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					            Depression, Bipolar Disorder and Anxiety
                  Symptoms, Side Effects, Withdrawal Symptoms
                       Prescription and Natural Treatments
            Hippocrates, the great Greek physician and Father of Medicine, said:
            "From the brain, and from the brain only, arise our pleasures, joys,
             laughter, and jests, as well as our sorrows, pains, griefs, and tears."


This 47 page book is written for people who suffer from Depression, Bipolar Disorder (Manic
Depression), General Anxiety, Social Anxiety and Panic Disorder. It contains a thorough
analyses of these disorders including their symptoms, causes, diagnosis and alternative methods
of treatment.

The book lists and discusses the psychotropic drugs prescribed for each disorder, along with their
side effects, with drawl symptoms and risks, as well as, natural remedies that have proven to be
just as or more effective that antidepressants with no side affects or withdrawal symptoms.
Natural remedies include nutrition programs, taking food supplements, vitamins and
herbs, as well as, exercise, therapy and other ways of naturally addressing these
disorders. These alternative programs have been proven to be just as, if not more
effective in dealing with these disorders than prescription drugs without the side effects
and withdrawal symptoms.

The purpose of the book is to help save the reader from the misery caused by a
combination of the disorder’s symptoms, drug side effects, withdrawal symptoms, and
feelings of public embarrassment.

In your quest to learn about depression, manic depression, and anxiety you may have learned
some things about their symptoms and how to deal with them that were true, some that were only
partially true, and some that may not be true or not be true for you. You will learn many things
that are contradictory. This book should help you filter out all the misinformation and determine a
proactive, personal system to cope with these disorders.

People who experience these disorders can live normal lives. You may continue to have
symptoms, but you will know how to manage them so they have minimal impact on your life.

Facts, Just The Facts

According to the National Institute of Mental Health, in any given year, major depression afflicts
nearly 10 million Americans over the age of 18, or about 5% of the population.

When dysthymia (chronic mild depression) is included in the head count, the numbers rise to 18.8
million American adults, or about 9.5% of the population.

Around 25% of the population may experience some form of depression at some point in their
lives.




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Between 10 and 15 percent of people will experience at least one episode of major depression
during their lifetime.

Millions of depression cases are never diagnosed or treated. Men and teenage boys may not
want to admit the they suffer from such a emasculating disorder. Others take illegal drugs to
handle what actually is depression, while others simply don’t know what they are suffering from
and never have it diagnosed. These categories could easily add up to another 20-30 million in the
US alone. It boggles the mind to think of how many cases there are throughout the rest of the
world.

Major depression is the leading cause of disability in the U.S. Depressed mood ranks just behind
high blood pressure as the most common chronic condition doctors see.

Depression costs our society an estimated $44 billion a year, including $23 billion for lowered
productivity and absenteeism at work, and $12.3 billion for medical and psychiatric care.

Between 1986 and 1996, mental health expenditures grew at an average annual growth rate of
more than 7 percent per year. Among the fastest-rising expenses for mental health services were
outpatient prescription drugs, which account for about 9 percent of total mental health direct
costs. Antidepressants are currently the third-leading drug class by prescription revenues,
generating estimated global sales of $17 billion in 2002.

A study conducted by the Medical University of South Carolina’s National Crime Victims
Research and Treatment Center revealed that the extent of mental health problems among
American adolescents has reached 'alarming' levels. The study found at least 16 per cent of boys
and 19 per cent of girls have a diagnosis of at least one problem, such as post-traumatic stress
disorder (PTSD), major depression or substance dependence. The study also found that sexual
and physical assault or even witnessing violence increases the risk of PTSD, depression and
substance abuse. The study involved more than 4,000 young people between the ages of 12 and


Depression
There are many contributing factors to depression, which include lifestyle, stress, behavior and
relationships.

Depression frequently follows some life-shattering event, such as, loss of a loved one and
consequent bereavement, serious illness in the family, pregnancy, divorce, bankruptcy or other
financial difficulties and in many situations all that is needed is good support.

Nearly twice as many women as men suffer from major depression each year.

Untreated, major depression may last for 6 months to a year, with recurrences becoming more
frequent and severe. Without treatment, dysthymic disorder (mild depression) is so persistent that
periods of normal mood may last only a few weeks at a time.

If you have just one episode of major depression, there's a 50/50 chance you'll have more,
perhaps as many as one or two a year.




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Examples of symptoms include: changes in appetite; changes in sleeping habits; feelings of
worthlessness, being out of control; loss of interest; reduced energy and fatigue; feelings of
worthlessness or guilt, and thoughts of death or suicide.

People who live in northern climates often notice that they have more difficulties with depression
when the days are short or there is a series of cloudy days. This problem is called seasonal
affective disorder. Air quality, exposure to noxious vapors, and chemical sensitivities may also
play a role.

Every year thousands of people commit suicide because of depression. In 1997, 30,535 people
committed suicide, partly or largely as a result of depression.


        The medical profession recognizes two main types of depressive mood disorders:

    1. Depressive disorders—characterized by one or more periods of major depression; and

    2. Bipolar disorder, commonly called manic depression, which includes at least one period
              of extreme elation or mania and one or more periods of major depression.


    There are also several other types of depression including:

         Seasonal affective disorder: mild to moderate depression with carbohydrate cravings,
          headaches, low energy, and fatigue occurring regularly in the fall or winter, and
         Premenstrual dysphoric disorder: depression, irritability, and anxiety limited to the
          few days before the onset of menses.


Definition/ Symptoms
.
According to the DSM-IV, the Diagnostic and Statistical Manual for Psychiatric Disorders,
Fourth Edition, you suffer from major depression when you have at least five of the following
symptoms for at least two weeks:

          Depressed mood most of the day, nearly every day,
          Diminished interest or pleasure in almost all activities of the day, nearly every day,
          Profound, persistent, exaggerated and inappropriate feelings of sadness,
           worthlessness, emptiness, and dejection.
          Profound, persistent irritability.
          Unexplained crying.
          Loss of self-esteem.
          Feelings of hopelessness, helplessness, pessimism, worthlessness, inappropriate guilt,
           and emptiness
          Ruminations over the past, particularly the errors you think you've made.
          Changes in sleeping patterns. Insomnia or hvpersomnia (sleeping too much) nearly
           every day,
          Changes in eating habits.
          Unexplained, significant weight gain or loss when not dieting, and decreased appetite
           nearly every day,


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          Abnormal Restlessness.
          Fatigue or loss of energy nearly every day,
          A "slow down" in physical movements.
          A drop in physical activity nearly every day,
          Diminished ability or Inability to think, concentrate, or make decisions nearly every
           day, Memory difficulties.
          Difficulty making decisions.
          Loss of interest in usually pleasurable activities.
          Loss of interest in sex.
          Social withdrawal.
          Unexplained headaches, stomach upset, or other physical problems that are not helped
           with standard treatment


It also says that one of the first two symptoms (depressed mood or diminished interest) must be
among the five symptoms you are experiencing—and that these behaviors must reflect a change
from your ordinary behavior. In addition, the following must also be true:

The disturbance is not being caused by another illness and the disturbance is not a reaction to the
loss of a loved one.

More and more people suffer from mild chronic depression called, dysthymia meaning “bad
mood.” These may be chronic underachievers, unhappy with their home life, job and life in
general.

