Archive