Real Prescription for Depression

Antidepressant medicine seems to be displayed and advertised in many places in America. Nevertheless, it is still a new drug to counter depression. In 1950's medicine for anxiety and other mood disorders were generally the same until more understanding of the brain chemistry was done (Carlsson & Healy, 1988). It has been seven decades since then. There are a plethora of antidepressant medications and even other medications to go with the initially prescribed antidepressant as a booster. They are still ineffective and only help those with major clinical depression symptoms. Other ways to improve depression requires a simple lifestyle change that does not have harmful side effects like drugs. Though exercise and nutrition, a person can improve and prevent relapse of depression episodes.

Drug Therapy for Depression

There are perceptions that depression is not a real condition. It is classified and separated in levels of degrees in the Diagnostic and Statistical Manual of Mental Disorders. It includes mood dysregulation, major, persistent, premenstrual, substance, and unspecific depression. The symptoms can be seen in children to old-age adults and both genders. Life experiences and individual reactions influence the ranges if a person even becomes effected. Soldiers can go into battle, but only one develops a disorder.

Medicine that is given to help ease and in hopes erase the symptoms do a variety of things. Selective serotonin reuptake inhibitors block neurotransmitters to reuptake the release of serotonin when receiving and sending messages. This will allow for more serotonin to stay between neurons in the brain to effectively communicate with messages.

There are around seven types of this one action of drugs. Each drug has levels of active drug and is different in each person. That is not the end of antidepressant medication. If the SSRIs do not help, there are serotonin and norepinephrine reuptake inhibitors. Not only do these drug block serotonin uptakes, but also norepinephrine, which is a chemical in the brain that is released in the body when stress happens, increasing heart rate and making more energy from fat and blood sugar. MAOIs, monoamine oxidase inhibitors, tricyclic antidepressants, and atypical antidepressants that do not fall into a particular category such as mirtazapine, are other antidepressants. MAOIs seem to be more effective and help with norepinephrine, serotonin, and dopamine levels but interact with a large number of food sources that are commonly consumed and are dangerous to mix with many other drugs.

FDA drug acceptance and reviews

Prescription drugs must go through rigorous testing and clinical studies before they are deemed safe for public use. This keeps the mortality rate low from prescription drugs. The constant testing of chemicals leads the public to believe their safety is upheld. The actual studies, reviews, and testing submitted by drug manufacturers tend to be just the cases that have more positive results than negative results. A new drug can be tested a hundred times and have sixty failures, but the company is not required to submit those. They file the other forty cases with more positive outcomes with the FDA showing that the medicine is generally helpful. Before the

FDA accepts case studies, they must have double-blind placebo trials. "82% of the placebos were more effective in depression, and 57% of the actual drug failed" (Kirsch,2014, pg.129) when a meta-analysis study gathered up filed and unfiled research work. The drug companies enhance the new drug's abilities using this loophole. It is the same loophole that makes the antidepressants less effective when data is gathered from the general population that is using them.

Doctors still prescribe the medication to patients with depression, mild to major, symptoms. "Patients with severe clinical depression symptoms are helped more though medication than those with mild symptoms" (Penn & Tracy, 2012, pg.183). For some individuals, these group drugs do help, but for most, they are ineffective. "Less than 10% of the American population has clinical major depression; however, 80% has suffered other ranges of symptoms," according to the Center for Disease Control and Prevention (Brody, Pratt, & Hughes, 2018). With many people taking antidepressant medication with little improvement or no avail, it leaves bothering side effects or dangerous outcomes.

Side-effects and the use of multi-drugs

Antidepressants can take anywhere from two to six weeks to start working, but as mentioned, only the clinical major depressed diagnosed individuals are likely to benefit. The other population group can take a year or more to find the correct drug, dosage, and even a combination of drugs to alleviate their symptoms. All the while, the person can develop side effects of the drugs. Adverse drug reactions have been studied when it comes to antidepressants. All the studies have received different percentages from "10.2-42.3% of individuals taking the drugs are negatively affected" (Al Zaabi, Sridhar, & Tadross, 2020, pg.135). This wide range could be due to geographical, gender, race, culture, a number of participants, published and unpublished studies, and several other factors. After seventy years of discovering the chemicals in the brain, it seems apparent that it is still not clearly understood what happens, why it happens, and how drugs affect the brain and the body system.

