As published in The Erin Advocate
For the treatment of a complex illness such as depression, patients should not expect a simple pharmaceutical cure. Success will usually involve a combination of therapies, with a lot of effort put into the choices, to see what works best for the individual.
This is the second column based on a panel discussion held last month by the East Wellington Family Health Team (EWFHT).
There are not simply enough psychiatrists to treat every person with depression or other mental illness, so family doctors and therapists often start a patient on the road to recovery.
Michele Ross Miller is a Mental Health Therapist who provides one-on-one, marital and family counselling to patients of the EWFHT, as well as public education programs.
"By the time you come to counselling, you have experienced a lot of judgement about your depression," she said. "There are traditional beliefs about depression – it’s laziness, you just have to pull up your socks, you have to try harder. Counselling is about different kinds of therapies that challenge not only how you’re thinking, but also how you’re behaving."
People should seek help when they are no longer able to function at what they consider a normal level. They may still be going to work or school, but unable to concentrate and make decisions.
"The purpose of counselling is to set personal goals for improving your life, gaining greater insight into who you are," she said. "It’s not a process where the counsellor tells the client what he or she should do. You come to the session and the counsellor helps you come to decisions. Also, to get some education about what contributes to depression."
One of the popular strategies is called Cognitive Behaviour Therapy, based on the concept that thoughts create feelings. Just as a brain can become accustomed to negative thoughts and feelings, it can be trained in the opposite direction through positive thinking. This short-term program works well for some people, but should not be considered a substitute when acute psychiatric care is needed.
Another panelist was Dr. Wendy Davis, a naturopathic doctor at the Harmony Naturopathic Clinic in Orangeville. She tries to discover root causes of patients' health concerns, treating them with various dietary, lifestyle and naturopathic remedies.
"We’re based on treating the whole person, which isn’t that different from conventional medicine – it is very much preventative," she said. "I believe in a combination of conventional and naturopathic medicine."
She looks at digestion, stress, sleep, energy, immune function, hormone balance, and environmental toxins. She stresses the value of B vitamins, Omega 3 fatty acids, vitamin C and vitamin D, with the priority on diet rather than supplements.
"They actually help to decrease that anxiety, that stress effect that gets you to that depressive state," she said. "We need to support the body so it has what it needs to get back up and to work with the stress."
Blood sugar control is important, since the ups and downs caused by skipping meals and eating high-carb snacks are very stressful on the body. She said black licorice can help with stress (if you don’t have high blood pressure), and she prescribes combinations of supplements, such as the common anti-depressant St. John’s Wort, with passion flower and skullcap.
"Just because you get a vitamin or supplement from a health food store, or Walmart or Shoppers, and it’s ‘natural’, it doesn’t necessarily always mean it’s safe. You should see a medical doctor or a naturopathic, someone who has an idea of how different things interact. Health Canada is really cracking down on different supplements – they’re making sure that what it says on the bottle is actually going to be in the product."
She also uses techniques of meditation, and elements of Traditional Chinese Medicine. "Acupuncture increases endorphins, just like exercise increases those feel-good hormones. It’s really good for relaxation and pain relief. It overall helps to balance the nervous system. The whole concept is the body in balance, it’s ying and yang. Too much of anything – too much broccoli – is not good for you. So it’s moderation in everything."
There will be one more column in this series on depression, including comments from the other panelists: Amy Cousineau, an Anglican priest (formerly at All Saints in Erin), who told her personal story of recovery; and Fred Cousineau, her husband of 40 years, who shared the frustrations and satisfactions of being a support person for someone in crisis.
