Via the Holford Watch miniblog: Guardian story on The Foresight Project on Mental Capital and Wellbeing. I’ve even stolen HW’s idea for a campaign name. Apparently, a “five-a-day”-style campaign to boost the mental health of the nation is needed to combat rising rates of depression, anxiety and drug abuse. The five actions recommended are these: developing friendships, being physically active, fostering curiosity about the world, continuing education throughout life and doing voluntary work. Funnily enough, not one of the recommendations is to take 5-HTP supplement tablets. Nor do they recommend any of these: Depression and natural therapies. Homeopathic potassium phosphate, Bach flower remedies and Inositol (AKA Vitamin B8, according to Wikipedia) are listed on this page along with saffron and Reiki (Reiki? It’s “energy medicine” or “bullshit” as I prefer to refer to it). The reference provided for saffron in depression is for a paper that was apparently presented at the International Symposium on Saffron Biology and Biotechnology and this paper includes these lines:
On the basis of these results, the antidepressant effect of C. sativus stigma extracts may be mediated via safranal and crocin. Crocin may act via the uptake inhibition of dopamine and norepinephrine, and safranal via serotonin.
Whatever natural therapy I am reading about for depression, it always seems to act on a specific neurotransmitter. It would be nice if it were that simple, but as the recommendations of five-a-day actions would seem to suggest depression seems to be a bit more complicated than that. Taking physical activity makes sense to me, not least because daily physical activity is associated with a lower risk of psychological distress and there are benefits of exercise for the treatment of depression. While trawling Google Scholar and Pubmed for studies that fit with my preconceptions (I believe it’s known as cherry-picking), I found a PDF of a study with what I thought were some really interesting points. Here, we are told that in a study looking at three groups (exercise; medication; combination) “During treatment, several in the combined group mentioned spontaneously that the medication seemed to interfere with the beneficial effects of the exercise program”. This ties in with the view that taking pills for an ill can be disempowering and also makes me wonder if reductionist AltMed gurus with their magic treatments or Big Pharma salesmen with their multiple small studies purporting to show benefit for their particular anti-depressant solution are selling us short. I’m not very good at discussing this sort of thing but, fortunately, some people from the Department of Psychiatry and Behavioral Sciences at Duke University Medical Center are rather better at it than I am.
One of the positive psychological benefits of systematic exercise is the development of a sense of personal mastery and positive self-regard, which we believe is likely to play some role in the depression-reducing effects of exercise. It is conceivable that the concurrent use of medication may undermine this benefit by prioritizing an alternative, less self-confirming attribution for one’s improved condition.
As Oliver Burkeman once said, some people are just really strange. I find it weird that giving someone an antidepressant can hinder their recovery from depression simply because they no longer feel like their recovery is “all their own work”. But then… I consider lots of things people think, say or do to be weird – perhaps it is actually me that is strange.