Depression & Anxiety

Q. I suffer from depression and anxiety. My doctor prescribed anti-depressants, which I had to stop because they were making my anxiety much worse. My depression is manageable, but I am having a hard time controlling the anxiety. Can you recommend any supplements that can help with both, or at least not worsen one while treating the other?

A. I would like to start by saying that anxiety is a normal reaction to stress. It becomes pathological when it becomes constant and/or when it prevents us from our normal activities of daily living. At this point it is most often referred to as an anxiety disorder. How anxiety manifest in the body and the severity with which it manifest, varies significantly between individuals. Similarly, the cause of anxiety is relatively unknown. For some individuals there is a clear genetic component, some studies have shown that specific areas in the brain, the amygdala and hippocampus are involved. Stress, both present and past, has also been shown to be a major contributor. Sleeping and eating habits, as well as availability or a lack of social support, can also greatly impact our ability to cope effectively with difficult challenges. There are also theories that relate anxiety to "chemical imbalances in the brain", more specifically, serotonin imbalances. Low serotonin levels are also thought to be a major risk factor in the development of depression.

Panic attacks are acute periods of intense fear and/or anxiety in which individuals are often overwhelmed with both physical and emotional sensations of impending death. For some, these attacks are unpredictable, while for others they are situational (public speaking, heights, crowds, etc). Avoidance of these situations can often prevent their occurrence. Common symptoms include sweating, shaking, heart pounding, dizziness, shortness of breath, numbness/tingling, intense heat or chills and chest pain. Stress can both predispose us to attacks, as well as decrease our ability to cope with anxiety when it happens in acute situations like these.

It is easy to understand why doctors have a hard time isolating anxiety symptoms and causes from those of depression, and similarly, treating these disorders individually. It is very common for anxiety and depression to be lumped in together and treated as one pathology. It is also true that they do often go hand in hand. The DSM IV lists these disorders individually and in combination. This being said, one or the other are usually at the root of the problem. Intense anxiety, for instance, can cause depression in individuals who are forced to change their lives to avoid the feared situations. By treating the cause, the secondary symptoms of anxiety or depression, depending on the individual, will also often improve. It is not uncommon for anxiety disorders to be treated with benzodiazepines and other popular anti-depressants, the only problem being that some individuals find that this treatment helps with depression but worsens anxiety.

I would imagine, if you feel the anxiety is more prevalent and you found that anti-depressants only worsen the problem, that you need to deal with the anxiety first, and hopefully you find some relief from symptoms of depression as a result. The following is a summary of some effective natural products, as well as nutritional and lifestyle habits, that can help to alleviate anxiety, prevent and treat anxiety attacks, as well as help to support individuals suffering from depression.

B vitamins are essential for nervous system function. Deficiencies are often correlated to anxiety, as well as depression and poor stress management. There are many B combinations that include 50-100 mg/day of all the essential B vitamins. Suntheanine is a component of green tea. For individuals worried about the effects that caffeine can have in terms of exacerbating anxiety symptoms, know that this is an extract of theanine, an amino acid present in green tea and contains no caffeine. It has been shown to promote calm and relaxation without drowsiness. Relora is another blend of herbs, this time magnolia and phellodendron. It is effective in reducing stress induced anxiety, by regulating cortisol levels and ensuring a natural pattern of cortisol secretion. Homeopathics are a very gentle and effective way to help lower anxiety, without the worry of interfering with current pharmaceutical medications.

Passionflower and Valerian are two well-known herbs. Valerian can be more sleep promoting than Passionflower, so individuals may choose to take before bed. Passionflower can be taken as needed throughout the day, for those who suffer from stress-induced anxiety. These herbs can also be found dried, in capsule or tincture form.

Deep breathing techniques can be very effective in easing anxiety and preventing acute panic attacks. Other important lifestyle tools include exercise, acupuncture, yoga, meditation. Social support, adequate rest to optimize nervous system health, as well as limiting triggers – like caffeine, alcohol, and refined sugar - can also further add support and compliment supplemental interventions.

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