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DESCRIPTION
Depression is a whole-body illness. This means it involves the body, nervous system, moods, thoughts, and behavior. It affects the way you eat and sleep, the way you feel about yourself, and the way you react to and think about people and things around you. Symptoms can last for week, months, or years. There are many types of depression, with variations in the number of symptoms, their severity, and persistence. People with depression may experience a continuing feeling of sadness, despondency or hopelessness with accompanying symptoms.
Major depression occurs in about 1 in 10 Americans. Depression affects an estimated 11 million or approximately 22 percent of the American population aged 18 and older (1 in 5 adults) every year and is on the rise. It is one of the most common medical problems in the United States, affecting young and old and both sexes, but is more twice as common in women than in men. It can be difficult to treat, but there is continued improvement in effectiveness of treatment.
TWO MAJOR CLASSIFICATIONS OF DEPRESSIVE DISORDERS
The two major classifications of depressive disorders are unipolar and bipolar.
- Unipolar disorders are characterized by depressive episodes that most often recur at least several times in the course of a person's life.
- Bipolar disorders usually begin as depression, but as they progress, they involve alternating episodes of depression and mania. As a result, bipolar depression is commonly known as manic depression.
THREE MAIN TYPES OF CLINICAL DEPRESSION
There are three main types of clinical depression:
- Major Depressive Disorder. Major depressive disorder (also known as clinical depression, major depression, unipolar depression, or unipolar disorder) is a mental disorder characterized by an all-encompassing low mood accompanied by low self-esteem, and loss of interest or pleasure in normally enjoyable activities. The term "major depressive disorder" was selected by the American Psychiatric Association to designate this symptom cluster as a mood disorder in the 1980 version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III) classification, and has become widely used since. The general term depression is often used to describe the disorder, but as it can also be used to describe other types of psychological depression, more precise terminology is preferred for the disorder in clinical and research use. Major depression is a disabling condition which adversely affects a person's family, work or school life, sleeping and eating habits, and general health. In the United States, approximately 3.4 percent of people with major depression commit suicide, and up to 60 percent of people who commit suicide have depression or another mood disorder.
- Dysthymic Disorder. Unlike major depressive disorder, dysthymic disorder is a chronic but less severe type of depression that does not strike in discrete episodes, but is instead characterized by milder, persistent symptoms that may last for years. Although it does not interfere with everyday tasks, people with this milder form of depression rarely feel like they are functioning at their full capacities.
- Bipolar Depression. As stated under classifications of depressive disorders, bipolar disorders usually begin as depression, but as they progress, they involve alternating episodes of depression and mania, which is characterized by abnormally and persistently elevated mood, energy, restlessness, or irritability. As a result, it is commonly known as manic depression. Other symptoms of mania include overly inflated self-esteem, a decreased need for sleep, and increased talkativeness, racing thoughts, distractibility, physical agitation, and excessive risk taking. Because bipolar disorder requires different treatment than major depression or dysthemia, obtaining an accurate diagnosis is extremely important.
Within these types are variations in the number of associated mental symptoms, their severity, and their persistence.
This web page focuses primarily on various types of unipolar depression. For more information on manic depression / bipolar mood disorder see the following link:
MoonDragon's Health & Wellness: Manic Depressive / Bipolar Mood Disorder
FREQUENT SIGNS AND SYMPTOMS
Major depression is a serious illness that affects a person's family, work or school life, sleeping and eating habits, and general health. Its impact on functioning and well-being has been equated to that of chronic medical conditions such as diabetes. Depression often coexists with physical disorders common among the elderly, such as stroke, other cardiovascular diseases, Parkinson's disease, and chronic obstructive pulmonary disease
Loss of interest in life; boredom. A person suffering from a major depressive episode usually exhibits a very low mood that pervades all aspects of life. They lose interest in hobbies and other activities and things around them and become incapable of experiencing pleasure in activities that formerly were enjoyed.
Listlessness and fatigue. Chronic fatigue. Some try to "sleep off" depression, or do nothing but sit or lie around.
Insomnia; excessive or disturbed sleeping. Sleep disturbances. Restlessness. Insomnia is common: in the typical pattern, a person wakes up early and is unable to get back to sleep. Hypersomnia, or oversleeping, is less common.
Social isolation. People with depression typically withdraw and hide from society, social situations and activities.
Appetite loss or overeating. Changes in appetite. Digestive disorders. Appetite often decreases, with resulting weight loss, although increased appetite and weight gain occasionally occurs.
Reduction or loss of sex drive.
Constipation.
Difficulty making decisions; concentration difficulty and poor memory (especially in those with melancholic or psychotic features. Older depressed persons may have cognitive symptoms of recent onset, such as forgetfulness, and a more noticeable slowing of movements.
Unexplained crying bouts.
Intense quilt feelings over minor or imaginary misdeeds. Depressed people may be preoccupied with, or ruminate over, thoughts and feelings of worthlessness and inadequacy, inappropriate guilt or regret, helplessness, hopelessness, and self-hatred. Things appear bleak and time seems to pass slowly.
Restlessness; irritability. Quickness to anger, may become chronically angry and irritable, sad and despairing, or display little or no emotion at all. Family and friends may notice that the person's behavior is either agitated or lethargic.
Many think of death and consider suicide.
Various pains, such as headaches, backaches, or chest pains, without evidence of disease. The person may report multiple physical symptoms such as fatigue, headaches, or digestive problems; physical complaints are the most common presenting problem in developing countries according to the World Health Organization's criteria of depression.
In severe cases, depressed people may have symptoms of psychosis such as delusions or, less commonly, hallucinations, usually of an unpleasant nature.
Depressed children often display an irritable rather than a depressed mood, and show varying symptoms depending on age and situation. Most exhibit a loss of interest in school and a decline in academic performance. They may be described as clingy, demanding, dependent, or insecure. Diagnosis may be delayed or missed when symptoms are interpreted as normal moodiness. Depression may also coincide with attention-deficit hyperactivity disorder, complicating the diagnosis and treatment of both.
CAUSES
The causes of depression are not fully understood, but they are probably many and varied.
A truly depressive illness has no single obvious cause. Some biological factors can play a part, e.g., physical illness, hormonal disorders, certain drugs. Chemical imbalances in the brain, thyroid disorders, upset stomach, headache, nutritional deficiencies, poor diet, the consumption of sugar, mononucleosis, lack of exercise, endometriosis, any serious physical disorder, or allergies may all be depression triggers.
- Social and psychological factors can play a part. Depression may be triggered by tension and stress.
- Other depression triggers may include hyperstimulated immune system, chemical imbalances in the brain, thyroid disorders, nutritional deficiencies, poor diet, the consumption of sugar, mononucleosis, any serious physical disorder, or even allergies. Hypoglycemia (low blood sugar) is another common cause of depression.
- Inherited disorders may contribute (manic-depression runs in families). Heredity is a significant factor in this disorder. In up to 50 percent of people suffering from recurrent episodes of depression, one or both of the parents also experienced depression.
- May relate to the number of disturbing events or a traumatic life event in a person's life.
- Death rates can be higher for depressed people. A recent study based on the Women's Health Initiative, the largest study of U.S. women's health ever undertaken, shows that depressed women had a 50 percent greater chance of dying of heart attack, and 30 percent high chance of dying from other causes, than non-depressed women. This was in spite of the fact that depression was only mild or moderate, and was under treatment. Why this should be is still unknown.
- Older adults with hardening of the arteries ( atherosclerosis) are more likely to have depression than older adults without the coronary disorder, according to a study by Dutch researchers. This study, reported in a relationship between vascular factors, such as hardening of the arteries or calcium deposits in the blood vessels, and late-life depression. A theory has been put forward that atherosclerosis may have an affect on the brain that leads to depression. Depression is not a normal part of growing older, but rather a treatable condition that affects more than 6 million of the more than 40 million Americans over the age of 65, according to the American Association for Geriatric Psychiatry.
DEPRESSION TRIGGERS
A variety of things can trigger an episode of depression, but whatever the factors that trigger it, depression begins with a disturbance in the part of the brain that governs moods. Most people can handle everyday stresses; their bodies readjust to these pressures. When stress is too great for a person and his or her adjustment mechanism is unresponsive, depression may be triggered.
Perhaps the most common type of depression is chronic low-grade depression called dysthymia. This condition involves long-term and/or recurring depressive symptoms that are not necessarily disabling but keep a person from functioning normally and interfere with social interactions and enjoyment of life. Research has found that this type of depression often results from (unconscious) negative thinking habits. Double depression is a variation of dysthymia in which a person with chronic low-grade depression periodically experiences major depressive episodes, then returns to his or her "normal," mildly depressed state.
Some people become more depressed in the winter months, when the days are shorter and darker. This type of disorder is known as seasonal affective disorder (SAD). Women are more likely to suffer from SAD than men are. People who suffer this type of depression in the winter months lose their energy, suffer anxiety attacks, gain weight as a result of craving the wrong foods, sleep too much, and have a reduced sex drive. Many people get depressed around the December holidays; while most of them probably just have the "holiday blues," some of them may be suffering from seasonal affective disorder. Suicides seem to be highest during this time of year.
Foods greatly influence the brain's behavior. A poor diet, especially one with a lot of junk foods, is a common cause of depression. The levels of brain chemicals called neurotransmitters, which regulate our behavior, are controlled by what we eat, and the neurotransmitters are closely linked to mood. The neurotransmitters most commonly associated with mood are dopamine, serotonin, and norepinephrine. When the brain produces serotonin, tension is released. When it produces dopamine or norepinephrine, we tend to think and act more quickly and are generally more alert.
At the neurochemical and physiological level, neurotransmitters are extremely important. These substances carry impulses between nerve cells. Serotonin, for example, plays a role in mood, sleep, and appetite. Low levels of serotonin can lead to depression, anxiety, and sleep disorders.
The substance that processes serotonin is the amino acid tryptophan. The consumption of tryptophan increases the amount of serotonin made by the brain. Thus, eating complex carbohydrates (not simple carbohydrates such as fructose, sucrose, and lactose), which raise the level of tryptophan in the brain (thereby increasing serotonin production), has a calming effect. High protein foods, on the other hand, promote the production of dopamine and norepinephrine, which promote alertness.
Some researchers believe that depression can be "caught" like a cold or the flu. In a marriage, if one person is chronically depressed, both probably will be. Researchers have found that some people are powerful mood transmitters and others are mood receivers. Mood transmitters can control the mood of a family or group of co-workers just by being in the room. Mood receivers are very susceptible to the changing moods of those around them. This subconscious interaction is most dangerous when the mood transmitter is exhibiting depression through constant moodiness, anger, anxiety, or sadness; he or she can then "give" a case of depression to others.
This disorder is the focus of a considerable amount of research, and as we learn more about this disease in all its complexity, perhaps we will abandon the catchall category called depression and diagnose people according to their particular chemical imbalances.
THE BIOPSYCHOSOCIAL MODEL
The biopsychosocial model proposes that biological, psychological, and social factors all play a role to varying degrees in causing depression. The diathesis-stress model posits that depression results when a preexisting vulnerability, or diathesis, is activated by stressful life events. The preexisting vulnerability can be either genetic, implying an interaction between nature and nurture, or schematic, resulting from views of the world learned in childhood. These interactive models have gained empirical support. For example, researchers in New Zealand took a prospective approach to studying depression, by documenting over time how depression emerged among an initially normal cohort of people. The researchers concluded that variation among the serotonin transporter (5-HTT) gene affects the chances that people who have dealt with very stressful life events will go on to experience depression. Specifically, depression may follow such events, but seems more likely to appear in people with one or two short alleles of the 5-HTT gene.
GENETICS
A Swedish study estimated the heritability of depression - the degree to which individual differences in occurrence are associated with genetic differences - to be approximately 40 percent for women and 30 percent for men, and evolutionary psychologists have proposed that the genetic basis for depression lies deep in the history of naturally selected adaptations. A substance-induced mood disorder resembling major depression has been causally linked to long-term drug use or abuse, or to withdrawal from certain sedative and hypnotic drugs.
THE BIOLOGY OF DEPRESSION - THEORIES
MONOMINE HYPOTHESIS
Most antidepressant medications work by increasing the levels of one or more of the monoamines - the neurotransmitters serotonin, norepinephrine and dopamine - in the synaptic cleft between neurons in the brain. Some medications affect the monoamine receptors directly.
SEROTONIN HYPOTHESIS
Serotonin is hypothesized to help regulate other neurotransmitter systems; decreased serotonin activity may allow these systems to act in unusual and erratic ways. According to this "permissive hypothesis", depression arises when low serotonin levels promote low levels of norepinephrine, another monoamine neurotransmitter. Some antidepressants enhance the levels of norepinephrine directly, whereas others raise the levels of dopamine, a third monoamine neurotransmitter. These observations gave rise to the monoamine hypothesis of depression. In its contemporary formulation, the monoamine hypothesis postulates that a deficiency of certain neurotransmitters is responsible for the corresponding features of depression: "Norepinephrine may be related to alertness and energy as well as anxiety, attention, and interest in life; [lack of] serotonin to anxiety, obsessions, and compulsions; and dopamine to attention, motivation, pleasure, and reward, as well as interest in life." The proponents of this theory recommend the choice of an antidepressant with mechanism of action that impacts the most prominent symptoms. Anxious and irritable patients should be treated with SSRIs or norepinephrine reuptake inhibitors, and those experiencing a loss of energy and enjoyment of life with norepinephrine- and dopamine-enhancing drugs.
SYNAPSES & NEURONS
Schematic of a synapse between an axon of one neuron and a dendrite of another. Synapses are specialized gaps between neurons. Electrical impulses arriving at the axon terminal trigger release of packets of chemical messengers (neurotransmitters), which diffuse across the synaptic cleft to receptors on the adjacent dendrite temporarily affecting the likelihood that an electrical impulse will be triggered in the latter neuron. Once released the neurotransmitter is rapidly metabolized or pumped back into a neuron. Antidepressants influence the overall balance of these processes. In the past two decades, research has revealed multiple limitations of the monoamine hypothesis, and its explanatory inadequacy has been criticized within the psychiatric community. Intensive investigation has failed to find convincing evidence of a primary dysfunction of a specific monoamine system in patients with major depressive disorders. The medications tianeptine and opipramol have long been known to have antidepressant properties despite the fact that the former is a serotonin reuptake enhancer and the latter has no effect on the monoamine system. Experiments with pharmacological agents that cause depletion of monoamines have shown that this depletion does not cause depression in healthy people nor does it worsen symptoms in depressed patients - although an intact monoamine system is necessary for antidepressants to achieve therapeutic effectiveness. According to an essay published by the Public Library of Science (PLoS), the monoamine hypothesis, already limited, has been further oversimplified when presented to the general public as a mass marketing tool.
BRAIN STRUCTURE THEORY
MRI scans of patients with depression have reported a number of differences in brain structure compared to those without the illness. Although there is some inconsistency in the results, meta-analyses have shown there is strong evidence for smaller hippocampal volumes and increased numbers of hyperintensive lesions. Hyperintensities have been associated with patients with a late age of onset, and have led to the development of the theory of vascular depression.
HIPPOCAMPUS NEUROGENESIS THEORY
There may be a link between depression and neurogenesis of the hippocampus, a center for both mood and memory. Loss of hippocampal neurons is found in some depressed individuals and correlates with impaired memory and dysthymic mood. Drugs may increase serotonin levels in the brain, stimulating neurogenesis and thus increasing the total mass of the hippocampus. This increase may help to restore mood and memory. Similar relationships have been observed between depression and an area of the anterior cingulate cortex implicated in the modulation of emotional behavior. One of the neurotrophins responsible for neurogenesis is the brain-derived neurotrophic factor (BDNF). The level of BDNF in the blood plasma of depressed subjects is drastically reduced (more than threefold) as compared to the norm. Antidepressant treatment increases the blood level of BDNF. Although decreased plasma BDNF levels have been found in many other disorders, there is some evidence that BDNF is involved in the cause of depression and the mechanism of action of antidepressants.
