Complementary Therapy as a Treatment for Mood

Mood disorders are common, persistent, and recurrent. Depression is the second leading cause of illness worldwide. A healthy lifestyle and healthy environment are the cornerstones for promoting positive moods. Nutritional supplements, mind-body therapies, massage, and acupuncture can be helpful. Positive lifestyle approaches synergize with complementary therapies to open the heart, quiet the mind, and cultivates your inner smile.

Health: Physical and Mental

I’ve stated in previous articles, mental health is tied to physical health. A successful athlete exhibits strength, flexibility, coordination, focus, resilience, and teamwork. Similarly, a mentally healthy person shines with confidence, courage, cheerfulness, coping abilities, resilience, and focused attention. It’s not that this individual never stumbles, but getting back up and trying again is likely. Similarly, a mentally healthy person experiences a spectrum of human emotions such as sadness, worry, misery, happiness, exhilaration, and ecstasy. Recognizing that the ebb and tide of emotions is natural rather than insurmountable is key.

Spiritual health is an essential element of overall wellbeing. This table shows some of the characteristics of each category: 

Physical fitness	Mental health	Spiritual health
Strength	Confidence and courage	Faith
Flexibility	Adaptability	Forgiveness
Endurance	Cheerfulness	Hope
Focus	focus and attention	Love
Coordination	Harmony	Kindness
Resilience	Hardiness	Charity and generosity
Teamwork	Social network, communication skills, and connection to community	Connection with a higher power

Lifestyle Essentials: The Fundamentals for Healthy Moods

Practicing yoga beyond the asanas is a lifestyle designed to improve mood among other substantial benefits. Though the physical practice improves mood, the Eightfold Path is a practical guide to sustain balance and equanimity. In fact, yoga postures are merely one aspect of this process also known as the Eight Limbs of Yoga. Written some two thousand years ago by the sage Patanjali, The Yoga Sutras (threads) describes the inner workings of the mind and provides an eight-step blueprint for controlling its restlessness. In turn, a calm mind leads to greater realms of potential, and at the very least it will enhance the quality of life by connecting the body, breath, and mind. Eight Fold Path

Other fundamentals are excellent nutrition, exercise balanced with restful sleep; a healthy environment such as plenty of sunshine. In a German study, intensive lifestyle therapy was as effective as counseling and medication in improving depressive symptoms. Abstract

Nutrition

Healthy nutrition means optimal amounts of essential nutrients while avoiding or minimizing toxic substances. Individual genetic variability, previous dietary patterns, medical illnesses, medications, allergies, and environmental exposures may increase the need for nutrients in the form of supplements.

Evidence-based guidance includes the following suggestions:

• Promote stable blood sugar with foods of low glycemic index, such as proteins and complex carbohydrates.

•Eat breakfast, (which means don’t pig-out at night) including protein, to promote stable blood sugar throughout the day.

•Drink pure water, eat fresh fruits and vegetables, legumes, grains, and fish. Keep dairy and meat at less than 10% of your daily diet. If meat and dairy are eaten, go organic. Locally raised products are better than conventional.  ….hmm, don’t say you can’t afford it, buy less –eat better.

• Cut out food products containing refined sugar and refined grains whenever possible. Same for sweetened and artificially sweetened beverages, (like diet soda) processed foods, saturated fat, fried foods, and junk food.

The most common food allergies or sensitivities are wheat, corn, soy, dairy, eggs, tree nuts, shell fish, and peanuts. Food sensitivities can cause mood problems in addition to rashes, asthma, and rhinorrhea. (runny nose) Detection of food sensitivity begins with mindfulness. Notice how you feel after a meal. Sometimes it may be the next morning before changes appear in the form of a stuffy nose, congestion, lethargy etc. Eliminate that food from the diet and substitute it with something healthier that the body recognizes as food. You’ll know because you’ll feel good afterward and at the very least, the simple absence of discomfort may be experienced. Be accountable for what you eat by keeping a food diary like the easy online fitday.com. In some cases, blood testing, skin testing, or an endoscopic biopsy may be necessary.

Eliminating “trigger food” can improve mood, maybe even chronic headaches, rashes, and gastrointestinal upset. Trigger food overstimulates the senses and causes uncontrolled overeating. People with food sensitivities are susceptible to trigger food and may benefit from nutritional counseling to ensure adequate intakes of essential nutrients.