Some antidepressant drugs include "unwanted sedation, body mass weight gain, abdominal pain and nausea, gastrointestinal hemorrhage, headaches, hypertension, sexual-dysfunction, flu-like symptoms, blurred vision and fatigue" (Al Zaabi, Sridhar, & Tadross, 2020, pg.136). These symptoms are more of the common ones with much of this class of medication. Some people ignore the adverse outcomes and continue to take the antidepressant pills. They could develop other chronic diseases, such as migraines, joint pain and deterioration due to weight, and high blood pressure.

Exercise To Improve Depression

The body and the mind are connected. Mind refers to thoughts, mood, and energy, not the organ, the brain, which is also the center's connection. Being physically active in the day, the AHA and CDC mentions this limit to be more than 5 thousand steps a day and elevating heart rate higher than resting for a period, improves many aspects of life. With added exercise, a person can rest better at night and even have higher cognitive function throughout the day. "Improved mood is one of the major outcomes form physical activity with increased hormones and neurotransmitters" (Nagata, McCormick & Austin, 2020, pg.82). Exercise has many benefits and improves depression and relapse depression during, and after that, a fifty-chance working pill could not ever achieve.

Nervous system

The nervous system is also improved through physical activity. This is important for signals from the environment and effectively and swiftly reach the brain, the brain then decodes and send back the needed reaction. The interaction can be physical, but it includes hormones and the immune system as well. "Oxidative stress, cellular health, and cortisol had shown improvement when subjects participated in yoga routinely" (Tolahunase, Sagar, Faiq & Dada,2018, pg.429). These improvements help the central nervous system's pathways, lymphatic system, and it can help nutrition uptake from the digestive system. The same study later found "improvement after 12-week yoga taught session regulatory feedback with the hypothalamus, biological rhythms, emotion, social behavior and increases serotonin and melatonin levels" (Tolahunase, Sagar, Faiq & Dada,2018, pg.435). Yoga is its serotonin uptake, which is what some of the drugs for depression target but have added adverse reactions.

Exercise enhances mood

There have been many studies that involve physical activity, mood, and emotions. Many of them show a positive influence with little negative outcomes, providing if the individual is exercising within their ability. "Diagnosed clinical depression has been decreased when physical activity is used as a treatment, aerobic and anaerobic" (Nagata, McCormick & Austin, 2020, pg.80). An individual suffering from depression can add in any exercise and even mix them up to what fits their lifestyle and preference. As long as the activity does not go beyond their abilities and caution is used during unfavorable weather with other safety concerns, there are few negative side effects, unlike prescribed drugs. "Greater depression symptoms were related to greater sedentary behavior and less physical activity" (Wu et al. 2019, pg.724). Doing nothing only encourages unwanted feelings, such as depression.

Nutrition Improves Mood

Processes food affects hormones

A study with prenatal children to age fifteen and process foods was conducted. "Depression symptoms were low at age eight symptoms were low but increases by ten, thirteen and fifteen" (Mesirow et al., 2019, pg. 2581). One could make a rebuttal that this is also the same age range that hormones in the body start to be released, mood swings, and new experiences happen. With hormonal changes, a quality nutrition intake is essential for this age range of children to stabilize mood. Processed foods inhibit the body's response to insulin and glucose. This can increase the risk of diabetes. Oxidative stress and increase body inflammation are also linked to process foods. This can slow down the message system with neurotransmitters that regulate mood, pain, sleep, and even digestive processing.

Vitamins, mineral intake, and Diets

Most vitamins and minerals are in vegetables and fruits. The further away from the foods' original state, the less of these components they have. "Antioxidants in fruits and vegetables protect against neuronal damage…Norwegian diet is high in berries, and this is associated with reduced depressive symptoms (Opie et al., 2017, pg.163). Antioxidants corrects oxidative stress and further helps inflammation.

There is a common thread in clinically depressed patients of most levels when the micronutrients are viewed. "folate, omega-3 fatty acids, monounsaturated fatty acid, magnesium, zinc, vitamin B and D at low levels increase depression rates" (Pagliai et al., 2018, pg.569). A person's usual way of eating can increase or decrease the symptoms of depression and contribute to the recurrence of unwanted symptoms.

"Eight separate studies found a significant association with depressive symptoms and the typical American diet (Rahe, Unrath & Berger,2014, p,1004). The Standard American Diet (SAD) lacks many important vitamins due to highly processed foods and a low amount of fresh vegetables and whole fruits. "Mediterranean diet has shown decreased depression risk in the very elderly as well as protection against depressive symptoms in older age" (Pagliai et al., 2018, pg.572). The Mediterranean diet has an intense focus on omega-3s and whole vegetables and fruit. Similar nutrition plans that limit processed foods and sugars can have the same depression-reducing effects.

