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Sunday, October 12, 2008

Feeling down? Take a dose of Nature's Prozac

From St John's Wort to a stroll in the park, there are plenty of ways to beat the blues and remain buoyant and healthy
Peta Bee

Financial struggles are the latest worry for a generation that is already overburdened with stress. Rising divorce rates, long working hours, relationship problems and a lack of time to relax are all contributing to a rise in mood problems. One person in five now suffers a mental health problem at some point in his or her life, says Mind, the mental health charity.

But how do you know whether you are simply down in the dumps or suffering from clinical depression? According to Paul Farmer, chief executive of Mind, if feeling blue lasts more than a couple of weeks you probably have mild to moderate depression, which affects 9 per cent of the population. So you should seek professional advice and make positive changes to your diet and exercise. If that doesn't work you may need medical treatment for chronic depression.

There is much that you can do to alleviate milder conditions and prevent them getting worse. Last week it was reported that the supplement St John's Wort is as effective as some antidepressants in lifting mood. “Getting outside, being active and talking are some measures that can be really beneficial,” says Farmer.


On bright, sunny autumn and winter days, make sure that you go outside. Warm or sunny, but not hot, weather has a positive impact on mental health, according to researchers at the University of Michigan. Dr Paul Keller, a social psychologist, found that the optimal temperature for a good mood was about 22C (72F) - about room temperature - with the good feeling decreasing if temperatures became significantly higher or lower.

“For pleasant weather to improve mood you need to spend at least 30 minutes outside,” Keller says. “It really does offer a way to alter your mindset.” If the next few months are dull and dark and your mood suffers as a result, then light therapy might help. A lack of daylight is thought to be the main cause of seasonal affective disorder (SAD), also called the winter blues. The condition is thought to be linked to the way light triggers messages to the part of the brain called the hypothalamus, which controls sleep, sex drive, appetite and mood. Ordinary electric light bulbs, which produce 200 to 500 units of light energy (lux) won't boost mood, but specially designed light boxes that emit about 10,000 lux from a fluorescent bulb are effective for those in front of them for at least 45 minutes a day.


“There is very good evidence that regular exercise is beneficial for people with depression,” says Paul Farmer, adding that Mind launched a major campaign called Get Moving last week. “Any exercise helps and people should do whatever makes them feel good.”

Physical activity need not be too strenuous to achieve results. A study by researchers at the University of Texas two years ago asked subjects with clinical depression to rest or walk at a gentle pace on a treadmill for half an hour. When their mood was tested afterwards both groups showed improvements, but the walkers had much more positive feelings of well-being and energy. Last year Dr Astrid Bjornebekk, of the Karolinska Institutet, Stockholm, revealed that exercise, particularly running, stimulates the production of new brain cells and has a similar effect to antidepressant drugs in depression.

Where your exercise takes place is also important. A report called Eco-therapy, which was conducted last year by Mind and experts from the department of biological sciences at the University of Essex, indicated that physical activity outdoors offers more of a mental boost than gym workouts. “We found there were significant benefits to being outside as opposed to an enclosed environment,” Farmer says. “Ninety-four per cent of people with depression said that Nature and exercise is most important in improving how they feel.” Kite flying, for instance, sent moods soaring with 71 per cent of subjects in the Eco-therapy study experiencing significant improvements in their depression.


Laughter has a powerful effect on depression and researchers recently revealed that even anticipating a laugh can lower stress hormones and boost mood. Dr Lee Berk, a researcher in physical therapy, and her team at the Loma Linda University, California, have indicated that levels of beta-endorphins, the family of chemicals that alleviate depression, went up by 27 per cent when subjects were asked to watch a comedy video. Levels of three stress hormones - cortisol, epinephrine and dopac - that can also affect mood and anxiety were reduced by up to 70 per cent. “By seeking out positive experiences that make us laugh we can do a lot to stay well,” Berk says. It is the theory on which “laughter yoga”, now practised in more than 40 countries including the UK, is based. Laughing releases feel-good hormones called endorphins into the body and laughter yoga is said to utilise this as a way of getting fit by stimulating the body. While there is no medical evidence that it works, more than 40,000 people claim that the activity has helped them.

