Recovery from depression

The conventional antidepressant approach
Antidepressants are the most commonly prescribed treatment for depression. Although they are often helpful in reducing depressive symptoms, increasingly people are educating themselves on their risks and limitations. 
The following graphic highlights statistics about antidepressants extracted from a number of gold-standard scientific studies.

In addition, antidepressants are relatively slow to "kick in" and have a variety of other potential side effects that may persist even after you stop using antidepressants: [1]
  • Gastrointestinal issues
  • Weight gain and metabolic abnormalities
  • Cardiovascular issues 
  • Urinary retention and incontinence
  • Osteoporosis and risk of fractures
  • Parkinsonian-like involuntary movements
  • Cognitive disturbances
  • Sweating
  • Sleep disturbances
  • Affective disturbances (apathy) 
  • Eye issues (glaucoma, cataract)
After reviewing the evidence of antidepressants, the U.S. FDA states that they work only slightly better than placebo (sugar pills). [2]  In fact, authors of an analysis of 27,422 people on antidepressants concluded, "the potential small beneficial effects (of antidepressants) seem to be outweighed by harmful effects." [3]

This small benefit may stem from the fact that the underlying theory of depression is considered flawed and untenable. [4] For many years it was thought that low levels of serotonin  (a brain chemical) in the synapse caused depression. To address this suspected deficiency, serotonin-increasing antidepressants were prescribed. However, it was found that drugs that increase serotonin have very similar impact as drugs that decrease serotonin - both providing relief only slightly better than placebo. [5

Additionally, the FDA has issued a black box warning – the most serious type of warning for prescription drugs – for antidepressants, because of the doubling of the frequency of suicidal thoughts of children and young adults on antidepressants. [6]  

And finally, the long-term use of antidepressants appears to do more harm than good. In one study, people with major depression who took antidepressants had significantly more severe symptoms at a nine-year follow-up than people with major depression who did not take antidepressants. [7]

Your health, your choice
A growing number of doctors see antidepressants as a seriously flawed option, especially for the developing brain and personhood of a child. 

They note that antidepressants have limited effectiveness, that the underlying theory justifying their use appears to be faulty, that antidepressant side effects can be substantial, and that our mind, body and emotions require a much more holistic and integrated approach than a pill can provide. 

Understanding these realities, many people are reevaluating the risk/reward profile of antidepressants and are working to take a more holistic evidence-based approach to their recovery.

Before deciding to take antidepressants, consider reviewing the above information with your practitioners. You may want to discuss the specific studies referenced below. 

The good news is that there are a number of non-drug approaches that often work as well as, or better than antidepressants, without the many side effects and withdrawal difficulties. These non-drug approaches also leverage common sense approaches that can often lead to sustainable mental wellness without drugs.

Always work with trusted and licensed practitioners.  Any changes in psychiatric drug use should always be done under practitioner care. Please see disclaimer.

An integrated wellness approach
There are thousands of peer-reviewed gold-standard medical studies that support the use of non-drug approaches for mental health recovery. In fact, there are 27 broad non-drug approaches that have proven effective. Many are useful for depression (download free monograph).

It is often best to consider depression from a holistic perspective that includes many therapeutic options separated into four categories of care.

The "higher" in this diagram we operate (toward Preventive), the better, since these are the approaches that help us sustain mental wellness. However, once we develop depressive symptoms, it may be helpful to use techniques in multiple categories simultaneously to maximize recovery. 

Preventive care
Preventive approaches include a number of common sense health practices we can adopt that often have a significant impact on mental health. Often called wellness basics, many of these approaches have been proven very helpful for depression including proper diet, aerobic exercise, mindfulness, controlled breathing, ensuring gut-health, social interaction, being in a bright natural light, mind-body disciplines (especially yoga) and more.

Restorative care
Restorative approaches address root-causes and direct influencers of mental health symptoms. They come in two varieties: biomedical and psychosocial. Since our body and mind interact so deeply, it is often helpful to address both simultaneously.

Biomedical practitioners can help identify an individual’s unique bio-individuality through blood/urine and other testing, using detailed biomedical test panels. This is important since over 25% of the time, mental health symptoms are caused by or significantly influenced by physical issues. These tests can uncover nutrient imbalances, hormonal issues, amino acid irregularities, food allergies, pathogens, inflammation, toxicities, or other root-cause physical conditions. 

Walsh-protocol nutrient therapy has been found to be particularly effective: over 70% of people who use customized Nutrient Therapy for six months return to normal without antidepressants. In nearly all the remaining 30%, symptoms can go into remission with lower antidepressant dosages.[8] In the absence of individualized testing, EPA Omega-3 fatty acids and SAM-e - both natural substances - have proven effective. To help you locate practitioners, review our practitioner finder

Psychosocial practitioners can help identify and address an individual's past trauma, stress, social challenges, emotional difficulties and unhelpful thinking patterns that can cause or influence depressive symptoms. 

Cognitive Behavioral Therapy and individual psychotherapy are two approaches that are superior to drugs for depression.[9] In addition, peer support - from those who have experienced similar mental health challenges and recovered - offers a unique "been there" perspective and personal sensitivity that can be invaluable. Directories of therapists, psychologists, peer specialists and other psychosocial practitioners are usually available in your community.

Symptom relief care
Symptom relief approaches seek to address any residual symptoms that are not removed by preventive and restorative care. Although antidepressants are by far the most common treatment for depressive symptom relief, various herbs (including St. John's wort), sensory therapies and very low charge electrical stimulation have been shown effective.

Over-care avoidance
Over-care avoidance is limiting the use of psychiatric drugs and other medical interventions to only what is necessary. Increasingly, practitioners work to minimize the use of psychotropic drugs because of their side effects, withdrawal difficulties and inability to cure.

However, some people find psychiatric drugs helpful. When using drugs, they should be taken in minimum effective dosages - no greater than the amount needed to gain significant symptom relief and for no longer than is required. 

This is important since excessive drug use can not only be expensive, but harmful. Over-prescribing of psychiatric drugs is an important issue, especially for children, the elderly and other vulnerable populations. The American Psychiatric Association and a variety of public health organizations are working to curb over-care practices.

Work with trusted integrative practitioners
Many practitioners are joining the paradigm shift to Integrative Mental Health - a discipline that embraces the best of both drug and non-drug treatments.

We are all different and require individualized paths to recovery. Integrative practitioners offer a variety of therapy options, and can advise you on the ones most appropriate for your bio-individuality, personal history, stressors, and preferences. Through experimentation, you can find the ones that work best for you. If your practitioners do not offer non-drug options, it is often best to engage practitioners that do. 

Dr. Kenneth Duckworth, Medical Director of the National Alliance on Mental Illness, is clear: "psychiatric medications... are rarely enough to promote recovery alone [10] ... many (people) report that a combination of treatments is most effective."[11]  In support of this outlook, NAMI highlights select non-drug options that can aid recovery [12] while Mental Health America articulates many more. [13]

Although non-drug approaches are not a universal panacea and they often take more work than popping a pill, many people have found that diligent use of non-drug options can significantly reduce or eliminate the symptoms of depression with little or no side effects, helping them realize mental health recovery.