Anti-depressants vs natural approaches to depression

Should you treat your depression with anti-depressant drugs or through natural approaches? This question gets posed a lot. Personally I think it’s a false choice. The answer is both.

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If you are predisposed to depression, you’re gonna have to deal with it your whole life. The most effective approach combines three weapons: anti-depressant drugs AND cognitive therapy AND lifestyle choices (diet, exercise, sleep, etc).

When people talk about “natural” approaches to depression, they can mean different things. Here I’ll try to separate and address them.

Anti-depressants vs herbal supplements

Sometimes the choice is posed as taking anti-depressant drugs (like Prozac, Zoloft or Wellbutrin) vs taking herbal supplements (usually St. John’s Wort). This issue resonates mostly with people who distrust science and/or corporations, who dislike anti-depressants because they’re chemicals developed by scientists and produced by pharmaceutical companies. Herbs like St. John’s Wort, on the other hand, occur naturally and have been used to treat melancholy for centuries.

The anti-science, anti-medicine sentiment frankly offends me. The anti-corporate sentiment does not impress me either. Capitalism has its pluses and minuses. The development and mass production of anti-depressant drugs is definitely one of the pluses.

To my mind, the most important difference between drugs like Zoloft and herbs like St. John’s Wort is this: the drugs work extremely well, and the herbs don’t. If you have mild depression, perhaps taking herbal supplements will be enough for you. But I’ve never spoken to a serious depression sufferer who said herbs worked as well as anti-depressants. I’ve never had a doctor tell me that herbs work just as well. In my personal experience, taking St. John’s Wort for serious depression is like trying to hold off a hurricane with a cheap umbrella.

The morality of anti-depressants

Some people believe it’s morally wrong to take anti-depressant drugs. The most vocal are religious nuts like Tom Cruise who oppose any psychiatric medication, but disapproval of anti-depressants runs much deeper in our culture.

How often have you heard flippant references to “happy pills”? The underlying message is that anti-depressant drugs are a crutch, a short cut, the lazy cheater’s way to avoid dealing with ordinary emotions or challenges. This galls me. No one who suffers from serious depression, or who loves someone with serious depression, thinks of anti-depressants as “happy pills”. They’re more like “will to live pills”. Taking medicine to ease the pain of a debilitating illness is not a weakness, not an act of cowardice or laziness.

Some take it further. A recent, otherwise reasonable book suggestion list piece at The Daily Beast included this hateful line: “In a turn that vindicates Aldous Huxley, one in ten Americans ingests their daily Soma supplement in the form of antidepressants.” In Huxley’s Brave New World, Soma is a recreational barbiturate-like drug promoted by the government as a form of social control. (Huxley.net has a page collecting passages about Soma from the novel.) The Beast columnist’s idea is that anti-depressant users are willingly turning themselves into passive, unthinking drones.

People who think this way are ignorant jerks. You can and should ignore them. Taking anti-depressants is not morally wrong, it’s not a sign of weakness or cowardice, it does not insulate you from honest emotions, it does not hamper your capacity for critical thinking, it’s nothing to feel guilty or ashamed about.

Natural approaches to depression

That said, lifestyle changes can make a big impact on your depression. Not instead of medical treatment, but in addition to. Healthy lifestyle choices are essential to managing your depression, while unhealthy choices can sabotage the positive neurochemical effects of anti-depressant drugs.

The essentials of healthy living for depression:

Diet: Eat a healthy, balanced diet; avoid fast food and junk food. Maybe you’ve heard it a million times, maybe it sounds like nagging, but it really makes a difference.

Exercise: Especially if you lead a sedentary lifestyle (like so many of us nowadays), regular exercise really improves your mood. You’ll feel less irritable, you’ll have more energy, you’ll sleep better. You don’t have to become a workout fanatic, just find something you enjoy and develop a routine.

Sleep: Depression can cause erratic sleep patterns, and erratic sleep patterns can exacerbate depression. It’s a vicious cycle, but one that you can take steps to address.

These are “natural” approaches to depression that work. They’re not alternatives to anti-depressant drugs, just complementary parts of an overall strategy for keeping depression at bay.

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