Mood disorders
Depression and Low Mood
How do I know if I am suffering from depression?
Depression is diagnosed by reviewing the symptoms, (their severity and frequency), a person is experiencing. Two systems of symptom classification are widely used in primary care – The International Classification of Mental Health and Behavioural Disorders and the Diagnostic and Statistical Manual (DSM) of The American Psychiatric Association. The symptoms associated with depression are as follows: |
|
What causes mood disorders?
A question I am often asked is ‘why have I become depressed’. There are three main theories regarding the cause of depressive disorders. Whilst each theory is reviewed separately (see below) for real people, in the real world the factors often interact.
1. Neurobiological
The neural circuits (located in the brain) underlying mood are complex and rely upon the interaction of several different systems. These systems communicate with one another through several chemical neurotransmitters: noradrenaline, serotonin, y-aminobutyric acid (GABA), dopamine, opiates and neuropeptides. It is thought that depression follows an imbalance or shortage of some of these neurotransmitters – most commonly serotonin. There are many reasons why levels of neurotransmitters can move ‘out of balance’ for example hormonal fluctuations at menopause or before menstruation.
|
2. Genetic
A review of many pieces of research looking into the genetic backgrounds of people suffering mood disorders has concluded that such disorders can ‘run’ in families. Heritability of depression has been estimated to range from 30-40%, i.e. people can have a genetic vulnerability to depression which will interact with environmental factors.
3. Environmental
There are two main theories regarding the importance of environmental factors.
1. There is evidence that the effect of early childhood experiences may be important.
2. Many studies have found a high correlation between experiencing anxiety and depression and the number of stressful life events in the prior 6 months. Loss events were significantly associated with depression, danger events with anxiety. |
Treatment of Depression with Medical Herbalism
I follow a 5 step approach to the treatment of most mood disorders:
1. Diagnosis
Firstly, it is important to diagnose which mood disorder you are experiencing. To do this accurately I utilise a questionnaire designed specifically for use in primary care. The accuracy of this questionnaire was confirmed in a study of 3000 adults.
2. Identify contributing & remitting factors
During our consultation we will try to identify which aspects of your present life (people, events, thoughts, feelings, behaviour) help, and which hinder your mood. Together we will then review if changes would be helpful.
3. Dispensing Herbal Medicine
The objectives for prescribing herbal medicine for mood disorders are:
- To help rebalance neurotransmitters, (if antidepressants have not been prescribed)
- To help balance the two components of the autonomic nervous system by promoting relaxation
- To help reduce some of the physical effects of mood disorders e.g. insomnia.
Research evidence published in authoritative journals has supported the efficacy of herbal medicine in the treatment of mood disorders e.g. a review of 23 high quality trials, published in ‘The Lancet’, found one herb to be therapeutically equivalent to, but with fewer side effects than, antidepressants such as amitriptyline.
Depending primarily upon the person (constitution, cause, symptom pattern, use of other treatments etc) and the diagnosis I will prescribe a combination of herbs which work well synergistically. During the consultation we will discuss the herbs and the rationale for their choice.
One patient recently described the role of herbal medicine in her recovery as ‘like stepping stones in a fast moving river’.
4. Agree goals & review progress
Regular updates are required to keep recovery on track. The choice herbs and dosage will be amended as different levels of recovery are reached. Progress towards agreed goals is closely monitored.
5. Flying solo!
People find (after differing time lengths) that they feel stronger, more in control. At this stage consultations are less frequent and the herbal medicine prescription is gradually reduced till people feel they no longer need help.
Please note. Herbal Medicine is most suitable for depression, stress related, and anxiety disorders. I suggest that you consult your GP is you suffer from Psychotic or eating disorders or Psychoactive substance (alcohol or drug) addiction.
If you would like to discuss any aspect of herbal medicine in more depth please contact me on 07985 200805. |
