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Ways To Deal with Depression

depression

By Dr. Steven Gelbard, MD, Medical Director of ReLife Miami Institute

According to American Psychiatric Association (APA), Depression (major depressive disorder) is a common and serious medical illness that negatively affects how you feel, the way you think and how you act. Fortunately, it is also treatable. Depression affects an estimated one in 15 adults (6.7%) in any given year. And one in six people (16.6%) will experience depression at some time in their life. Depression can strike at any time, but on average, first appears during the late teens to mid-20s.

When you’re dealing with clinical depression, everything in life can feel exhausting. While selective serotonin reuptake inhibitors, or SSRIs, can help, the side effects of these medications may make you want to learn more about non-medication options for treating depression. Let’s talk about some of the non-SSRI options for treating depression.

Non-SSRI Options For Treating Depression And Other Mental Health Issues

Swipe through each images to learn what are the other non-SSRI options for treating depression and other mental health issues​.

Exercise
It sounds almost too good to be true, but exercise is an effective method of treatment for low to moderate depression. Studies have shown that moderate to intense exercise most days of the week works as well as a low dose antidepressant for mild to moderate depression. Exercise can be great at relieving symptoms of depression on its own or in combination with SSRI treatment.
Talk therapy
Depression is caused by an imbalance of chemicals in the brain, and negative thought patterns can contribute to this imbalance. It can be hard to put a stop to these patterns on your own, and talk therapy can help. Seeing a therapist doesn't mean that you're crazy, or that you'll need to be in therapy forever. Short-term, solution-focused therapy can be life-changing for people who suffer from depression.
S-adenosylmethionine, or SAMe
SAMe, is the synthetic form of a compound that naturally occurs in the body. While SAMe is used widely in Europe to treat depression, it's not yet approved by the FDA for that use. Nevertheless, it's available in U.S. pharmacies and drug stores without a prescription and may be worth a shot if you're interested in using natural supplementation to ease your depression symptoms.
Microcirculation
Using an alternative treatment or medication that aids in your body's natural microcirculation processes may be helpful for people with several mental health conditions, including depression. D'OXYVA is a popular non-invasive therapy that uses medical grade CO2 that can significantly help your body's microcirculation process. This can improve the processes of your body's autonomic nervous system, which controls involuntary actions in your body (like digestion and breathing). When your body's autonomic nervous system is functioning at a higher level, you're likely to get better sleep, experience better digestion, and experience a heightened sense of well-being, which may contribute to the lessening of depressive symptoms.
Eating fish
Omega-3 fatty acids found in fish may help the brain to control the symptoms of depression. While more studies need to be done, the initial research has shown that the acids help ease depressive symptoms. Both D’OXYVA therapy and eating fish work to contribute to greater overall mental health.
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ABOUT THE AUTHOR, DR. STEVEN GELBARD

Dr. Steven Gelbard, MD is a Neurosurgeon that has been in practice in Florida for almost 30 years. He graduated from Tufts University School Of Medicine and then did additional training at NYU, Brown University and Harvard Medical School affiliated Hospitals, as well as other prestigious institutions. He holds several US patents for medical inventions and has worked with professional sports teams including the NHL Florida Panthers hockey team, the NFL Miami Dolphins football team, and the ABA Florida Pitbulls basketball team. He is currently the Medical Director of the ReLife Miami Institute.

HOW D’OXYVA CAN HELP?

D’OXYVA is the only fully noninvasive, completely painless transdermal (over-the-skin) microcirculatory solution that has been clinically tested to significantly improve microcirculation.

The improvement of microcirculation, i.e., blood flow to the smallest blood vessels, benefits one’s health, immune system and overall sense of well-being in a variety of ways.

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Capillary damage can lead to depression

A direct link has been found between damage to capillaries (microcirculation) and depression. Researchers at Maastricht UMC+ found that microcirculatory damage increases the risk of depression by twenty to fifty per cent. Their findings on the link between microcirculation and depression were recently published in the leading scientific journal JAMA Psychiatry.

Patients with type 2 diabetes – the most prevalent disease worldwide – are twice as likely to develop depression as healthy individuals. Until now, there was no explanation for this link. However, we did know that type 2 diabetes and hypertension damages microcirculation, which is the circulation of blood in the smallest blood vessels. Poor microcirculation is relatively common in adults and does not necessarily have negative consequences, as the body is equipped with physiological reserve capacity. However, if the damage is severe, this can have a negative impact on daily functioning. The capillaries supply oxygen and nutrients to all parts of the body, including the parts of the brain that regulate mood. If this supply is disrupted, it can have a negative effect on our mood.  

 

Measurements

The researchers based their findings on a literature study and their own microcirculatory measurements obtained through MRI imaging, biomarkers in the blood and research on the capillary function in the skin and retina. The capillary measurements, carried out as part of The Maastricht Study, were exceptionally tricky. Damage to major blood vessels is relatively easy to determine, but capillaries are hard to study because the slightest movement by the test subject can disrupt the measurement and render it unreliable.

