Chemicals in food can cause major problems, which I wrote about in a recent post. However, chemicals in the environment can be just as bad. Your skin is your largest organ and it can absorb enormous amounts of chemicals, not just from makeup. Chemicals also enter your body through your nose. Aromatherapy is an example where your mood can be altered through your sense of smell.

Can the chemicals in your environment make your mood worse or even make you sick? Absolutely.

Gas cookers increase the carbon monoxide and nitrogen dioxide levels in the house. Moulds give off toxic fumes. You should make sure that your house is well ventilated and clean.

Think about the personal care products that you use. Makeup is a big culprit. Look at the ingredients – I can’t pronounce most of them. Liquid soap normally contains a chemical called sodium laureth sulfate which is a detergent and known skin irritant. It is also found in shampoos and toothpaste. But the list of chemicals is long and so are their potential effects for people who are sensitive. They are in deodorants, moisturizers, sunscreens.

If you’re concerned about the chemicals in your life then it would be a good idea to research the products you are using and potential substitutes, either online or somewhere like your local health food shop. There are many alternative products that are safe, work well, and don’t use harsh chemicals. For example cleaning with a mixture of vinegar and bicarbonate soda is an excellent substitute for detergents on many surfaces in the home.

Sensitivity to chemicals can cause real problems for some people, including changes to their moods. But once you adjust the products that you use in the house it is fairly easy to keep going. An allergy specialist can also do tests that hone in on each class of chemicals. That is what we ended up doing for Maddie.

Most people head for a search engine to look for information, which is the first obstacle in finding what you need. Search engines are generally good at giving relevant results, but there is always rubbish in there as well. Search engines aren’t perfect.

Google is the most popular engine by far, because its results are normally good and it’s fast. In ranking websites Google places emphasis on links between same or similar industry websites. A blog about depression that has been linked to by large, reputable mental illness organzations will outrank a similar blog that is popular with large gambling sites. This makes sense for ranking sites by credibility.

I’ll write about Google here because it has such a large share of the market, but the same issues apply to other search engines.

When you type the search term “depression” into Google, you receive a lot of results for reliable sources. The first 10, 20 or 50 appear mostly good. But what about the other 120 million results? Click a few pages forward and the odd website looks a bit dubious, and it goes slowly downhill from there.

But the biggest roadblocks to finding reliable information are at the tops and sides of Google pages. In these positions there are 10 or so results under the subtle gray titles “Sponsored Links”. These are paid advertisements. If you look at the sponsored listings you can see that they are generally sales based. On the front page of my search one of the results is “Depression Free in 3 Minutes”. (LOL). For such a high rank this site will be paying at least $2 a click. It wouldn’t be advertising if it wasn’t making more than $2 per visitor for whatever it is selling.

Call me a fool but it took me years to realize that “Sponsored Links” can be anything, with no implication about reputation or credibility. There will be many others, especially new users, who like me lack this same knowledge. They click and find themselves on a site looking for the promised information, while the seller is taking them by the arm and guiding them towards the transaction tunnel.

Ads like these are now everywhere. They are on newspaper sites, blogs, portals, health sites, anywhere that the site owner wants to make a bit of extra money delivering Google ads to his or her visitors. Web designers blend them into their websites, so the distinction between content and advertising is blurred, even with the subtle “Sponsored Links” displayed somewhere close by. Blah!

Thanks to Dawn at the Experience Project for providing the idea and much of the information for this post.

What is Music Therapy?
It’s an established therapy for a wide range of conditions. According to the American Music Therapy Association it is used to alleviate physical pain, elevate mood, assist relaxation, induce sleep, and lessen muscle tension. As a treatment for an illness like depression it is an adjunctive therapy, that augments the other treatments being used, but doesn’t replace them. It focuses on reaching therapeutic goals, which sets it apart from straight music entertainment or education.

Who are Music Therapists?
Degree qualified allied health professionals, trained in music therapy, music, psychology, behavioral sciences, disabling illnesses, and a spattering of other things. They are normally part of a wider team of health professionals, working in general or psychiatric hospitals, nursing homes, community mental health centers, rehabilitation centers, prisons and schools. There are also plenty of music therapists in private practice.

How Does it Work?

I don’t know. Honestly. It confuses me no end and I would need to sit in on a session to get a good feel for it.

Here is the best explanation that I’ve found, from the Association of Professional Music Therapists.

