be well

Modern life is stressful and in winter we have less resilience to the effects of stress and depression. Excellent scientific evidence links chronic stress to clinical depression which can present as loss of sleep and appetite, or the “burn out” state where we sleep and eat more.

Depression is incredibly common, comprising around a third of consultations to GPs (in many cases the presenting complaint will be one or more of the symptoms, without the person realising the link to depression).

The good news is depression is very treatable. The bad news is that left untreated, the underlying abnormalities causing depression lead to an increase in other chronic inflammatory disorders including heart attacks and Alzheimers disease.

Symptoms of chronic stress

• Mind: constant worry, racing mind, illogical thoughts, can’t concentrate, easily distracted, uncertainty, forgetfulness, memory loss
• Feelings: irritability, anxiety, anger, impatience, depression, loneliness, low self-esteem
• Body: churning stomach, backache or bursts of pain, palpitations, muscle tightness, headache, diarrhoea, fatigue, poor sleep
• Actions: rapid speech, reckless driving, excessive drinking, poor eating habits, drug use,
  excessive smoking

Although these symptoms may be related individually to many causes, clusters of them should alert us to attend to our stress management. It is important to seek medical advice if you experience thoughts of suicide or have quite a cluster of these symptoms.

Treatment

Generally medical treatments especially with modern medications are very helpful in improving the brain chemistry of depression. It is too much to ask however for medication to do the whole job. We need to work on the underlying factors that led to problems in the first place. These supports for our natural processes work to support treatment or prevent the problem escalating in the first place.

Resilience

Improving our resilience helps make us less subject to the illnesses generated by life’s inevitable stresses.  Doing these things usually comes before the feeling better (Susan Jeffers, Feel The Fear and Do It Anyway). When we are resilient, we don’t crack under pressure, we bounce back from tough days, we cope with life’s changes, we look on the bright side, responding with creative solutions to life’s changes. Developing some good life habits can really help.

Talk therapies

Many of us have a strong “internal critic” demanding perfection and thereby discouraging us from learning or trying new things.  Working through a programme with a coach, a psychologist, counselor, or psychotherapist helps us regain a healthy perspective on life and leads to more lasting good results.

Exercise

Exercise is a great way to burn off stress and relax the body. Some of us do better with aerobic exercise and others with resistance exercise or yoga, Pilates, tai chi style programmes. Laughter and having fun works wonders as well.

Diet and nutrition

Unbalanced inflammatory processes lead to depressed mood and increase other long term health risks. Our food has a large impact on our inflammatory tendency.  It makes sense therefore to eat a diet which supports reduced inflammatory tendency. You need to limit simple sugars and starches in your diet especially if your waist is over 100cm for a male or 94 cm for a female. Exercise burns off sugars and fats so is essential every day.

The type of fat we eat has a large bearing on us developing inflammation. The unsaturated fats in fish oil, especially EPA are essential in our diet. Most of us will benefit from supplementing eating fish with taking fish oil supplements. EPA from fish oil or supplements is readily taken up by our bodies and used in our cells. Our natural “switch off” for inflammation is made from EPA, one of the main components of fish oil.

The minerals magnesium, calcium and zinc play key roles as co-factors for the enzymes and the brain chemistry which tone down the effects of stress on our system. Ensuring the 5+ servings of vegetables daily is essential, and supplementing with these minerals will provide extra insurance. We are prone to use up magnesium very quickly on stressful days and signs of magnesium insufficiency may include sleep disturbance, muscle cramps, headaches and jitteriness.

Supplements

If you are taking anti-depressant medication, it is important you talk to your pharmacist or doctor about supplements you are taking as interactions between these medications and supplements are common.

• Hypericum (or St John’s wort) has traditional use dating back to the 1500s for helping depression especially if it is associated with fatigue. It is best taken in the morning or midday as it can keep some people awake at night. It interacts with medication.
• Having sufficient folic acid and B vitamins helps maintain brain functional pathways, detoxification and energy. SAMe is the final step in a complex folic acid pathway. Supplements of SAMe are available because around a third of people have genetically-based slowness in some of the steps in the folic acid pathway.
• 5-hydroxytryptophan (5-HTP) is a precursor to serotonin (the “all is well”) neurotransmitter. It has been shown particularly in conjunction with SAMe above to help in production of the “all is well” state for the brain.
• Vitamin D is actually a hormone which we make with the help of sunlight. There are vitamin D receptors throughout our body including our brain. In winter when sunlight is at its lowest, our vitamin D levels drop. Interesting research is linking low vitamin D levels with “seasonal affective disorder” where we can feel a bit down in the dumps in winter. Whilst it can be good to have a period in the year when we are more reflective and quiet, some of us are affected to a greater degree by the “winter blues”. Low vitamin D may be a factor worth checking out. Oral supplements can help, and like everything, too much vitamin D can be toxic, so check your doses with your pharmacist or doctor. Vitamin D has effects on bone health and immune function in addition to the effects on brain function.

It is interesting that the same strategies keep coming up whether it’s to beat the blues, prevent heart and vascular disease, prevent brain or joint degenerative disease. The good news is that by following a healthy balanced lifestyle of eating healthy food, exercising, socialising, sleeping well and learning to build relaxation and laughter into our lives will help us generally to remain well and avoid many of the chronic illnesses common as we age.

-  © Dr Tony Edwards, Radius Medical

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