Miskawaan Health Group

Depression in Perspective

Depression is one of the most prevalent mental health issues of modern times. It’s estimated that 1 in 5 people will suffer from a moderate to severe episode of depression at least once during their lifetime. 

Worldwide, it affects more than 250 million people and costs the global economy a staggering $1 trillion every year in lost work hours.

What Is Depression?

When we discuss depression, it’s important to understand what it is and what it isn’t. We can feel depressed, for example, if we have lost a loved one or we’ve just lost our job or been diagnosed with a serious illness. 

For most people, this is a relatively transient moment in their life and will eventually resolve as they come to a better understanding of their situation. This is more grief or loss rather than medically defined depression. 

Endogenous depression, what we now call a major depressive disorder (MDD) or clinical depression, is a mood disorder that means the individual has long-standing, persistent feelings of sadness that harm their life. It’s thought that this affects around 7% of adults in the USA each year. 

This is not one set clinical disorder, however. We have women who may suffer from postpartum depression. There’s psychotic depression which is mixed with a psychotic episode and seasonal affective disorder where people feel depressed during the winter months.

What Causes Depression?

The exact cause of depression can be difficult to pin down. For some, there may be a genetic factor at play, for others, it’s a biological or environmental cause. Understanding the patient’s history and what may be going on at both a physiological and psychological level is critical. 

For instance, endogenous depression normally happens because of a physiological imbalance where several chemicals, including serotonin, are involved. The early indications may be feelings of sadness, fatigue, difficulty sleeping. As the condition progresses, the depression may deepen, even resulting in suicidal thoughts. 

While antidepressants may work in the short term, they might not be the final solution or even an effective stop-gap. Improving diet by including high-quality protein that contains tryptophan and including exercise, for example, may restore that chemical imbalance more effectively and reduce depression. 

The Conventional Medical Approach to Depression

The conventional medical approach to depression is often to treat the symptoms rather than the underlying cause. 

This presents a one size fits all approach that is ill-suited to major depressive disorders, often involving the use of fairly strong medications with some form of therapy thrown in for good measure. Indeed, we still use electroconvulsive therapy for refractive depression. While it can work in some cases, it’s not appropriate for everyone.

The Functional Medicine Approach to Depression – The Miskawaan Way

Functional medicine looks for the underlying cause of any condition and seeks to resolve this rather than simply treat the symptoms. Each patient is different and their treatment will need to be tailored – in other words, this is not a one size fits all approach. This treatment philosophy and approach to healthcare is one which Miskawaan Health Group fully subscribes to.

Some of the issues that functional medicine may uncover with patients can include: 

  • Insulin sensitivity and obesity: If someone is prediabetic or diabetic they will have trouble with insulin resistance. This in turn can influence the central nervous system. Obesity also puts the individual in a state of inflammation. All these issues combined can cause depression as a side effect. 
  • Chronic stress: The impact of long-term stress on physiology is important. Over time stress hormones are reduced and can affect different glands in the body, which can lead to depression-like symptoms. 
  • Environmental factors: Exposure to toxins in the environment such as mould spores and air pollution can cause inflammation of the nerves and may strongly affect mood. 

Other conditions such as inherited conditions, infections, a leaky gut because of a poor diet and even social situations can have an impact and cause episodes of depression. The point is that all these causes are different and simply giving a patient antidepressants and a psychotherapist to talk to does not fix the underlying cause. 

Functional medicine gives individuals different options depending on their underlying cause. For example, if someone is depressed because they are unhealthy and have led a sedentary lifestyle, then exercise and a better diet is more appropriate than antidepressants. 

Someone who has post-partum depression after giving birth may be deficient in certain vitamins and minerals. Not to be neglected are physical and mental exhaustion or changes in the metabolism.

Giving a mother antidepressants can have a knock on effect such as preventing bonding with their child or reinforcing their feelings of lack of self-worth. 

It’s important to investigate fully the underlying cause of any depressive condition and explore all the options. For some, light therapy may solve their seasonal affective disorder. For others, cognitive behaviour or talking therapy can make a difference. In short, the more we can tailor treatment to the individual, the better the outcomes are likely to be.

The content above is based on the information featured in the article linked below. 

The author of the article is Dr Ross Walker, one of Australia’s most esteemed cardiologists and a member of the Miskawaan Medical Advisory board.


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