It’s surprising how much the diagnosis of depression can dictate our medical care today. The number of retirement-age Americans taking at least three psychiatric drugs more than doubled between 2004 and 2013. This is despite almost half of them having no mental health diagnosis on record, per a recent paper in the journal JAMA Internal Medicine.
Geriatric medical organizations have long warned against over-prescribing to older people, who are more susceptible to common side effects of psychotropic drugs, such as dizziness and confusion. These symptoms lead to further decline in cognition, falls, and increased anxiety.These neuroleptics and antidepressants frequently make people look and act apathetic, zombie-like as if they’ve been lobotomized — even at moderate or low doses.
What’s really going on?
For more than 20 years, the American Geriatrics Society has published “Beers Criteria” which lists dozens of potentially inappropriate drugs and their mutual interactions. Unfortunately, inappropriate prescribing in older people is even more common than previously thought according to a recent study.
Prescription rates of drugs like antidepressants, sleeping pills and painkillers nonetheless generally increased in older people, previous studies have found. The new report captures one important fact; the rise in so-called poly-pharmacy — three drugs or more — is happening in primary care.
“I was stunned to see this, that despite all the talk about how poly-pharmacy is bad for older people, this rate has doubled,” said Dr. Dilip Jeste, a professor of psychiatry and neurosciences at the University of California, San Diego.
The research team, led by Dr. Donovan T. Maust of the University of Michigan and Dr. Mark Olfson of Columbia University, analyzed data from annual government surveys of office-based doctors. The team focused on office visits by people 65 or older that resulted in the prescribing of at least three of a list of psychiatric, sleep and pain medications like Risperidone, Valium, Prozac, OxyContin and Ambien. It found that the overall number of such visits increased to 3.68 million in 2013 from 1.5 million in 2004 — nearly a 150 percent increase, partly because the population is aging but mostly because of an increased percentage of prescribing multiple medications.
So what is the answer? It is very important an older adult have an advocate who is well versed in the dangers of poly-pharmacology and is aware of alternatives that are safer and effective. The RN Life Care Managers of Holistic Aging fit this profile and provide this service to any interested client.
Natural Ways to Treat Depression
There are a number of safe and effective ways to address anxiety and depression that do not involve drugs. Let’s take a look at a few natural methods to consider before reaching for and taking another pill.
Eat real organic food, as close to its original source as possible. Avoid all processed foods, sugar (particularly fructose), grains and genetically modified organisms (GMOs). Try eating a Gluten free diet as gluten has been directly linked to symptoms of depression. When you consume foods high in carbohydrates and sugars this leads to excessive insulin release. This starts a hypoglycemic cycle that can lend to agitation, anxiety, depression and panic attacks.
Reducing gut inflammation is imperative when addressing mental health issues. Increase consumption of traditionally fermented and cultured foods which can reduce gut inflammation, promote a healthy gut flora, and add healthy probiotics. Consume food such as sauerkraut, kefir, kimchi, and miso soup. New research from Lund University in Sweden has shown that certain types of intestinal bacteria can accelerate the development of Alzheimer’s disease.
2. Get adequate Vitamin B12
Vitamin B-12 and other B vitamins play a role in producing brain chemicals that affect mood and other brain functions. Low levels of B-12 and other B vitamins such as vitamin B-6 and folate may be linked to depression.
When you get older, the lining of your stomach gradually loses its ability to produce hydrochloric acid. This acid releases vitamin B12 from your food. If you’re over 50, it’s safe to assume you are not absorbing vitamin B12 at an optimal level.
With the long term usage of Proton Pump inhibitors and other antacids 3/5th of the population over the age of 50 is B12 deficient.
3. Optimize your Vitamin D levels
Vitamin D is very important for your mood. Your body actually makes most of its vitamin D from sunshine; vitamin D levels have been shown to be the lowest during the month of February for American’s. According to one recent study, seniors who have low vitamin D levels may double their risk of dementia and Alzheimer’s disease and were 11 times more prone to depression.
Check your Vitamin D level at least once a year. You’ll want to be within the therapeutic range of 40 to 60 ng/mL (100 to 150 nmol/L) year-round. If you cannot get sufficient sun exposure to maintain this level, taking an oral vitamin D3 supplement would be advisable. Also increase your vitamin K2 and magnesium when taking oral vitamin D.
4. Mindfulness Meditation
We can’t control our emotions, and the more that we try to stop anxiety, or sadness, or fear from coming up, the more it comes up. Mindfulness is paying precise, nonjudgmental attention to the details of our experience as it arises and subsides, doesn’t reject anything. Instead of struggling to get away from experiences we find difficult, we practice being able to be with them. We begin to realize that our thoughts and emotions are not who we are, and from this observing stance, we begin to create space for these difficult experiences to be as they are, where they already are. The amazing thing is that often, once a person stops spending all their energy on fighting how they feel, and get clear on what they really want their life to stand for, they become free to do things that really matter to them.
5. Get adequate daily exercise
Most people agree there is strong correlation between mood and exercise. However, did you know that, exercise might be an acceptable substitute for antidepressants? See this study in Health Harvard .
Exercising creates new GABA-producing neurons that help induce a natural state of calm. It also boosts your levels of serotonin, dopamine and norepinephrine, which help buffer the effects of stress.
6. Get enough sleep
Evidence suggests that people with insomnia have a ten-fold risk of developing depression compared with those who sleep well. When you don’t get the 7-9 hours of quality sleep you need, it can heavily influence your outlook on life, energy level, motivation, and emotions. Here are some recommendations on getting a good night’s sleep.
7. Emotional Freedom Techniques (sometimes called Tapping)
Recent research has shown EFT significantly increases positive emotions, such as hope and enjoyment, and decreases negative emotional states. The basic premise is that the cause of all negative emotions is a disruption in the body’s energy system, which is the centerpiece of eastern medicine. When the energy in our body is flowing normally, we feel great; when it becomes stagnant or obstructed, this causes disruptions along the energy meridians. That damage leads to negative or damaging emotions which can develop into physical symptoms. Tapping with your fingers on meridian points corrects these imbalances. At the same time, tapping tunes into the underlying issue. When done properly, the emotional factors that contribute to the problem are typically released along with the energy blocks.
EFT is particularly powerful for treating stress and anxiety because it specifically targets your amygdala and hippocampus, parts of your brain that help you decide whether or not something is a threat.