OVERACTIVE HYPOTHALAMIC-PITUITARY-ADRENAL AXIS THEORY
Major depression may also be caused in part by an overactive hypothalamic-pituitary-adrenal axis (HPA axis) that is similar to the neuro-endocrine response to stress. Investigations reveal increased levels of the hormone cortisol and enlarged pituitary and adrenal glands, suggesting disturbances of the endocrine system may play a role in some psychiatric disorders, including major depression. Oversecretion of corticotropin-releasing hormone from the hypothalamus is thought to drive this, and is implicated in the cognitive and arousal symptoms.
BIOLOGICAL CLOCK - CIRCADIAN RHYTHM THEORY
Depression may be related to the same brain mechanisms that control the cycles of sleep and wakefulness. Depression may be related to abnormalities in the circadian rhythm, or biological clock. For example, the REM stage of sleep, the one in which dreaming occurs, may be quick to arrive, and intense, in depressed people. REM sleep depends on decreased serotonin levels in the brain stem, and is impaired by compounds, such as antidepressants, that increase serotoninergic tone in brain stem structures. Overall, the serotonergic system is least active during sleep and most active during wakefulness. Prolonged wakefulness due to sleep deprivation activates serotonergic neurons, leading to processes similar to the therapeutic effect of antidepressants, such as the selective serotonin reuptake inhibitors (SSRIs). Depressed individuals can exhibit a significant lift in mood after a night of sleep deprivation. SSRIs may directly depend on the increase of central serotonergic neurotransmission for their therapeutic effect, the same system that impacts cycles of sleep and wakefulness.
LIGHT DEPRIVATION & SEASONAL AFFECTIVE DISORDER (SAD) THEORY
Research on the effects of light therapy on treating seasonal affective disorder suggests that light deprivation is related to decreased activity in the serotonergic system and to abnormalities in the sleep cycle, particularly insomnia. Exposure to light also targets the serotonergic system, providing more support for the important role this system may play in depression. Sleep deprivation and light therapy both target the same brain neurotransmitter system and brain areas as antidepressant drugs, and are now used clinically to treat depression. Light therapy, sleep deprivation and sleep time displacement (sleep phase advance therapy) are being used in combination quickly to interrupt a deep depression in hospitalized patients.
ESTROGEN CONNECTION THEORY
The hormone estrogen has been implicated in depressive disorders due to the increase in risk of depressive episodes after puberty, the antenatal period, and reduced rates after menopause. Conversely, the premenstrual and postpartum periods of low estrogen levels are also associated with increased risk. The use of estrogen has been under-researched, and although some small trials show promise in its use to prevent or treat depression, the evidence for its effectiveness is not strong. Estrogen replacement therapy has been shown to be beneficial in improving mood in perimenopause, but it is unclear if it is merely the menopausal symptoms that are being reversed.
NUTRITIONAL DEFICIENCIES
Other research has explored potential roles of molecules necessary for overall cellular functioning: cytokines and essential nutrients. The symptoms of major depressive disorder are nearly identical to those of sickness behavior, the response of the body when the immune system is fighting an infection. This raises the possibility that depression can result from a maladaptive manifestation of sickness behavior as a result of abnormalities in circulating cytokines. Deficiencies in certain essential dietary nutrients, particularly vitamin B-12 and folic acid, have been associated with depression; other agents such as the elements copper and magnesium, and vitamin A have also been implicated.
PSYCHOLOGICAL FACTORS THEORY
Various aspects of personality and its development appear to be integral to the occurrence and persistence of depression. Although depressive episodes are strongly correlated with adverse events, a person's characteristic style of coping may be correlated with their resilience. Additionally, low self-esteem and self-defeating or distorted thinking are related to depression. It is not always clear which factors are causes or which are effects of depression; however, depressed persons who are able to make corrections in their thinking patterns often show improved mood and self-esteem.
American psychiatrist Aaron T. Beck developed what is now known as a cognitive model of depression in the early 1960s. He proposed that three concepts underlie depression: a triad of negative thoughts composed of cognitive errors about oneself, one's world, and one's future; recurrent patterns of depressive thinking, or schemas; and distorted information processing. From these principles, he developed the structured technique of cognitive behavioral therapy. According to American psychologist Martin Seligman, depression in humans is similar to learned helplessness in laboratory animals, who remain in unpleasant situations when they are able to escape, but do not because they initially learned they had no control.
Depressed individuals often blame themselves for negative events, and a 1993 study of hospitalized adolescents with self-reported depression shows that those who do this may not take credit for positive outcomes. This tendency is characteristic of a depressive attributional, or pessimistic explanatory style. According to Albert Bandura, a Canadian social psychologist associated with social cognitive theory, depressed individuals have negative beliefs about themselves, based on experiences of failure, observing the failure of social models, a lack of social persuasion that they can succeed, and their own somatic and emotional states including tension and stress. These influences may result in a negative self-concept and a perceived lack of self-efficacy; that is, they do not believe they can influence events or achieve personal goals.
An examination of depression in women indicates that vulnerability factors - such as early maternal loss, lack of a confiding relationship, responsibility for the care of several young children at home, and unemployment - can interact with life stressors to increase the risk of depression. For older adults, the factors are often health problems, changes in relationships with a spouse or adult children due to the transition to a care-giving or care-needing role, the death of a significant other, or a change in the availability or quality of social relationships with older friends because of their own health-related life changes.
The understanding of depression has also received contributions from the psychoanalytic and humanistic branches of psychology. From the classical psychoanalytic perspective of Austrian psychiatrist Sigmund Freud, depression, or melancholia, may be related to interpersonal loss and early life experiences. Existential therapists have connected depression to the lack of both meaning in the present and a vision of the future. The founder of humanistic psychology, American psychologist Abraham Maslow, suggested that depression could arise when people are unable to attain their needs or to self-actualize, to realize their full potential.
SOCIAL FACTORS THEORY
Poverty and social isolation are associated with increased risk of psychiatric problems in general. Child abuse (physical, emotional, sexual, or neglect) is also associated with increased risk of developing depressive disorders later in life. Disturbances in family functioning, such as parental (particularly maternal) depression, severe marital conflict or divorce, death of a parent, or other disturbances in parenting are additional risk factors. In adulthood, stressful life events are strongly associated with the onset of major depressive episodes; a first episode is more likely to be immediately preceded by stressful life events than are recurrent ones.
The relationship between stressful life events and social support has been a matter of some debate; the lack of social support may increase the likelihood that life stress will lead to depression, or the absence of social support may constitute a form of strain that leads to depression directly. There is evidence that neighborhood social disorder, for example, due to crime or illicit drugs, is a risk factor, and that a high neighborhood socioeconomic status, with better amenities, is a protective factor. Adverse conditions at work, particularly demanding jobs with little scope for decision-making, are associated with depression, although diversity and confounding factors make it difficult to confirm that the relationship is causal.
EVOLUTIONARY THEORY
From the standpoint of evolutionary theory, major depression is hypothesized, in some instances, to increase an individual's ability to reproduce. Evolutionary approaches to depression and evolutionary psychology posit specific mechanisms by which depression may have been genetically incorporated into the human gene pool, accounting for the high heritability and prevalence of depression by proposing that certain components of depression are adaptations, such as the behaviors relating to attachment and social rank. Current behaviors can be explained as adaptations to regulate relationships or resources, although the result may be maladaptive in modern environments.
From a counseling psychology viewpoint, the therapist may see depression, not as a biochemical illness or disorder, but as "a species-wide evolved suite of emotional programs that are mostly activated by a perception, almost always over-negative, of a major decline in personal usefulness, that can sometimes be linked to guilt, shame or perceived rejection". This suite may have manifested in aging hunters in humans' foraging past, who were marginalized by their declining skills, and may continue to appear in alienated members of today's society. The feelings of uselessness generated by such marginalization could hypothetically prompt support from friends and kin. Additionally, in a manner analogous to that in which physical pain has evolved to hinder actions that may cause further injury, "psychic misery" may have evolved to prevent hasty and maladaptive reactions to distressing situations.
SUBSTANCE (DRUG) INDUCED MOOD DISORDER THEORY
The DSM precludes a diagnosis of major depressive disorder for those presenting with "the direct physiological effects of a substance" because sedative hypnotic drugs such as alcohol and benzodiazepines increase the risk of a syndrome that is similar to major depression. This increased risk may be due in part to the effects of drugs on neurochemistry, such as decreased levels of serotonin and norepinephrine. Alcoholism or excessive alcohol consumption significantly increases the risk of developing this syndrome. Chronic use of benzodiazepines, a class of medication that is commonly used to treat insomnia, anxiety and muscular spasms, also increases the risk. Chronic, severe depression can develop as a result of chronic use of benzodiazepines or as part of a protracted withdrawal syndrome.
RISK INCREASES WITH
Unexpressed anger.
Compulsive, rigid, perfectionist or highly dependent personalities.
Family history of depression.
Alcoholism.
Failure in occupation, marriage or other interpersonal relationships.
Death or loss of a loved one.
Loss of something important (job, home, investments).
Job change or move to a new area.
Surgery, such as mastectomy for cancer.
Major illness or disability.
Passing from one life stage to another, such as menopause or retirement.
Use of some drugs, such as reserpine, beta-adrenergic blockers or benzodiazepines.
Withdrawal from mood-altering drugs, such as narcotics, amphetamines or caffeine.
Some diseases, including coronary disease, diabetes mellitus, cancer and hormonal abnormalities.
Post-partum (after the birth of a baby). Some women experience postpartum depression (the baby blues) most often due to hormonal fluctuations that occur when pregnancy ends. Contributing factors may include a stressful or traumatic birth experience, fatigue, feeling overwhelmed by new responsibilities, lack of support from partner, friends and/or family. See Post-partum Depression for more information.
PREVENTIVE MEASURES
Maintain good communication with family and close friends. Have a good support system around you.
Raise children with love and reasonable expectations in school and home.
Anticipate and prepare for major life changes where possible.
Education and coping techniques regarding depression and stressful events that may trigger depressive episodes.
BEHAVORIAL INTERVENTIONS
A 2008 meta-analysis found that behavioral interventions are effective at preventing new onset depression. Because such interventions appear to be most effective when delivered to individuals or small groups, it has been suggested, they may be able to reach their large target audience most efficiently through the Internet. However, an earlier meta-analysis found preventive programs with a competence-enhancing component to be superior to behaviorally oriented programs overall, and found behavioral programs to be particularly unhelpful for older people, for whom social support programs were uniquely beneficial. Additionally, the programs that best prevented depression comprised more than eight sessions, each lasting between 60 and 90 minutes; were provided by a combination of lay and professional workers; had a high-quality research design; reported attrition rates; and had a well-defined intervention.
EXPECTED OUTCOME
Spontaneous recovery in many cases, but professional help can shorten the duration and help you learn to cope in the future. If you seek professional help to assist you with depression episodes, be sure to find a therapist that you "click" with and feel you can trust. A good therapist can offer you tools to deal with your depression and how you handle your life problems and stresses. Not all therapists are created equal. Avoid those that are quick to hand out prescriptions for potentially dangerous drugs in place of quality therapy. Recurrence is common. The recovery rate is high, despite one's pessimism while depressed.
MEDICAL PROGNOSIS
Major depressive episodes often resolve over time whether or not they are treated. Outpatients on a waiting list show a 10-15 percent reduction in symptoms within a few months, with approximately 20 percent no longer meeting the full criteria for a depressive disorder. The median duration of an episode has been estimated to be 23 weeks, with the highest rate of recovery in the first three months.
General population studies indicate around half those who have a major depressive episode (whether treated or not) recover and remain well, while 35 percent will have at least one more, and around 15 percent experience chronic recurrence. Studies recruiting from selective inpatient sources suggest lower recovery and higher chronicity, while studies of mostly outpatients show that nearly all recover, with a median episode duration of 11 months. Around 90 percent of those with severe or psychotic depression, most of whom also meet criteria for other mental disorders, experience recurrence.
Recurrence is more likely if symptoms have not fully resolved with treatment. Current guidelines recommend continuing antidepressants for four to six months after remission to prevent relapse. Evidence from many randomized controlled trials indicates continuing antidepressant medications after recovery can reduce the chance of relapse by 70 percent (41 percent on placebo vs. 18 percent on antidepressant). The preventive effect probably lasts for at least the first 36 months of use.
Depressed individuals have a shorter life expectancy than those without depression, in part because depressed patients are at risk of dying by suicide. However, they also have a higher rate of dying from other causes, being more susceptible to medical conditions such as heart disease. Up to 60 percent of people who commit suicide have a mood disorder such as major depression, and the risk is especially high if a person has a marked sense of hopelessness or has both depression and borderline personality disorder. The lifetime risk of suicide associated with a diagnosis of major depression in the US is estimated at 3.4 percent, which averages two highly disparate figures of almost 7 percent for men and 1 percent for women (although suicide attempts are more frequent in women). The estimate is substantially lower than a previously accepted figure of 15 percent which had been derived from older studies of hospitalized patients.
MORBIDITY & DEPRESSION
Depression is a major cause of morbidity worldwide. Lifetime prevalence varies widely, from 3 percent in Japan to 17 percent in the US. In most countries the number of people who would suffer from depression during their lives falls within an 8-12 percent range. In North America the probability of having a major depressive episode within a year-long period is 3-5 percent for males and 8-10 percent for females. Population studies have consistently shown major depression to be about twice as common in women as in men, although it is unclear why this is so, and whether factors unaccounted for are contributing to this. The relative increase in occurrence is related to pubertal development rather than chronological age, reaches adult ratios between the ages of 15 and 18, and appears associated with psychosocial more than hormonal factors.
People are most likely to suffer their first depressive episode between the ages of 30 and 40, and there is a second, smaller peak of incidence between ages 50 and 60. The risk of major depression is increased with neurological conditions such as stroke, Parkinson's disease, or multiple sclerosis and during the first year after childbirth. It is also more common after cardiovascular illnesses, and is related more to a poor outcome than to a better one. Studies conflict on the prevalence of depression in the elderly, but most data suggest there is a reduction in this age group.
Depression is often associated with unemployment and poverty. Major depression is currently the leading cause of disease burden in North America and other high-income countries, and the fourth-leading cause worldwide. In the year 2030, it is predicted to be the second-leading cause of disease burden worldwide after HIV, according to the World Health Organization. Delay or failure in seeking treatment after relapse, and the failure of health professionals to provide treatment, are two barriers to reducing disability.
The World Health Organization updated its report The global burden of disease in 2004. Their "Years Lost due to Disability", or YLD, is a measurement of the equivalent years of healthy life lost through time spent in states of less than full health, and they state that in all regions, "neuropsychiatric conditions are the most important causes of disability, accounting for around one third of YLD among adults aged 15 and over." Specifically, unipolar depressive disorders are the leading cause in both males and females, in high-income countries and in low- and middle-income countries.
Major depression frequently co-occurs with other psychiatric problems. The 1990-92 National Co-morbidity Survey (US) reports that 51 percent of those with major depression also suffer from lifetime anxiety. Anxiety symptoms can have a major impact on the course of a depressive illness, with delayed recovery, increased risk of relapse, greater disability and increased suicide attempts. American neuroendocrinologist Robert Sapolsky similarly argues that the relationship between stress, anxiety, and depression could be measured and demonstrated biologically. There are increased rates of alcohol and drug abuse and particularly dependence, and around a third of individuals diagnosed with attention-deficit hyperactivity disorder develop co-morbid depression. Post-traumatic stress disorder and depression often co-occur.
Depression and pain often co-occur. One or more pain symptoms is present in 65 percent of depressed patients, and anywhere from five to 85 percent of patients with pain will be suffering from depression, depending on the setting; there is a lower prevalence in general practice, and higher in specialty clinics. The diagnosis of depression is often delayed or missed, and the outcome worsens.