Depression has a different biochemical pathway in the brain than anxiety, which is why, in most
instances, a depressed person doesn’t suffer from anxiety. However, people often suffer from
both depression and anxiety at the same time.



Manic Depression/ Bipolar Disorder

Definition/ Symptoms
In order to be considered mania, The DSM-IV states that your mood must be:

      Inflated self-esteem,

      Decreased need for sleep (for example, the individual feels rested after only three hours
       of sleep),

      Irritability,

      Racing thoughts,

      Impulsiveness,

      Unusual talkativeness,


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     Fidgetiness,

     Distractibility (the person’s attention is too easily drawn to unimportant external
      stimuli),

     Increase in goal-oriented activity (for instance social or sexual) or physical activity,

     Excessive involvement in activities that bring pleasure but have a high potential for
      painful or harmful consequences (for example, the person engages in unrestrained buy-
      ing sprees, sexual indiscretions, or unwise business investments),

     Also, you must act differently from your normal personality.

     Your behavior must be unusually intense, and must last for a considerable period of time

In addition, the DSM-IV says that to be defined as mania, a mood disturbance must be severe
enough to affect your job performance and participation in regular social activities or
relationships, and that hospitalization may become necessary to prevent self-injury or injury to
others.

    Some people may see some consistency in their cycling, the length of the cycles cannot be
predicted. If the symptoms are not controlled in some way, a person can cycle often, occasionally,
or seldom. When you switch often from one phase to the other, it is referred to as “rapid cycling.”

Severe mania can be dangerous and life threatening. is a term taken to describe mild mania. It is
often hard to distinguish between mild mania, “Hypomania,” and an ordinary good mood where a
person feels happy, outgoing, exuberant, and creative.

Causes of Depression and Bipolar Disorder

Studies are now showing the strong relationship between the experience of any kind of
psychiatric symptom, including depression and mania, and having had a traumatic life experience
like sexual, physical, or emotional abuse, neglect, war, natural disaster, or an accident. Other
causes are:


     Depression may be inherent; a person can be born lacking a specific neurotransmitter.
      You may have parents, grandparents, siblings, cousins, or children who are experiencing
      symptoms similar to yours,

     Faulty, inadequate diet and nutrition causing a deficiencies in key minerals,

     Chronic low cholesterol,

     The stress of today’s fast-paced lifestyle that depletes the body’s reserves of amino acids
      and vital nutrients or inhibit the body’s production of these substances.

     Food allergies that cause a deficiency in amino acids,




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      Diseases of the immune systems like lupus, diabetes (people with diabetes appear to
       have twice the normal rate; infectious diseases like mononucleosis and infectious
       hepatitis, and diseases of the central nervous system like multiple sclerosis can affect the
       production of neurotransmitters. Various kinds of cancers can cause mood swings.

      Imbalances in the hormones secreted by the glands of the body and hypothyroidism or
       an under active thyroid can also cause mood instability.

      Overgrowth of yeast (Candida albicans) in the body, caused by eating too much sugar or
       taking antibiotics.


In recent years there has been a greater appreciation of the connection between what you are
thinking or what is happening in your life and how you are feeling, both physically and mentally.
This has become known as the mind-body connection. You may be able to appreciate this by
taking a close look at your daily life. Any of the following can cause depression:

      Inadequate spiritual life,
      Severely traumatizing experiences,
      Living in poverty,
      Loneliness,
      medications, and estrogen,
      Street drugs such as marijuana, any of the “downers,” methaphetarnine, cocaine, and any
       of the opiates,
      Some medications including ibuprofen, Benadryl, Xanax, Valium, Librium, Klonopin,
       Butisol, Fiorinal, Inderal, Lopressor, Seconal, Halcion, Compazine, Thorazine,
       Percodan, Darvocet, Percocet, and Dalmane.

These factors are all thought to affect the production and activity of the neurotransmitters,
chemicals that transfer informational signals from one part of the brain to another, serotonin
(serotonergic neurons) and dopamine in your brain. People with deficiencies in serotonin
(serotonergic neurons) and dopamine tend to be depressed while people without enough nor-
epinephrine and GABA (gamma-aminobutyric acid) suffer anxiety. Also, shortages of the amino
acid taurine, which is needed to produce serotonin, and in sulfur, a key component in amino acids
cause depression.

These neurotransmitters are found in the limbic system, the part of the brain responsible for
thought, regulating emotions, body temperature, appetite, hormone levels, sleep, blood pressure,
and behavior, lies deep within the brain below the cerebrum.

Another brain structure, the hypothalamus, is interconnected with the limbic system and plays an
important role in regulating hormones, sleep, appetite, and sex drive.

Two mechanisms within the limbic system allow signals to be passed by these neurotransmitters
from cell to cell. The first mechanism is electrical stimulation. An electrical impulse is generated
in one nerve cell, also known as apassing from cell to cell, travel in this manner throughout the
limbic system and the rest of the central nervous system as well.




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An electrical impulse or “neuron” is generated in one nerve cell and travels down the length of
the cell until it reaches a very small space or gap, called a synapse, between that cell and the next.
These routes taken by the neurons are called neural pathways.

For information to be transmitted, the nerve impulse from the first cell must somehow get across
the synapse to the next cell. As the electrical impulse reaches the end of the first cell, it initiates
the second mechanism, a chemical reaction. Small sacks (vesicles) containing neurotransmitters
fuse with the cell wall.

Shortages of these neurotransmitters cause depression and anxiety because they lead to flawed
message-sending in the biochemical brain. They’re short because the body’s amino acid pool
(from which they’re made) is low.

Exactly what information is transmitted depends on which neurons are activated and what part of
the brain is stimulated by these neurons. For instance, a particular series of neural firings will
stimulate the area of the brain that tells you that you’re tired. Another series of neurons fire and
stimulate a different part of the brain that tells you it’s time to eat. Still other series will let you
know that you’re angry or happy.

  Most of the time this complex balancing act works well. People are able to experience normal
patterns of sleep and appetite, feel alert and energetic, and have normal sexual feelings. However,
   for most people experiencing depression, subtle but important chemical changes occur in the
   limbic system, resulting in a host of physical symptoms. Having to endure mood changes of
 depression, plus sleep disturbances, fatigue, and other physical symptoms make coping difficult.

Studies indicate that bipolar depression continues to be under recognized and frequently
misdiagnosed, leading to inadequate or improper treatment.


ANXIETY

Definitions

Many people who are diagnosed as being depressed are actually suffering from anxiety.
Biochemically, anxiety is a state in which the brain is over-firing, that is, sending too many
messages at once.

The human body is built to deal with stress in the short term and stress only becomes a problem
when someone becomes overwhelmed and is unable to switch off. Common symptoms of anxiety
include:

Categories

There are two categories of anxiety: Generalized Anxiety Disorder (GAD) Social
Anxiety Disorder (SAD) and Panic Disorder (PD)

Symptoms



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Generalized Anxiety Disorder is characterized by:

        Fast pulse,
        Shallow breathing,
        Headaches,
        Insomnia,
        Irritability to rage,
        Uncontrollable muscle twitches,
        Trembling,
        Tightness in throat,
        Dry mouth and problems with speech,
        Inordinate sweating, blushing, and
        General feelings of malaise
        Excessive worrying and or inappropriate guilt nearly every day that can’t be controlled
        Insomnia or hypersomnia (sleeping too much) nearly every day,
        Fear of any number of things- going outside the house, dogs, social functions
        Recurrent thoughts of death,
        Recurrent suicidal thoughts with a specific plan; or
        A suicide attempt.