“There are different approaches to the use of music in therapy. Depending on the needs of the client and the orientation of the therapist, different aspects of the work may be emphasized. Fundamental to all approaches, however, is the development of a relationship between the client and therapist. Music-making forms the basis for communication in this relationship.

As a general rule both client and therapist take an active part in the sessions by playing, singing and listening. The therapist does not teach the client to sing or play an instrument. Rather, clients are encouraged to use accessible percussion and other instruments and their own voices to explore the world of sound and to create a musical language of their own. By responding musically, the therapist is able to support and encourage this process.

The music played covers a wide range of styles in order to complement the individual needs of each client. Much of the music is improvised, thus enhancing the individual nature of each relationship. Through whatever form the therapy takes, the therapist aims to facilitate positive changes in behaviour and emotional well-being. He or she also aims to help the client to develop an increased sense of self-awareness, and thereby to enhance his or her quality of life.”

Does it Work?
It’s been the subject of study for a long time now, and there is no doubt that it is effective for a range of illnesses (in combination with other therapies). The evidence is a bit light-on for depression, for lack of robust studies, although there is plenty of empirical evidence to suggest that it helps. Based on the description above, I expect that it is highly dependent on the individual. As with most every treatment many depressed people would benefit from the therapy, and many others wouldn’t.

Would I try It?

In a word, no.

Links:
The American Music Therapy Association
Canadian Association for Music Therapy
British Society for Music Therapy
Association of Professional Music Therapists (UK)

This is in response to a major deficiency in the Australian diet.

Innovation Director at McCain Foods, David Boyle, said “I think the food industry as a whole has got to get more serious about putting nutrients in our foods”. And it is getting serious. These “functional” foods, with nutrients added, are hitting supermarket shelves everywhere. Manufacturers like McCain are clearly concerned about our diets.

A quick refresher on Omega-3 fatty acids. Omega-3s are polyunsaturated fatty acids found mainly in fish, some plants, nuts and seeds. Those found in marine life consist mainly of EPA and DHA, the two principal Omega-3 fatty acids. They are highly biologically active fatty acids. Those found in plants (flaxseed, walnuts and canola oil) are usually in the form of alpha-linolenic acid. The body can convert this into EPA and DHA, but only inefficiently at the level of 10%-15%.

Why are DHA and EPA important?

How many reasons do you want?

Dietary DHA can reduce the level of blood triglycerides, which may reduce the risk of heart disease. Low levels of DHA causes a reduction of serotonin, which may in turn be associated with depression and other diseases. An increasing body of evidence suggests that supplementing the diet with DHA can provide therapeutic benefits for people with depression.

EPA is needed by the body to produce prostaglandins, which control blood clotting and other arterial functions. EPA also provides a natural lowering of blood cholesterol and triglycerides.

There is a comprehensive list of the effectiveness of Omega 3s on a range of health conditions at the US National Institute of Health’s MedlinePlus.

Depression and bipolar disorder still rate a “C” – “unclear scientific evidence for this use”. There is strong evidence linking depression with a reduced intake of Omega-3 fatty acids, but less evidence for the benefits of increasing Omega-3 to relieve depression more generally. In fact earlier in the year the British Medical Journal’s Drug and Therapeutics Bulletin (DTB) dropped a bomb-shell, stating that there is no convincing basis for using Omega-3 as a means of alleviating the condition.

UK firm Dairy Crest pulled a new ad campaign for its Omega-3 ‘clever milk’ shortly thereafter.

So I happened upon a packet of McCain’s SuperCrunchy Omega 3 Classic Chips in my local supermarket today. The vital statistics on my nutritional panel were:

Per 100g
Omega 3 – 348 mg
DHA – 26 mg
EPA – 7 mg

So the combined amount of DHA and EPA is less than 10% of total Omega 3. And guess what? Cooked in canola oil.

I would love to know how much Omega 3 there was before the new marketing campaign. Not much less than there is now, is my guess.

McCain Foods innovation director, David Boyle, said the launch was a big step forward in McCain’s quest to provide consumers with a healthier French fry without sacrificing taste or quality. Mmmm. That’s right. No fish oil here.

Here are the Omega 3 levels in some other everyday foods (per 100g), taken from the Australian government’s Food Standards database. Sorry to those who haven’t caught up to metric yet!