Depression is also associated with a 1.5- to 2-fold increased risk of cardiovascular disease, independent of other known risk factors, and is itself linked directly or indirectly to risk factors such as smoking and obesity. People with major depression are less likely to follow medical recommendations for treating cardiovascular disorders, which further increases their risk. In addition, cardiologists may not recognize underlying depression that complicates a cardiovascular problem under their care.
POSSIBLE COMPLICATIONS
Suicide or attempted suicide. Warning signs include:
- Withdrawal from family and friends.
- Neglect of personal appearance.
- Mention of wanting "to end it all" or being "a burden to others."
- Evidence of a suicide plan (e.g., buying or cleaning a gun).
- Sudden cheerfulness after prolonged despondency.
- Hallucinations or psychotic behavior.
- Manic behavior, characterized by inappropriate over-activity and comic or irresponsible behavior.
TREATMENT
MEDICAL DIAGNOSIS
The diagnosis of major depressive disorder is based on the patient's self-reported experiences, behavior reported by relatives or friends, and a mental status exam. There is no laboratory test for major depression, although health care providers generally request tests for physical conditions that may cause similar symptoms. The most common time of onset is between the ages of 30 and 40 years, with a later peak between 50 and 60 years. Major depression is reported about twice as frequently in women as in men, although men are at higher risk for committing suicide.
CLINICAL ASSESSMENT
A diagnostic assessment may be conducted by a general practitioner, or by a psychiatrist or psychologist, who records the person's current circumstances, biographical history and current symptoms, and a family medical history to see if other family members have suffered from a mood disorder, and discuss the person's alcohol and drug use. The assessment also includes a mental state examination, which is an assessment of the person's current mood and thought content, in particular the presence of themes of hopelessness or pessimism, self-harm or suicide, and an absence of positive thoughts or plans. Specialist mental health services are rare in rural areas, and thus diagnosis and management is largely left to primary care clinicians. This issue is even more marked in developing countries. The score on a rating scale alone is not sufficient to diagnose depression, but it provides an indication of the severity of symptoms for a time period, so a person who scores above a given cut-off point can be more thoroughly evaluated for a depressive disorder diagnosis. Several rating scales are used for this purpose. Screening programs have been advocated to improve detection of depression, but there is evidence that they do not improve detection rates, treatment, or outcome.
Before diagnosing a major depressive disorder, a health care provider generally performs a medical examination and selected investigations to rule out other causes of symptoms. These include blood tests measuring TSH and thyroxine to exclude hypothyroidism; basic electrolytes and serum calcium to rule out a metabolic disturbance; and a full blood count including ESR to rule out a systemic infection or chronic disease. Adverse affective reactions to medications or alcohol misuse are often ruled out, as well. Testosterone levels may be evaluated to diagnose hypogonadism, a cause of depression in men.
Subjective cognitive complaints appear in older depressed people, but they can also be indicative of the onset of a dementing disorder, such as Alzheimer's disease. Depression is also a common initial symptom of dementia. Cognitive testing and brain imaging can help distinguish depression from dementia. A CT scan can exclude brain pathology in those with psychotic, rapid-onset or otherwise unusual symptoms. No biological tests confirm major depression. Investigations are not generally repeated for a subsequent episode unless there is a medical indication.
It may be possible to diagnose depression by using a computerized tomography (CT) scan to measure a person's adrenal glands. Researchers found that people suffering from clinical depression have larger adrenal glands than non-depressed people.
DSM-IV-TR & ICD-10 DIAGNOSIS CRITERIA
The most widely used criteria for diagnosing depressive conditions are found in the American Psychiatric Association's revised fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR), and the World Health Organization's International Statistical Classification of Diseases and Related Health Problems (ICD-10) which uses the name recurrent depressive disorder. The latter system is typically used in European countries, while the former is used in the US and many other non-European nations, and the authors of both have worked towards conforming one with the other.
Major depressive disorder is classified as a mood disorder in DSM-IV-TR. The diagnosis hinges on the presence of a single or recurrent major depressive episode. Further qualifiers are used to classify both the episode itself and the course of the disorder. The category Depressive disorder not otherwise specified is diagnosed if the depressive episode's manifestation does not meet the criteria for a major depressive episode. The ICD-10 system does not use the term Major depressive disorder, but lists very similar criteria for the diagnosis of a depressive episode (mild, moderate or severe); the term recurrent may be added if there have been multiple episodes without mania.
A major depressive episode is characterized by the presence of a severely depressed mood that persists for at least two weeks. Episodes may be isolated or recurrent and are categorized as mild (few symptoms in excess of minimum criteria), moderate, or severe (marked impact on social or occupational functioning). An episode with psychotic features - commonly referred to as psychotic depression - is automatically rated as severe. If the patient has had an episode of mania or markedly elevated mood, a diagnosis of bipolar disorder is made instead. Depression without mania is sometimes referred to as unipolar because the mood remains at one emotional state or "pole".
DSM-IV-TR excludes cases where the symptoms are a result of bereavement, although it is possible for normal bereavement to evolve into a depressive episode if the mood persists and the characteristic features of a major depressive episode develop. The criteria have been criticized because they do not take into account any other aspects of the personal and social context in which depression can occur. In addition, some studies have found little empirical support for the DSM-IV cut-off criteria, indicating they are a diagnostic convention imposed on a continuum of depressive symptoms of varying severity and duration: excluded are a range of related diagnoses, including dysthymia which involves a chronic but milder mood disturbance, Recurrent brief depression which involves briefer depressive episodes, minor depressive disorder which involves only some of the symptoms of major depression, and adjustment disorder with depressed mood which involves low mood resulting from a psychological response to an identifiable event or stressor. SUBTYPES OF MDD
The DSM-IV-TR recognizes five further subtypes of MDD, called specifiers, in addition to noting the length, severity and presence of psychotic features:
- Melancholic depression is characterized by a loss of pleasure in most or all activities, a failure of reactivity to pleasurable stimuli, a quality of depressed mood more pronounced than that of grief or loss, a worsening of symptoms in the morning hours, early morning waking, psychomotor retardation, excessive weight loss (not to be confused with anorexia nervosa), or excessive guilt.
- Atypical depression is characterized by mood reactivity (paradoxical anhedonia) and positivity, significant weight gain or increased appetite (comfort eating), excessive sleep or sleepiness (hypersomnia), a sensation of heaviness in limbs known as leaden paralysis, and significant social impairment as a consequence of hypersensitivity to perceived interpersonal rejection.
- Catatonic depression is a rare and severe form of major depression involving disturbances of motor behavior and other symptoms. Here the person is mute and almost stuporose, and either remains immobile or exhibits purposeless or even bizarre movements. Catatonic symptoms also occur in schizophrenia or in manic episodes, or may be caused by neuroleptic malignant syndrome.
- Postpartum depression (Mild mental and behavioral disorders associated with the puerperium, not elsewhere classified in ICD-10) refers to the intense, sustained and sometimes disabling depression experienced by women after giving birth. Postpartum depression, which has incidence rate of 10-15 percent among new mothers, typically sets in within three months of labor, and lasts as long as three months.
- Seasonal affective disorder (SAD) is a form of depression in which depressive episodes come on in the autumn or winter, and resolve in spring. The diagnosis is made if at least two episodes have occurred in colder months with none at other times, over a two-year period or longer.
DIFFERENTIAL DIAGNOSIS
To confer major depressive disorder as the most likely diagnosis, other potential diagnoses must be considered, including dysthymia, adjustment disorder with depressed mood or bipolar disorder. Dysthymia is a chronic, milder mood disturbance in which a person reports a low mood almost daily over a span of at least two years. The symptoms are not as severe as those for major depression, although people with dysthymia are vulnerable to secondary episodes of major depression (sometimes referred to as double depression). Adjustment disorder with depressed mood is a mood disturbance appearing as a psychological response to an identifiable event or stressor, in which the resulting emotional or behavioral symptoms are significant but do not meet the criteria for a major depressive episode. Bipolar disorder, previously known as manic-depressive disorder, is a condition in which depressive phases alternate with periods of mania or hypomania. Although depression is currently categorized as a separate disorder, there is ongoing debate because individuals diagnosed with major depression often experience some hypomanic symptoms, indicating a mood disorder continuum.
CONVENTIONAL MEDICAL TREATMENT
Most patients are treated in the community with antidepressant medication and some with psychotherapy or counseling. Hospitalization may be necessary in cases with associated self-neglect or a significant risk of harm to self or others. A minority are treated with electroconvulsive therapy (ECT), under a short-acting general anaesthetic. The course of the disorder varies widely, from one episode lasting months to a lifelong disorder with recurrent major depressive episodes. Depressed individuals have shorter life expectancies than those without depression, in part because of greater susceptibility to medical illnesses. Current and former patients may be stigmatized.
The understanding of the nature and causes of depression has evolved over the centuries, though many aspects of depression remain incompletely understood and are the subject of discussion and research. Psychological, psycho-social, hereditary, evolutionary and biological causes have been proposed. Psychological treatments are based on theories of personality, interpersonal communication, and learning. Most biological theories focus on the monoamine chemicals serotonin, norepinephrine, and dopamine that are naturally present in the brain and assist communication between nerve cells. Monoamines have been implicated in depression, and most antidepressants work to increase the active levels of at least one.
The three most common treatments for depression are psychotherapy, medication, and electroconvulsive therapy. Psychotherapy is the treatment of choice for people under 18, while electroconvulsive therapy is only used as a last resort. Care is usually given on an outpatient basis, while treatment in an inpatient unit is considered if there is a significant risk to self or others. A significant number of recent studies have indicated that physical exercise has beneficial effects.
Treatment options are much more limited in developing countries, where access to mental health staff, medication, and psychotherapy is often difficult. Development of mental health services is minimal in many countries; depression is viewed as a phenomenon of the developed world despite evidence to the contrary, and not as an inherently life-threatening condition.
PSYCHOTHERAPY
Psychotherapy can be delivered, to individuals or groups, by mental health professionals, including psychotherapists, psychiatrists, psychologists, clinical social workers, counselors, and psychiatric nurses. With more complex and chronic forms of depression, a combination of medication and psychotherapy may be used. In children and young people under 18, medication should only be offered in conjunction with a psychological therapy, such as CBT, interpersonal therapy, or family therapy. Psychotherapy has been shown to be effective in older people. Successful psychotherapy appears to reduce the recurrence of depression even after it has been terminated or replaced by occasional booster sessions.
The most studied form of psychotherapy for depression is cognitive behavioral therapy (CBT), thought to work by teaching clients to learn a set of useful cognitive and behavioral skills. Earlier research suggested that CBT was not as effective as antidepressant medication; however, research evidence for CBT has began to emergence from the mid 1990s and suggests that it can perform as well or better than antidepressants in patients with moderate to severe depression.
Several variants of cognitive behavior therapy have been used in depressed patients, most notably rational emotive behavior therapy, and more recently mindfulness-based cognitive therapy.
Evidence shows CBT to be effective in depressed adolescents, although one systematic review noted there was insufficient evidence regarding severe episodes. Combining fluoxetine with CBT appeared to bring no additional benefit, or, at the most, only marginal benefit. Several variables predict success for cognitive behavior therapy in adolescents: higher levels of rational thoughts, less hopelessness, fewer negative thoughts, and fewer cognitive distortions.
Interpersonal psychotherapy focuses on the social and interpersonal triggers that may cause depression. The therapy takes a structured course with a set number of weekly sessions (often 12) that focus on relationships with others. Therapy can be used to foster interpersonal skills that allow people to communicate more effectively and to reduce stress.
Psychoanalysis, a school of thought founded by Sigmund Freud that emphasizes the resolution of unconscious mental conflicts, is used by its practitioners to treat clients presenting with major depression. A more widely practiced, eclectic technique, called psychodynamic psychotherapy, is loosely based on psychoanalysis and has an additional social and interpersonal focus. In a meta-analysis of three controlled trials of Short Psychodynamic Supportive Psychotherapy, this modification was found to be as effective as medication for mild to moderate depression.
Logotherapy, a form of existential psychotherapy developed by Austrian psychiatrist Viktor Frankl, addresses the filling of an "existential vacuum" associated with feelings of futility and meaninglessness. This type of psychotherapy may be particularly useful for depressed adolescents.
ANTIDEPRESSANTS
The effects of prescription antidepressants can be comparable to those of psychotherapy, although more patients cease medication than cease psychotherapy, most likely due to side effects from the medication.
To find the most effective antidepressant medication with tolerable or fewest side effects, the dosages can be adjusted, and if necessary, combinations of different classes of antidepressants can be tried. Response rates to the first antidepressant administered range from 50-75 percent, and it can take at least six to eight weeks from the start of medication to remission, when the patient is back to their normal self. Antidepressant medication treatment is usually continued for 16 to 20 weeks after remission, to minimize the chance of recurrence. People with chronic depression may need to take medication indefinitely to avoid relapse.
Selective serotonin reuptake inhibitors (SSRIs), such as sertraline, escitalopram, fluoxetine, paroxetine, and citalopram are the primary medications prescribed owing to their effectiveness, relatively mild side effects, and because they are less toxic in overdose than other antidepressants. Patients who do not respond to one SSRI can be switched to another, and this results in improvement in almost 50 percent of cases. Another option is to switch to the atypical antidepressant bupropion. Venlafaxine, an antidepressant with a different mechanism of action, may be modestly more effective than SSRIs. However, venlafaxine is not recommended in the UK as a first-line treatment because of evidence suggesting its risks may outweigh benefits, and it is specifically discouraged in children and adolescents. For adolescent depression, fluoxetine and escitalopram are the two recommended choices. Antidepressants have not been found to be beneficial in children. Any antidepressant can cause low serum sodium levels (also called hyponatremia); nevertheless, it has been reported more often with SSRIs. It is not uncommon for SSRIs to cause or worsen insomnia; the sedating antidepressant mirtazapine can be used in such cases.
Monoamine oxidase inhibitors, an older class of antidepressants, have been plagued by potentially life-threatening dietary and drug interactions. They are still used only rarely, although newer and better tolerated agents of this class have been developed.
The terms refractory depression or treatment-resistant depression are used to describe cases that do not respond to adequate courses of least two antidepressants. In many major studies, only about 35 percent of patients respond well to medical treatment. It may be difficult for a health care provider to decide when someone has treatment-resistant depression or whether the problem is due to coexisting disorders, which are common among patients with major depression.
PHARMACOLOGICAL AUGMENTATION
A health care provider may add a medication with a different mode of action to bolster the effect of an antidepressant in cases of treatment resistance. Medication with lithium salts has been used to augment antidepressant therapy in those who have failed to respond to antidepressants alone. Furthermore, lithium dramatically decreases the suicide risk in recurrent depression. Addition of a thyroid hormone, triiodothyronine may work as well as lithium, even in patients with normal thyroid function. Addition of atypical antipsychotics when the patient has not responded to an antidepressant is also known to increase the effectiveness of antidepressant drugs, albeit offset by increased side effects.
The effectiveness of antidepressants continues to be questioned. Their effectiveness has been shown to increase with the severity of the depression, and to reach clinical significance only in studies involving the most severely depressed, perhaps because the very severely depressed had a decreased response to the placebo effect rather than an increased response to the medication. An editorial in the BMJ drew attention to bias in the publication of studies showing antidepressant efficacy compared to unpublished studies where the data did not support efficacy. Though these unpublished studies might have suffered methodological or other problems, the article called attention to the possibility that sponsor or journal bias might have inflated or created the apparent efficacy of antidepressants over placebo. A black box warning was introduced in the United States in 2007 on SSRI and other antidepressant medications due to increased risk of suicidality in patients younger than 24 years old.
