Beating anxiety and depression drug-free

Mental illness affects about one in five Australians in any year. Only a third of these will seek treatment. The most common problems are anxiety, depression and substance use disorder and these three types of mental illness often occur in combination. For example, substances like alcohol or cannabis might be used as a form of self-medication in an attempt to relieve symptoms, or a person with disabling anxiety may develop depression.

Almost half of Australians will experience a mental illness in their lifetime, so a strategy for dealing with it becomes an essential life skill.

The symptoms of anxiety and depression can be very difficult to tolerate and there is a temptation to reach for a pharmaceutical solution to ease the emotional pain and the physical symptoms.  It can be quite a struggle to have the patience to persist with a non-pharmaceutical strategy for anxiety or depression, but the effort is worth it.

Over recent decades there has been a dominant philosophy of prescribing medication for these problems.  Antidepressants, sedatives, sleeping pills, “benzos” like Xanax or Serepax have become common ways of patching over mental health problems without providing skills that can help you to deal with the underlying issues.

In recent years a number of pieces of evidence have emerged to fundamentally change the way we approach the management of anxiety and depression. 

Major scientific reviews have shown that antidepressant medications are ineffective in treating all but the most severe cases of depression, yet they continue to be prescribed for milder forms of depression or episodes of grief or sadness.

Side effects of anti-depressants often mimic anxiety disorder and continuing or increasing medication can exacerbate the problem.

We have come to realize the disturbing impact of over-reliance or addiction to medication for anxiety.

WHERE TO GET HELP

Your general practitioner is a good place to start.  If you are diagnosed with anxiety or depression, you will qualify for a mental health care plan. Under these plans, Medicare provides some subsidy for counselling with a qualified psychologist.

Counselling will help you to identify and understand early life traumas or recent life circumstances that might be contributing to your feelings. They will also help you to think differently about situations in a way that helps you avoid anxiety. This is called cognitive behaviour therapy, or CBT.

You may also learn self-treating techniques such as breathing exercises, and relaxation. 

Activities like Tai Chi and yoga can also be helpful.

Mindfulness is a thinking technique which helps you to alleviate anxiety and depression and more fully engage with life here and now.  This needs to be taught by an expert.

Massage therapy can be  useful for relaxation and easing of muscle tension.

REMEMBER THE BASICS

Anxiety and depression can dominate your life, and take your attention away from the basics of good health such as nutrition, sleep routines and exercise. Healthy lifestyle habits also work as therapy.

If you are anxious, you need to avoid caffeine completely. Alcohol is best avoided too, as are illicit substances such as cannabis, cocaine and ecstasy. 

The right diet is essential. The Medical Journal of Australia reviewed the evidence on the direct effects of food on mood and concluded the following:

• Eating breakfast regularly leads to improved mood, better memory, more energy and feelings of calmness.
• Eating regular meals and nutritious afternoon snacks may improve cognitive performance.
• Slow weight reduction in overweight women can help to elevate mood.
• High levels of refined sugar consumption were also found to be linked to a greater prevalence of depression.

Make sure you are eating the recommended 5 vegetables and 2 pieces of fresh fruit a day as well as daily sources of protein including seafood. High levels of saturated fat consumption may be linked to a greater prevalence of depression so a low fat diet is helpful. 

It is important to eat regular meals throughout the day to avoid hypoglycaemia (low blood sugar).

Regular moderate exercise elevates your mood and can improve your energy and concentration. Make sure you get exposure to sunlight during the day because lack of sunlight can depress your mood.

It is important to look at sources of stress which you can reasonably avoid. Get organized, and cull things that are not important for you to deal with.  Make space in your life for the activities that will help you manage your anxiety and depression.

Allow enough time to sleep and provide a calm quiet sleeping environment.  

SUPPLEMENTS

If your diet is deficient or you have medical problems which make it difficult for you to absorb nutrients from food, you may benefit from a balanced multivitamin and mineral supplement, at least in the short term.  Avoid excessive B vitamins as they can cause jitteriness that exacerbates anxiety.

Calcium and magnesium work together and can help with anxiety. 

HERBAL MEDICINES

Traditional herbal treatments for depression and anxiety have been used for many hundreds of years. If you are planning to try herbal medicines in conjunction with your lifestyle changes, you need to see an expert to prescribe them correctly and to make sure there are no interactions with your other prescribed medicines.

• St. John’s wort has the best evidence for treatment of depression, or anxiety associated with depression. It must not be taken at the same time as SSRI antidepressants.
• Kava kava (Piper methysticum), passionflower (Passiflora incarnata), lemon balm (Melissa officinalis), lavender (Lavandula angustifolia), withania and skullcap (Scutellaria lateriflora) are popular herbs for anxiety.