Social Anxiety Disorder is characterized by:

       Extreme, constant fear of one or more social or public situations,
       Intense self consciousness in social situations
       Blushing,
       Sweating,
       Trembling,
       Fast Heartbeat,
       Nausea,
       Unreasonable Fear Of Embarrassment.


Panic Disorder is characterized by:

     Recurrent unexpected panic attacks,
     At least one attack is followed by 1 month or more of the following:
        Persistent concern about having more attacks,
        Worry about the consequences of an attack (eg. Losing control or having a heart
           attack)
        Significant change in behavior related to attacks
     Excessive sweating,
     Feeing sick,
     Suffer palpitations, and
     Worry about the way you are feeling


Most people have suffered some form of panic at some time. Definitions of a panic attack vary.




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Causes

Anxiety results from shortages of nor-epinephrine and GABA (gamma-aminobutyric
acid. Today, most of our stress revolves around finance, relationships and employment. None of
these problem areas can be avoided. For most of us that causes significant unrelenting stress in
our everyday lives. Quite simply, the brain can handle only so much stress then it manufactures
adrenalin, the fear hormone. Adrenalin works by prioritizing the blood supply. Sometimes
spurring the heart to pump oxygenated blood to the arms and legs, for a quick getaway and/or to
through the brain to help make split second decisions. The blood supply is diverted from areas it
is not needed in times of stress or danger, such as the stomach.

Smoking increases the level of nicotine that is a stimulant and causes the heart to beat faster. The
inhalation of smoke retards gas exchange in the lungs. Both can cause anxiety. However, quitting
smoking while suffering from anxiety can increase anxiety levels. Cutting back would be a good
compromise.

No one knows exactly what causes Panic Disorder, but a specific stressful event, a physical
illness or the use (or abuse) of certain drugs may trigger an initial attack. Panic Disorder may run
in families. Sometimes, however, there are no clear reasons why Panic Disorder occurs.
Numerous panic attacks can cause mood swings, irritability, loss of appetite and consequently
nutritional deficiencies. These deficiencies are primarily in B-group vitamins and can adversely
affect the central nervous system, which, in turn, can make the sufferer's anxiety even worse.
Panic Disorder is a treatable medical condition and although it cannot be prevented, it can be
managed with your doctor’s help and with proper treatment.


Researchers are currently looking at a number of possible factors that cause anxiety and panic
disorder such as:
      Genetics,
      Breathing disorders,
      Shortages of key brain chemicals or neurotransmitters such as dopamine and nor
         epinephrine,
      Emotional or cognitive conditions,
      Insufficient levels of nerve-signal-blocking chemicals in the brain, such as GABA and
         magnesium, that offset the onslaught of rapid, randomly triggered information,
      Surgs of Adrenalin.



Diagnosis And Treatment Of
Depression, Bipolar Disorder and Anxiety


Diagnosis

The first step in minimizing depression and anxiety should include a complete patient
examination including hair analysis, blood profiles urinalysis and electro-dermal screening.
Electro-dermal screening is conducted to determine more detailed biochemical information about
the patient’s health, nutrient needs, possible heavy metal toxicity, and the presence of food
allergies that affect the brain.


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Also the practitioner should interview the patient in order to determine significant past and
present life style problems, and changes or events that may have triggered chemical imbalances.
Also, the patient’s diet should be thoroughly analyzed in order to tell if they are eating the right
mix of elements that create neuro-transmitters.

Treatment

Several types of medical professionals treat depression, including family doctors, internists,
psychiatrists, psychologists, RNs and social workers. There are three main types of therapy
offered today:
      Psychotherapy, or "talk therapy;"
      Drugs, and
      Electro convulsive shock therapy.

Types of psychotherapy include:
     Behavioral therapy,
     Cognitive therapy, and
     Psychodynamic therapy.

These treatments may be taken alone or in combination. Such treatments help people learn to
restructure the way they behave, think, and relate to others to better improve mental well being.

The principal treatment for depression, bipolar depression and anxiety is to prescribe
psychotropic drugs. When patients complain of symptoms mentioned above they are directed to
see their doctor, a therapist, psychologist or psychiatrist. Typically these practitioners interview
the patient or give them quizzes in order to determine their symptoms, eating and sleeping habits,
psychological background and characteristics- trauma experienced during childhood, recent or
past traumatic life changing events, etc. Then they almost automatically prescribe a drug to
correct the biochemical imbalance they perceive is causing anxiety and depression. In essence
they take an educated guess without really knowing exactly which chemical is deficient.

There is also a shift away from more invasive and traumatizing treatment to simpler, noninvasive
self-help, wellness, and recovery-oriented strategies.

Today, there are many different medications available and new ones are constantly coming on the
market. The new medications are purported to be more effective at relieving symptoms with
fewer side effects.

Practitioners seldom prescribe natural herbs or supplements as an alternative to prescription drugs
and rarely do they conduct or suggest a full medical workup prior to writing a prescription.

Prescription Drugs

As noted earlier depression, bipolar and anxiety disorders may be the result of shortages of
certain brain chemicals or neurotransmitters.




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Therefore, the principal treatment goal is to enhance the amounts of those chemicals. The most
contemporary method of treatment involves 15 minute sessions with a psychopharmacologist (An
expert in using medications to treat chemical imbalances in neurotransmitters) once a week in the
beginning and once a month later. The conventional method Psychopharmocologists
(Psychopharmacologist, M.D., Psychologist, Psychiatrist, RN or other practitioner certified to
prescribe medications) employ to enhance those chemicals is through prescribing psychotropic
drugs or antidepressants.

As indicated above, usually these drugs are prescribed without any physical examination or
chemical analyses what so ever. Therefore, they take an educated guess at which chemicals are
lacking in the patient. They guess at the chemical imbalance and prescribe a medication on a trial
basis for a month and monitor it’s effects. If there is improvement the patient continues taking
that medication with an increase or decrease in the dosage. If the patient doesn’t improve then the
Psychopharmocologist prescribes another drug and so on until the drug is found that shows the
most promise.

During this period the patient may experience mild to severe side effects from the new
medication and withdrawal symptoms from the old medication. These may last four or more
weeks. A certain number of these patients end up in a hospital for treatment of these side effects
and symptoms.

Psychopharmocologists also recommend seeing a therapist on a regular basis, as well as, changes
in diet, more sleep, exercise, a job change or relocation to name a few.

When you consider taking an antidepressant it is important that you first become informed of
how the medication works, it’s side effects, withdrawl symptoms and alternative treatments.
There is always the chance of severe, adverse side effects or overdosing. Therefore their effects
on your system must be closely monitored through regular blood testing. Medications must be
taken regularly to be safe and effective.

Antidepressants are generally not "addictive" and have low abuse potential. However, it is
possible to have a rebound of depressive symptoms, especially if the medication is stopped
prematurely. Furthermore, "withdrawal" syndromes occur when a patient stops taking the
medication. These can be severe if it is stopped too abruptly.

