Depression

Depression refers to a condition of sadness or despair lasting weeks to months. There are many kinds of depression, including normal transient states of low mood derived from life events, or in response to many life stressors. It can be triggered by changes in sleep, light, food, medications, substances or changes in health. These all result in a change in brain chemistry. About 50% of people with depression have a co-existing medical problem that also needs to be treated. Depression is often accompanied by changes in sleep patterns, eating habits, fatigue, poor concentration, social withdrawal or irritability.

 

Standard medical treatments:

Antidepressants –

SSRIs (serotonin regulating antidepressants)

Bimodal agents – (i.e. Serzone) that act on both the neurotransmitters serotonin and     dopamine

Dopamine agonists – Wellbutrin

Tricyclic antidepressants

MAO inhibitors

Psychotherapy

Treatment of any underlying medical condition

Exercise

 

Supportive and alternative treatments:

Nutritional – avoid sugar and alcohol

5-HTP – 5-hydroxytryptophan, an amino acid derivative, pre-serotonin

L-Trytophan – an amino acid, pre-serotonin

L-Tyrosine, phenylalanine – amino acids, pre-dopamine

SAMe – S-adenosyl methionine, an amino acid derivative

Blue green algae

DHEA – steroid pro-hormone, supports adrenal function

Herbal –

St. Johnswort – increases serotonin

Ginseng – adrenal tonic

Homeopathy

Light therapy

Movement therapy – dance, yoga

Hormone balancing

Acupuncture

Meditation

Flower essences

 

Depression and Cannabis

Some recent studies have linked depression to chronic use of cannabis (several times/day for several years). This idea remains controversial. A 2005 Australian study reviewed thousands of such cannabis users and found normal rates of depression once other factors such as alcohol use, gender, illness, etc. were accounted for.  A study in the Journal of Neuroscience published in 2007 showed that cannabinoids elicit antidepressant effects and  activate serotonergic neurons  at low dose levels. There is currently a debate as to which “strain” of cannabis is most appropriate for the adjunctive treatment of depression. Strain selection is important, because strains that are too sedating may contribute to the lethargy of depression, and could accentuate dysfunctional symptoms. Since symptoms are so individualistic it is hard to determine what strain is right empirically. In general Sativa dominant strains are more uplifting.

Cannabis use has also been used as a method of harm reduction, to substitute for a more detrimental substance use. Rates of depression in substance abusers are three times higher than the normal population. While many substance abusers are self-medicating a depression, studies show that chronic substance abuse itself leads to brain changes and depression.