Depression: Facts, Myths and Remedies

By Stephen T. Sinatra, M.D., F.A.C.C., F.A.C.N., C.N.S., C.B.T.

No one likes when the days get shorter, including me. It’s easy to get a little down when darkness creeps in on your normal day-lit routine like a heavy set of bookends. It’s during colder, darker times of the year that we are more prone to seasonal illnesses like colds and flu, and some people are more likely to feel depressed. When people feel depressed at the same time each year, it’s called Seasonal Affective Disorder, or SAD, which we think has to do with not enough sunlight.

While it’s very typical to feel less motivated or perky – even depressed – in these colder months, there’s a large number of people who suffer from more major depression, the kind that’s bad enough to require medical attention. According to the National Institute of Mental Health (NIMH) approximately 6.7% of American adults suffered a major depressive episode in 2015. Major, or clinical, depression, according to the CDC, is a leading cause of disease or injury worldwide, and increases a person’s risk of death from both suicide as well as chronic diseases (like heart disease).

A good number of clinically depressed people take medication, a number that has increased tremendously over the last decade. While it’s good people are getting the treatment they need, it’s also hard to believe that so many people are depressed enough to think they are beyond the help of natural remedies. Don’t get me wrong: your doctor must diagnose you individually, and depression medication does indeed help a great many people handle some of their worst depressive symptoms. (On that note, and despite the bad reputation it has, even ECT or “electroshock therapy” has helped people with severe depressive symptoms, the late Carrie Fisher among them. But, as an extreme therapy deserving some mention, ECT is a last resort depression treatment.)

However, what if there was an extra boost to these efforts that could help? What if there was something else that could relieve symptoms entirely, or at least supplement other treatment?

I’m going to dig into all of this (and more), but first I’ll start with a breakdown of what depression really is by way of addressing some common myths that can also help shed light on what depression isn’t.

What is depression?

Depression and other mood disorders are caused by significant chemical imbalances in the brain. When brain chemicals such as norepinephrine, dopamine, and serotonin (which control mood and emotional disposition) get concentrated in the wrong ratios, it can have a huge impact on your well-being and how you feel.

Part of understanding what depression is involves understanding what it is not. So here are 6 common myths about depression, and what you need to know about them:

1. MYTH: Depression isn’t a real sickness.

Actually, yes it is. When the chemicals in the brain become imbalanced enough, it can take more than just self-motivated effort to get them back to normal. Depression can manifest itself in ways that do make the body actually feel sick or develop illness-consistent symptoms. So it’s definitely more than just “feeling sad.” If depression goes from moderate to major, it’s much easier to recognize. For example, a mild or moderately depressed person may continue life as usual, which is why people around him or her may never know something’s the matter. On the other hand, a severely depressed person may just sit in a chair, with no energy. This is because she may harbor immobilized anger, which causes blocks in the mind and body, and that unexpressed emotion can turn into sadness. The more sadness a person has, the lower her energy state.

(I say “her” instead of “his or her” to simplify things and because women are more likely to report that they are depressed. Know all of this absolutely applies to men too – depression is an equal-opportunity condition.)

Depression symptoms – which manifest as both cognitive (of the mind) and somatic (of the body) – support this fact. You can find a list of depression symptoms in The Link Between Depression and Obesity.

2. MYTH: Depression medications can cure depression.

 Antidepressants cannot actually cure depression 100%, but they can help treat the problems related to it. A treatment is just that, but it’s not a complete “fix.” That’s why a person who’s being treated with depression medication should also work with her doctor to explore natural remedies and lifestyle adjustments that might help fix the root causes of the depression…not just the symptoms. Really, medication should only be used in moderate-to-severe cases of depression. In cases such as these, the patient is often in such a state, she could be at-risk for suicide. Suicide is a disaster. So at this point, no matter what other treatments are in progress, pharmacology comes into play as a crucial intervention —because we are trying to prevent disaster. After medication helps get a depressed person into a less risky state, natural methods of treatment can continue and/or be reverted to as the sole course of treatment.

3. MYTH: Depression happens because you’re sad.

A depressed person (or a friend of someone with depression) often doesn’t know why she’s depressed. Many people think there should be some direct cause of depression, or some sad or negative event that set it off. However, depression often isn’t always attributable to any particular circumstance. It is like a thief in the night – insidiously draining your energy, the result of an imbalance of chemicals so significant, it’s beyond the help of normal pick-me-ups. Also, keep in mind that some people with depression don’t act sad. Some act normal or happy as a way to mask what’s going on beneath the surface. So just be aware of that: depression has many faces, and some of them wear smiles. Recognizing depression truly is an art; keep an eye out for someone, for example, who suddenly loses interest in her favorite hobbies. This is a common indicator that something greater than just being a bit down is at play. I always tell my wife, “If I stop fishing, something is wrong.” And it’s very true.