ELECTROCONVULSIVE THERAPY
Electroconvulsive therapy (ECT) is a procedure whereby pulses of electricity are sent through the brain via two electrodes, usually one on each temple, to induce a seizure while the patient is under a short general anaesthetic. Hospital psychiatrists may recommend ECT for cases of severe major depression which have not responded to antidepressant medication or, less often, psychotherapy or supportive interventions. ECT can have a quicker effect than antidepressant therapy and thus may be the treatment of choice in emergencies such as catatonic depression where the patient has stopped eating and drinking, or where a patient is severely suicidal. ECT is probably more effective than pharmacotherapy for depression in the immediate short-term, although a landmark community-based study found much lower remission rates in routine practice. Used on its own the relapse rate within the first six months is very high; early studies put the rate at around 50 percent, while a more recent controlled trial found rates of 84 percent even with placebos. The early relapse rate may be reduced by the use of psychiatric medications or further ECT (although the latter is not recommended by some authorities) but remains high. Common initial adverse effects from ECT include short and long-term memory loss, disorientation and headache. Although objective psychological testing shows memory disturbance after ECT has mostly resolved by one month post treatment, ECT remains a controversial treatment, and debate on the extent of cognitive effects and safety continues.
PHYSICAL EXERCISE
Physical exercise is recommended by U.K. health authorities, and a systematic review of 23 studies indicated a "large clinical effect". Among these, three studies employing intention to treat analysis and other bias-reducing measures were inconclusive.
OVER-THE-COUNTER COMPOUNDS
St John's wort is available over-the-counter as a herbal remedy in some parts of the world; however, the evidence of its effectiveness for the treatment of major depression is varying and confusing. Its safety can be compromised by inconsistency in pharmaceutical quality and in the amounts of active ingredient in different preparations. Further, it interacts with numerous prescribed medicines including antidepressants, and it can reduce the effectiveness of hormonal contraception.
Herbal Remedies: St. John's Wort, Perika, 200 mg, 60 Tabs
Herbal Remedies: St. John's Wort Tonic (Formerly Depression Tincture), 2 fl. oz.
The issue of efficacy of omega-3 fatty acids for major depression is controversial, with controlled studies and meta-analyses supporting both positive and negative conclusions. Recent meta-analyses support their use as adjunctive treatments in major depressive disorder. Because side effects are minimal, they may prove a useful approach for pregnant women or children.
Herbal Remedies: Wild Salmon Oil Capsule, NOW Foods, 120 EPA/80 DHA, 2000 mg, 250 SoftGels
Herbal Remedies: Omega 3 Fish Oil Supplement, Mood Aid, EFA Gold, Enteric Coated, Nature's Way, 60 Softgels
Herbal Remedies: Super Omega 3-6-9, NOW Foods, 1200 mg, 90 Softgels
Reviews of short-term clinical trials of S-adenosylmethionine (SAM-e) indicate that it may be effective in treating major depression in adults. A 2002 review reported that tryptophan and 5-hydroxytryptophan appear to be better than placebo, but it did not recommend their widespread use owing to lack of conclusive evidence on efficacy and safety, and generally preferred the use of safer antidepressants instead.
Herbal Remedies: SAM-e, Enteric Coated, NOW Foods, 100 mg, 30 Tabs
Herbal Remedies: SAM-e With B Vitamin Cofactors, Vegetarian, Enteric Coated, NOW Foods, 200 mg, 60 Tabs
Herbal Remedies: SAM-e, S-Adenosyl-L-Methionine, 400 mg, 30 Tabs
Herbal Remedies: SAM-e, S-Adenosyl-L-Methionine: The Remarkable Substance That Promotes Detoxification, Relieves Arthritis, & Fights Depression, By Rita Elkins, M.H.
Atypical depression is a common but often undiagnosed disorder affecting up to 40 million Americans. Although classification is still ongoing, it could arguably be thought of as a subset of bipolar depression. Symptoms include mood swings, carbohydrate cravings, weight gain, sensitivity to rejections, and lethargy. In a recent study, daily supplementation with chromium picolinate reduced the symptoms significantly, especially the carbohydrate cravings. No side effects were observed that were different from placebo. This study was presented at the June 2004 conference of the National Institutes of Mental Health (NIMH) New Clinical Evaluation Unit. People with atypical depression often find it difficult to stay on currently prescribed depression medication due to the common side effects of sexual dysfunction and weight gain.
Herbal Remedies: Chromium Picolinate, NOW Foods, 200 mcg, 100 Caps
Herbal Remedies: Ionic Chromium Supplement, Trace Minerals, 550 mcg, 2 fl. oz.
Herbal Remedies: Chromium Ionic Mineral Supplement, Fully Absorbable, 50 +/- ppm, 16 fl. oz.
For more information about herbal and nutritional supplements and products, see information further down on this page.
OTHER SOMATIC TREATMENTS
Repetitive transcranial magnetic stimulation (rTMS) applies powerful magnetic fields to the brain from outside the head. Multiple controlled studies support the use of this method in treatment-resistant depression; it has been approved for this indication in Europe, Canada, Australia, and the US. rTMS appeared similarly effective for both uncomplicated depression and depression resistant to medication; however, it was inferior to ECT in a side-by-side randomized trial.
Vagus nerve stimulation was approved by the FDA in the United States in 2005 for use in treatment-resistant depression, although it failed to show short-term benefit in the only large double-blind trial when used as an adjunct on treatment-resistant patients; a 2008 systematic review concluded that despite the promising results reported mainly in open studies, further clinical trials are needed to confirm its efficacy in major depression.
Poor diet or medical disorders leading to deficiency in certain nutrients have been linked to major depression disorder. Thus improved diet or correction of nutritional deficiency may be of value in some cases of major depression.
MEDICATION
Finding the right treatment for depression can be as difficult as convincing someone that he or she needs help. Even so, according to the National Institute of Mental Health, clinical depression is one of the most treatable of all medical illnesses. Today, most people with depression can be treated with antidepressant medications, "talk" therapy (psychotherapy), or a combination of the two. Experts agree that successful treatment also hinges on early intervention. Early treatment increases the likelihood of preventing serious reoccurrences. Newer medications, such as the selective serotonin reuptake inhibitors, or SSRIs, are helping. SSRIs generally produce fewer side effects than the other older drugs, making it easier for people, including older adults, to adhere to treatment. Both generations of medication are effective in relieving depression, although any given individual may respond to one type of drug and not another. It is difficult to predict which people will respond to which drug, or who will experience what side effects.
A variety of different drugs are commonly prescribed to treat depression. Antidepressant drugs for some persons with prolonged or moderately severe depression. These work in fighting depression by changing the balance of neurotransmitters in the body. These medications include:
- Tricyclics. These drugs work by inhibiting the uptake of the neurotransmitters serotonin, norepinephrine, and dopamine, making more of the mood-enhancing chemical messengers available to nerve cells. Examples include amitriptyline (Elavil, Endep), desipramine (Norpramin, Pertofrane), imipramine (Janimine, Tofranil), and nortriptyline (Aventyl, Pamelor). Possible side effects included blurred vision, constipation, dry mouth, irregular heartbeat, urine retention, and orthostatic hypotension, a severe drop in blood pressure upon sitting up or standing, which can lead to dizziness, falls, and fractures.
- Tetracyclics. These drugs have an action similar to that of the tricyclics, but have a slightly different chemical structure and appear to cause fewer side effects. Maprotiline (Ludiomil) is in this category.
- Monoamine oxidase (MAO) inhibitors. These drugs increase the amounts of mood- enhancing neurotransmitters in the brain by blocking the action of the enzyme monoamine oxidase, which normally breaks them down. Examples of MAO inhibitors include isocarboxazid (Marplan), phenelzine (Nardil), and tranylcypromine (Parnate). Possible side effects include agitation, elevated blood pressure, over-stimulation, and changes in heart rate and rhythm. MAO inhibitors also have a high potential for dangerous interactions with other substances, including drugs and foods. Persons taking these drugs must adhere strictly to a diet that includes no foods containing the chemical tyramine, such as almonds, avocados, bananas, beef or chicken liver, beer, cheese (including cottage cheese), chocolate, coffee, fava beans, herring, meat tenderizer, peanuts, pickles, pineapples, pumpkin seeds, raisins, sausage, sesame seeds, sour cream, soy sauce, wine, yeast extracts (including brewer's yeast), yogurt, and other foods. In general, any high-protein food that has undergone aging, pickling, fermentation, or similar processes should be avoided. Over-the-counter cold and allergy remedies should also be avoided.
- Paxil (paroxetine) has been approved by the FDA for treatment of generalized anxiety disorders (GAD). The drug is already approved for treating social anxiety disorder, depression, panic disorder, and obsessive-compulsive disorder. GAD affects about 4 million adult Americans, and about twice as many women as men, according to the National Institute of Mental Health. People with GAD experience exaggerated, worrisome thoughts and tension about routine life events, lasting a minimum of 6 months. GAD is often accompanied by physical symptoms such as fatigue, trembling, muscle tension, headache, and nausea. The effectiveness of Paxil in long-term treatment of GAD (greater than 8 weeks) was not evaluated, nor was Paxil studied in children and adolescents with GAD. Caution: Paxil should not be used in children and adolescents for the treatment of major depressive disorder. Antidepressants in adults and children should be used with caution. Never discontinue use of antidepressants without first consulting a health care provider.
- Other Drugs. Several drugs known as "second-generation" antidepressants have become available in the past few years. These new drugs have not been shown to be more effective than the others, but they tend to have fewer serious side effects. They include the newer tricyclic amoxapine (Asendin); fluoxetine (Prozac) and sertraline (Zoloft), which specifically block the uptake of the neurotransmitter serotonin but, unlike tricyclics, not that of norephinephrine or dopamine; buproprion (Wellbutrin), which is believed to act by inhibiting the uptake of dopamine but not serotonin or norephinephrine; and trazodone (Desyrel), an antidepressant with stimulant properties that also inhibits the uptake of dopamine.
Specific drugs are used for alternating mania and depression.
Anti-anxiety drugs may be prescribed.
Sedatives may be prescribed temporarily for insomnia.
Hormonal therapy, particularly estrogen replacement for pre-menopausal (the 5 to 10 year period before menopause) women. Steroid drugs and oral contraceptives may cause serotonin levels in the brain to drop.
Steroid drugs and oral contraceptives may cause serotonin levels in the brain to drop.
CATEGORIES OF ANTIDEPRESSANTS DRUGS
Following is a quick reference guide to the major categories of antidepressant medications currently in use, according to their mode of action and including both generic and brand names.
CATEGORY OF ANTIDEPRESSANT GENERIC NAME BRAND NAME(S) Monoamine Oxidase Inhibitor
(MAOI)Isocarboxazid
Phenelzine
Tranylcypromine Marplan
Nardil
Parnate Tricyclic Amoxapine
Desipramine
Doxepin
Maprotiline
Nortriptyline
Protriptyline Asendin
Norpramin
Pertofrane
Sinequan
Ludiomil
Aventyl
Pamelor
Vivactil Serotonin Transport Blocker
(Selective Serotonin Reuptake Inhibitor or SSRI)Amitriptyline
Citalopram
Clomipramine
Fluoxetine
Fluvoxamine
Imipramine
Paroxetine
Sertraline
Trimipramine
Venlafaxine Elavil
Celexa
Anafranil
Prozac
Luvox
Tofranil
Paxil
Zoloft
Surmontil
Effexor Dopamine Transport Blocker Buproprion Wellbutrin Serotonin 5-HT-2A Receptor Blocker Mirtazapine Nefazodone Rameron Serzone Trazodone Desyrel
ACTIVITY
No restrictions. Maintain daily activities and interests even if you don't feel like it. Attend social functions, concerts, athletic events, plays and movies. Keep in touch with friends and loved ones.
Keep your mind active and get plenty of rest and regular exercise. A regular exercise program can help relieve depression. Studies have shown that exercise - walking, swimming, or any activity that you enjoy - is most important for all types of depression. Avoid stressful situations.
Vigorous exercise can be an effective antidote to bouts of depression. During exercise, the brain produces pain-killing chemicals called endorphins and enkephalins. Certain endorphins and other brain chemicals released in response to exercise also produce a natural "high." Most of those who exercise regularly say that they feel really good afterward. This may explain why exercise is the best way to get rid of depression.
Music can have powerful effects on mood and may be useful in alleviating depression. See Music & Sound Therapy for more information.
HOLISTIC & NUTRITIONAL TREATMENT & MANAGEMENT
SELF-MANAGEMENT OF DEPRESSION
NON-TREATMENT OF DEPRESSION
The American Psychiatric Society estimates that 80 to 90 percent of cases of depression can be treated effectively, but that two-thirds of people who suffer from depression do not get the help they need. Many people do not seek treatment because they are ashamed, or they feel lethargic and despondent. In many cases, people with major depression only seek help when they are at the point of breakdown, or when they are hospitalized following a suicide attempt (an estimated 15 percent of chronic depression cases result in suicide). A good support system from friends and family members is often crucial in getting a depressed person to seek help for his or her illness.
According to the National Institute of Mental Health (NIMH), most people with depressive illness do not get the help they need, although the great majority - even those whose depression can last for weeks, months, or even years. With treatment, many people can find relief from their symptoms and lead a normal, healthy life.
THINGS YOU CAN DO FOR YOURSELF
Have a hair analysis to rule out heavy metal intoxication as the cause of depression.
Keep your mind active, and get plenty of rest and regular exercise. Studies have shown that exercise - walking, swimming, or any other activity that you can enjoy - is the most important for all types of depression. Avoid stressful situations.
Learn to recognize, and then to "reroute," negative thinking patterns. Working with a qualified professional to change ingrained habits can be rewarding (cognitive-behavioral therapists specialize in this type of work). Keeping a daily log also can help you to recognize distorted thoughts and develop a more positive way of thinking.
HOMEOPATHICS FOR SITUATIONAL DEPRESSION
If you are suffering from situational depression - depression that occurs in response to an event such as in the death of a loved one or the breakup of a relationship - try using Ignatia amara. This is a homeopathic remedy derived from a plant, the Saint Ingatius bean, that helps control emotions during periods of extreme grief and hysteria.
Herbal Remedies: Ignatia Homeopathic Clikpak, 30C, 84 Pellets
Homeopathic treatment for emotional upset, grief, and headaches. Nelson's Ignatia is a homeopathic medicine available in a 30C potency. Nelson's natural care since 1860. Made according to the Homeopathic Pharmacopoeia of the United States. Portable, convenient and easy to use Homeopathic medicines should be taken regularly to be most effective. The new clikpak is therefore much better suited to a busy lifestyle. The pillules are smaller and easier to take than tablets. They can even be dissolved in warm water if preferred. Their sucrose coating and small lactose core means they taste better. Press base twice to release two pillules into cap. Unscrew cap and without touching pillules tip them into mouth. Pillules to be sucked or chewed and taken between meals. Dosage For Adults and children: 2 pillules every 2 hours for the first 6 doses, then 4 times daily for up to 5 days or until symptoms improve. Cautions: If symptoms worsen or persist, consult a health care provider. Always read the label and follow directions. Keep all medicines out of the reach of children.
Herbal Remedies: Hyland's Insomnia Homeopathic Formula (With Ignata Amara 3X HPUS), 100 Tabs
Hyland's Insomnia is a traditional homeopathic formula for the relief of insomnia, sleeplessness and restlessness due to worry or stress. Hyland's offers natural relief for insomnia due to stress, worry and grief. Working without contraindications or side effects, Hyland's Insomnia stimulates your body's natural healing response to relieve symptoms without sedative hangover. Hyland's Insomnia is safe for adults and children and can be used in conjunction with other medications. Formula contains Hyoscyamus Niger 3X HPUS for the relief of the symptoms of nervous agitation, muscular twitching and intense sleeplessness, Ignatia Amara 3X HPUS helps to relieve the effects of grief, worry, nervousness and apprehension. Tenseness characterized by facial twitching, jerking of limbs, itching arms and Kali Phos. 3X HPUS, which helps to restore health to the nerves of the body, combating the results of excitement, overwork and worry.
