How Come They're Happy and I'm Not? (23 page)

Finally, other studies with larger groups of depressed patients with cardiovascular disease have also reported similar results. Cardiac patients taking antidepressants place themselves at greater risk, likely because serotonin and norepinephrine reuptake inhibitors can also diminish heart rate variability. With no known risks, biofeedback seems to be an effective and safe alternate treatment that may be especially useful for cardiac patients with depression.

Art therapy is the therapeutic use of creating art by people who have experienced illness, trauma, or challenges, and also by people who seek personal growth and development. By making art and subsequently reflecting on the work, patients can increase awareness of self and others and learn how to cope with symptoms, stress, and even traumatic experience. Also, art therapy is known to enhance brain function and foster the life-affirming pleasures of making art.

Expression of depression and other painful feelings via art therapy can help depressed patients process their feelings and resolve conflict. It's thought that art therapy can reactivate the nondominant hemisphere of the brain. Particularly in chronic or recurrent depression cases, this reactivation may serve to open a person up
to new perspectives and solutions to the challenges that encourage depressive feelings.

As a drummer since age eleven, I can attest to music's ability to calm and improve mood (although as I was a teenager with a drum set in the house, I am not so sure all that noise made my parents feel so relaxed). One large study in Finland has recently verified what I already learned: that music has a clear benefit on mood and quality of life. This analysis looked at thirty studies covering 1,891 patients with cancer. Cancer may arguably be one of the most difficult stressors a person can face. Using music therapy, or prerecorded music, these patients showed beneficial effects on heart rate, respiratory rate, and blood pressure. Previous studies report that music helps decrease anxiety before and during surgical and chemotherapy procedures, reduce side effects of cancer treatment, help mood, decrease pain, boost the immune system, and improve life quality.

Even more to our subject, music therapy has been shown to help depression when added to standard antidepressant treatments. Another study by the same Finnish researchers looked at twenty biweekly sessions of music therapy for thirty-three depressed patients of working age (eighteen to fifty years) using conventional drugs, while another forty-six patients just used conventional drug therapy. According to the researchers:

Music therapy offers an alternative and is another way to get in touch with emotions and develop relationships without relying on talking and verbally expressing feelings, which can be hard for some people. . . . Moreover, you don't have to be a musician nor musically talented in order to get benefit from this treatment.

The music therapy consisted of one-on-one sessions with a music therapist, in which the patients were free to make music
with drums and a xylophone, followed by discussion. After ninety days, the volunteers who received music therapy had clearly greater improvement than those who only took the drugs.

The researchers also noticed that music therapy dropout rate was very low and the commitment level was very high, probably because people were having fun.

* * *

Congratulations on making it through
chapter 6
. We briefly discussed a few forms of psychotherapy as well as a number of treatments that I myself would have thought a bit “out there” before I learned about the practical and effective benefits of natural healing. You certainly will not need to use all of these modalities (at least not at the same time), but I would like you to think about the ones we discussed and see which ones resonate with you the most. They may not all make sense to you from an intellectual standpoint, but do your best to open up aspects of your spirit that go beyond sense; rely on intuition, for this can help guide you to which methods to try first.

He's the best physician that knows the worthlessness of most medicines
.

—B
ENJAMIN
F
RANKLIN

If you are on medication right now, it's important to continue it, especially if it is helping you feel better.

Remember, it's never a good or safe idea to simply stop taking antidepressant medication. We will talk about how to safely wean off at the appropriate time with your doctor's monitoring at the end of this chapter. But for now, do not change a thing about your medications.

However, if your medications are not helping you, or you believe the side effects are greater than the benefits, it's important you speak to your prescribing doctor now about some alternatives. In the meantime, the natural remedies covered in this chapter are backed up by solid research to support your life with medication, either to make it work better or to help avoid side effects.

Because you are on medication, the first thing to think about is making sure the medication is working best for you. I have worked
with scores of patients who have come in on medications (oftentimes two or three) and have told me that the medications have not been working, their psychiatrists are seemingly randomly taking them off one and putting them on another, and they are still not getting any better. Patients have also told me that medications did work for a time but then stopped working and they don't know what to do. The first thing I think of is to use some of the natural nutrients below, which can jump-start a medication regimen and get you feeling better.

In the field of medicine, I have noticed that the more medication choices there are for a condition, the less any of them are likely to work. This is very true for depression.

About 70 percent of depressed patients do not experience an elevated mood when given medication. As a result, these patients are run through a series of adjunctive, or add-on, drugs (like antipsychotic medications) in the hopes of finding a combination that will help the depressed person feel better. These secondary medications boast a paltry 20 to 30 percent success rate (also known as 70 to 80 percent failure rate). One proven way to avoid this is by taking folate.

One 2000 study of 127 patients found that 500 mcg of folic acid taken daily with Prozac greatly improved the drug's effect. A more recent folate study looked at seventy-five patients who were already taking antidepressant medication but were not responding. It was shown that patients taking 15 mg of folate per day (which is a high amount for this vitamin) found their medication to work significantly better—and these effects were as good or better than the added conventional medications studied, according to the authors. These studies suggest that this simple B vitamin may be a viable alternative to the vast array of adjunctive medications, including antipsychotic medications like Abilify or even antiepileptic meds like Lamictal.