Conclusion

There are far better treatments that a person can take to help depression. Only those with manic or clinically diagnosed severe depression will be helped with using drugs. Exercise and quality of nutrition are far less expensive than seeing a doctor. Less time consuming than finding the individual combination of drugs to help depression. Exercise and nutrition do not have many adverse side effects as drugs do. There are added benefits to quality food intake and physical activity, including cardiovascular health, improved sexual wellness, and lower chances of other chronic diseases. Medical care is needed for everyone, but physical activity and food intake can be done instantly and effectively improve depression symptoms when a pill can take months with a 50/50 chance of working and cause weight gain and bleeding in the brain.

References

Al Zaabi, M. S. R., Sridhar, S. B., & Tadross, T. M. (2020). Assessment of Incidence, Causality, Severity, and Preventability of Suspected Adverse Drug Reactions to Antidepressant Medications in a Psychiatry Outpatient Setting of a Secondary Care Hospital. Journal of Pharmacy & Bioallied Sciences, 12(2), 131–138. https://doi-org.proxy-library.ashford.edu/10.4103/jpbs.JPBS_196_19

Brody, D, Pratt, L., and Hughes, J. (2018). Prevalence of Depression Among Adults Aged 20 and Over: United States, 2013–2016. NCHS Data Brief NO.303. Retrieved from https://www.cdc.gov/nchs/products/databriefs/db303.htm

Carlsson, A., & Healy, D. (1988). Neuropsychopharmacology: Gazing into the Crystal Ball. Human Psychopharmacology: Clinical & Experimental, 3(3), 217–226. https://doi-org.proxy-library.ashford.edu/10.1002/hup.470030311

Kirsch, I. (2014). Antidepressants and the Placebo Effect. Zeitschrift Fur Psychologie, 222(3), 128–134.

Mesirow, M. S. C., Roberts, S., Cecil, C. A. M., Maughan, B., Jacka, F. N., Relton, C., & Barker, E. D. (2019). Serum cholesterol, MTHFR methylation, and symptoms of depression in children. Developmental Psychology, 55(12), 2575–2586. https://doi-org.proxy-library.ashford.edu/10.1037/dev0000831.supp (Supplemental)

Nagata, S., McCormick, B. P., & Austin, D. R. (2020). Physical Activity as Treatment for Depression in Recreation Therapy: Transitioning from Research to Practice. Therapeutic Recreation Journal, 54(1), 77–91.

Opie, R. S., Itsiopoulos, C., Parletta, N., Sanchez-Villegas, A., Akbaraly, T. N., Ruusunen, A., & Jacka, F. N. (2017). Dietary recommendations for the prevention of depression. Nutritional Neuroscience, 20(3), 161–171. https://doi-org.proxy-library.ashford.edu/10.1179/1476830515Y.0000000043

Pagliai, G., Sofi, F., Vannetti, F., Caiani, S., Pasquini, G., Molino Lova, R., Cecchi, F., Sorbi, S., Macchi, C., & Mugello Study Working Group. (2018). Mediterranean Diet, Food Consumption and Risk of Late-Life Depression: The Mugello Study. Journal of Nutrition, Health & Aging, 22(5), 569–574. https://doi-org.proxy-library.ashford.edu/10.1007/s12603-018-1019-3

Penn, E., & Tracy, D. K. (2012). The drugs don’t work? antidepressants and the current and future pharmacological management of depression. Therapeutic Advances in Psychopharmacology, 2(5), 179–188. https://doi-org.proxy-library.ashford.edu/10.1177/2045125312445469

Rahe, C., Unrath, M., & Berger, K. (2014). Dietary patterns and the risk of depression in adults: a systematic review of observational studies. European Journal of Nutrition, 53(4), 997–1013. https://doi-org.proxy-library.ashford.edu/10.1007/s00394-014-0652-9

Tolahunase, M. R., Sagar, R., Faiq, M., & Dada, R. (2018). Yoga- and meditation-based lifestyle intervention increases neuroplasticity and reduces severity of major depressive disorder: A randomized controlled trial. Restorative Neurology & Neuroscience, 36(3), 423–442.

Wu, I. H. C., Strong, L. L., Nguyen, N. T., Cho, D., John, J., & McNeill, L. H. (2019). Psychosocial Stressors, Depression, and Physical Activity among African Americans. American Journal of Health Behavior, 43(4), 717–728. https://doi-org.proxy-library.ashford.edu/10.5993/AJHB.43.4.6