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Category Archives: Depression
Exercise benefits depression and can prevent its development, according to a major review by the Federal University of Santa Maria in Brazil and King’s College London. Highlights of the study include:
– Physical activity can confer protection from the development of depression in children and adults. These effects are evident on all continents.
– A robust body of evidence from randomised controlled trials demonstrates that exercise is effective in treating depression.
– The type of exercise should fit personal preferences, and be enjoyable or challenging eg training to achieve a 5km run. It would be a mistake to prescribe say, gym sessions for everyone.
– Encouraging patients to exercise with friends or family may increase the chances of treatment success, and the subsequent adoption and maintenance of exercise.
– The dropout rate in exercise trials for people with depression is about 18%. By comparison, that from psychotherapy is about 19% while that from SSRI medication (eg prozac, citalopram) is about 26%.
– Just like other interventions, exercise may not work equally for all.
– Evidence of the effectiveness of exercise is substantial and growing fast. Despite this, only some guidelines have included physical activity and exercise among recommended strategies for depression.
(The Role of Exercise in Preventing and Treating Depression. Current Sports Medicine Reports, August 2019.)
In this article, I shall explain something about what to expect when you seek acupuncture treatment for depression. In a survey of 9000 UK acupuncture patients, 11% were presenting with psychological complaints; in many practices, depression represents a significant portion of this category. Additionally, the 2015 Global Burden of Disease Study (1), found that depression was the third leading cause of disability internationally. It is a common problem, and two-thirds of adults will at some time experience depression severe enough to interfere with normal activities.
Should you decide to come for acupuncture, I shall be interested in whether you have a history of depression previously, when and how it began (eg. identifiable events or disproportionate reactions thereto), and how it affects your daily life (eg. ability to work, family and social relationships etc). Your wider health is enormously important too. Do you feel the depression is a reaction to the burden of chronic pain or to limitations imposed by some other medical problem? Might it even stem from medication used to control that problem? Did it arise out of chronic stress, from say work, a difficult relationship or caring for relatives?
Have you had depression in the past which now seems to have recurred in response to a new health problem, a recent life event, or stressful circumstances? Perhaps you are only in your twenties, have studied hard for a job, but are now disenchanted by it. Is there any link with hormonal changes such as being pre-menstrual or peri-menopausal? Oestrogen levels fall at these times, in turn reducing serotonin levels.
Looking more widely still, I am interested in the full array of other symptoms which accompany your depression. These can encompass fatigue, poor concentration, sleep disturbance, appetite or weight changes, or feelings such as irritability, anger, anxiety, panic or guilt. I can then begin to re-frame the picture of your health from a Chinese medical perspective, and devise a plan of treatment. If it is practical, we can try to directly help obvious causes of your depression, such as stress or chronic pain. In other cases, the causes do not lend themselves to such an approach, in which case we just try to tackle the depression.
Lifestyle advice is often a particularly useful part of treatment. In Chinese medicine, the health of our physical body is considered important for our mental and spiritual health too. This gives our shen or spirit, a good home in which it can settle.
Rest assured, acupuncture can safely and effectively be used alongside other interventions like counselling or anti-depressant medication.
Please do contact me if you would like to discuss anything further. Below you will find the results of recent research, some into acupuncture for depression, and some which suggests worthwhile self-help measures. Scientists at the University of Bern for example, published a paper(2) confirming the benefits of exercise for patients with depression.
(1) Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015, page 1552.
(2) Effects of Exercise on Anxiety and Depression Disorders: Review of Meta-Analyses and Neurobiological Mechanisms. CNS & Neurological Disorders-Drug Targets, 2014.
A systematic review undertaken by researchers at University College, London, suggests an association between adherence to the Mediterranean diet and lower rates of depression. A total of 41 studies were included in the review. An array of dietary approaches were covered by the studies, but the most compelling link was that between the Mediterranean diet and depression. An anti-inflammatory diet was also associated with lower rates of depression.
Although the link has not yet been proven as causal, the authors speculate on possible biological mechanisms. These include the microbiome-gut-brain axis which is now believed to play a key role in neuropsychiatry.
(Healthy dietary indices and risk of depressive outcomes: a systematic review and meta-analysis of observational studies. Molecular Psychiatry, on-line 26 September 2018.)
A pilot study undertaken in Japan shows acupuncture can significantly help medication-resistant depression and improve autonomic nervous system function. Thirty in-patients received either true acupuncture or sham acupuncture. Treatment was given by the application of small, low-profile press needles for 72 hours. Compared with sham acupuncture, the true acupuncture patients showed significant improvement in depression scores, blood pressure and measures of vagal nerve function. The authors suggest that the latter may be associated with the therapeutic mechanism behind acupuncture’s effect on depression.
(Acupuncture-induced changes of vagal function in patients with depression: A preliminary sham-controlled study with press needles. Complementary Therapies in Clinical Practice, online 6 July 2015.)
A study from Oregon State University in the US suggests a relationship between low levels of vitamin D, and depression in otherwise healthy young women. Those with lower levels of vitamin D were more likely to have clinically significant symptoms over the course of a five-week study. The results were consistent even when researchers took into account other possible explanations, such as time of year, exercise and time spent outside.
A lot of past research has found no association between the two, but much of that research has been based on older adults or special medical populations.
This study focused on young women in the Pacific Northwest because they are at risk of both depression and vitamin D insufficiency. Researchers recruited 185 female college students, aged 18-25, to participate in the study at different times during the academic year. Vitamin D levels were measured from blood samples and participants completed a depression symptom survey over five weeks.
As expected, the women’s vitamin D levels depended on the time of year, with levels dropping during autumn, reaching their lowest in winter, and rising again in the spring. Depression did not show as a clear pattern, prompting the team to conclude that links between vitamin D deficiency and seasonal depression should be studied in larger groups of individuals. They say the study does not conclusively show that low vitamin D levels cause depression, and a clinical trial examining whether vitamin D supplements might help prevent or relieve depression is the logical next step to understanding the link between the two.
(Associations between vitamin D levels and depressive symptoms in healthy young adult women. Journal of Psychiatry Research, 30 May 2015.)