LIGHT THERAPY FOR SEASONAL AFFECTIVE DISORDER (SAD)
If depression is seasonal, light therapy may help. Exposure to the sun and bright light seem to regulate the body's production of melatonin, a hormone produced by the pineal gland that is, in part, responsible for preventing the blues. Stay in brightly lit rooms on dark days. Keep all draperies, curtains, and blinds open and use full-spectrum fluorescent lights in your home. The normal room has about 500 to 800 lux of light. Choose one room and light it with about 10,000 lux of full-spectrum light and spend at least half an hour there each day.
Season affective disorder can be treated using light therapy, which involves exposing yourself to light of a certain frequency from a light box for 15 minutes to 2 hours per day. The reason this therapy works is that more melatonin, a hormone produced by the pineal gland in the brain, is produced in the dark, or on dark days. At certain levels, melatonin appears to trigger the onset of depression in some people. Most insurance companies now honor claims for these special boxes.
For information about devices for this type of light treatment, contact either:
The SunBox Company
Telephone: 301-869-5980 or 800-548-3968
Apollo Light Systems, Inc.
Telephone: 801-226-2370 or 800-545-9667
Amazon.com has a selection of Light Therapy products available. Be sure to read product descriptions and choose the right device for your situation and preference:
COLOR THERAPY
Try using color to alleviate depression. See Color Therapy for more information.
THYROID FUNCTION TESTS FOR HYPOTHYROIDISM
If you suspect you have a hypothyroid condition, take the Thyroid Self-Test to detect an under-active thyroid. If your temperature is low, consult your health care provider. For people with hypothyroidism, Armour Thyroid Tables is recommended. This product is produced by Forest Pharmaceuticals and is available by prescription only.
THYROID SELF-TEST
OTHER CONSIDERATIONS
People who smoke are more likely than non-smokers to be depressed. Smokers and non-smokers alike may benefit from Zoban (a sustained release preparation of buproprion, also sold as Wellbutrin SR), an antidepressant also approved to help people quit smoking. Buproprion elevates levels of dopamine and norepinephrine, substances that are also elevated by nicotine in tobacco products. It allows patients to obtain the same feeling while weaning themselves off nicotine.
Allergies, hypoglycemia, hypothyroidism, and/or malabsorption problems can cause or contribute to depression. In people with these conditions, vitamin B-12 and folic acid are blocked from entering the system, which can lead to depression.
Individuals with depression are more likely than other people to have various disturbances in calcium metabolism.
Pregnenolone is a naturally occurring hormone that may improve brain function, enhancing mood, memory, and thinking ability.
Herbal Remedies: Pregnenolone Cream, Life-Flo, 2 oz.
Depression is not a natural part of aging, but is frequently linked to age-related nutritional problems, such as Vitamin B deficiencies and poor eating habits. Older people who suffer from depression are as likely to benefit from treatment as a person in any other age bracket.
Some preliminary studies show promise in using dehydroepiandrosterone (DHEA) - a hormone naturally produced by the body - in the treatment of depression. In one study, nearly all patients taking DHEA for 6 weeks significantly improved, and about half of those were no longer considered clinically depressed.
Vigorous exercise can be an effective antidote to bouts of depression. During exercise, the brain produces pain-killing chemicals called endorphins and enkephalins. Certain endorphins and other brain chemicals released in response to exercise also produce a natural "high". Most of those who exercise regularly say that they feel really good afterward. This may explain why exercise is the best way to get rid of depression.
Music can have powerful effects on mood and may be useful in alleviating depression.
COUNSELING & THERAPY
Approach to therapy consists of treating acute symptoms, avoiding a relapse, and maintenance therapy to prevent recurrence.
Psychotherapy or counseling possibly along with drug treatment appears to be the medical standard of approach and obtains the best results. Different types of psychotherapy are available including cognitive therapy, behavioral therapy and interpersonal therapy. Each may take 12-20 sessions over 12-16 weeks.
Hospitalization or inpatient at special treatment center may be required for severe depression.
Seek support groups. Contact social agencies for help.
- The National Mental Health Association
(800) 969-6642
- The National Foundation for Mental Illness
(800) 239-1263
- The National Depressive and Manic Depressive Association
(800) 826-3632
Call your local suicide-prevention hot-line if you feel suicidal.
There is no doubt that attitude affects health. Study after study has shown that optimistic people are not only happier but healthier. They suffer less illness, recover better from illness and surgery, and have stronger immune defenses.
DIET
Eat a normal, well-balanced diet even if you have no appetite. Vitamin and mineral supplements may be necessary. Make sure you are getting enough B-Vitamins in your diet to help you with stress.
Eat a diet that includes plenty of raw fruits and vegetables, with soybeans and soy products, whole grains, seeds, nuts, brown rice, millet, and legumes. A diet too low in complex carbohydrates can cause serotonin depletion and depression.
If you are nervous and wish to become more relaxed, consume more complex carbohydrates. For increased alertness, eat protein meals containing essential fatty acids. The omega-3 fatty acids in particular are very necessary for healthy bodies and healthy minds. Salmon and white fish are good choices. If you need your spirits lifted, you will benefit from eating foods like turkey and salmon, which are high in tryptophan and protein.
The Omega-3 fat DHA, docosahexaenoic acid, which is found in many cold water fish such as salmon, tuna, and mackerel, is known to have cardioprotective effects. Researchers at the University of California - Los Angeles School of Medicine found that genetically engineered mice fed a diet rich in DHA also were found to have less brain cell damage than those fed a diet which substituted safflower oil, which is low in omega-3 fatty acids. It is recommended that at least two meals a week of fish (not fried) rich in omega-3 fatty acids. While this is for good for cardiovascular health, it is possible that this diet can also favorably affect people with Alzheimer's disease or depression. Low levels of DHA have also been associated with postpartum depression.
Omit wheat products from the diet. Wheat gluten has been linked to depressive disorders.
Limit your intake of supplements that contain the amino acid phenylalanine. It contains the chemical phenol, which is highly allergenic. Most depressed people are allergic to certain substances. If you take a combination free-form amino acid supplement, look for a product that does not contain phenylalanine, such as that made by Ecological Formulas. Phenylalanine is one of the major components of aspartame.
Avoid diet sodas and other products containing the artificial sweetener aspartame, such as found in Equal, NutraSweet and other products. This additive can possibly block the formation of serotonin and cause headaches, insomnia, and depression in individuals who are already serotonin deprived.
Avoid foods high in saturated fats; the consumption of meat or fried foods, such as hamburgers and French fries, leads to sluggishness, slow thinking, and fatigue. They interfere with blood flow by causing the arteries and small blood vessels to become blocked and the blood cells to become sticky and tend to clump together, resulting in poor circulation, especially to the brain.
Avoid all forms of sugar, including normally "good" sweeteners such as honey, molasses, and fruit juice. The body reacts more quickly to the presence of sugar than it does to the presence of complex carbohydrates. The increase in energy supplied by the simple carbohydrates (sugars) is quickly followed by fatigue and depression. Stevia, a concentrated natural sweetener derived from a South American shrub, does not have the same effect on the body as sugar, and does not have the side effects of artificial sugar substitutes.
Avoid alcohol, caffeine, and processed foods.
Tyrosine is needed for brain function. This amino acid is directly involved in the production or norepinephrine and dopamine, two vital neurotransmitters that are synthesized in the brain and the adrenal medulla. A lack of tyrosine can result in the deficiency of norepinephrine in certain sites in the brain, resulting in mood disorders such as depression. The effects of stress may be prevented or reversed if this essential amino acid is obtained in the diet or by means of supplements. Mustard greens, beans, and spinach are good sources of tyrosine. Caution: If you are taking an MAO inhibitor drug for depression, do not take tyrosine supplements, and avoid foods containing tyrosine, as drug and dietary interactions can cause a sudden, dangerous rise in blood pressure. Discuss food and medicine limitations thoroughly with your health care provider or a qualified dietitian.
Selenium has been shown to elevate mood, and also to decrease anxiety. These effects were more noticeable in people who had lower levels of selenium in their diets to begin with.
In one study, people suffering from depression were found to have lower than normal levels of folic acid in their blood than non-depressed individuals. Other studies have shown that zinc levels tend to be significantly lower than normal when people suffer from depression.
Prozac and other "selective serotonin uptake inhibitors" work to increase the activity of serotonin, while 5-Hydroxy-L-Tryptophan (5-HTP) works to boost the body's production of serotonin.
Investigate the possibility that food allergies are causing or contributing to depression.
HERBAL RECOMMENDATIONS
Balm, also known as Lemon Balm, is good for the stomach and digestive organs during stressful situations.
Herbal Remedies: Lemon Balm Powder (Melissa Officinalis), 4 oz. Bulk
Herbal Remedies: Lemon Balm Tincture, 100% Organic, 2 fl. oz.
Herbal Remedies: Valerian Nighttime With Lemon Balm Supplement, Nature's Way, 265 mg, 100 Tabs
Herbal Remedies: Melissa Leaves, Lemon Balm, Nature's Way, 490 mg, 100 Caps
Herbal Remedies: Lemon Balm Supplements & Products
Ephedra (Ma Huang) may be helpful for lethargic depression. Caution: Do not use this herb if you suffer from anxiety disorder, glaucoma, heart disease, high blood pressure, or insomnia, or if you are taking a monoamine oxidase (MAO) inhibitor drug.
Ginger, Gingko Biloba, Licorice root, Oat Straw, Peppermint, and Siberian Ginseng (Eleuthero Root) may be helpful. Caution: Do not use licorice on a daily basis for more than seven days in a row. Avoid it completely if you have high blood pressure. Do not use Siberian ginseng if you have hypoglycemia, high blood pressure, or a heart disorder.
Herbal Remedies: Ginger Supplements & Products
Herbal Remedies: Ginkgo Biloba Supplements & Products
Herbal Remedies: Licorice Root / Glycyrrhiza Glabra / Yastimadhu Supplements & Products
Herbal Remedies: Oatstraw Supplements & Products
Herbal Remedies: Mint / Menthol / Peppermint / Mentha Piperita Supplements & Products
Herbal Remedies: Siberian Ginseng / Eleuthero Root Supplements & Products
Kava kava helps to induce calm and relieve depression. Caution: This herb can cause drowsiness. If this occurs, discontinue use or reduce the dosage.
Herbal Remedies: Kava Kava Supplements & Products
St. John's Wort acts in the same way in monoamine oxidase (MAO) inhibitors do, but less harshly. A study published in the British Medical Journal indicates that extracts of St. John's Wort may be as effective as prescription antidepressants for mild and moderate depression. St. John's Wort is the most prescribed antidepressant in Germany, but is treated as a dietary supplement in the United States (it is not approved as a safe and effective drug by the FDA). Many studies are underway to determine the effectiveness and safety of long-term use of St. John's Wort. Research published recently in the British Medical Journal indicates that, in a German study where St. John's Wort was matched against Paxil, the supplement proved to be just as effective and subjects had fewer side effects.
Herbal Remedies: St. John's Wort Supplements & Products
CAN DEPRESSION BE CAUSED BY TESTOSTERONE DEFICIENCY?
Testosterone deficiency is a factor in causing heart disease, depression, and a host of aging-related ailments in men. This is a relatively new opinion, but there is evidence to support it. Many people are leery of testosterone because of media hype concerning sports-related usage. But there is more than one type of testosterone, and one is beneficial. First of all, it is true that all the anabolic steroids are "bad" over the long term. Their molecules resemble those of natural testosterone but are chemically different and do not react the same way in the body. The notorious methyl testosterone may be the worst of these steroids.
In the body, natural testosterone is either free (unattached to anything else) or bound to a molecule known as sex hormone binding globulin (SHAG). While the total amount of testosterone in the body, as measured by a blood test, might be the same as a man ages, more and more of the testosterone is bound to SHBG. Bound testosterone cannot interact with testosterone receptors and thus is, in effect, biologically inert. The amount of free, or active, testosterone available declines as a men age. As it turns out, this free testosterone is important to health in many ways. Men with low free testosterone levels are more prone to high blood sugar, high blood cholesterol and triglycerides, high blood pressure, obesity in general and abdominal obesity in particular, high levels of clotting factors, and low levels of clotting inhibitors. There is data suggesting that osteoporosis, which affects millions of men, and depression also are linked to low testosterone levels.
Aside from testosterone therapy under a health care provider's care, there is an herbal product, the bioflavonoid chrysin, extracted from the plant Passiflora coerula (a type of Passionflower), which can help the body produce testosterone naturally.
Shaman Shop: Chrysin, Jarrow Formulations, 500 mg, 30 Caps
Shaman Shop: Chrysin, Extra Strength, Scifit, 750 mg, 60 Caps
Shaman Shop: Chrysin X, Universal Nutrition, 60 Caps
Another useful herbal is an extract made from Nettle root (Urtica dioica). Nettle Root is widely used in Europe for the treatment of Benign Prostatic Hyperplasia (BPH), or prostate enlargement. This binds to SHBG better than testosterone does, thus helping to increase the body's level of free testosterone. If you choose to try this remedy, make sure you use a product made from the root, not the stems and leaves.
Herbal Remedies: Prostactive, Saw Palmetto Supplement With Nettle Root, Nature's Way, 140 mg, 50 Softgels
Men around the world use ProstActive Plus combination formula as they age to help promote prostate health and maintain proper urinary flow. Scientific study using ProstActive Plus indicates that its highly concentrated combination of Saw Palmetto (Serenoa revens) berry and Nettle root (Urtica dioica) extracts provides unique synergistic properties as they have distinct, yet complimentary modes of action. ProstActive Plus has been proven to outperform Saw Palmetto alone.
Shaman Shop: Nettle Root Powder (Utica Dioica), Starwest Botanicals, 1 lb Bulk
Shaman Shop: Nettle Root Powder, Nature's Herbs, 60 Caps
A word of caution: Men with prostate cancer, or possible prostate cancer, should not take any herbal that increases the supply of free testosterone because it may enhance the cancer.
NUTRITIONAL SUPPLEMENT RECOMMENDATIONS
The following nutrients are important for healing once appropriate local treatment has been administered. Unless otherwise specified, the following recommended doses are for those over the age of 18. For a child between 12 and 17 years old, reduce the dose to 3/4 the recommended amount. For a child between 6 and 12 years old, use 1/2 the recommended dose, and for a child under 6, use 1/4 the recommended amount.
NUTRIENTS Supplement Suggested Dosage Comments Essential Essential Fatty Acids
(Black Currant Seed Oil, Primrose Oil, Flax Seed Oil, Salmon Oil, or Kyolic EPA are good sources)As directed on label. Take with meals. Aid in the transmission of nerve impulses, needed for normal brain function.
Wild Salmon Oil, NOW Foods, 120 EPA/80 DHA, 2,000 mg, 250 Softgels,
Flax Oil, Highest Lignan, Organic, Barlean's, 8 fl. oz.,
Flax Oil, Highest Lignan, Barlean's, 1,000 mg, 250 Caps,
Evening Primrose Oil With Gamma-Linolenic Acid (GLA), Barlean's, 1,300 mg, 120 Softgels,
Evening Primrose Oil, NOW Foods, 100% Pure, 4 oz.,
Ultimate Oil, Essential Fatty Acids, Nature's Secret, 90 Softgels,
Omega 3-6-9 Oil, Mega EFA Blend, Lime Flavored, Nature's Way, 1350 mg, 90 Softgels,
Omega 3-6-9 Oil, Mega EFA Blend, Lime Flavored, Nature's Way, 16 fl oz.5-Hydroxytryptophan
(5-HTP)As directed on label. Increases the body's production of serotonin. It should not be used with other antidepressants.
Natural Mood Stabilizer, 5-HTP Optimum Mood Support, 50 mg, 60 Caps,
5-HTP Hydroxy-Tryptophan, Vegetarian, NOW Foods, 100 mg, 120 VCaps,
5-HTP With L-Tyrosine, NOW Foods, 200 mg, 60 VCaps,
5-HTP Supplement, Hydroxytryptophan Natural Serotonin With Vitamin B-6 & C, Nature's Way, 50 mg, 60 Tabs,
Mood Aid Formula, 5-HTP & St. John's Wort Supplement, Nature's Way, 60 CapsL-Tyrosine Up to 50 mg per pound of body weight daily. Take on an empty stomach with 50 mg Vitamin B-6 and 100-500 mg vitamin C for better absorption. Best taken at bedtime. Alleviates stress by boosting production of adrenaline. It also raises dopamine levels, which influence moods. Caution: Do not take tyrosine if you are taking an MAO inhibitor drug.