All antidepressants require at least two to four weeks of treatment before the first signs of
improvement are noticed. The majority of people taking antidepressants in the United States stop
taking the medication before this period of time, and thus do not benefit at all from the
medication.

There are more than 20 antidepressant medications currently available in the United States; they
are not all alike. They are grouped into three classes: 1) first generation anti-depressants,
developed in the 1950s through the 1970s; most of these are known as tricyclics, 2) monoamine
oxidase inhibitors (MAOIs), and 3) second generation antidepressants, which have been
developed more recently.

Lithium carbonate , a tricyclic, was the first drug taken for depression. An unknown
psychiatrist located in Australia accidentally discovered lithium. In the 1950’sand 1960’s the
manufacture and use of such drugs grew exponentially. By 1969 five hundred million patients
around the world had taken them. Since then the figure has at least doubled. It is estimated that in



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the United States alone two million patients use them. The tricyclics enhance the concentrations
of norepinephrine and serotonin,.

Classifications of Prescription Drugs

These prescription drugs are classified as:

    1.   Tricyclics (heterocyclics),
    2.   MAOIs (monoamine oxidase inhibitors),
    3.   MAORIs-monoamine oxidase ruptake inhibitors), and
    4.   SSRIs- serotonin reuptake inhibitors



While there is considerable overlap in their actions and uses, these different categories of
antidepressants work by distinct mechanisms, have different side effect profiles, and may be
favored for varying reasons.

For these reasons, they will be discussed separately below.

Tricyclics

The following medications are Tricyclics:

        Tofranil, Tofranil-PM
        Amitriptyline ( Elavil, Endep),
        Desipramine (Norpramine, Pertofrane),
        Nortriptyline (Pamelor And Aventyl),
        Trimipramine (Surmontil),
        Protriptyline (Vivactil),
        Doxepin (Adapin, Sinequan), and
        Clomipramine (Anafranil)




MAOIs

The monoamine oxidase inhibitors (MAOIs), are also available-but they are rarely used. (MAOIs
are very toxic drugs that if taken in large amounts, and can cause death. These medications are
effective against depression by inhibiting the metabolism of the neurotransmitters serotonin,
norepinephrine, and dopamine.. The list of foods to avoid includes chocolate, aged cheeses, beer,
and many more. If you or your child must take a MAOI, familiarize yourself thoroughly with
these dietary restrictions. The most frequently prescribed drugs in this class are:

      Aurorix (moclobemide),
      Nardil (phenelzine), and
      Parnate (tranylcypromine sulfate).




                                                                                               12
If your doctor prescribes a MAOI, read the package insert carefully, and learn more about its
possible side effects from a medication reference book or your physician.

The function of monoamine oxidase is to break down the neurotransmitters. Monoamine oxidase
inhibitors prevent this, so higher levels of neurotransrnitters are retained in the synapse. People
who overeat and oversleep when they are depressed usually get the most benefit from MAOIs.
Because of the chemical reactions caused by them MAOIs and antidepressants.should not be
taken at the same time.

Serotonin Reuptake Inhibitors (SSRIs)

Selective serotonin reuptake inhibitors (SSRIs) include Zoloft (sertraline), Paxil (paroxetine),
Celexa (citalopram), Serzone and Prozac (fluoxetine). These widely prescribed drugs are SSRIs
and enhance or increase serotonin levels by preventing the hormone from being reabsorbed and
"taken out of circulation."

The antidepressants, along with their aliases, most commonly prescribed to increase serotonin
(SSRI), dopamine (SDRI) and/or nor-epinephrine (SNRI) are:

         Cymbalta/Yentreve
         (Duloxetine);
         Prozac/Sarafem/Fluctin (Fluoxetine);
         Paxil/Seroxat/Aropax/Pexeva
         (Paroxetine);
         Remeron/Remergil (Mirtazapine);
         Meridia/Reductil (Sibutramine);
         Effexor/Efexor (Venlafaxine); and
         Luvox/Fevarin (Fluvoxamine), etc.


MAORIs (monoamine oxidase ruptake inhibitors)

MAORIs such as Valium, Wellbutrin (Zyban), Effexor (Venlafaxine), Lorazipam (Ativan); and
the other benzodiazepene drugs affect two or more elements and therefore affect both depression
and anxiety at the same time:

         Effexor (affects norepinephrine and serotonin)
         Wellbutrin (serotonin, norepinephrine and dopamine)
         Remerort (norepinephrine and serotonin
         Lorazipam (norepinephrine and dopamine)

Antidepressant medications, while helpful to many people, are not panaceas. Some studies have
shown that drugs are of no value in treating about 33% of depression cases. In another 33% of
cases, the drugs were only a little more effective than placebos and they cause side effects.


Antidepressants take two to four weeks or more to work, so they are not a way to quickly feel
better.




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On the basis of clinical experience and research, there is a consensus that patients with major
depression can typically be taken off their antidepressant medication after six to eight months of
clinical response without doing worse than patients who continue on the medication. In contrast,
premature discontinuation after fewer months or after a less complete treatment response can
often lead to a relapse.

Dosage

If you are in good health, the dose should be increased every two to four days as tolerated until it
is in the therapeutic range. For the elderly or infirm, the interval between dosage increases is
lengthened, generally to between seven and ten days as tolerated. Your doctor should do a
thorough review with you of what side effects to anticipate.

Side Effects

Antidepressants have potentially serious side effects and must be taken with caution. Fortunately,
the more serious adverse effects are rare.

The most common side effects by classification include:

Tricyclics: headache, dry mouth, constipation, diarrhea, nausea, indigestion, fatigue, weakness,
drowsiness, nervousness, anxiety, excessive sweating, tremor, insomnia, weight gain, "sweet
tooth." dry mouth or eyes (of concern particularly in patients with dental problems and contact
lenses, respectively); a peculiar taste in the mouth; and dilation of the pupils with resultant
sensitivity to bright light. blurry vision

MAORIs: dizziness, restlessness, tremors, dry mouth, constipation, difficult urination, "sweet
tooth." abnormal dreams, abnormal ejaculation or orgasm, anxiety, appetite loss, blurred vision,
chills, diarrhea, dizziness, frequent urination, flushing, gas, headache, impotence, infection,
insomnia, muscle tension, nausea, nervousness, rash, sleepiness, sweating, tingling feeling,
tremor, upset stomach, vomiting, weakness, yawning, abnormal taste, abnormal thinking,
agitation, chest pain, confusion, decreased sex drive, depression, dilated pupils, dizziness upon
standing up, high blood pressure, itching, loss of identity, rapid heartbeat, ringing in the ears,
trauma, twitching, urinary problems, weight loss, heart palpitations, and migraine headache


SSRIs: nausea, diarrhea, nervousness, anxiety, drowsiness, insomnia, headache, increased
sweating, increased or decreased appetite, and decreased sexual drive (Most of these symptoms
wane or disappear with time.)

Generally the most common side effects of antidepressants include:

      Blurred and other abnormal vision,
      Confusion,
      Dry and horse throat,
      Fogginess,
      Weakness
      Low blood pressure,
      Dizziness,
      Sleeping disorders,


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      Irritability/anxiety, extreme anger,
      Sweating,
      Fogginess,
      Runny nose,
      Muscle aches,
      Increased saliva,
      Tremor,
      Stomach knots or pain,
      Indigestion, and

Withdrawal Symptoms

Each person responds differently to stopping serotonin boosters, or Selective Serotonin Reuptake
Inhibitors (SSRI's). While some people experience mild side-effects when stopping the drug,
others will have horrendous side-effects from just lowering the dosage, since the neural system in
the brain has become dependent on the actions of the (SSRI) anti-depressant.