Cake, Carrot, Iced, Commercial 56 mg
Cream, Thickened, 35% Fat 90 mg
Lamb, Leg Roast, Roasted, Lean 114 mg
Pancake, Home Prepared 120 mg
Sauce, Hollandaise 122 mg
Tip Top Omega 3 Bread 163mg
Beef, Mince, Hamburger, Dry Fried 277 mg
Beef, Chuck Steak, Casseroled, Lean 357 mg

…then the fish…

Bream, Baked In Foil, Oil Or Fat Not Added In Cooking 1089 mg
Fresh Gemfish, Flesh, Steamed 1753 mg
Salmon, Atlantic, Grilled Without Fat Or Oil 1822 mg
Salmon, Red, Canned In Water, No Added Salt, Drained 2225 mg
Sardine, Canned In Oil 2502 mg

Sardines on toast is looking good.

In the U.S. macronutrients, as fats, are not assigned recommended daily allowances. Instead they have Acceptable Intake, which is 1.6 grams/day for men and 1.1 grams/day for women.

There aren’t many academics or clinicians around who will advise a “therapeutic” dosage of Omega 3 for depression. If such a thing exists it will be vastly different between people, probably a lot higher than the normal Acceptable Intake, and only beneficial for some. A Finnish review of Omega 3 studies shows how variable the results have been so far, and this list is far from complete.

Further reading:
Omega 3 Overview
Omega-3 for Depression and Bipolar Disorder (a bit out of date but still good)

It is important to remember, when working through a resource list like this, that some things may work for you and others may not – a treatment for depression should start with professional help. Irrespective of this, it’s important to be involved in learning about your illness, including the treatments available. It seems that those who actively participate in their treatments have the most success in maintaining good health. Good luck!

THE BIG PICTURE

Large Website Resources
National Institute of Mental Health
National Alliance on Mental Illness
Medline Plus
MayoClinic.com
Blackdog Institute

Comprehensive PDF publications
National Institute of Mental Health
Mental Health Foundation – Dealing with Depression
HereToHelp – Depression Toolkit
Understanding Major Depression and Recovery

PDF Fact Sheets
Mind (National Association for Mental Health)
National Institute of Mental Health
SANE Australia
Black Dog Institute
Beyond Blue

Staying Well Plans
National Mental Health Information Center – Self-Help Guide
SANE Australia – Mental Illness and Keeping Well
Black Dog Institute – Ways of Staying Well
Sarah Russell – “Staying well with bipolar disorder”
(5th article from the top. Very applicable to depression.)

EVERYDAY LIFE

Exercise
MayoClinic.com – Depression and Exercise
Better Health – Depression and Exercise
MIND – The Mind Guide to Physical Activity
Mental Health Foundation UK – Up and Running!

Food
Mental Health Foundation – Healthy Eating and Depression
MIND – The Mind Guide to Food and Mood
MyPyramid.gov – Healthy Diet Plan

Stress Management and Relaxation
MIND – The Mind Guide to Managing Stress
MIND – The Mind Guide to Relaxation
Families for Depression Awareness – Coping With Stress

Sleep
HelpGuide – Tips for a Good Night Sleep
National Sleep Foundation – All About Sleep

TRUSTED BOOKS (links to Amazon)

Dealing with Depression: A Commonsense Guide to Mood Disorders

Living Well with Depression and Bipolar Disorder: What Your Doctor Doesn’t Tell You…That You Need to Know (Living Well)

The Relaxation & Stress Reduction Workbook

A Lifelong Journey: Staying Well With Manic Depression/bipolar Disorder

Loving Someone With Bipolar Disorder

PHYSICAL TREATMENTS

Medicines
National Alliance on Mental Illness – Information on Specific Medicines
Drug Digest – Information on Specific Medicines
National Institute of Mental Health – Detailed Information on Types of Medicines
Beyond Blue – Brief Introduction to Types of Medicines
MayoClinic – Brief but Helpful video on Understanding Antidepressants

Electroconvulsive therapy
MayoClinic.com Overview
MayoClinic.com Video
infrapsych

Vagus Nerve Stimulation
MayoClinic.com – VNS: A New Depression Treatment Option

Transcranial magnetic stimulation
National Alliance on Mental Illness – TMS
MayoClinic.com – TMS: An experimental depression treatment

PSYCHOLOGICAL TREATMENTS

Overview
APA – How Psychotherapy Helps People Recover From Depression
APA – How to Find Help Through Psychotherapy
Mental Health Foundation – We Need to Talk PDF

