Overcoming....Subclinical DEPRESSION

Feeling Generally Dissatisfied and “Not Happy”? How to Nip Subclinical Depression in the Bud

November 28, 2013 | 

By Dr. Mercola

Your emotions can have a powerful effect on your physical health and well-being—and vice versa. Happiness can not only protect your body from stressors that can lead to coronary heart disease, it can also boost your immune system's ability to fight off the common cold.

Happy people also tend to live longer, and enjoy more fulfilling relationships. But happiness can be rather subjective. And there’s a wide spectrum between “happiness” and “depression.”

With winter fast approaching and lack of sunlight in the northern hemisphere, which increases the risk for SAD (seasonal affective disorder), this is a particularly timely topic.

According to Shelley Carson, an associate at Harvard University’s Department of Psychology and co-author of the book, "Almost Depressed: Is My (or My Loved One's) Unhappiness a Problem?" many suffer with subclinical symptoms of depression.

In other words, they’re “almost depressed.” In a recent article for CNN Health,¹Carson sheds light on this “in-between” state.  “Research suggests that as many as 12 million people in the United States may be suffering from low-grade depression symptoms that are not severe enough to warrant clinical treatment,”she writes.

Symptoms of being in the “almost depressed” category include:

• Inability to enjoy things that you used to consider fun
• Being easily irritated and overreacting to minor incidents
• Regularly finding excuses to avoid socializing
• “Going through the motions” and feeling like each day is a struggle
• Feeling overstressed, thinking you’ll never catch up with all your to-do’s

Major depression is typically associated with thoughts of death or suicide, and feelings of deep hopelessness or helplessness, making it critical to recognize and address such symptoms. To assess your or a loved one’s risk factors, please review this previous article.

If you are feeling desperate or have any thoughts of suicide, call the National Suicide Prevention Lifeline,² a toll-free number 1-800-273-TALK (8255), or call 911, or simply go to your nearest Hospital Emergency Department.

Below, I will share what I believe are some of the most effective options for preventing and/or treating symptoms of depression, “the Blues,” or what Carson refers to as “almost depression” that saps the joy out of your life and detrimentally affects your health.

Subclinical Depression Can Take a Toll on Your Health

Besides the increased suicide risk, major depression also quadruples your risk of major heart disease, and raises your risk of a cardiac event by six times, compared to people who are not depressed. There’s simply no doubt that your emotional state impacts your health.

Subsequently, while being “almost depressed” is not considered a clinically treatable mental health condition, that certainly doesn’t make it any less important to address. According to Carson:³

“At Harvard Medical School, we have been investigating the effects that almost depression and other subclinical conditions can have on an individual's quality of life.

People who are almost depressed report a number of issues, including lower job satisfaction, lower satisfaction with their marriage and other personal relationships, more anxiety issues, less control over their lives and lower overall well-being than people who do not fall into the almost depressed range.

Research indicates about 75 percent of cases of low-grade depression will devolve into full-blown major depression if they are not recognized and arrested.”

How to Combat the Blues

In her article,⁴ Carson lists nine simple strategies that have been tested and found effective against subclinical depression in randomized clinical trials. These include:

Get sufficient amounts of exercise	Schedule activities you know you’ve enjoyed in the past, as this will help activate your brain’s pleasure centers	Express your negative feelings creatively, through painting, singing, music or other creative pursuits
Manage your day-to-day stress levels	Assess your thoughts and change how you interpret events	Practice mindfulness, i.e. pay attention to the moment you’re in right now
Silence your “inner critic” and practice more positive self-talk	Widen your social support network	Improve your self-care, such as eating better and getting enough sleep

Energy Psychology to the Rescue

I believe it’s helpful to view depression—whatever “level” of it you may be experiencing—as a sign that your body and life are out of balance, rather than as a disease. It’s a message, telling you you’ve veered too far off course, and you need to regain your balance.  One of the key ways to do this involves addressing negative emotions that may be trapped beneath your level of awareness. My favorite method of emotional cleansing is Emotional Freedom Techniques (EFT), a form of psychological acupressure.

Some people avoid energy psychology, believing it’s an alternative form of New Age spirituality. Nothing could be further from the truth. It is merely an advanced tool that can effectively address some of the psychological short circuiting that occurs in emotional illnesses. It is not associated with any religion or spiritual outlook at all, but merely an effective resource you can use with whatever spiritual belief you have.

If you have severe depression, I would strongly urge you to consult with a mental health professional who is also an EFT practitioner. Self-treatment for serious mental health issues is NOT recommended, because although it is easy to learn EFT and far less expensive to do it yourself, it is nearly always better to work with a professional. It’s truly an art that takes years of practice to develop the skill to successfully address deep-seated, significant issues.