Withdrawal symptoms from (SSRI) Anti-depressants may occur within 8-hours. These often
include a spontaneous experience of a "flu-like" syndrome, feeling "crummy", tired, achy, etc.
These last up to 3-4 weeks. Frequently patients have been hospitalized because they didn’t take
adequate time to “wean” themselves off the medication.

In addition to the flu-like symptoms the following symptoms frequently occur:
     Anxiety,
     Dizziness,
     Fatigue,
     Headache,
     Migraine-like feelings,
     Nerves jangling when moving eyes, continuous indigestion,
     Neck and back pain,
     Psychotic features such as visual and/or audile hallucinations/illusions,
     Insomnia,
     Nausea,
     Restlessness,
     "Electrical shock" like phenomena/electrical surges or shocks through the head and/or
        body,
     Hyper-sensitivity of the nervous system to light, sound, colors & stressors,
     Remors,
     Severe agitation,
     Extreme irritability,
     "Over-reacting",
     Vomiting,
     Paranoia,
     Aggressive behavior,
     Roller coaster emotions,
     Out of character behavior,
     Severe malaise,
     General dysphoria,
     Derealization,
     Panic attacks.



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By stopping cold turkey, serotonergic activity will drop drastically. This causes withdrawal
symptoms such as:
      Electrical surges/shocks in the head (brain shivers) and/or
      Body, pins and needles on the skin,
      Feelings as being on the verge of losing consciousness,
      Blackouts,
      Short term memory problems, etc.

Transition Symptoms

Transitional symptoms experienced while changing from one medication to another include some
of both the side effects and with drawl symptoms.


The Right Way to Wean Off an SSRI/SNRI/SSNRI Antidepressant

No one should stop taking their medication cold turkey, but anti-depressant use should be tapered
off very, very slowly. When dosages are cut back gradually withdrawal symptoms are at least
minimized.

Don’t go off medication without medical supervision. The best way to minimize withdrawal
symptoms is to wean off the medication. By reducing the dosage in small increments, your
serotonergic system can gradually take over it's own natural serotonin producing activity and
slowly adapt to living without the drug. This process may take up to a year or longer. Some
doctors are halving the dose every week or two. It is generally recommended that you take much
longer to taper off. Nor should you skip daily doses. Taper gradually with an absolute maximum
of 5% per week. When it gets down to the smallest dose, (10mg capsule), you can try "The
Orange Juice Bit", "Cutting Tablets" or "Oral Suspensions-Liquid Preparations":

"Orange Juice Bit"
   1. Pour a glass of orange juice
   2. Pull apart the capsule and stir into the orange juice
   3. Drink 9/10 of it and repeat this every day until the 7th day
   4. The next week drink 8/10 of it until the 14th day, then 7/10 until the 21th day, 6/10 until
      the 28th day, and so on...
   5. Repeat the "orange juice bit" several weeks until you've totally come off your (SSRI)
      antidepressant...

Never ever use Grapefruit Juice. Grapefruit juice is an inhibitor of the cytochrome P-450
enzymes. These enzymes are known to metabolize (break down) (SSRI) antidepressants in the
liver. Drinking grapefruit juice w toxic reaction, because the chemical ingredient will build to
toxic levels in the bloodstream!

"Cutting Tablets"
If you don't take capsules but tablets, you can try to chip smaller doses off the tablets.
Unfortunately this is a very uneasy task. You could order a pill cutter or pill splitter at your local
pharmacist to facilitate this procedure. Pill-cutters aren't that expensive.


Anxiety


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An SSRI antidepressant can often relieve the symptoms of anxiety and panic attacks, but in more
severe cases an anti-anxiety medication (tranquilizer) may be prescribed. Depending on your
doctor's advice, these may be taken daily or on an "as-needed" basis. Often they are prescribed as
a temporary measure only. The most common medications taken for anxiety are:

        Allegron (nortriptyline)
        Ativan (lorazepam )
        BuSpar (buspirone
        Centrax (prazepam)
        Klonopin (clonazepam)
        Librium (chlordiazepoxide)
        Serax (oxazepam)
        Tranxene (clorazepate)
        Valium (diazepam)
        Xanax (alprazolam)

Medication treatment of manic depression depends on the phase of the disorder (i.e., whether the
person is experiencing depression or mania). When the current phase is depression, an
antidepressant and a mood stabilizer are usually given together. Mood stabilizers when given
alone rarely are effective in reducing depressive symptoms and it antidepressants are prescribed
without a mood stabilizer, there is a significant risk that the medication will set off a rapid shift
from depression to out-of-control mania.

Any of the previously mentioned antidepressants can be taken, although often the choice is
Wellbutrin (this drug appears to have a somewhat smaller likelihood of causing a shift into mania,
and is often taken to treat bipolar depression). The antidepressant targets depressive symptoms
and the mood stabilizer plays two roles: it helps to prevent a rapid shift into mania and once the
depression is gone, the continued use of a mood stabilizer helps to prevent future episodes. Mood
stabilizers (discussed below) are often very effective in preventing recurrence If a person is
experiencing symptoms of mania, a different approach is taken.

The most commonly taken mood stabilizer is lithium. This drug has been used in the United
States since 1970 and is considered to be an effective medication for many people suffering from
bipolar disorder. Lithium is a medication that, unlike antidepressants, must be monitored very
closely to make sure the blood level is appropriate and well controlled. If lithium blood levels are
a bit too tow, the medication does not work; it a little too high, there are serious side effects. Thus
frequent blood tests are required, especially during the first two months of treatment. Lithium side
effects often include:

        Weakness,
        Tremor,
        Fatigue,
        Lethargy,
        Weight gain,
        nausea,
        Diarrhea, and
        Sedation.




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Some of these medications also require blood monitoring, but not as frequently as are needed
with lithium. It is unclear how lithium and the anticonvulsants work to treat bipolar disorder,
although some data suggest that they help to normalize the internal chemistry of certain nerve
cells.



Natural Remedies

Holistic Approach
Many people are reporting success in relieving their symptoms by consulting with holistic health
care practitioners like naturopathic physicians and nutritionists, and using specific therapies like
food supplementation (using vitamins, minerals, herbs, amino acids, homeopathics remedies,
etc.), acupuncture, acupressure, and massage. Several doctors are doing work reporting excellent
results in many cases. Some people prefer this option to medical treatment because they achieve
higher levels of wellness without the side effects of traditional medication therapy.

If you have suffered a traumatic experience some part of your treatment should involve seeking
help from other supportive people so that you regain the trust lost in the trauma. While there are
effective trauma treatment programs in many areas, there are other areas where it is difficult or
impossible to get help.



