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What treatment alternatives are there besides medication for depression?

answered 06:23 PM EST, Thu December 08, 2011
My wife is struggling with depression but she is very resistant to the idea of taking medications. She is seeing a therapist and I think that it is helpful but she could very clearly benefit from something more – anything that would help would be a godsend, really.

I do not know much about alternative therapies but I would be very interested in anything that might be effective for someone who is dealing with depression. Can you recommend what might be useful for her? She is 32, and a professional woman (very intelligent – scary smart actually) so whatever it is has to be something that is going to make sense to her. It can be alternative but she is not going to go for crystal healing or anything that she can’t get her head behind.

Art Matthews Says...

There are of course as many different therapies for depression as there are theories on why people become depressed. Some alternatives have been studied closely and others, not so much. Medication and psychotherapy (talk therapy) are the most common treatments with the most research to back them up.

Within talk therapy, there are quite a few different approaches from old fashioned psychoanalysis to humanistic (empathy-based) counseling to Cognitive Behavioral Therapy and Dialectical Behavior Therapy. There has never been a study to definitively suggest one form of talk therapy is more effective than another overall; however, some forms of therapy are thought to reach results somewhat faster than others. What makes therapy work best in my opinion is a match between therapist, client and the therapeutic intervention.

Outside of the mental health mainstays, there are:

Naturopathic Medicine: the use of natural herbs and plant-based supplements to do essentially the same things that high powered anti-depressants and anti-anxiety medications are thought to do. Depending on the studies you find, natural remedies are said to be completely ineffective -- and in some cases harmful -- or effective and even better than pharmacologic alternatives. To me, anything that goes into my body (whether natural or man-made) has the potential to change my body and brain chemistry, so it all needs to be approached with caution and with the advice of experts.

Mindfulness Based Cognitive Therapy and Meditative Techniques: the use of present focus and non-judgmental attitude to change mood and behavioral expression. Dr. Jon Kabat-Zinn began exploring yoga and meditation as a young man and has been very active in the movement to integrate body-mind medicine into mainstream medical treatments. He is the former Executive Director of the Center for Mindfulness in Medicine, Health Care, and Society at the University of Massachusetts Medical School. Mindfulness has been researched quite rigorously and shows great promise. The essence of his teachings are outlined in his book, "Wherever You Go, There You Are: Mindfulness Meditation in Everyday Life."

EMDR or Eye Movement Desensitization and Reprogramming: the combined use of mental and verbal recall with simultaneous controlled eye movements to reduce the emotional impact of traumatic events. Early research is promising that this approach can help people overcome reactions to assaults, rapes, abuse, events of war, natural disasters, etc. Some therapists have also been using it with other situations with undocumented results at this time.

Light-box therapy: the use of artificial light equivalent to sunlight in order to supplement the lack of natural daylight lost due to change of seasons and living in dark environments. This form of therapy is typically used in the winter season with the most success for those suffering from Seasonal Affective Disorder in the northern latitudes. However, many of us living in the Desert Southwest might also benefit from light-box therapy in the summer when being in the daytime heat becomes too oppressive to leave one's home for long periods of time.

Massage/Reiki: the use of therapeutic touch to affect relaxation, stress management and mood stabilization. We aren't sure what touch does, but we do know that it is important. Psychologists have studied the importance of contact and touch fairly extensively on the development of infant primates and discovered that the absence of touch and loving contact can greatly affect not only the infant's mood and behavior in childhood but also its adult wellbeing.

Aroma Therapy/Color Therapy/Music Therapy: altering scents, sounds and images in the environment can also impact a person's subjective feeling of stress and therefore their ability to heal (we do know that stress can impair a person's immune system and uses up physical and mental energy).

Creative Expression Therapy: the process of creating (art, music, performance, etc) as a therapeutic intervention. Some say the actual act of creating is healing (it IS a mindful activity) and others say it is the transference between the art therapist and client that promotes healing. I believe it is a combination of both; that each and every one of us needs spiritual engagement in our lives -- something that "feeds your soul." Hobbies, crafts, fine arts, singing, etc. all allow us to find a part of ourselves that we may have disconnected from or never knew existed.

In reading your question, the thought comes to me that your wife's biggest obstacle may be her "scary" intelligence. Highly intelligent people can often believe they are too smart to be fooled by optimists and positive people. If you have a highly intelligent person who has also experienced trauma, abuse or loss, they are doubly sure of the rightness of their negative and pessimistic beliefs as they also have evidence on their side. They believe that they simply see the world as it really is and know that catastrophe will be right around the corner. "Just you wait and see." Changing a pessimist to an optimist can be a difficult task indeed. Sometimes it is impossible, so we set our sights on being more positive than they are. Eventually the goal is to get the client to see that expecting the worst and preparing for disaster actually creates their distress, and that developing a more reasonable, rational and realistic outlook (perhaps even positive) will reduce their distress and allow them to feel and function better.

Therapy of any kind can take time and it's understandable that you would be concerned for her and might want to see improvement in her before she is able to reach it. Perhaps you also need to consider some options for yourself as you deal with your feelings and thoughts about your wife and her journey. Her condition doesn't just impact her. Consider it and take best care.

Written by Art Matthews, MA LPC

AZ Body-Mind Counseling

Mesa, Arizona

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