Avoid toxins. Managing moods by smoking, drinking alcohol, or taking drugs is an effort in futility. These things “get your mood-on” for the short term, but over the long haul contribute to misery. Petrochemicals, artificial flavors, artificial colors, and artificial sweeteners are food additives not essential nutrients, and can be a mood hazard. Avoid them by reading product labels. Organic food is a good way to go chemical-free. (for the most part) Advocate for farm, nutrition, and environmental policies that are health promoting.

An adequate intake of the nutrients listed are essential to healthy a mood. For optimal production of neurotransmitters affecting mood, such as serotonin (made from tryptophan, with B vitamins and zinc as cofactors). The easiest way for most bodies to absorb nutrients is through unprocessed, locally grown, organic foods.

Nutrients essential for mental health and their Food sources

Essential fatty acids (omega-3s)	Fish (tuna, salmon, and mackerel) fish oil, flax seeds, flax oil, canola oil, walnut oil, dark green leafy vegetables
Vitamin B6	Beans, nuts, legumes
	Eggs, meats, fish
	Whole grains and fortified breads and cereals
Vitamin C	(All fruits and vegetables contain some amount of vitamin C.) Green and red peppers, citrus fruits and juices, strawberries, tomatoes, broccoli, turnip greens and other leafy greens, sweet and white potatoes, cantaloupe, papaya, mango, watermelon, Brussels sprouts, cauliflower, cabbage, winter squash, raspberries, blueberries, cranberries, and pineapples
Folate	Beans and legumes
	Citrus fruits and juices
	Wheat bran and other whole grains
	Dark green leafy vegetables
	Poultry, pork, shellfish
Calcium	Skim milk, yogurt, cheese
	Calcium-fortified orange juice
	Green leafy vegetables (broccoli, collards, kale, mustard greens, turnip greens, and bok choy or Chinese cabbage)
	Canned salmon and sardines canned with their soft bones
	Shellfish
	Almonds, Brazil nuts
	Dried beans
Vitamin D	Fish, fish oils, oysters
	Fortified foods such as skim milk, soy milk, and rice milk, and some cereals
Tryptophan	Turkey, chicken, fish
	Skim milk, cheese (in moderation)
	Eggs
	Soy, tofu
	Sesame seeds
	Pumpkin seeds
	Tree nuts, peanuts, peanut butter
Zinc	Oysters, dark meat of poultry
	Peanuts, almond butter, nuts, and legumes (beans)
	Fortified cereals

Because of our individual uniqueness, (genomic variability) diet, and environment, some individuals require additional nutrients to benefit from specific biochemical therapies to achieve healthy moods. Omega-3 fatty acids such as alpha linolenic acid, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) reduce inflammation, so EPA, or DHA in the diet helps maintain normal cell function and a healthy mood.  Abstract Summary

Vitamins & Minerals

Several investigators have concluded that multivitamin and mineral combinations can help improve mood and behavior.

Exercise and Rest

Vigorous physical exercise is sometimes more effective than antidepressants in promoting positive moods. People who are sedentary report higher levels of depression, and fatigue is common in deprived exercise activity. (Whether from an injury or acute illness) Getting away from the computer in favor of activity can improve mood. In a meta-analysis of yoga therapy, five randomized controlled trials (RCTs) in adults suffering from depression, all reported positive effects with exercise.  Decreased obesity, lower risk of heart disease, improved sleep, less chronic fatigue, improved cognitive performance, and decreased pain are other benefits of exercise. Over-use injuries and in some cases and over exertion were also reported.  Depression is relieved with regular exercise.

Sleep deprivation can lead to moodiness, and insomnia is a common symptom of depression. Improving sleep hygiene by incorporating the use of the bedroom for sleep only, (and well, you know)… ANYway, remove the television from the bedroom and ensure that the bedroom is dark and cool. Try taking a hot shower or listen to relaxing music, read positive or inspiring books or ask for a brief massage from a loved one. Writing in a journal before bed can help improve mood and set the tone for a restful sleep.

Environment

A healthy environment is important for a healthy mood. An environment that includes poverty, abuse, neglect, or absence of work or school can have severe adverse effects on moods that cannot be corrected through medications alone. The primary elements that affect mood are the physical and psychological environment.