L-Tyrosine, High Potency, NOW Foods, 750 mg, 90 Caps,
L-Tyrosine Powder, Vegetarian, NOW Foods, Free Form, 4 oz.,
L-Tyrosine, Pharmaceutical Grade, Free Form, NOW Foods, 500 mg, 120 CapsS-Adenosylmethionine
(SAM-e)As directed on label. Works as an antidepressant. Caution: Do not use if you have manic depressive disorder or take prescription antidepressants.
SAM-e, Enteric Coated, NOW Foods, 100 mg, 30 Tabs,
SAM-e With B Vitamin Cofactors, Vegetarian, Enteric Coated, NOW Foods, 200 mg, 60 Tabs,
SAM-e, S-Adenosyl-L-Methionine, 400 mg, 30 TabsSub-Adrene
(American Biologics)As directed on label. A dietary supplement for adrenal support.
Adrenal, Organic Glandular (Hypoallergenic), Allergy Research Group / Nutricology, 75 Caps
Supports the entire adrenal gland, both medulla and cortex portions. The adrenal cortex is the outer portion of the adrenal gland and is involved in the secretion of a variety of adrenal hormones, mainly cortisol. The medulla is the inner portion of the adrenal gland and is involved in the synthesis and secretion of epinephrine (adrenaline) and norepinephrine. Adrenal Cortex, Organic Glandular (Hypoallergenic), Allergy Research Group / Nutricology, 100 Caps
Supports the cortex portion of the adrenal gland. The adrenal cortex is the outer portion of the adrenal gland and is involved in the secretion of a variety of adrenal hormones, mainly cortisol.
Super Cortisol Support with Relora, Vegetarian Adrenal Support Formula, 90 VCapsTaurine Plus
(American Biologics)As directed on label. An important antioxidant and immune regulator, necessary for white blood cell activation and neurological function. Use the sublingual form.
Taurine Powder, 100% Pure, Free Form, NOW Foods, 1000 mg, 8 oz.,
L-Taurine, Free Form, NOW Foods, 500 mg, 100 CapsVitamin B Complex 100 mg of each major B vitamin 3 times daily (amounts of individual vitamins in a complex will vary) or as directed on label. Injections: 2 cc once weekly or as prescribed by health care provider. If injections are not available, a sublingual form of B complex is recommended. B vitamins are necessary for the normal functioning of the brain and nervous system. If depression is severe, injections (under a health care provider's supervision) are recommended. All injectables can be combined in a single shot.
Ultimate B (Vitamin B Complex), Nature's Secret, 60 Tabs,
Vitamin B-100 Complex, w/ Coenzyme B-2, Nature's Way, 631 mg, 100 CapsPlus extra
Vitamin B-6
(Pyridoxine)50 mg 3 times daily. Injections: 1/2 (0.5) cc once weekly or as prescribed by a health care provider. Needed for normal brain function and to correct deficiencies. May help lift depression and is essential for healthy nervous system. B Vitamins must be replenished daily. All injectables can be combined in a single injection.
Vitamin B-6 (Pyridoxine), 100 mg, 100 CapsAnd
Vitamin B-121,000-2.000 mcg daily on an empty stomach. Injections: 1 cc once weekly or as prescribed by a health care provider. Linked to the production of the neurotransmitter acetylcholine. Important in making myelin, the substance of which the sheaths covering the nerves are made. Injections (under a health care provider's supervision) are best. All injectables can be combined in a single injection. If injections are not available, use a lozenge, sublingual, or spray form.
Vitamin B-12 Complex Liquid, NOW Foods, 2 fl. oz.,
Vitamin B-12, Nature's Way, 2000 mcg, 100 Sublingual Lozenges,
Vitamin B-12 Liquid Supplement, 50 mcg, With Vitamin B-9 (Folic Acid), 400 mcg, 1 oz.
Vitamin B-12, California Natural, 1000 mcg, 60 Tabs,
Vitamin B-12 LipoSpray, NOW Foods, 2 fl. oz.,Plus
Raw Liver ExtractAs directed on label. Injections: 2 cc once weekly or as prescribed by a health care provider. A good source of B vitamins, iron and other valuable nutrients. Consider injections (under a health care provider's supervision). All injections can be combined in a single injection. Liquid Liver Extract
(Enzymatic Therapy)As directed on label. Helps to prevent anemia and supplies necessary B vitamins in natural form. Plus Extra
Pantothenic Acid
(Vitamin B-5)500 mg daily. The most potent anti-stress vitamin.
Pantothenic Acid (B-5), 100% Natural, Nature's Way, 250 mg, 100 CapsAnd
Vitamin B-3
(Niacin)50 mg 3 times daily. Do not exceed this amount. Improves cerebral circulation. Caution: Do not take niacin if you have a liver disorder, gout, or high blood pressure.
Niacin (B-3), 100% Natural, Nature's Way, 100 mg, 100 Caps,
Niacinamide, Non-flushing Niacin, 100% Natural Vitamin B-3, Nature's Way, 500 mg, 100 CapsAnd
Folic Acid400 mg daily. Found to be deficient in people with depression.
Vitamin B-12 (Cobalamin), 50 mcg & B-9 (Folic Acid), 400 mcg, 1 fl. oz., B-9 (Folic Acid), 100% Natural, Nature's Way, 800 mcg, 100 CapsZinc 50 mg daily. Do not exceed a total of 100 mg daily from all supplements. Found to be deficient in people with depression. Use zinc gluconate lozenges or OptiZinc for best absorption.
Colloidal Silver & Zinc Lozenges, SilvaSolution, 90 Lozenges,
Zinc Lozenges w/ Echinacea & Vitamin C, Nature's Way, 23 mg, 60 Lozenges,
Zinc (Chelated), 100% Natural, Nature's Way, 30 mg, 100 CapsImportant Choline
and
Inositol
or
Lecithin100 mg each twice daily.
As directed on label.Important in brain function and neurotransmission. Caution: Do not take these supplements if you suffer from manic (bipolar) depression.
Choline & Inositol, 100% Natural, Nature's Way, 250mg/250mg, 100 Caps, Lecithin Vegetarian Granules, NOW Foods, 1 lb.GH3
(Gero Vita)As directed on label for those 35 years or older. Aids in proper brain function, promotes alertness and increased energy. Caution: Do not use this product if you are allergic to sulfites.
Procaine Ultra CH9 (Ultimate 9), 100 mg, 60 Caps
Procaine Ultra GH9 is the most trusted Anti-Aging therapy of choice of the rich & famous in over 70 countries. Gerovital H3 (GH3) Injectable is now advanced 600% to Procaine Ultra GH9.
GH3 Plus, Gero Vita Vitality FormulaHelpful Calcium 1,500-2,000 mg daily. Has a calming effect. Needed for the nervous system.
Just An Ounce, Calcium & Magnesium Liquid, Almond Flavor, 16 fl. oz.,
Calcium Citrate / Malate Complex, Nature's Way, 500 mg, 250 Caps,
Calcium Carbonate Powder, NOW Foods, 12 oz.
1 level teaspoon contains 1.2 g (1,200 mg) calcium.
Calcium Ionic Mineral Supplement, Fully Absorbable, 700 +/- ppm, 16 fl. oz.,
Liquid Calcium W/ConcenTrace, Orange Vanilla, Trace Minerals, 1000 mg, 32 fl. oz.,
Cal-Mag Pre-Chelated Calcium & Magnesium, Vital Earth, 240 GelcapsAnd
Magnesium1,000 mg daily. Works with calcium. Use magnesium asporotate or magnesium chelate form.
Magnesium Ionic Mineral Supplement, Fully Absorbable, 350 +/- ppm, 16 fl. oz.,
Just An Ounce Calcium & Magnesium Liquid, Almond Flavor, 16 fl. oz.,
Calcium & Magnesium Mineral Complex, 100% Natural, Nature's Way, 500 mg / 250 mg, 250 Caps,
Magnesium Citrate Complex, Nature's Way, 250 mg, 100 CapsChromium 300 mcg daily. Aids in mobilizing fats for energy.
Chromium Ionic Mineral Supplement, Fully Absorbable, 50 +/- ppm (0.75 mg or 750 mcg per tablespoon), 16 fl oz.,
Chromium Picolinate, NOW Foods, 200 mcg, 100 Caps,
Ionic Chromium Supplement, Trace Minerals, 550 mcg, 2 fl. oz.Gamma-Aminobutyric Acid (GABA) 750 mg daily. Take with 200 mg niacinamide for best results. Has a tranquilizing effect, much as diazepam (Valium) and other tranquilizers do.
GABA, 250 mg, Pharmaceutical Grade, 90 Tabs,
GABA Powder, NOW Foods, 100% Pure, Vegetarian Formula, 500 mg, 6 oz.,
GABA Supplement, NOW Foods, 500 mg Plus B-6, 2mg, 100 CapsLithium As prescribed by a health care provider. A trace mineral used to treat bipolar (manic) depression. Available by prescription only. Lithium orotate is an organic form of lithium that is sold in health food stores.
Lithium Supplement as a Trace Mineral,Megavital Forte from Futurebiotics As directed on label. A balanced vitamin and mineral formula that increases energy and sense of well-being. (Unable to find a online source for this product.) Multi-Vitamin & Mineral Complex As directed on label. To correct vitamin and mineral deficiencies, often associated with depression.
Daily Two Multi-Vitamin Supplement, Iron Free, 100% Natural, Nature's Way, 100 Tabs,
Multi-Vitamin & Multi-Mineral with Iron, Nature's Way, 100 Caps,
Multi-Vitamin & Multi-Mineral ChildLife Children's Liquid, 8 fl. oz.,
Alive! Whole Food Energizer, Multi-Vitamin & Multi-Mineral, Effervescent, Lemon-Lime Flavor, Nature's way, 15 Packets,
Super Multi-Vitamin & Multi-Mineral, Pure Vital Earth, 32 fl. oz. (98% Bio-Available for Absorption),
Damage Control Master Formula, High Potency, Multi-Vitamin & Mineral, 60 Packets (30 Day Supply)
Nicotinamide Adenine Dinucleotide (NADH) As directed on label. Enhances production of dopamine and serotonin.
ENADAlert ENADA NADH Supplement, Source Naturals, 5 mg, 30 Tabs,
NAD (Niacin), NOW Foods, 25 mg, 60 LozengesVitamin C 2,000-5,000 mg daily, in divided doses. Needed for immune function. Aids in preventing depression.
Vitamin C Liquid w/ Rose Hips & Bioflavonoids, Kosher, Natural Citrus Flavor, Dynamic Health, 1000 mg, 16 fl. oz.,
The Right C, Vitamin C Powder, Nature's Way, 120 grams,
Ester C With Bioflavonoids, Nature's Way, 1000 mg, 90 Tabs,
Vitamin C 1000 With Bioflavonoids, Nature's Way, 100% Natural, 1000 mg, 250 VCaps,
The Right C, Nature's Way, 1000 mg, 120 TabsRutin 200-300 mg daily. Buckwheat-derived bioflavonoid. Enhances vitamin C absorption.
DEPRESSION SUPPLEMENTAL PRODUCTS
Information and help with depression, a mood disorder that is often triggered by a chemical imbalance or stressful situations.
Acupressure's Potent Points, Guide To Self-Care For Common Ailments, By Michael Reed Gach
Acupressure is an ancient healing art that uses the fingers to stimulate key points on the skin that, in turn, activate the body's natural self-healing processes.Addiction Free Naturally, Liberating Yourself From Sugar, Caffeine, Food Addictions, Tobacco, By Brigitte Mars
A comprehensive guide that helps you overcome addictions by using natural remedies including herbs, homeopathy, aromatherapy, flower essence remedies, color therapy, acupressure, and more.After Baby Mood Support Wellness Oil, Post Partum Depression, Pregnancy & Nursing Safe, 2 fl. oz.
After Baby Mood Support Wellness Oil, for Post Partum Depression is an absolute must have for any new mother.American Ginseng Root Candy, Prince of Peace, 5.3 oz.
American Ginseng, an adaptogen with yin properties that has a sedative effect on the central nervous system.Appetite Suppressor Rx, 60 Tabs
Nature's Rx Appetite Suppressor Rx is the comprehensive appetite suppressant diet supplement which is all natural, stimulant free containing no ephedra, caffeine or other dangerous stimulants.Ashwagandha Root Powder, (Withania Somnifera), 4 oz. Bulk
Ashwagandha Root (Withania Somnifera) is also known as Indian ginseng. Ashwagandha is useful for coughs, infertility, impotence and more.Avea Mood, Liquid Extract, 30 ml
Via the proprietary extraction and enhancement process utilized to produce Avea, the product has been enhanced to address the majority of the causes of endogenous depression.Black Cohosh Extract, Standardized, Nature's Way, 40 mg, 120 VCaps
Black Cohosh extract is the most popular herbal supplement in Europe for women experiencing change of life (peri-menopause) symptoms. Black Cohosh extract provides isoflavones and other constituents that help support a woman's health during this phase of her life.Black Cohosh, Nature's Versatile Healer, A Natural Alternative Method for Balancing Hormone Levels, By James B. Lavalle R.,Ph.., N.D., Ernest B. Hawkins
This practical guide explains the remarkable benefits provided by black cohosh. Due to its effects on the cardiovascular system, this versatile herb is often employed to treat certain pre-menstrual and menopause symptoms.Black Cohosh Tincture, Menopause Herb, 100% Organic, 2 fl. oz.
As a menopause herb, medical studies reported Black Cohosh to be more effective than estrogen in relieving symptoms.Black Seed Herbal Honey, Energizing, 16 fl. oz.
A sensational blend of honey and herbs in three different formulations that offer a natural boost of energy, immune support, or relaxation that's great for anyone who wants to enjoy the benefits of Black Seed without taking capsules or oil. This rich tasting honey can be added to tea, smoothies, shakes, or deserts, and may be used in cooking.Blue Scullcap (Scutellaria Lateriflora), Standardized, Nature's Way, 100 mg, 60 VCaps
Scullcap is most commonly used as a sedative and it can take the edge off anxiety and promote sleep for those who struggle with insomnia.B-Stress Vitamin Complex With Siberian Eleuthero (Siberian Ginseng Root), Nature's Way, 100 Caps
If you are looking for herbal stress relief, you have come to the right place. B vitamins are essential precursors of coenzymes involved in the conversion of cellular energy, manufacture of hormones and proteins, and repair and maintenance of nerve structures.Cat's Claw Extract, Standardized, Nature's Way, 335 mg, 60 Caps
Nature's Way Cat's Claw extract, also known as Una de Gato is derived from the bark of plants wild-harvested in Peru and Brazil.Chromium Ionic Mineral Supplement, Fully Absorbable, 50 +/- ppm, 16 fl. oz.
WaterOz Ionic Chromium is a pure liquid chromium supplement. Chromium helps the body regulate metabolism, regulate insulin and blood sugar levels, helps the body lose weight by stimulating enzymes that metabolize glucose, burns fat.Complete Tonic Uplifter, Shiguan Dabu, Balanceuticals, 60 Caps
Complete Tonic Uplifter contains natural extracts from various plants, trees, and berries to promote natural healing for many different ailments.Coping With Grief Wellness Oil, 2 fl. oz.
Coping With Grief Wellness Oil was created to be used as a support system for those dealing the heartache of grief.CoQ10, NOW Foods, 400 mg, 60 Softgels
As an active contributor to all aspects of cellular function, coq10 has become universally regarded as one of the most vital nutrients ever made available to the public.Damiana Leaves Powder (Turnera Diffusa), 4 oz. Bulk
Damiana Leaves (Turnera Diffusa) is held in high repute by Mexican herbalists, particularly as an aphrodisiac, prescribed as a thick decoction before bedtime.Depression Support Formula Tincture, 100% Organic, 2 fl. oz.