4. MYTH: You can make up your mind to feel better.

If it were that easy, people wouldn’t be depressed. Depression is prolonged, and if we could make up our mind to feel better, it wouldn’t last more than an hour or a day because who wants to feel down and out? A positive mindset can help a person cope with depression, but usually isn’t an end-all-be-all solution.

5. MYTH: Depression is normal.

It doesn’t make you strange to have depression, so it’s “normal” in the sense that many people have bouts of it. However, being depressed is not your body or brain in a “normal” state. It’s a state of imbalance that needs to be corrected, whether it’s by natural, prescribed or therapeutic means. It shouldn’t be accepted as a new way of life, but instead, should be actively addressed.

6. MYTH: Depression needs to be treated with antidepressants.

While severity of depression and the success rate of alternative methods should be the first factors to consider before stopping or avoiding antidepressants, it may be a relief to some people to learn that depression doesn’t necessarily need to be treated with medication. Besides methods involving exercise and relaxation, psychotherapy, diet and other natural means can be a primary approach to not only treating the symptoms of depression, but also to curing it.

Broken Heart Syndrome, Stress and Heart Disease

Can food shift brain chemistry?

Indeed it can, and in my book, The Healing Kitchen, I actually explain how diet can help or aggravate depression. It’s crazy to think about, but research has found a clear correlation between food and your mood. So adopting the right kind of diet and avoiding the wrong foods can be a first step in relieving depression.

Natural ways to fight depression:

  1. Diet and depression play into each other a lot. Traditional Mediterranean and Asian diets are among the healthiest diets in the world.  I like them both so much that the diet I recommend is a combination of the two that I call the Pan-Asian Modified Mediterranean Diet (PAMM Diet.) This is what you should be eating!
  2. Avoid foods with added sugar and refined, simple carbs that cause extreme highs and lows in blood sugar and insulin levels, triggering inflammation and imbalanced brain chemistry. Up to 77% of people who experience hypoglycemia also suffer from depression.
  3. Choose the right carbs: complex carbohydrates such as fresh vegetables, fruits, nuts, beans, peas, and whole grains. They encourage steady glucose levels and promote a steady production of the feel-good amino acid tryptophan, which is converted in the brain to serotonin, which calms you.
  4. Eat turkey, which is not only another great source of tryptophan, but also a delicious lean meat.
  5. Get your protein! A low level of B-12 is associated with depression and memory issues, and meat and dairy products in general are an excellent source of vitamin B-12 to keep that from happening.
  6. Take (and eat) your omega-3 fatty acids. Researchers have documented a connection between low omega-3 fats and depression, making the addition of fish such as wild salmon, as well as fish or squid oil supplements, beneficial for staving off the blues.
  7.  Consider dark chocolate, which contains phenylethylamine, a chemical that increases the level of endorphins in your body that cause feelings of comfort and euphoria.
  8. Chocolate also contains magnesium, which is vital to a positive mood. I know at least one case of depression that was cured by magnesium supplementation alone. While that’s not a typical scenario, ensuring you’re getting plenty of it can only help.
  9. Exercise! This one is really important –  Regular moderate exercise is essential for keeping stress at bay. It also helps boost metabolism and encourages better sleep. Adding mind-body practices like yoga and meditation (which you can do while sitting or even walking) also helps reduce stress that can lead to depression.
  10. Talk to someone about the stress in your life. Whether a psychotherapist or personal confidante, having someone to help you explore your feelings about things can help you get to the root of your depression and release the negative emotions underlying it.
  11. Consider St. John’s wort to treat mild to moderate depression, which contains hypericin to raise your serotonin level. It works a lot like conventional anti-depressants without the side effects..
  12. Go bananas: bananas and whole grain cereal give your body much-needed B-12 complex vitamins (as mentioned before) to keep your memory sharp and your mood upbeat.
  13. Cut back on the alcohol. Though moderate amounts of alcohol can be beneficial for your heart and arteries, too much can put you at risk for depression.

Mediterranean Diet: Optimal Body and Brain Fuel

So if you are battling depression right now or know someone who is, the most important approach to depression is to take a good look at the stress in your life and treat these “blues” as naturally as possible (since natural body chemistry is at issue). Often, natural depression treatments and a healthy lifestyle can stave off or “fix” mild depression. But in cases of moderate to major depression, more acute interventions such as medication may be necessary, with natural ways to fight depression playing a more supportive role.

Over time, natural methods implemented alongside the medication may alleviate or cure the root causes of depression to a point where depression medication may no longer be needed. And in that situation, once your doctor gives you the go-ahead to begin reducing or to stop your medication entirely, you can continue on indefinitely with natural ways to fight depression.


© Stephen Sinatra, MD. All rights reserved.

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