That said, for most of you with depression symptoms, this is a technique you can learn to do effectively on your own. In fact, it's so easy that children are learning it. In the videos below, EFT practitioner Julie Schiffman shows how you can use EFT to relieve symptoms of depression.

There are other effective stress-management methods you could try as well, such as meditation, journaling, breathing exercises, yoga, or simply sharing your feelings with a close friend. Experiment with a number of approaches, and then pick the methods you find most helpful.

Research Backs the Use of EFT for Depression

EFT was developed in the 1990s by Gary Craig, a Stanford engineering graduate specializing in healing and self-improvement. It’s akin to acupuncture, which is based on the concept that a vital energy flows through your body along invisible pathways known as meridians. EFT stimulates different energy meridian points in your body by tapping them with your fingertips, while simultaneously using custom-made verbal affirmations. This can be done alone or under the supervision of a qualified therapist. By doing so, you help your body eliminate emotional “scarring” and reprogram the way your body responds to emotional stressors.

I have been a fan of energy psychology for many years, having witnessed its effectiveness in my medical practice and in my own personal life. However, studies have been few and far between as science has been trying to “catch up” with clinical experience. That has finally started to change.  Several studies have been published in the last few years, showing just how safe and effective EFT really is. For example, the following three studies show remarkable progress in a very short amount of time for people with a history of trauma:

1. A 2009 study⁵ of 16 institutionalized adolescent boys with histories of physical or psychological abuse showed substantially decreased intensity of traumatic memories after just ONE session of EFT.
2. An EFT study⁶ involving 30 moderately to severely depressed college students was conducted. The depressed students were given four 90-minute EFT sessions. Students who received EFT showed significantly less depression than the control group when evaluated three weeks later.
3. In a study of 100 veterans with severe PTSD⁷ (Iraq Vets Stress Project⁸), after just six one-hour EFT sessions, 90 percent of the veterans had such a reduction in symptoms that they no longer met the clinical criteria for PTSD; 60 percent no longer met PTSD criteria after only three EFT sessions. At the three-month follow-up, the gains remained stable, suggesting lasting and potentially permanent resolution of the problem.

Dietary Considerations for Optimal Mental Health

The following strategies are important to consider if you are facing depression and the earlier you address your symptoms the better. These strategies have nothing but positive effects and are generally very inexpensive to implement. Besides using EFT, I strongly recommend addressing your diet as one of your first steps. Foods have an immense impact on your body and your brain, and eating whole foods as described in my nutrition plan  will best support your mental and physical health. Avoiding processed foods, sugar (particularly fructose) and grains is particularly important as it will help normalize your insulin and leptin levels, which is an important contributing factor to depression.

Sugar causes chronic inflammation, which disrupts your body's normal immune function and can wreak havoc on your brain. Sugar also suppresses a key growth hormone called BDNF (brain derived neurotrophic factor), which promotes healthy brain neurons and plays a vital role in memory. BDNF levels are critically low in people with depression, which animal models suggest may actually be causative. Other important dietary recommendations include the following:

1. Optimize your gut flora. Mounting research indicates that the bacterial colonies residing in your gut may play key rolesin the development of brain-, behavioral- and emotional problems—from depression to ADHD, autism and more serious mental illness like schizophrenia.
In a very real sense you have two brains, one inside your skull and one in your gut, and each needs its own vital nourishment. It’s important to realize that you have neurons both in your brain and your gut -- including neurons that produce neurotransmitters like serotonin. In fact, the greatest concentration of serotonin, which is involved in mood control, depression and aggression, is found in your intestines, not your brain! Perhaps this is one reason whyantidepressants, which raise serotonin levels in your brain, are often ineffective in treating depression, whereas proper dietary changes often help.
A recent proof-of-concept study found that probiotics (beneficial bacteria) actually altered participants’ brain function.⁹Compared to the controls, the women who consumed probiotic yogurt had decreased activity in two brain regions that control central processing of emotion and sensation. The implications are particularly significant in our current era of rampant depression and emotional “malaise.”
Fermented foods are the best route to optimal digestive health, as long as you eat the traditionally made, unpasteurized versions. Some of the beneficial bacteria found in fermented foods are also excellent chelators of heavy metals and pesticides, which will also have a beneficial health effect by reducing your toxic load. Healthy choices include fermented vegetables, lassi (an Indian yoghurt drink), fermented milk such as kefir, and natto (fermented soy). If you do not eat fermented foods on a regular basis, taking a high-quality probiotic supplement is recommended.
2. Supplement your diet with animal-based omega-3 fat. I strongly recommend taking a high-quality, animal-basedomega-3 fat, like krill oil. This may be the single most important nutrient for optimal brain function, thereby preventing depression. DHA is one of the omega-3 fatty acids found in fish and krill oil, and your brain is highly dependent on it for optimal function. Low DHA levels have been linked to depression, memory loss, Schizophrenia, and Alzheimer's disease.
3. Get adequate vitamin B12. Vitamin B12 deficiency can contribute to depression and affects one in four people.
4. Evaluate your salt intake. Sodium deficiency actually creates symptoms that are very much like those of depression. Make sure you do NOT use processed salt (regular table salt), however. You’ll want to use an all natural, unprocessed salt like Himalayan salt, which contains more than 80 different micronutrients.
5. Make sure your cholesterol levels aren't too low for optimal mental health. I have been educating the public about the underreported, adverse effects associated with lowering cholesterol through drugs like statins for many years, but what many still do not know is that low cholesterol is linked to dramatically increased rates of suicide, as well as aggression towards others.¹⁰