Proper Nutrition
Proper nutrition plays a major role in controlling anxiety. Generally our diet should include the
following:
      Green vegetables,
      Nuts,
      Low-fat cheese,
      Bananas, and
      Seaweed for their B vitamins;
      Live yogurt for the bacteria that synthesizes B vitamins;
      Blackcurrants,
      Blueberries,
      Bilberries,
      Cherries,
      Apples,
      Oranges,
      Grapefruit, and
      Cranberries for their vitamin C and Bioflavonoids;
      Pasta,
      Rice, and
      Potatoes for complex carbohydrates;
      Honey and
      Dried fruit for their tryptophan.




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Someone suffering from anxiety should eat less refined sugar and fewer carbohydrates, drink less
alcohol, avoid drinks and food that contains high levels of caffeine such as tea, coffee, soft drinks
and chocolate etc.

Regular exercise such as a ten-minute walk may be sufficient to reduce anxiety, although a more
vigorous exercise regime will increase oxygen in your system and use up excess adrenalin.

Quit Caffeine
Not eating foods and drinks that contain caffeine, such as coffee, soft drinks, cakes, candy, soda,
and refined and processed foods reduces anxiety and depression.
Caffeine can leave you mentally and physically drained. Avoid coffee, tea, soft drinks, chocolate,
and cocoa, as well as the "hidden" caffeine in Excedrin, Midol, Anacin, and many other
medicines. (Ask your physician or pharmacist if the medicines you are taking contain caffeine. If
they do, talk to your physician about switching to other medications.)


Avoid Sugar
Sugar jolts us with a burst of energy which can make us feel excited, talkative, and ready to take
on the world. However, when the body responds by snatching the excess sugar out of circulation,
it often takes too much, leaving us tired and depressed. Some depressed patients experience wild,
sugar-induced fluctuations in their moods.


Amino Acids
According to Harold Whitcomb, M.D., and biochemical nutritionist Phyllis Bronson who practice
orthomolecular medicine at the Clinic for Preventive and Environmental Medicine in Aspen,
Colorado.

Substituting natural amino acids for the psychotropic drugs to lift depression results in more
thorough healing with no side effects, with drawl or transition symptoms. Amino acids
supplements that can be substituted for antidepressant drugs include:

       SAMe
       5-Hydroxytryptophan
       Omega-3 Fatty Acids
       Adrafinil,
       DMAE,
        KH3,
       L-Carnitine,
       NADH,

Good sources of amino acids are fertile eggs and Brazil nuts, both high in sulfur.


DMAE (Dimethylaminoethanol)
DMAE is a naturally occurring nutrient, found in sardines and other foods, that may help relieve
depression and/or fatigue. A brain stimulant, DMAE passes through the blood-brain barrier into
the Scientific study and clinical experience show that several natural remedies can help alleviate
depression.




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DMAE has been shown to elevate mood; improve memory and learning; and increase intelligence
and is even more effective when taken with vitamin B5 (pantothenate). DMAE has also been
taken with great success in the treatment of attention deficit disorder (ADD) in children and
adults.

SAMe is a natural substance that the body can produce from the essential amino acid methionine
and adenosine triphosphate (ATP). Found in all our cells, it plays an important role in critical
biochemical processes. It serves as a precursor for glutathione, coenzyme A, cysteine, taurine,
and other essential compounds, and is needed for the production of serotonin and other
neurotransmitters.

Researchers from the University of Alabama at Birmingham found that depressed patients were
not making enough SAMe in their brains. After checking red blood cells from patients suffering
from depression and schizophrenia, they discovered a deficiency in methionine adenosyl
transferase (MAT), an enzyme necessary for the formation of SAMe. This enzyme was, however,
higher in people with mania.

5-Hydroxytryptophan (5-HTP) To make serotonin, the body first converts the amino acid L-
tryptophan into 5-hydroxytryptophan (5-HTP). Some studies have shown that supplemental L-
tryptophan relieves depression. In people with a personal or family history of depression, a diet
devoid of tryptophan can cause moods to crash in a matter of hours.

Tryptophan is an essential amino acid component of protein. Dried skimmed milk is rich in
tryptophan and one can stir a couple of teaspoons into yogurt, or add it to soups, sauces, milk
shakes and desserts.

Omega-3 Fatty Acids According to our culture consumes too much saturated fat (found in
animal fats) and omega-6 fatty acids (found in the corn and soybean oils taken in so many
processed foods), and too little of the omega-3 fatty acids (found in fish oils and some plants such
as flax seed). This imbalance has been associated with increased levels of depression.

Cold water fish, green leafy vegetables, flaxseed, chia seeds, grapeseed, pumpkin seeds, Brazil
nuts, and walnuts increase omega-3 fatty acids.


Other Supplements

Herbs
Kava is an herb that has been taken for centuries in the Pacific islands for treating anxiety. It also
has been found to be very effective in treating mixed anxiety and depression. Kava has been
approved in certain European countries, including Great Britain, for the treatment of anxiety and
depression. Kava is non-addictive amid does not decrease mental functioning like other anti-
anxiety drugs, such as Lorazepam and Valium.

St. John's Wort (Hypericum perforatum) In Germany, where it is covered by health insurance
as a prescription drug, some 20 million people take St. John's Wort for depression. Like Prozac,
St. John’s Wort inhibits serotonin reuptake. St. John’s Wort also can help you sleep
better. The brand of St. John’s Wort you purchase should have a 0.3 percent hypericin
content.


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Ginkgo (Ginkgo biloba) An extract from the leaf of the ginkgo tree increases blood circulation
to the head and other parts of the body. It also acts as an antioxidant, stabilizes cell membranes
and scavenges free radicals, particularly in the brain. Although better known for improving
mental function in normal people and those with Alzheimer's, ginkgo may be of value in older
people with depression.

Caution: Because ginkgo has a mild blood-thinning effect, it could theoretically cause bleeding
problems if combined with blood-thinning drugs such as warfarin, heparin, aspirin, or
pentoxifylline.


Ginseng There are three types of ginseng; the stronger Asian variety (Panax ginseng), the
milder American ginseng (Panax quinquefolius) and Eleuthero or Siberian ginseng
(Eleutherococcus senticosus). All three plants are adaptogens, substances that help the body adapt
to stress. Eleuthero ginseng, however, has not demonstrated antidepressant activity, according to
the medical literature.

Caution: Asian ginseng at high doses can cause side effects.


Vitamins And Minerals

There are 15 trillion neurons (nerve cells) in the human brain. There are far more glial cells
(neuroglia) that fill the spaces between the neurons, Schwann cells, and miles of blood vessels to
nourish the three or so pounds (2% of the body weight of a person weighing 150 pounds) of brain
tissue in the average head.

Brain cells demand nourishment from as much as 30% of circulating blood. If the brain doesn't
get specific nutrients, its biochemistry changes, resulting in fatigue, depression, irritability, and
other symptoms.

For example, the brain needs a good supply of B vitamins to act as coenzymes (catalysts) for
many functions, including converting nutrients from food to fuel that our bodies can use. Glucose
is the brain's primary fuel. If glucose levels fall, we may feel depressed, tired, or unable to think
clearly.

B vitamins are also needed to help the brain make neurotransmitters.

A host of vitamins and minerals help maintain normal brain function. A deficiency of any one of
those listed below can lead to depression and other mental disorders:

        Folic Acid
        Vitamin B12
        Vitamin B6
        Vitamin B1
        Vitamin B3
        Vitamin B2
        Vitamin D
        Vitamin C
        Choline


                                                                                                        21
      Inositol
      Potassium

Folic acid is a member of the B family of vitamins. Low levels have been linked to depression
and bipolar disorder in a number of studies. Insufficient folic acid is one of the most common
nutritional deficiencies, and one third of depressed adults are low in this vitamin.