Songs, poems, stories, and folk wisdom support the association between sunshine and happiness, and lack of sunshine and sadness (the blues). Bright light suppresses daytime melatonin production and shifts circadian rhythms. Desynchronization of internal rhythms plays an important role in  depressive disorders. Serotonin levels are lowest during the winter months. Seasonal affective disorder has been well documented. Given the modern lifestyles of living indoors and travelling in enclosed vehicles, today’s society receives far less sunshine than ever. Psychiatrists have noted that depressed patients hospitalized in sunny rooms have shorter lengths of stay than patients in drab rooms.

Sunlight is an essential component of our natural environment. Bright light therapy plays an effective role in the treatment of mood disorders. In an RCT published in 2006, bright light was as effective as fluoxetine in improving symptoms of seasonal affective disorder (67% response rate for both)

Nature

Recently, a new field of inquiry has emerged that explores the therapeutic effects of nature and the natural environment. Investigators have called this field biophilia, which emphasizes the connection to our natural environment. This field of study includes both natural settings alone and those combined with contact with animals. One recent study from the British Medical Journal explored the value of swimming with dolphins, a variation of animal-assisted therapy, controlled for the beneficial effect of the natural setting. A significant positive effect with this approach was found for 30 adult participants who had mild to moderate depression after 2 weeks of treatment in this single-blind RCT.

Environmental Toxins

Heavy metals like lead and mercury and especially carbon monoxide poisoning are also associated with depressive symptoms. Checking for toxins and avoiding them may help improve mood. The accumulated ingestion of pesticides has recently been associated with ADHD.

Another type of environmental toxin is comparing oneself to others. TV and marketing increases the likelihood that comparisons are made, such as others that are more attractive, intelligent, having more friends, possessions, a bigger house, better car etc. The “if it bleeds, it leads” philosophy that’s driven by the media has resulted in relentless disturbing news that can dampen anybody’s sunny disposition. Granted; keeping up with current events is essential, but take a break from the disheartening hype and practice “appreciation audits,” make a list of things to be grateful for or keep a diary of random acts of kindness like displays of thoughtfulness, compassion, benevolence, etc.

Mind–Body Therapies: Meditation

As part of the Eight Fold Path, meditation, particularly mindfulness meditation (moment-to-moment nonjudgmental awareness of breathing, emotions, and thoughts) contributes to enhanced mood, and can change brain patterns beneficially. Meditation training leads to significant increases in left-sided anterior activation, a pattern associated with relaxing alpha waves. Long-term meditators, compared with age-matched controls, exhibit increased cortical thickness in brain regions associated with attention and sensory processing, including the prefrontal cortex. The effects of meditation may include improved ability to cope with stress, reduced pain, reduced anxiety, and enhanced immune function. A regular yoga asana practice will enhance efforts to cultivate the mind by physically conditioning the body to sit longer and more comfortably. This is acheived with strength and flexibility exercises.

Dialectic Behavior Therapy

Dialectic behavior therapy is a psychosocial therapy based in cognitive behavioral therapy and mindfulness. Originally designed for chronically suicidal patients with borderline personality disorder, dialectic behavior therapy helps people build awareness about their emotional states and about how to gain control over behavior. This technique works well for chronic mood issues and oppositional defiant disorders (common with comorbid mood disorders). A 1-year open trial with bipolar youth also found promising beneficial effects.  Abstract

Gaining control over behavior also involves quieting the mind. Observing the existence of one’s consciousness and just being aware thoughts, feelings and emotions distinguishes the difference between you and the chattering mind. The idea is simple: subject-object. If you’re looking at something, then it is not you. In this way one chooses to respond instead of reacting or getting caught up in the mental chaos. You, the experiencer, have a certain quality. That quality is awareness, consciousness, and an intuitive sense of existence. You know that you’re in there. You don’t have to think about it; you just know. You can think about it if you want to, but you will know that you’re thinking about it. You exist regardless, thoughts or no thoughts, this is the lucid self.