Cognitive Behavior Therapy (CBT)
National Alliance on Mental Illness – About CBT Treatments
National Association of Cognitive-Behavioral Therapists
MoodGym program – free online CBT course
Living Life to the Full – free online CBT course
liveandworkwell.com – Steps to Change: free online CBT course

ALTERNATIVE, COMPLEMENTARY AND SELF-HELP TREATMENTS

Overview
Healthy Place
National Mental Health Information Center
New Hope – Natural Remedies for Depression
Introduction to Dietary Supplements

Bibliotherapy
Holistic Online – Bibliotherapy

Omega-3
Medline Plus
Black Dog Institute – The Role of Omega-3 Fatty Acids as a Treatment for Bipolar Disorder
(Online presentation also applicable to unipolar depression)

Vitamin B6
National Institute of Health – Dietary Supplement Fact Sheet
Medline Plus

Vitamin B12
National Institute of Health – Dietary Supplement Fact Sheet
Medline Plus

SAMe
Drug Digest – Article on SAM-e

DHEA
Medline Plus – DHEA Overview
MedPage Today – DHEA Effective for Midlife-Onset Depression

Ginkgo Biloba
Medline Plus – Ginkgo Overview
NCCAM – Herbs at a Glance: Ginkgo

St John’s Wort
National Center for Complementary and Alternative Medicine – St John’s Wort
Drug Digest – St John’s Wort

Light therapy
MayoClinic – Seasonal Affective Disorder
PsychEducation.org – Light Therapies for Depression

Yoga
Better Health Channel – General Article on Yoga
The MIND Guide to Yoga

Aromatherapy
Holistic Online – Depression Remedies
Wavelengths Natural Therapy – How to use Aromatherapy for Depression
depression-guide.com – Depression and Aromatherapy

Massage therapy
National Center for Complementary and Alternative Medicine
Medline Massage Therapy Interactive Tutorials

Spirituality
Mental Health Foundation – The Impact of Spirituality on Mental Health

Creative Therapies
American Art Therapy Association
American Music Therapy Association
American Dance Therapy Association

Acupuncture
National Center for Complementary and Alternative Medicine
Acupuncture.com – Depression and the Five Elements

Meditation and Relaxation
National Center for Complementary and Alternative Medicine
MayoClinic online meditation video
MayoClinic Relaxation Techniques

Progressive Relaxation, Guided Imagery and Autogenic Relaxation
Calming.org
McMaster University – Relaxation: Physical and Mental

Ecotherapy
Mind (National Association for Mental Health)

Keep this list expanding! If you have another resource that you’d like to share please add it in the comments.

What is St John’s wort?
It is a perennial herb with a yellow flower, that is commonly used to treat mild depression. It is sold as capsules, teas and extracts.

How Does It Work?
St John’s wort has many chemical compounds, some of which are believed to inhibit the reabsorption of serotonin, dopamine and noradrenaline. These are chemicals in the brain that are closely linked with depression.

Clinical trials have found that for mild or moderate depression St John’s wort is an effective treatment, and for some people it may be as effective as taking antidepressants. Interestingly, there are also many reports of people who have had no benefit from St John’s wort whatsoever. For severe or biological depression there is no evidence that St John’s wort is effective, and it carries significant risks in these cases.

What are the Pluses?

• It provides much needed relief for many people with mild or moderate depression
• It is an alternative for some people who find antidepressants to be ineffective
• The unpleasant side-effects experienced by some from anti-depressants may not be present
• Some aren’t willing to take antidepressants, but are happy to use herbal remedies
• The cost is a lot lower than antidepressants, and it is sold over the counter (except in Europe where it is widely prescribed).

What are the Minuses?

• In many countries where it is available over the counter, the active ingredients are not as precisely controlled as for drugs. Products can differ in content from brand to brand and batch to batch.
• It can interact with other medications, including antidepressants, HIV medications, some heart medications, the contraceptive pill and anticonvulsants for epilepsy. Treatment with St John’s wort needs to be medically supervised.
• Possible side effects include photosensitivity (increased sensitivity to sunlight), fatigue, dizziness and gastrointestinal symptoms
• It is not suitable for treating severe or melancholic / biological depression
• It shouldn’t be combined with many prescription drugs.

Further resources:
NCCAM – Herbs at a Glance
McMan’s Wort for Depression
Black Dog Institute Fact Sheet