 

Image translation:
The Maastricht Study: challenges of a healthy lifestyle Measuring microcirculation in the human body.
In the brain, In the eye, Under the tongue; In the skin of the wrist, In the fingertip; In the skin of the ankle.
8000 participants (1800 of which have type 2 diabetes), 40 FTE (23 PhD candidates – 63 internships), 20 million (invested), 36 publications (in scientific journals), 9 publications (in prestigious journals).

 

Treatment

The researchers assume that microcirculatory damage can be treated with medication. Certain hypertension medications improve microcirculation to some extent, but a targeted drug for this purpose does not yet exist. Developing one will require further insight into the underlying mechanisms that cause depression. 

Marnix van Agtmaal is currently conducting PhD research on the link between microcirculatory damage and depression. He expects to complete his dissertation in early 2018. The link to the publication in JAMA Psychiatry.

HOW D’OXYVA CAN HELP?

D’OXYVA is the only fully noninvasive, completely painless transdermal (over-the-skin) microcirculatory solution that has been clinically tested to significantly improve microcirculation.

The improvement of microcirculation, i.e., blood flow to the smallest blood vessels, benefits one’s health, immune system and overall sense of well-being in a variety of ways.

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Depression and cerebral blood flow

Depression and cerebral blood flow

Maybe a benefit will arise from the current debate about the usefulness of antidepressants in depression, if it draws attention to the published studies concerning reduced regional cerebral blood flow in depression which have failed to influence clinical opinion. Perhaps the relevance of such information can be appreciated by reference to the study by Lucey et al. (1) They showed that in patients with panic disorder with agoraphobia, obsessive compulsive disorder and post traumatic stress disorder, there were regional reductions in cerebral blood flow, but in each disorder in different regions of the brain.

It is proposed that depression is the dysfunctional state arising from inadequate rates of blood flow to deliver the necessary oxygen and nutrient substrates to sustain normal tissue function in specific regions of the brain. This means that the condition would be reversible when there were adequate rates of blood flow.

In 1990, Sackheim et al (2) critically examined what had been written about regional cerebral blood flow in mood disorders. An important contribution was made by Bench et al (3) who reported their findings in a study in which previously scanned patients were rescanned on remission. They concluded, “Thus, recovery from depression is associated with increases in regional cerebral blood flow in the same area in which focal decreases in regional cerebral blood flow are described in the depressed state, in comparison with normal subjects.” Similar findings were reported in another paper (4) which reported that the reduced rate of blood flow in the left frontal region which had been observed during depression, returned to normal during remission. The lack of attention given to such findings probably reflects the current antipathy to reports which imply a role for the flow properties of blood (blood rheology).

It is possible to interpret such changes in blood flow in terms of the effects of poorly deformable red cells, which reflect change in their environment by a reduction in fluidity of the the cell membrane. Normalisation of the cell environment restores normal levels of deformability. So it is not surprising that depression is a frequent problem in chronic disorders which are known to have altered blood rheology manifested as increased blood viscosity and poorly deformable red cells, such as in diabetes for example.

Kamada et al (5) in 1986 reported that sardine oil so increased the fluidity of the membranes of diabetic red cells that they were unable to distinguish such cells from those of non-diabetics. Ten years later Maes et al (6) noted that, ” Major depressed subjects had significantly lower C18-3 omega-3 in cholesteryl esters than normal controls. Major depressed subjects showed significantly lower total omega-3 polyunsaturated fatty acids… than minor depressed subjects and healthy controls.” A later study of the omega-3 fatty acid content in the diet and in red cell membranes of depressed patients (7) noted that, “Lower red blood cell membrane n-3 polyunsaturated fatty acids are associated with the severity of depression,” and concluded, “The findings raise the possibility that depressive symptoms may be relieved by n-3 polyunsaturated fatty acid supplementation.”

Ten years later there is no indication that the significance of such findings have been recognised and therapy for depression has been based upon antidepressants rather that omega-3 rich fish oil which might correct the primary problem. Possibly, if the current debate leads to a more public recognition of the problems of cerebral blood flow in depression, then maybe those who suffer from depression will explore the potential benefits of taking 2 x 1000mg capsules of fish oil, three times daily. Many studies have used 10 capsules daily, and one study reported that the maximal tolerable dose was twenty grams daily. Because of the need for the enzyme delta-6-desaturase to be functional in order to utilise the plant derived alphalinolenic acid, it is safer to use fish oil as a source of omega-3 fatty acids. An alternative would be to increase the dietary intake of omega-3 fatty acids by including sardines or oily fish in meals on a daily basis.

In addition, because regular light exercise has been shown to reduce blood viscosity, an activity such as walking or dancing should be part of the daily programme. A good example was an Australian study involving “pram pushing” which was shown to be beneficial for women with post-partum depression.

HOW D’OXYVA CAN HELP?

D’OXYVA is the only fully noninvasive, completely painless transdermal (over-the-skin) microcirculatory solution that has been clinically tested to significantly improve microcirculation.

The improvement of microcirculation, i.e., blood flow to the smallest blood vessels, benefits one’s health, immune system and overall sense of well-being in a variety of ways.