Depression

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Depression, specifically major depressive disorder (MDD), is a mood disorder characterised by persistent feelings of sadness, hopelessness, and lack of interest in daily activities. 

It affects thoughts, emotions, and behaviours and can lead to various physical and emotional problems.

Depression's exact cause is unknown, but various factors contribute:

• Genetic predisposition
• Chemical imbalances in the brain
• Traumatic or stressful life events
• Chronic illnesses
• Certain medications

Symptoms may vary but commonly include:

• Persistent sadness or hopelessness
• Loss of interest or pleasure in activities
• Sleep disturbances (insomnia or oversleeping)
• Fatigue and lack of energy
• Difficulty concentrating
• Changes in appetite and weight
• Feelings of guilt or worthlessness
• Suicidal thoughts or attempts

• Selective Serotonin Reuptake Inhibitors (SSRIs): Fluoxetine, Sertraline
• Serotonin-Noradrenaline Reuptake Inhibitors (SNRIs): Venlafaxine, Duloxetine 
• Tricyclic Antidepressants: Amitriptyline, Imipramine
• Monoamine Oxidase Inhibitors (MAOIs): Phenelzine, tranylcypromine

• SSRIs: Nausea, insomnia, sexual dysfunction, weight gain
• SNRIs: Increased blood pressure, dry mouth, constipation
• Tricyclics: Dry mouth, blurred vision, constipation, urinary retention
• MAOIs: Hypertension, dietary restrictions due to interaction with certain foods

Approximately 264 million people worldwide suffer from depression. 

In Australia, an estimated 1 million adults experience depression annually.

• Dietary Intervention: Nutrient-dense diets may positively impact mood.
• Mindfulness-Based Cognitive Therapy: Helps prevent recurrence in those with chronic depression.
• Exercise: Regular physical activity can improve mood and energy levels
• Herbal and Nutritional Medicines: herbal medicines rosemary, saffron, St. John's Wort and lavender; as well as nutritional supplements such as omega 3 fatty acids, probiotics and zinc are supported by evidence in the treatment of depression.

De-prescribing in depression requires caution, and often a gradual reduction of medication under professional guidance, along with complementary therapeutic support.

• Medication tapering: Gradual tapering of antidepressants has been shown to reduce the incidence of withdrawal symptoms and to increase the chance of medication discontinuation
• Evidenced based complementary medicines for depression: Prescribed alongside medication withdrawal, a wholistic integrated approach can help to replace your pharmaceutical medicines.

Treating and managing depression requires a comprehensive approach that might include talking therapy, diet and lifestyle changes, nutritional and herbal medicines along side ongoing support. Careful consideration of de-prescribing must always be based on individual needs and performed under professional guidance.