Depression Support is a combination of herbs found to help alleviate depression and strengthen the nervous system.Diet Cure, By Julie Ross, M.A.
This fast, personalized body repair manual for weight loss, mood balance and energy will leave you satisfied and not starving.DMAE Supplement (Dimethylaminoethanol), Vegetarian, NOW Foods, 250 mg, 100 VCaps
Taken as a maintenance supplement, DMAE Supplement works synergistically with other smart nutrients like Ginkgo Biloba, GABA, Phosphatidyl Serine and L-Tyrosine, or can be taken alone.Dry Vitamin D, Nature's Way, 100% Natural, 400 IU, 100 Caps
Vitamin D helps the body to regulate the transport of calcium from the digestive system through the bloodstream to bone. It also assists in the retention of calcium and phosphorus.Elm Bach Flower Remedies Tincture, Bach Flower Essences, Ulmus Procera, 20 ml
Elm (Ulmus Procera) is the Bach Flower Remedy for people suffering a temporary loss of self-confidence due to the overwhelming amount of responsibility they have taken on.Emotional Balance Wellness Oil, Nature's Inventory, 2 fl. oz.
Not only does Emotional Balance Wellness Oil smell incredible, it also calms and centers those who use it.Encyclopedia Of Healing Foods, By Michael Murray, N.D. & Joseph Pizzarno, N.D.
Providing the best natural remedies for everyday aches and pains, as well as potent protection against serious diseases, The Encyclopedia of Healing Foods is a required daily health reference.Encyclopedia Of Nutritional Supplements: The Essential Guide For Improving Your Health Naturally, By Michael T. Murray, N.D
The companion volume to the Encyclopedia of Natural Medicine offers detailed profiles of vitamins, minerals, essential fatty acids, and other nutritional supplements. What sets this guide apart from similar works is the impressive list of references for each entry (55 pages in total).Enzyme PhytoNutrient (EPN) Ionic Supplement, Fully Absorbable, 16 fl. oz.
WaterOz Ionic EPN is a pure liquid enzyme supplement. EPN complex is a patent-pending enzyme phytonutrient from a plant source that provides enzyme and saccharides necessary for optimal cellular communication.5-HTP (Hydroxy Tryptophan), Vegetarian, NOW Foods, 100 mg, 120 VCaps
5-HTP / Hydroxy Tryptophan is an Amino Acid and precursor to serotonin, a brain chemical responsible for regulating mood, appetite, behavior, and sleep and may help elevating mood, encouraging relaxation, controlling appetite, promoting sleep and may prove beneficial in the treatment of depression, obesity, insomnia, and migraine headaches.5-HTP Supplement, Natural Serotonin With Vitamin B-6 & C, Nature's Way, 50 mg, 60 Tabs
Nature's Way 5 HTP Supplement is available in an easy to swallow enteric coated tablet.5-HTP The Natural Serotonin Solution, By Richard Passwater, Ph.D. & J. South, M.A.
Explains how 5-HTP (Hydroxytryptophan) helps raise serotonin levels to alleviate depression, insomnia, anxiety and eating disorders.GABA (Gamma Aminobutyric Acid) Supplement, NOW Foods, 500 mg, Plus B-6, 2 mg, 100 Caps
GABA is a non-essential amino acid found mainly in the human brain and eyes. It is considered an inhibitory neurotransmitter, which means it regulates brain and nerve cell activity by inhibiting the number of neurons firing in the brain. GABA is referred to as the brain's natural calming agent.GABA, Pharmaceutical Grade Gamma Aminobutyric Acid, 250 mg, 90 Tabs
Gama-aminobutyric acid (GABA) is an amino acid that acts as a Neurotransmitter in the central nervous system. Together with niacinamide and inositol, it prevents anxiety and stress related messages from reaching the motor centers of the brain by occupying the receptor sites.GABA Powder, 100% Pure, Vegetarian, NOW Foods, 500 mg, 6 oz.
GABA is a non-essential amino acid found mainly in the human brain and eyes and it is considered an inhibitory neurotransmitter, which means it regulates brain and nerve cell activity by inhibiting the number of neurons firing in the brain - GABA is referred to as the brain's natural calming agent.Ginger Essential Oil, NOW Foods, 100% Pure, 1 fl. oz.
Ginger Essential Oil is an ideal oil for those who lack confidence, personal drive and tend to procrastinate.Ginger Root Tincture, 100% Organic, 2 fl. oz.
Ginger root has also been recommended as a treatment for atherosclerosis, migraine headaches, rheumatoid arthritis, high cholesterol, burns, ulcers, depression, impotence, and liver toxicity.Ginkgo Biloba Extract, Standardized, Nature's Way, 60 mg, 120 VCaps
Supports circulation to the brain as well as the extremities. This is achieved by maintaining healthy blood vessel tone and reducing blood viscosity. Additionally, Ginkgo biloba is a proven free radical scavenger and antioxidant.Ginkgold, Ginkgo Biloba Extract, Vegetarian, Standardized, Nature's Way, 60 mg, 150 Tabs
Ginkgold improves mental sharpness, concentration, memory and cognitive activity. It also supports healthy circulation to the brain as well as the extremities. And, it maintains healthy blood vessel tone and reduces blood viscosity.Ginkgo Leaf Powder (Ginkgo Biloba), 4 oz. Bulk
Modern research has confirmed that the ginkgo flavone glycosides and the terpene lactones do indeed produce these results, increasing circulation to the brain and other parts of the body as well as exerting a protective action on nerve cells.Gold Ionic Mineral Supplement, Fully Absorbable, 30 +/- ppm, 16 fl. oz.
WaterOz Ionic Gold is a pure liquid Gold supplement. Gold promotes a general euphoric feeling, enhances the body's natural defenses against illness, and promotes vitality and longevity.Grape Seed Extract, Lycopene & Red Raspberry, 350 mg, 90 Caps
A very powerful antioxidant, this standardized Grape Seed Extract helps maintain capillary health, and has the ability to neutralize free radicals.Graviola, Healthy Cell Support, NOW Foods, 100 Caps
Graviola may support the immune system's ability to cull undesirable cells. There is a historic use as a sedative or nerve tonic, also to elevate mood and to maintain healthy blood sugar levels.Happy Wellness Oil, Nature's Inventory, 2 fl. oz.
Add a little happiness to any day with this wonderful oil. Like heaven in a bottle.Health Mom Fish Oil, Pregnancy Supplement, High Potency Omega-3, EPA/DHA, Nutrition During Pregnancy & Lactation, Lemon Flavored, 90 Softgels
Healthy Mom Fish Oil Pregnancy Supplement is a pure and pristine source of molecularly distilled, pharmaceutical grade fish oil formulated with the ideal dose and ratio of DHA and EPA to address the health and nutrition priorities of pregnant and lactating women.Holy Basil, Vegetarian, Nature's Way, 450 mg, 60 VCaps
Nature's Way Holy Basil Extract is standardized to 2.5% ursolic acid and is typically used to relieve stress and nervous tension.Hops Herb Supplement, Nature's Way, 310 mg, 100 Caps
Hops Herb has been known to be beneficial in the treatment of insomnia and sleep disorders because of its calming effect.Horny Goat Weed With Maca, Standardized Formula For Men & Women, 808 mg, 60 Caps
Horny Goat Weed provides a serious boost to men or women who need it. Based on the latest scientific research into performance and well-being.Iron Ionic Mineral Supplement, Fully Absorbable, 20 +/- ppm, 16 fl. oz.
WaterOz Ionic Iron is a pure liquid Iron supplement. Iron is called the "energy giver." It attracts oxygen and builds blood.Irwin Naturals Advanced Ginza Plus, Multi Adaptogen, 75 Gelcaps
Irwin Naturals Advanced Ginza-Plus is a balanced formula combining five powerful adaptogens, including one of the highest potency ginseng extracts on the market.Juniper Berry (Juniperus Communis) Oil, NOW Foods, 100% Pure, 1 fl. oz.
Juniper has been used as a fragrance since ancient times and was thought to purify the air where it was used. It has a pleasing floral aroma that is uplifting and stimulating.Kira St. John's Wort, Kwai, 45 Tabs
Other brands may try to make generic St. John's Wort claims based on extensive scientific research, but only Kira has been proven in over 23 clinical studies. Kira's ingredients work together to support a healthy balance among the brain's chemical messengers to promote a feeling of well being and positive mood.Lavender Essential Oil, 100% Pure, NOW Foods, 1 fl. oz.
Lavender essential oil is often considered an aromatic Rescue Remedy allowing for a release of anger, the emotion which so often is cause for severe depression. Lavender Essential Oil calms, releases, and balances strong emotions such as frustration, irritability, nervous anxiety, panic, hysteria and insomnia.Lavender Essential Oil, 2 fl. oz.
Lavender essential oil is strong antimicrobial and antibacterial and helps to heal wounds. As aromatherapy, lavender essential oil helps to calm anxiety and stress.Lavender Essential Oil, 100% Pure, NOW Foods, 4 fl. oz.
Lavender essential oil is often considered an aromatic Rescue Remedy allowing for a release of anger, the emotion which so often is cause for severe depression. Lavender Essential Oil calms, releases, and balances strong emotions such as frustration, irritability, nervous anxiety, panic, hysteria and insomnia.L-Carnitine Liquid With Pantothenic Acid, Dynamic Health, 16 fl. oz.
Dynamic Health's liquid l-carnitine can help boost energy, build new muscle and improve mental performance.Lifting Depression - The Chromium Connection, By Malcolm McLeod M.D.
Lifting Depression: The Chromium Connection. A new, safe, natural treatment-with no side effects-for atypical depression has been discovered by psychiatrist and psychoanalyst Malcolm McLeod.L-Phenylalanine, Free Form, NOW Foods, 500 mg, 60 Caps
L-Phenylalanine is an Essential Amino Acid that helps to elevate positive mood and may be used in the treatment of some forms of depression. It is essential for the production of adrenalin.L-Tyrosine, Pharmaceutical Grade, Free Form, NOW Foods, 500 mg, 120 Caps
L-Tyrosine is used to treat insomnia, improve muscle tone, improve skin and hair pigment and depression and anxiety. L-Tyrosine should not to be used while taking prescription antidepressants or MAO inhibitors.Magnesium Ascorbate Powder, 100% Pure, NOW Foods, 8 oz.
Magnesium Ascorbate is a buffered (non-acidic) form of Vitamin C that will not contribute to gastric irritation in acid-sensitive persons.Magnesium Ionic Mineral Supplement, Fully Absorbable, Magnesium Water, 350 +/- ppm, 16 fl. oz.
WaterOz Ionic Magnesium is a pure liquid Magnesium supplement. Magnesium is a natural tranquilizer and assisting in proper digestion.Manganese Ionic Mineral Supplement, Fully Absorbable, 30 +/- ppm, 16 fl. oz.
WaterOz Ionic Manganese is a pure liquid Manganese supplement. Manganese, also called the "brain mineral," is important in the utilization of all mental facilities/functions.Melatonin Cream, Melatonin Supplement, Life-Flo, 2 oz.
From being a natural sleep regulator to providing the body with a potent anti-oxidant, Life-Flo's Melatonin Cream, Melatonin Supplement, is a superior choice for those looking for better health and anti-aging nutrients.Menopause Formula Tincture, 2 fl. oz.
The Menopause Formula aids the menopausal woman and helps to alleviate the classical menopausal symptoms.Mental Clarity, Promotes Memory & Intelligence, Banyan Botanicals, 90 Tabs
The herbs in Mental Clarity have traditionally been used to enhance all aspects of mental performance, including intelligence, concentration, awareness, perception and learning capacity. This effective blend sharpens the mind and is useful for those prone to forgetfulness, confusion or indecisiveness. Mental Clarity is an ideal supplement for anyone with a mentally demanding workload, students, and those experiencing loss of memory.MetaRest With Melatonin, Natural Sleep Aid, 60 Caps
MetaRest with Melatonin combines two of the most potent ingredients found in nature to help reduce nighttime wakefulness.Midlife Soother, Balanceuticals, 100% Natural, 60 Caps
This time-honored formula is used in Chinese medicine for its tonifying, detoxifying, tranquilizing, nerve soothing, hemolytic, vasodialating, blood circulation invigorating, cardio tonic, diuretic, kidney nourishing and antipyretic properties to facilitate midlife (menopausal) changes.Mood Aid Formula With St. John's Wort & 5-HTP, Nature's Way, 60 Caps
Mood Aid uses St. John's Wort, to promote a positive mood. 5-HTP, the precursor of seratonin - a mood regulating neurotransmitter.Mood Lifter, Chaizhi Jieyu, Balanceuticals, 60 Caps
Chinese medicine uses their nerve soothing, tranquilizing, mental harmonizing and regulating, fright resolving, and mood pacifying properties to deal with anxiety, depression, fright, restlessness, forgetfulness, poor sleep quality and to harmonize mental state.Mood Support, NOW Foods, 90 Caps
NOW Mood Support is a nutritional supplement that contains both nutrients and herbal extracts that aid in the support of a healthy nervous system and a positive, balanced mood state.Multi-Vitamin & Multi-Mineral Without Iron, Complete Vitamin Supplement, Nature's Way, 100 Caps
The vitamins and minerals in iron free Multi-Vitamin & Multi-Mineral play many important roles in the body: antioxidants to protect fats, cells and DNA, coenzyme precursors for energy production and metabolism, and cofactors for hormones and enzymes which regulate body processes.Mustard Bach Flower Remedies Tincture, Bach Flower Essences, Sinapis Arvensis, 20 ml.
Mustard (Sinapis Arvensis) is the Bach Flower Remedy for deep gloom and depression that descends for no apparent reason out of a clear blue sky.NAD (Niacin), NOW Foods, 25 mg, 60 Lozenges
Vitamin B-3 (niacin) is widely regarded as one of the most effective nutrients in elevating mood, overcoming moderate depression and fighting the effects of fatigue. NOW's NAD complex is a highly effective and genuinely unique form of Vitamin B-3 that shares many of the same qualities as NADH at a fraction of the cost. In addition to its mood enhancing properties, NAD is being studied with regards to its positive effects on naturally increasing the brain's levels of dopamine, a neurotransmitter essential to brain health as we age.Natural Calm, Anti-Stress Drink Packets, Peter Gillham's Natural Vitality, 30 Packets
Natural Calm is used by over 1,000 health care providers and health clinics nationwide with great success.Natural Calm, Magnesium Supplement, Peter Gillham's Natural Vitality, 8 oz.
What makes Natural Calm Magnesium Supplement so special over other forms of magnesium supplements is that it is water soluble and assimilates instantly and thoroughly, and works even in cases of highly impaired digestion.Natural Cures, Updated Edition, "They" Don't Want You To Know About, By Kevin Trudeau
Learn how the food industry is purposely putting secret chemical ingredients in the food that can cause you to become hungrier, become fat, and become physically addicted, and not listing them on the label.Natural Mood Stabilizer, 5-HTP Optimum Mood Support, 50 mg, 60 Caps
5-HTP Optimum Mood Support Natural Mood Stabilizer is used to increase serotonin that in turn reduces symptoms such as mood disorders, depression, weight problems and migraine headaches.Natural Pet Calmer, Happy Traveler, Pet Supplement, 500 mg, 30 Caps
Ark Naturals, A safe all natural pet supplement, herbal calming formula for stressed, nervous, or anxious pets.Natural Progesterone Cream: A Safe Alternative To Conventional Hormone Replacement Therapy, By C. Norman Shealy, M.D., Ph.D.
In this Keat's Good Health Guide, Dr. Norman Shealy answers all your questions about natural progesterone cream, a viable and safe alternative to synthetic hormone replacement therapy.Natural Progesterone Cream, Liposomal Lotion, NOW Foods, 3 oz.
