Depression and self help, where do you turn for the answers?

General practice is the formal point of entry into the mental health care system, and GPs act as the ‘gatekeepers’, playing a central role in this help-seeking process. A good GP is therefore central to ensuring that individuals receive the best and most appropriate mental health care possible. It is also important to remember that pharmaceutical intervention is not necessarily the key to all treatments – diet, as well as alternative therapies, can be key players in recovery.

Whilst many forms of depression can be easily treated in primary care, many people chose not to undertake, or are certainly reluctant to begin, the journey that takes them on this route of self-help. There is such a high prevalence of mental health problems and disorders that develop in adolescence and early adulthood, yet young people in particular are the least likely to seek professional help. It seems that the stigma that is associated with mental health issues plays a significant role in the choices that people make. Individuals are also less likely to ask for help if they are experiencing suicidal thoughts and depressive symptoms, hold negative attitudes toward seeking help or have had negative past experiences with help offered. Furthermore, the belief that they should be able to sort out their own mental health problems on their own plays a strong inhibitory role when it comes to asking for help. On the other hand, people are more likely to seek help through talking to their family and friends, since this helps with expressing their feelings without fear of prejudice. If they have some knowledge about mental health issues and the relevant sources of help, they are more likely to seek help. Thus, internet-based information is now a routine source of knowledge for mental health issues and can provide key information. There is so much information on the internet on self-help and advice for people with depression that it can quite overwhelming!

For this reason, I’ve formulated a nice easy to read info pack that people can download, read online or print and take away. It covers depression facts and various treatments including conventional treatments, dietary changes that are known to help, as well as alternative treatments to pharmaceutical drugs. Download my depression help pack now.

Middle age and hot sweats, oh joy!

I was invited out to a dinner party a few weeks ago, joining a group of friends that I had known for many years but some of whom I had not seen for some time. By the time we had finished desert and were sipping our coffees the conversation turned from general catch up to a subject that seems to involve some degree of doom and gloom.

The subject was the ugly word ‘menopause’ (to which I still shudder slightly) and seemed to be on the minds of many of my dinner comrades. Whilst we all still proclaimed to be of healthy ‘child-bearing’ age it seemed that the menopause was in fact the next major event to look forward to in most of our lives (bar the daughter of my friend Shelly who, at the age of 24, found the whole conversation quite amusing).

So why the long faces? Well simply put, the menopause can be a rather unpleasant experience for many women. When the ovaries cease to produce eggs, oestrogen levels drop, the normal menstrual cycle is disrupted and the whole package results in a number of generally unpleasant symptoms. I have only one friend that I know of who is currently at this stage of her life, and as we were chatting her face lit up like a cartoon creation that had eaten chillies unwittingly. You could almost see the smoke leaving her ears as she panted like a small dog that had been left out in the sun without any water. After a few minutes her ruddy cheeks returned to normal and she muttered the words “sorry, hot flush”. Oh, what a joy to look forward to! Thereafter the subject was focused on who would and who wouldn’t turn to HRT (hormone replacement therapy). Whilst HRT is by far the most effective therapy, it seems that many people are turning to natural methods to alleviate the symptoms of menopause, for fear of side effects. So, what is out there exactly?

First let us consider the phytoestrogens (isoflavones: genistein and daidzein) found in red clover and products such as soya flour, soya milk, and tofu, which have a wide range of heath positive benefits. The interest in phytoestrogens has developed because of the epidemiological evidence that women whose diets are rich in these compounds, such as women in Japan and Asia, appear to have a much lower incidence of “Western diseases” such as heart disease, osteoporosis, and cancers of the breast, colon, and womb. Women in these countries also do not appear to suffer the same way with hot flushes and sweats as we do in the western world. Another beneficial plant is black cohosh from the buttercup family, which grows in eastern and central areas of the United States. Black cohosh was used by Native Americans as a traditional folk remedy for womens’ health conditions, such as menstrual cramps and hot flashes, arthritis and muscle pain. Whilst some people may not be familiar with the benefits associated with black cohosh, they are likely to be aware of the general association between menopausal as well as premenstrual syndrome (PMS) and evening primrose oil.

Evening Primrose oil is a plant oil that contains gamma-linolenic acid (GLA), an omega-6 fatty acid. GLA is involved in the metabolism of hormone-like substances called prostaglandins that regulate pain and inflammation in the body and can help with both the hot flushes and mood swings associated with menopause. Whilst all of the above are relatively well known alternatives to HRT, ethyl-eicosapentaenoic acid (E-EPA), an omega-3 fatty acid found in fish oil, has recently been shown to be an effective method for reducing hot flushes.

Results from the first double-blind, placebo-controlled randomized clinical trial of E-EPA published last year found that E-EPA was more effective than the placebo in reducing hot flushes, with a 55% average reduction in symptoms in these women (Lucas et al, 2009). EPA, like GLA, is the precursor to a family of anti-inflammatory prostaglandins and works, therefore, in a similar way to that of GLA. Combining these two anti-inflammatory products in one product such as Vegepa certainly offersa unique method of managing menopausal symptoms, either on its own or in combination with other approaches.

Lucas M, Asselin G, Mérette C, Poulin MJ, Dodin S. (2009) Effects of ethyl-eicosapentaenoic acid omega-3 fatty acid supplementation on hot flashes and quality of life among middle-aged women: a double-blind, placebo-controlled, randomized clinical trial. Menopause 16:357-66.