This increased expression of violence towards self and others may be due to the fact that low membrane cholesterol decreases the number of serotonin receptors in the brain (which is approximately 30 percent cholesterol by weight). Lower serum cholesterol concentrations therefore may contribute to decreasing brain serotonin, which not only contributes to suicidal-associated depression, but prevents the suppression of aggressive behavior and violence towards self and others.

Other Lifestyle Strategies that Can Help You Rebalance

Next, the following three common-sense lifestyle strategies can go a long way toward warding off symptoms of depression, by helping your regain a sense of health and wellbeing.

1. Get regular exercise. Regular exercise is one of the "secret weapons" to overcoming depression. It works by helping to normalize your insulin levels while boosting the "feel good" hormones in your brain. For more information, please review my article about the many ways exercise can benefit your brain. According to Dr. James S. Gordon, MD, a world-renowned expert in using mind-body medicine to heal depression:

"What we're finding in the research on physical exercise is that exercise is at least as good as antidepressants for helping people who are depressed… physical exercise changes the level of serotonin in your brain. And it increases your endorphin levels, your "feel good hormones."

Also—and these are amazing studies—exercise can increase the number of cells in your brain, in the region of the brain called the hippocampus... they're very important because sometimes in depression, there are fewer of those cells in the hippocampus. But you can actually change your brain with exercise. So it's got to be part of everybody's treatment, everybody's plan."

2. Get regular sun exposure. Have you ever noticed how great it can feel to spend time outdoors on a sunny day? Well, it turns out that getting safe sun exposure, which allows your body to produce vitamin D, is great for your mood. One study even found that people with the lowest levels of vitamin D were 11 times more prone to depression than those who received adequate vitamin D. You can optimize your vitamin D either by sunlight exposure or by using a safe tanning bed, or by taking a high-quality vitamin D3 supplement.
3. Try “ecotherapy.” Spending time outdoors has been shown to dramatically improve people’s mood and significantly reduce symptoms of depression. Outdoor activities could be just about anything, from walking a nature trail to gardening, or simply taking your exercise outdoors. According to a 2009 report on Ecotherapy by the British Depressionalliance.org:¹¹

“94 percent of people taking part in a MIND survey commented that green exercise activities had benefited their mental health; and 100 percent of volunteers interviewed during an outdoor conservation project agreed that participation benefited their mental health, boosted self-esteem and improved confidence.”

4. Make sure you get adequate sleep. Set a bedtime and stick to it. Staying up until the wee hours of the morning is going to have a detrimental effect on your mood, as well as your overall health. Adequate rest has been proven to protect against depression and suicidal thoughts—especially in teenagers.

Your Lifestyle Can Significantly Impact Your Emotional Well-Being

I strongly believe that energy psychology is one of the most powerful tools for resolving emotional issues, but the evidence also clearly points to the fact that outdoor activities like gardening can have a significantly beneficial impact on depression, and exercise in any form is one of the best-kept secrets to preventing the blues in the first place. Strengthening your spiritual faith can be another important aspect of mental and emotional health, as discussed in a previous article.

In terms of diet, dramatically decreasing your consumption of sugar (particularly fructose), grains, and processed foods is very important, as is getting adequate vitamin B12. In fact, vitamin B12 deficiency can contribute to depression and affects one in four people. Vitamin D and omega-3 fats are also very important for your mood and brain health. You may also want to evaluate your salt intake. Sodium deficiency actually creates symptoms that are very much like those of depression. Again, make sure you ONLY use all natural, unprocessed salt like Himalayan salt, which contains more than 80 different micronutrients.

Please remember, your lifestyle can make or break your health and general sense of wellbeing and may be one of the most fundamental contributors to depression, so you’d be well advised to address the factors discussed in this article before resorting to drug treatment—which science has shown is no more effective than placebo, while being fraught with potentially dangerous side effects.

While I’ve addressed what I believe is one of the most powerful mind-body techniques in this article, namely EFT, there are many others that can also be helpful. For even more inspiration, please see my previous article 13 Mind-Body Techniques That Can Help Ease Depression.