In my opinion, it makes sense that when possible, patients already using medication should augment their therapy with natural solutions instead of layering on another pharmaceutical. If you are on medications, take a total of 15 mg of folate a day in the methyl-folate form. Look for the methyl-folate version of this nutrient, which is more natural than other versions. More about folate can be found in
chapter 5
.

Like our B vitamin friend, zinc may be a valuable ally if you are using medication that simply is not working.

One study looked at the effect of zinc deprivation on antidepressant drugs. The researchers gave some mice a zinc-deficient diet, while control mice had a normal diet. Then, they gave animals a stressor (called the forced swim test) to induce depression. They found that the animals who were zinc deprived had a minimal response to the antidepressant, whereas the animals with plenty of zinc in their body were much more able to respond positively when given medication.

Is it possible that antidepressants could be engineered to work well, but the reason they are not effective in so many people is because we are a nutrient-depleted society?

Animal studies show positive results, but mice and humans are very different creatures. How do we know this zinc issue is important in humans?

One group of researchers asked that very question and gave a daily dose of 25 mg of zinc to six patients on antidepressants, while the control group of eight patients was given standard antidepressant drug therapy only. Each patient's sense of well-being was evaluated before the treatment and then up to twelve weeks after. Within six weeks, patients taking zinc reported elevated mood, while those who didn't take the extra zinc did not.

This was a small study, but given the safety of zinc and its possible benefit, I highly recommend you add 25 mg of zinc to your
regimen. If you are taking zinc for more than a few months, please make sure you are taking 2 mg of copper per day (often found in a good multiple vitamin), for extra zinc can decrease copper levels in your body over the long term. More about zinc can be found in
chapter 5
.

One study looked at serum vitamin B
₁₂
levels in 115 people taking medication for major depressive disorder. It's interesting, for none of the patients in this study had deficient vitamin B
₁₂
levels—meaning all patients were in normal range for the vitamin. In the group of forty patients who weren't responding to medication, the average vitamin B
₁₂
level was 470.5 pg/mL (normal range is 200 pg/mL to 1,100 pg/mL). Of the thirty-four people who had a partial response to medication, the average vitamin B
₁₂
level was 536.6 pg/mL. The forty-one people who reported a full response to medication had an average vitamin B
₁₂
measurement of 594.9 pg/mL. It's clear from this study that the higher the vitamin B
₁₂
level, the better the patient outcome. This suggests to me that all my patients with depression should have a B
₁₂
level of at least 600 pg/mL, even though most doctors would be happy with a level over 200 pg/mL. Many blood tests even state that people with levels between 200 and 400 may show neuropsychiatric problems, so looking for 600 pg/mL or higher makes a lot of sense. I know of no reason to worry about B
₁₂
toxicity, even at levels around 1200 pg/mL.

If you are taking medication, you can ask a doctor for intramuscular B
₁₂
shots once a week, or if you prefer oral doses, I recommend the methylcobalamin version, starting at 10,000 mcg once a day, which is about ten times the daily maintenance dose recommended in
chapter 5
. Please check your blood B
₁₂
levels in one month to look for a change. If there's no change, you can increase the dose, and you may also want to consider improving your diet to help digestion and absorption (see
chapter 3
). More about B
₁₂
can be learned in
chapter 5
.

We discussed the importance of this hormone way back in
chapter 4
when discussing blood tests. Testosterone may be even more beneficial in patients who are already taking medications but are not experiencing good results.

In a small, eight-week study, nineteen men taking medication for depression were given either 10 g of transdermal (through the skin) testosterone gel per day or an equivalent amount of placebo cream. These men had not responded well to drugs and also had low or normal testosterone levels. The testosterone-treated patients reported a significant decrease in depression than the placebo-treated patients.

I have seen many cases of healthy mood adjustments using a little testosterone in both men and women. I find that low-testosterone patients often have a bit of hard-to-lose belly fat and have low or irritable mood. Even women should have testosterone checked, and if it's low, talk to your doctor about taking a small amount to see if your mood improves. Have your doctor recheck your levels in a month or two.

In
chapter 4
, we talked about the multiple ways thyroid hormone helps the mind and body of a person with depression. Thyroid hormone may also be an ally to medication that is otherwise not working.

As early as 1969, astute researchers showed that when patients on tricyclic antidepressants were given a form of thyroid hormone called triiodothyronine (T3), the result was an “enhanced and accelerated recovery.” Since that time, it has been shown that 55 to 60 percent of patients who previously failed to respond to tricyclic antidepressants experienced an improvement with thyroid hormone.

In one study of almost three hundred patients, those treated with T3, or a more natural glandular thyroid support, ranging
from 20 to 50 mcg per day were twice as likely to respond than to placebo and almost three times more likely to respond than to thyroxine (T4).

There were also a few studies in which T3 was used successfully when given to patients who were also taking serotonin reuptake inhibitor medications. It was shown in these studies that lack of energy was common in patients given Prozac, but when the T3 was added, the low energy went away, with no side effects noted.