Folic Acid can be found in dried baker's yeast, fortified yeast extract such as marmite,
blackeye beans, kidney beans, endive, broccoli, legumes (especially chickpeas), soy
beans, vegetables (especially spinach, brussels sprouts, spring greens, okra, cabbage),
almonds, beetroot, parsnips, walnuts, oatmeal, brown rice, and corn (on cob).


Vitamin B12 (also called cobalamin) is needed by the body only in very small quantities. A
major deficiency causes a serious disease called pernicious anemia. Lesser deficiencies, which are
common among the elderly, can produce depression, psychotic behavior, confusion, loss of
memory, paranoia and other symptoms. B12 may help to fight depression by inhibiting
monoamine oxidase (MAO), an enzyme that metabolizes some of the neurotransmitters that help
to elevate mood.

This vitamin is found in beef liver, chicken liver, clams, oysters, and sardines, with smaller
amounts in eggs, many fish, and cheeses (especially cheddar, parmesan and edam), fortified
yeast extract such as marmite, cottage cheese and milk. Vegetarians should consider taking
supplements to make sure they are getting enough of this vitamin.

Vitamin B6 (also known as pyridoxine) is needed for conversion of the amino acid tryptophan to
serotonin. While serious deficiencies of B6 are not common, minor deficiencies are and they can
cause depression, convulsions, and other problems. Alcoholics are more likely to be lacking this
vitamin as are those who have heart disease, liver disease, diarrhea, or other illnesses or injuries.

Vitamin B1 (also know as thiamin) was the first of the B family of vitamins to be discovered. A
severe lack of this vitamin leads to beriberi which causes confusion, depression, irritability,
loss of memory, loss of concentration, exhaustion, high blood pressure, problems with the
heart, and other symptoms. Taking B1 supplements, or in some cases simply eating lots of foods
rich in this vitamin, has resolved side effects of antidepressant medication, such as dry mouth,
insomnia, and stomach upset--inexpensively and with no side effects.

Foods containing B1, including kale, spinach, turnip greens, green peas, lettuce, cabbage, and
other vegetables, breakfast cereals, etc..

Vitamin B3 (niacin or niacinamide) is needed to convert the amino acid tryptophan into
serotonin, a neurotransmitter that plays an important role in keeping us happy. Not enough B3
means not enough serotonin, with resultant depression and anxiety. Prozac and the other SSRIs
work by increasing brain levels of this neurotransmitter.

Without sufficient B3, the body cannot convert tryptophan into serotonin, leading to loss of
memory, mood swings, depression and anxiety.




                                                                                                   22
Foods such as brewer's yeast, brown rice, whole wheat, seeds, nuts, peanuts, and other legumes
fortified yeast extract (such as marmite), brewer's yeast, peanuts and peanut butter,
sesame seeds, brown rice, whole meal flour, wheat germ, whole meal spaghetti, whole
meal bread, barley, and cheeses (especially parmesan, cheddar and blue cheeses) contain
niacin.

Vitamin B2 (riboflavin) has been linked to mood swings. In 1973, researchers discovered that if
normal, healthy men were given diets nearly devoid of this vitamin, they would soon score higher
ratings on tests designed to detect depression.

Foods containing this vitamin include asparagus, broccoli, spinach, almonds, wheat germ, millet,
and whole wheat bread.


Vitamin D is considered both a vitamin and a hormone because our bodies, given exposure of the
skin to sunlight, can produce it. During the winter, there is less sunlight and we also tend to spend
less time outdoors. At this time or year, we are most vulnerable to becoming low in vitamin D.
Winter is also the time when vulnerable people develop seasonal affective disorder or "winter
blues." One treatment for this disorder involves the use of "light boxes" to artificially increase
exposure to light. One theory is that this works by stimulating, via the eye's retina, the brain's
pineal gland. It may also promote vitamin D production.

Potassium is a mineral that helps to keep the heart beating regularly and has also been linked to
depression. Mood upsets, fatigue, and weakness, all symptoms of depression, have been
associated with low levels of the mineral. These problems can occur if there is not enough of the
mineral inside the cells, even if there is enough potassium in the body fluids (outside the cells).
Lower levels of potassium in the brain have been found in suicide victims. Replenishing
potassium stores helps to reverse the fatigue and muscle weakness that may be associated with
depression--or may be present on its own.

Natural Hormone Replacement.
Scientific studies continue to show that depression is often caused by a deficiency in one of the
following hormones:

         DHEA
         Progesterone
         Pregnenolone
         Testosterone

There are natural hormone therapies available to both men and women who may be suffering the
consequences of a deficiency in certain hormones

Thyroxine, a thyroid hormone usually taken for the treatment of hypothyroidism, has been found
to alleviate depression in patients with treatment-resistant chronic depression when the thyroxine
is taken in concurrence with their normal medication.

DHEA (Dehydroepiandrosterone) is produced by the adrenal glands and gonads. It serves as a
parent compound for estrogen and testosterone. It is important for brain function. The brain



                                                                                                    23
contains six and a half times more DHEA than any other organ. From puberty, DHEA levels rise
steadily, peaking at about the age of 25. By age 70 or 80, there is only about 10% of that peak
amount left. Thus, it may be helpful for many people to take supplemental DHEA. Preliminary
research suggests that it is helpful in treating adrenal insufficiency and in improving well-being in
menopausal women and elderly men.

Caution: DHEA supplementation is contraindicated in men and women with hormone-related
cancers. Consult the DHEA Replacement Therapy protocol for more information. A blood test
can determine if DHEA levels are low. If you need supplementation, periodic blood monitoring
can determine whether your DHEA levels have risen to the youthful normal range.

Progesterone Women experience a gradual loss of the critical sex hormone progesterone
throughout adult life. This decline becomes significant as women get closer to menopause.
Symptoms of a progesterone deficit include premenstrual discomfort, night sweats, and hot
flashes, along with feelings of depression. During and after menopause, natural progesterone
synthesis often grinds to a halt, setting the stage for a host of menopausal miseries and
degenerative diseases. In addition to making people feel better, progesterone may help to prevent
the mental decline that occurs with aging. Progesterone has been shown to increase neuronal
energy production and to protect brain cells.

 Pregnenolone is another hormone produced by the ovaries and by the adrenal glands in men and
women. It can be very useful for treating depression. Some studies have shown that depressed
people have less than normal amounts of pregnenolone in their spinal fluid. Pregnenolone likely
works by preventing the brain from being overwhelmed by GABA (gamma-aminobutyric acid)
and other hormones that slow its activity.

Testosterone As men enter their 40s, hormonal changes occur that often produce a noticeable
effect on physical, sexual, and cognitive energy levels, as well as a loss of feeling of well being.
Until recently, these changes were attributed to "growing old," and men were expected to accept
the fact that their body was entering into a long degenerative process that would some day result
in death.