The more you are willing to let the world be something you’re aware of, the more it will let you be who you are; the awareness. –Singer, Untethered Soul)

Social Support and Spirituality

Religion works for many people. Studies show that attending church lowers the risk of developing depression by 20% compared to nonattendees. Church may be protective because of inherent spiritual factors and because it provides a sense of social support and cohesiveness for connecting with someone in whom to confide. Numerous studies document benefit from various spiritual paths. The positive factors seem to be faith and community, rather than a specific belief system. Abstract

Massage

Massage is used widely to improve mood. In fact, despite its recreational marketing problems, massage has many medical uses. Therapeutic massage contributes to increased blood flow and lymphatic drainage; muscle relaxation; stress reduction; and social support. Physiologically, massage balances right and left prefrontal cortex activity in those with right dominance. The left prefrontal cortex has been associated with positive mood, whereas dominance of the right prefrontal cortex (as with artists) is associated with depressed mood.  Right/Left Brain Table

Furthermore, massage decreases cortisol levels and increases levels of serotonin and dopamine in patients who have depression. In depressed women, massage, compared with progressive relaxation, led to higher dopamine and serotonin levels and lower levels of cortisol and norepinephrine. Massage is good for kids too.

Considerable research has been published on the pervasive and persistent negative effects of maternal depression on childhood mental health.

Depressed mothers who received massage gave birth to infants who scored higher on various measures in the Brazelton scale than mothers who only received light touch, thus reducing the ensuing emotional risk to the unborn child.

Acupuncture

Acupuncture involves the stimulation (using pressure, heat, needles, or magnets) on specific points on the body, with the intention of promoting healing. Studies suggest that acupuncture has significant benefits for depressed adults and may be comparable in effectiveness to prescription antidepressant medications. Acupuncture rarely causes bleeding, bruising, or infection; it causes sleepiness in about 5% of patients. In general, it has fewer side effects than medications and serious side effects are rare. Pediatric patients will accept it, but it’s not usually their first choice of therapies.

Even though most complementary therapies and medicines have been in use for hundreds or even thousands of years, many have not been subject to the rigorous scientific testing and in many cases, the nature of a complementary therapy, such as music therapy or prayer, can make it difficult or impossible to evaluate by the same scientific methods or criteria. Fortunately, more research is being done and The National Center for Complementary and Alternative Medicine  and other offices of the National Institutes of Health provide information to the public and to health professionals on the use and effectiveness of complementary medicine therapies. As always, check with your physician or health care practitioner to see what’s right for you. Peace.

 

 

 

 Good Mood (printable text)

 

References

Antonioli,C. M.A. Reveley, Randomised controlled trial of animal facilitated therapy with dolphins in the treatment of depression, BMJ 331 (7527) (2005), p. 1231.

Conklin, S.M, J.I. Harris and S.B. Manuck et al., Serum omega-3 fatty acids are associated with variation in mood, personality and behavior in hypercholesterolemic community volunteers, Psychiatry Res 152 (1) (2007), pp. 1–10.

Davidson, R.J. J. Kabat-Zinn and J. Schumacher et al., Alterations in brain and immune function produced by mindfulness meditation, Psychosom Med 65 (4) (2003), pp. 564–570.

Hamre, H.J. C.M. Witt and A. Glockmann et al., Anthroposophic therapy for chronic depression: a four-year prospective cohort study, BMC Psychiatry 6 (2006), p. 57.

Khalsa, D. (2003). Food as Medicine. Atria Books: New York.

National Institutes of Health. (2010). National Center for Complementary and Alternative Medicine. Department of Health and Human Services. Retrieved 4/14/2010. http://nccam.nih.gov/.

Rama, S. (1992). Meditation and Its Practice. The Himalayan Institute Press. Honesdale, Pa.

Satchidnanada. S.(2001). The Yoga Sutras: Translation and Commentary. Integral Yoga Publications. Buckingham, Va.

Simmons, M. Nutritional approach to bipolar disorder, J Clin Psychiatry 64 (3) (2003), p. 338 [author reply 338–9].

Singer, M. (2007). The Unthethered Soul. New Harbinger Publication, Inc.: Oakland, Ca.

Stein, R.E. (2006). Interventions for adolescent depression in primary care. Pediatrics 118 (2), pp 669-682.

Teufel, M. T. Biedermann and N. Rapps et al., Psychological burden of food allergy, World J Gastroenterol 13 (25) (2007), pp. 3456–3465.