Talking therapies are also proven to be effective. One study showed that cognitive behaviour therapy (CBT) was as effective as drugs in preventing the return of severe depression over time. Dr Steve Hollon, a psychologist at Vanderbilt University, Tennessee, indicated that the risk of relapse over 16 months was no higher, perhaps even lower, for patients receiving CBT than those taking antidepressants. If you can't find a counsellor, try computerised cognitive behaviour therapy (CCBT) online. A study by the City University, London, revealed that more than three people in five with mild depression could stop treatment after eight days of the online approach. Another, by Swedish researchers, found that computer therapy is as effective as face-to-face treatment for moderate to mild depression.


A lack of sleep will almost certainly leave you feeling tired, groggy and grumpy, but over time those feelings can escalate into depression. Young adults who took part in research at the Psychiatric University Hospital Zurich displayed far greater symptoms of depression if they suffered from insomnia. Up to 50 per cent of the subjects who experienced sleeplessness lasting two weeks or longer during their early twenties were more likely to get a depressive episode later in life.

“We used to think that insomnia was often just a symptom of depression,” says Dr Daniel Buysse, of the University of Pittsburgh. “But growing evidence suggests that it may actually precede depression. In other words, people who can't sleep but have no depression are at increased risk of later developing it.”

Dr Sara Mednick, a scientist and sleep expert at Harvard University, says that regular napping might help people to relax, reducing stress levels. “Even short sleep reduces stress and anxiety [both a result of rising levels of the hormone cortisol being produced by the adrenal glands] by triggering the release sleep hormones that act as an antidote to mood problems,” she says.

John Shneerson, director of Britain's largest sleep clinic at Papworth Hospital, Cambridge, says “a 15 to 20-minute siesta is enough to be refreshing without giving you grogginess afterwards” .


A study by Dr Klaus Linde, of the Centre for Complementary Medicine, Munich, suggested that St John's Wort (Hypericum perforatum) is as effective as selective serotonin reuptake inhibitors (SSRIs) such as Prozac for mild to moderate depression. In a review of 29 studies of the plant, which grows in hedgerows, Linde revealed that it was not only effective for many of the 5,489 depressed patients, but also that it had fewer side-effects than conventional drugs.

“Using a St John's Wort extract may be justified, but products vary considerably, so these results apply only to the preparations tested,” he says. Trials generally use preparations containing only a standard 0.3 per cent dose of the active ingredient hypericin. Capsules or tablets of 300- 450mg are regarded as optimal.

Other supplements may also help to alleviate the blues. Earlier this year, a report in the Archives of General Psychiatry journal showed that increasing vitamin D intake could protect the elderly against depression. Sunlight is the best supplier of vitamin D and a lack of exposure to it can lead to deficiency. As well as supplements, it can be found in margarine, fortified cereals, dairy products, egg yolk and oily fish. Dr Birgit Teucher, of the Institute of Food Research, Norwich, says that around 5mcg a day is recommended.

Food and drink can lift the spirits

Probably the best you can do when going through tough times is to stick, as much as you can, to a healthy, balanced diet. Make sure you get your five fruit and veg a day, eat wholegrain foods and skip the junk. Some psychologists believe that colours have a profound effect on our moods so eating colourful fruit and veg can all help to lift your mood. Dehydration can cause stress, headaches and irritably so also make sure you have plenty of fluids.

Peter Rogers, Professor of Psychology at Bristol University, is not convinced about the use of certain supplements as mood enhancers. “We've reviewed the data on omega-3 supplements. They may affect mood in people who are clinically deficient, but I'm less convinced that they have a general benefit.”

As for the B vitamin folate, which has had reports of improving low moods, Rogers says that this is an area in which needs more good, robust research.

Knowing that you are eating healthily will provide a variety of essential nutrients and help you to feel that you are doing your best for yourself.

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