Natural Progesterone Cream is effective for women experiencing the symptoms of mid-life, before, during and after menopause.Nerve & Tension Tincture, 2 fl. oz.
To soothe the nervous system, which may help reduce stress and benefit Hyperactivity/Hyperkinetic, Mental Fatigue, Migraine Headache, Muscular Problems (Aches, Pain & Spasms) Nervous Disorders, Neuralgia, Palsy, Parkinson's Disease, Schizophrenia, Spasms, Stress, and Tension among other things.Neti Pot Nasal Rinse Cup, Porcelain, Banyan Botanicals, 1 Neti Pot
This Neti Pot is a hygienic, non-porous, porcelain cup used for nasal and sinus rinse. Considered useful for individuals prone to nasal congestion.New Energy Liver Rejuvenator, Peter Gilliam's Natural Vitality, 120 Tabs
New Energy Liver Rejuvenator is a special blend of Chinese and American herbs which effectively stimulate the production of new liver cells.Noni Juice, Trace Minerals, 32 fl. oz.
Trace Minerals Noni Juice product may provide nutritional support for Bio-Electric Health and Body Mineral Balancing.Noni, Liquid Extract, 30 ml
Noni (Morinda citrifolia) is a tropical fruit that is grown in the Pacific Islands. It has been successfully used for over 2,000 years in Polynesia to treat a variety of illnesses. The most beneficial Noni is grown organically in pollution free volcanic soil.Oxybolin 250, Body Building Supplement, Hi-Tech, 60 Tabs
Oxybolin 250 Body Building Supplement is the product every athlete or health conscious person has been waiting for! Oxybolin 250 is perfect for anyone who wants to build muscle and/or enhance athletic performance.Patchouli Oil, 100% Organic Essential Oil, 2 fl. oz.
Using Patchouli in inhalation, baths, and massage has an uplifting effect on depression and anxiety, and can help alleviate fluid retention.Peppermint Leaf Powder (Mentha X Piperita), 4 oz. Bulk
Peppermint leaf calms the muscles of the stomach and improves the flow of bile, which the body uses to digest fats. As a result, food passes through the stomach more quickly.Procaine Ultra GH9 (Ultimate 9), Procaine HCl, 100 mg, 60 Caps
Procaine Ultra GH9 is the most trusted Anti-Aging THERAPGH9 with its patented PBN will put that "Ump" back into your cells, catapulting your wellness or sports program to a multi-quantum level.Pumpkin Seed Oil, NOW Foods, 100% Natural, 1000 mg, 100 Softgels
Pumpkin Seed Oil is a nutritional oil rich in essential fatty acids. Our pumpkin seed oil is 100% natural and is screened for potency and purity.Rainbow Green Live-Food Cuisine, By Gabriel Cousens, M.D., & The Tree Of Life Cafe Chefs, Paperback
Rainbow Green Live-Food Cuisine is the most practical solution to the critical personal and planetary issues of foods that have been genetically engineered; commercially grown with pesticides, herbicides, and hormones; irradiated, microwaved, or even (just) cooked are also addressed.Redbush Chai Tea, Yogi Tea, Certified Organic, 16 Tea Bags
The total experience of our Organic Caffeine Free Redbush Chai by Yogi Tea is taken to an exciting new level with the addition of Organic Rooibos Leaf, an African leaf that is sweet and earthy.Relora, NOW Foods, 300 mg, 60 Caps
Relora is used to normalizes hormone levels associated with stress-induced obesity and poor eating and drinking behaviors. Preliminary findings suggest that Relora can decrease the cravings for high fat and high sugar foods in stressed individuals.Renewal Oral HGH Spray, Original, 1 fl. oz.
The 3X portion of this formula is designed to focus the HGH for maximum results in the physical body.Rhodiola Root Extract, Standardized To Minimum 3% Rosavins & 1% Salidrosides, NOW Foods, 500 mg, 60 VCaps
Today, Rhodiola root extract is a commonly used herb to boost the immune system and boost energy levels naturally and supports memory and mental clarity.Rooibos Green Unfermented Extract Powder, 1.3 oz.
Recent studies have found that the unfermented green Rooibos tea contains even more antioxidants than Rooibos Red tea because many valued antioxidants are destroyed in the fermentation process.Rooibos Red Tea, Organic, Kosher, 20 Tea Bags
This is a great tasting tea - naturally sweet, 100% Organic, full bodied and extremely smooth. Just honest to goodness tea.Rooibos Red Tea Pure Extract Powder, 1.3 oz.
Since 1900, Red Tea has been treasured as an elixir for the mind, body and spirit.Rooibos Red Tea Tincture, African Red Tea, 2 fl. oz.
Studies conducted at the Institute for Science of Aging at AICHI Medical University in Japan termed Red Tea "an anti-aging beverage," which can significantly help counter the aging process.Rooibos Red Tea With Madagascar Vanilla Beans, Organic, Kosher, 20 Tea Bags
Scientific studies show that Red Tea is naturally high in Super Oxide Dismutase (SOD), an outstanding antioxidant. Red Tea contains very little tannin, a substance that is known to effect the metabolism by decreasing absorption of certain nutrients like iron and protein.Rooibos Tea, Organic, Caffeine-Free Herb Tea, 20 Tea Bags
Rooibos is a red tea indigenous to South Africa, Wisdom Herbs Organic Rooibos Tea is caffeine free and tastes great.Rosemary Leaf Tincture (Rosmarinus Officinalis), 2 fl. oz.
Rosemary has been traditionally used for tension headaches, stimulating circulation, strengthening the nervous system. Good tonic for the heart and for high blood pressure.Rose Oil, Rosa Centrifolia, 100% Natural Absolute In A 5% Base of Grape Seed Oil Base, NOW Foods, 1 fl. oz.
Rose Oil from NOW Foods is all natural and has a sweetly floral aroma. While primarily used as a fragrance, Rose essential oil can be used for aromatherapy.SAM-e, Enteric Coated, NOW Foods, 100 mg, 30 Tabs
SAM-e was discovered in 1952 in Italy and has been researched and manufactured there. SAM-e works closely with folic acid and vitamin B-12.Samento Liquid Extract, Uncaria Tomentosa, 0.5% POA, 1 fl. oz.
Samento Uncaria Tomentosa is a Cat's Claw herb that may be beneficial in supporting the treatment of a wide range of immune system related conditions. Immune disorders may be the cause for various conditions such as cancer, arthritis, bursitis, rheumatism, allergies, ulcers, systemic candidiasis, all forms of herpes, diabetes, lupus, chronic fatigue syndrome, intestinal disorders and HIV infection.Samento Uncaria Tomentosa, Extra Strength, 100 Times More Effective Than Regular Cat's Claw, 0.5% POA, 600 mg, 30 Caps
Samento is beneficial in supporting the treatment of a wide range of immune system related conditions; these include but are not limited to cancer, arthritis, bursitis, rheumatism, allergies, ulcers, systemic candidiasis, all forms of herpes, diabetes, lupus, chronic fatigue syndrome, intestinal disorders and HIV infection.SAM-e 2X, NOW Foods, 200 mg, 30 Tabs
As a natural line of support to the nervous system functions, it increases the synthesis and breakdown of certain neurotransmitters, thus enhancing the sensitivity of nerve receptors.SAM-e S-Adenosyl-Methionine: The Remarkable Substance That Promotes Detoxification, Relieves Arthritis, & Fights Depression, By Rita Elkins, M.H.
Woodland Health Series - This booklet provides valuable information on the breakthrough research, safety and therapeutic uses of this amazing natural substance that promotes detoxification, relieves arthritis and fights depression.SAM: The Remarkable Substance That Promotes Detoxification, Relieves Arthritis, and Fights Depression By Rita Elkins, M.H.
This Booklet provides valuable information on the breakthrough research, safety and therapeutic uses of SAM-e that promotes detoxification, relieves arthritis and fights depression.Seabuckthorn Seed Oil, 100% Natural, 500 mg, 60 Softgels
A rare source of vitamin E, Seabuckthorn Oil also provides other vitamins including Vitamins A, C, D, K, etc, carotenoids, flavonoids, phytosterols, amino acids, serotonin and 28 trace elements: iron, zinc, calcium, magnesium, selenium, iodine, etc.Seroprin-24, 560 mg, 90 Tabs
Seroprin-24 has been designed by our pharmacologists, researchers, and physicians to do the following: help occasional simple nervous tension or irritability, help nervousness due to common everyday overwork and fatigue, gently soothe away tension, help you relax, and support mood enhancement.St. John's Tonic Depression Formula, 2 fl. oz.
Herbal Remedies St. John's Tonic Supplement Formula is designed to help alleviate depression and strengthen the nervous system. Other ingredients support a positive outlook.St. John's Wort, 350 mg, 180 Caps
St. John's Wort is helpful in support of depression, menopause, cramps, and insomnia.St. John's Wort Herbal Tea, 20 Tea Bags
St. John's Wort Herb Tea is made of wild St. John's Wort and Siberian Ginseng. These Herbs tonify the nervous system, ease anxiety and depression, and support the immune system.St. John's Wort Herb Tincture, 100% Organic, 2 fl. oz.
St. John's Wort is mainly used for the treatment of mild to moderate depression.St. John's Wort, Perika, 300 mg, 60 Tabs
Nature's Way St. John's Wort is scientifically advanced to maintain a healthy emotional outlook.St. John's Wort Powder (Hypericum Perforatum), 4 oz. Bulk
St. John's Wort is mainly used for the treatment of mild to moderate depression.St. John's Wort, Standardized Extract, 300 mg, 90 Caps
St. John's Wort promotes a positive mood and extracts have been proven in many clinical studies in Europe, to have antidepressant effects, and is widely used for this reason.St. John's Wort Supplement, 350 mg, 180 Caps
St. John's Wort Supplement can be helpful in support of depression, menopause, cramps, and insomnia. Nature's Way St. John's Wort extract standardized to 0.3% Hypericin, then synergistically blended with the whole St. John's Wort herb in the perfect balance to ensure consistent hypericin content in each capsule.St. John's Wort Tincture, Alcohol Free, 1 fl. oz.
St. John's Wort promotes a positive mood and extracts of St. John's Wort have been proven in many clinical studies in Europe, to have antidepressant effects, and is widely used for this reason.Sugar Blues By William F. Dufty
Chilling facts about the health disaster and social dangers created by wide-spread use of sugar, white flour and other refined carbohydrates.Sulfur Homeopathic Clikpak, 30C, 84 Pellets
Homeopathic Nelson's Sulfur in the new clikpak is easy to carry and dispense for skin disease, eczema and acne and therefore much better suited to a busy lifestyle.Sutherlandia (Sutherlandia frutescens), 300 mg, 60 Tabs
Sutherlandia powerfully assists the body to mobilize its own immunological physiological resources to cope with diverse physical, mental and chemical stressors.Sweetleaf Stevia Plus Fiber, 100 Packets, (1 gm/Pack)
Stevia has a delicious and refreshing taste that can be 30 times sweeter than sugar. Stevia is also an excellent diabetic aid which nourishes the pancreas, helping to achieve healthful blood sugar levels.Tension & Stress Homeopathic Clikpak, 100% Natural, 84 Pellets
Homeopathic Nelsons Tension & Stress in the new clikpak is easy to carry and dispense for minor symptoms of tension or stress and therefore much better suited to a busy lifestyle.The Mood Cure, By Julie Ross, M.A.
This comprehensive program is based on the use of four mood-building amino acids and other surprisingly potent nutrient supplements, plus a diet rich in good-mood foods such as protein, healthy fat, and certain key vegetables. Including an individualized mood-type questionnaire.The Power Of Now, A Guide to Spiritual Enlightenment, By Eckhart Tolle
In The Power of Now, Eckhart Tolle shows readers how to recognize themselves as the creators of their own pain, and how to have a pain-free existence by living fully in the present.Tri-Chromium With Cinnamon, NOW Foods, 500 mcg, 90 VCaps
Chromium is an essential trace mineral that helps the body maintain normal blood sugar levels and preliminary research has found that chromium supplementation also improves glucose tolerance in people with Turner's syndrome disease linked with glucose intolerance.True Balance, NOW Foods, 120 Caps
True Balance provides a full compliment of essential nutrients like Chromium and Vanadium, important minerals that support energy production and cellular metabolism, and a full array of key B-complex vitamins that support a healthy mood state.True Calm, Amino Acid Relaxing Formula, NOW Foods, 90 Caps
True Calm is an effective combination amino acid supplement synergistically blended with vitamins, herbs and other amino acids to support relaxation and a balanced mood.Uber Rest, Pure Pharmaceutical Grade L-Tryptophan, 500 mg, 60 Caps
Psychiatrists, medical doctors, and nutritionists, alike, have long recognized the importance of pure L-Tryptophan for maintaining good heath and supporting mood and sleep.Ultra Ginkgo Plus Rhodiola & Eleuthero, Endurance Formula, 10 ml Vials, 30 Vials
Ultra Ginkgo Plus Rhodiola & Eleuthero Endurance Formula combines Tibetan Rhodiola and Eleuthero.Valerian Root Glycerite Tincture, 2 fl. oz.
After numerous scientific studies, Germany's Commission E approved Valerian Root as a sleep aid.Vanilla Herb & Yerba Mate Organic & Caffeine Free Tea, 26 Tea bags
Like caffeine, Yerba Mate has a stimulating effect on metabolism, without the "jitters". A faster metabolism not only means you burn more calories, it means you turn more calories into energy. As it stimulates the metabolism into turning more calories to energy, it simultaneously soothes the nervous system. You feel less nervous and anxious, and you are better able to resist physical and mental fatigue.Vitamin B-12 Complex Liquid, NOW Foods, 2 fl. oz.
Vitamin B-12 Helps to maintain a healthy nervous system, and helps in the prevention of pernicious anemia. Folic Acid should be taken by all females of child bearing age to help prevent neuro-tube birth defects. Folic acid is also linked to heart health.Vitamin B-50 Complex With B-2 Coenzyme, 100% Natural, 330 mg, 100 Caps
B Vitamins are precursors of coenzymes involved in the conversion of cellular energy, manufacture of hormones and proteins, and repair and maintenance of nerve structures. They also function as lipotropics which converts fats to other useful products.Water, The Ultimate Cure, Discover Why Water Is The Most Important Ingredient In Your Diet & Find Out Which Water Is Right For You, By Steve Meyerowitz (Sproutman)
Discover why one's drinking habits may be the cause and cure of headaches, lower back pain, stress and depressions, high blood pressure, high cholesterol and excessive weight.Wild Oat Bach Flower Remedies Tincture, Bach Flower Essence, 20 ml
Wild Oat (Bromus Ramosus) is the Bach Flower Remedy for people who feel that they want to do something worthwhile with their lives but do not know in which direction they should move.Yeast Connection & Women's Health, By William Crook, M.D. & Hyla Cass, M.D.
Covering vaginitis, migraines, multiple sclerosis, depression, and more, this book is a completely revised and updated version of Dr. Crook's classic The Yeast Connection And The Woman.Yohimbe Powder (Corynanthe Yohimbe), 4 oz. Bulk
Orally, yohimbe is used as an aphrodisiac, for impotence, exhaustion and even angina. Yohimbe is also used for general sexual dysfunction in men and women.
Herbal Remedies: Depression Information
Herbal Remedies: Depression Supplements & Products
Herbal Remedies: Bipolar Disorder / Manic Depressive Disorder Information
Herbal Remedies: Postpartum Depression Information
Herbal Remedies: Postpartum Depression Supplements & Products
Herbal Remedies: Women's Health & Beauty Information
NOTIFY YOUR MIDWIFE OR HEALTH CARE PROVIDER IF...
You or a family member has signs and symptoms of depression.
You feel suicidal or hopeless.
Symptoms of depression recur after treatment.
You have unexplained or new symptoms (drugs used in treatment may produce side effects).
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