Data gathered over the last few years indicates that many of the diseases that men begin
experiencing over age 40, including depression, abdominal weight gain, prostate, and heart
disease, are directly related to hormone imbalances that are correctable with currently available
drug and nutrient therapies. Unfortunately, conventional doctors typically prescribe
antidepressant, cholesterol-lowering, and other drugs to correct symptoms of a possible hormone
imbalance. If doctors checked their male patient's blood levels of estrogen, progesterone,
testosterone, prolactin, thyroid, and DHEA (instead of prescribing drugs to treat symptoms), they
might be surprised to learn that many problems could be eliminated by adjusting hormone levels
to fit the profile of a healthy 21 year old.


Self Help

While you may think of self-help as those things you do to help yourself, like going for a walk or
avoiding alcohol, it also includes deciding what kind of assistance from others would be helpful
in relieving these troubling symptoms

Counseling:


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Counseling services are available through both the public and private sectors. You can contact the
mental health center or ask your doctor for referral to a counselor. Find a counselor who has a
good reputation and is recommended by someone. Sometimes a counselor will help you address
daily issues that are upsetting to you, or on your way of dealing with stress in your life. There
may be a spiritual focus, or a focus on changing negative thought patterns to positive ones In
order to be effective for you personally, you must be comfortable with your counselor and with
the approach they are taking. Your choice of a counselor, how often you see your counselor and
how much time you spend with your counselor, may be affected by your insurance coverage.

Choices about Relieving Your Symptoms
Because there are many reasons why you experience depression and manic depression, there are
also many ways that you can relieve these symptoms. Unless your symptoms are so severe that
your life is in danger, or you put the lives of others in danger, the choice on how you will relieve
these symptoms is yours. In the past you may have been dependent on your health care provider,
particularly a doctor or psychiatrist, to make the decisions on how you would relieve these
symptoms.

Programs and Services

Various kinds of mental health—oriented community services are available everywhere. To find
out what programs and services are available in your area, you may need to do some research.
Ask your physician or psychiatrist

Go to a support group and ask attendees what services have been helpful to them. The following
list will give you an idea of some efforts that have been initiated around the country.

Recovery Centers:
A recovery center is a place where you can go to learn specific skills and strategies that support
your recovery or that may be useful to you in your life. For instance, at the Boston University
Center for Psychiatric Rehabilitation, you can attend free classes in things like computer use,
yoga, and nutrition. You can learn to how to develop a Wellness Recovery Action Plan.

Educational Programs:
Educational programs, either as part of or separate from a mental health center or mental health
organization, are becoming more and more widely available. These programs are usually held on
a weekly basis and may be from one to three hours in length. They teach attendees recovery skills
and strategies, as well as other life skills. There is a network of over 300 trainers nationwide who
teach Wellness Recovery Action Planning, along with other mental health recovery skills, in
mental health centers and in the community.

Mental health centers:
Mental health centers across the country offer a wide variety of services like case management,
medication monitoring, financial assistance and oversight, vocational training, support groups,
meals, and recovery-oriented educational programs. Many have a treatment program that you can
attend during the day, going home in the evening instead of hospitalization.

Respite Centers:
Respite centers are an alternative to hospitalization. You can go to a respite center when your
symptoms are severe and be supported by trained people who have had symptoms similar to the
ones you are experiencing. These centers have proven to be helpful, cost effective, and non-
traumatizing. There is a national effort to support the development of more of these centers.


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Personal Growth or “Spiritual Awakening”

Some people feel that the onset of their symptoms was triggered by a need to address some
pressing life issues or take a different life path. Many have considered it to be a time when they
had to address issues related to spirituality that had “come up” for them or that they had avoided
in the past. There is documentation of cultures that honor the occurrence of these symptoms as a
time when a person needs to “look into their soul.”

In the 1950s, John Weir Perry did some exciting work with people who were having troubling
symptoms. He set up a comfortable home where people could come and, while being well
supported, explore the depths of their soul in any way they chose. They could draw, paint, sing,
cry, talk, rant, work with clay—whatever felt right to them at the moment—without guidance or
criticism. They were given food and kept safe while they were going through this process. In
time, usually five to six weeks, they felt better and went back to resume their lives.


Stigma and Shame

Experiencing a mood disorder is painful and can seriously disrupt your life. The stigma and
shame that can come with these symptoms make the situation worse. Instead of getting the
support and compassion you need to get through these very hard times, you may be ostracized by
others, treated badly, and prevented from doing the things you want to do. In addition, you may
have seen others with symptoms similar to yours being portrayed harshly in the media. This
increases the stigma. Jobs, housing, relationships, respect in the community—all can be lost if
you reveal or others find out you experience extremes of mood. However, this situation is
changing.

More and more educational programs are being offered to the general public, while literature on
depression, bipolar disorder and anxiety is more prevalent.

In addition, changes in the way these symptoms are treated are helping to reduce stigma and
shame. Today even short-term hospital care for these conditions is infrequent. Community based
mental health centers and short-term care facilities that are becoming more and more user-
friendly and helpful are becoming the norm rather than the exception.

Things to Keep in Mind
In your quest to learn about depression and/or manic depression, you may have learned some
things about these symptoms and how to deal with them that were true, some that were only
partially true, and some that may not be true or not be true for you. You will learn many things
that are contradictory.

People who experience these kinds of symptoms do get well. They go on to do the things they
want to do in their lives. You may continue to have symptoms, but you will know how to manage
them so they have less impact on your life.

It is not your fault you have these symptoms. There are many possible reasons why you could
have developed these symptoms, including genetics, environmental factors, and bad things that
have happened to you.



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People who have these kinds of symptoms move on in their lives and do the things they want to
do. There are people who experience these symptoms who have followed every conceivable
career path. They have gotten the needed education, training, and experience. Many of them have
excelled in their chosen fields.

You should not have to “put up” with medication side effects that make your life even more
difficult—things like loss of sex drive, weight gain, or uncontrollable twitching and lethargy.
There are many medications available today. There might be another that would be more helpful
to you. Maybe you should explore natural treatments and programs.


If you’re feeling melancholy, down in the dumps, some basic techniques can help brighten up
your feeling of the blues. Remake your lifestyle with these basic depression-easing remedies:

Keep Yourself Active. Do something to stimulate yourself. Hanging around the house and feeling
sorry for yourself will make you more depressed. Get away from your home. No matter what you
do, as long as it is active. Try taking a walk, a bicycle ride. Visit a friend. Play a game of cards,
checkers, or anything you like. Do NOT look at television because that is not being active.”

What Fun Things Do You Like to Do Write down activities that taken to be enjoyable. Then I
advise: pick one—and do it! Getting involved in physical activities, if they are fun, is a great way
to get out of the blues.”

Talk It Out. Relieve the pressures of depression by airing your feelings. Share your feelings with
someone who cares and is sympathetic. Tell what is on your mind. The mere act of talking it out
is helpful. Normal everyday life can cause ups and downs bringing about feelings, which include
happiness/sadness, euphoria/despondency and laughing/weeping. Sometimes one can understand
and relate to why they are feeling this way.

Put Big Decisions on “Hold.” You should not trust your judgment if depressed. Put off any
major decisions until you’re feeling better; otherwise, you are likely to make the wrong decision
and that will depress you further.”

Avoid Conflict with Others. Being depressed, you have a tendency to snap at others. Doing so
means others will snap back at you. Try to keep away from conflicts. Avoid crowds because a
wrong word or move and you could fly off the handle.




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