Why natural depression therapies are better than pills

Winter is upon us. And with it comes the annual worsening of depressive symptoms. Sadly, in the United States, suicide continues to claim more lives than firearms, and suicide rates are increasing in nearly all states. The U.S. Centers for Disease Control and Prevention reports that death by suicide has increased by 30 per cent since 1999 and a similar trend is observed in Canada.

I was distressed but not surprised to learn that these increases occurred over a period of time in which use of antidepressants skyrocketed by 65 per cent. By 2014, around one in eight Americans over the age of 12 reported recent antidepressant use.

I practice critical-care medicine in Guelph, Ontario. Sadly, 10 to 15 per cent of my practice is the resuscitation and life support of suicide and overdose patients.

It is not uncommon for these patients to have overdosed on the very antidepressants they were prescribed to prevent such a desperate act. The failures of antidepressants are a clear and present part of my clinical experience.

Wedded to drugs that barely work

Ten years ago, when finishing medical school, I carefully considered going into psychiatry. Ultimately, I was turned off by my impression that thought leaders in psychiatry were mistakenly wedded to a drug treatment that barely works.

A 2004 review by the Cochrane Foundation found that when compared against an “active” placebo (one that causes side effects similar to antidepressants), antidepressants were statistically of almost undetectable benefit.

Studies that compared antidepressants to “dummy” placebos showed larger but still underwhelming results. On the 52-point Hamilton Depression Rating Scale (HDRS), patients who took the antidepressants fluoxetine (Paxil) or venlafaxine (Effexor) experienced an average decrease of 11.8 points, whereas those taking the placebo experienced an average decrease of 9.6 points.

I am not suggesting that antidepressants do not work. I am suggesting that they are given a precedence in our thinking about mental health that they do not deserve.

I leave it to readers to look at the Hamilton Depression Rating Scale and decide for themselves whether a drop of 2.5 points is worth taking a pill with myriad potential side effects including weight gain, erectile dysfunction and internal bleeding.

It might be, but do note that taking an antidepressant does not seem to decrease the risk of suicide.

Natural therapies that work

The far more exciting and underplayed point, to me, is that multiple non-drug treatments have been shown to be as effective. As a staunch critic of alternative medical regimes such as chiropractic, acupuncture and homeopathy, it surprises me to note that the following “natural” therapies have rigorous, peer-reviewed scientific studies to support their use:

1. Exercise

In 2007, researchers at Duke University Medical Center in North Carolina randomly assigned patients to 30 minutes of walking or jogging three times a week, a commonly prescribed antidepressant (Zoloft), or placebo. Their results? Exercise was more effective than pills!

A 2016 review of all the available studies of exercise for depression confirms it: Exercise is an effective therapy. And it’s free!

2. Bright light therapy

You know how you just feel better after an hour out in the sun? There probably is something to it. Bright light therapy is an effort to duplicate the sun’s cheering effects in a controlled fashion. Typically, patients are asked to sit in front of a “light box” generating 10,000 Lux from 30 to 60 minutes first thing in the morning.

A review of studies using this therapy showed significant effect. The largest study showed a 2.5 point drop on the HDRS, roughly equal to that seen from antidepressants.

The sun gives 100,000 lux on a clear day and I can’t think of a reason why sunlight itself wouldn’t work, weather permitting.

3. Mediterranean diet

This one surprised me when it came out last year. Researchers in Australia randomly assigned depressed patients to receive either nutritional counselling or placebo social support.

The nutritionists recommended a Mediterranean diet, modified to include local unprocessed foods.

Thirty-two per cent of the depressed dieters experienced remission versus eight per cent of those who only received social support, a far larger effect than seen in antidepressant trials.

4. Cognitive Behavioural Therapy (CBT)

This is the best recognized of the “natural” treatments for depression and the evidence is indisputable.

CBT is as effective as antidepressants but more expensive in the short term. However, antidepressants stop working when you stop taking them, whereas the benefits of CBT seem to last.

And as an aside, it is very difficult to overdose fatally on a bottle of therapy.

I freely admit that the trials I have mentioned are smaller than the major antidepressant trials. But whereas antidepressants are projected to bring in almost $17 billion a year for the pharmaceutical industry globally by 2020, the jogging and sunlight industries will never have the resources to fund massive international trials. With this in mind, I am convinced that they are at least as worthwhile as the pills.

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Chemists prove chromones are effective against Alzheimer’s disease

RUDN chemists synthesized a range of biologically active molecules called chromones and demonstrated their use in the treatment of Alzheimer’s disease. The results of the work were published in the Bioorganic & Medicinal Chemistry journal.

Alzheimer’s disease is a progredient form of dementia causing irreversible deterioration of cognitive functions (attention, memory, orientation, and thinking) and resulting in complete disintegration of personality. According to the World Health Association, about 6-7 million people are diagnosed with Alzheimer’s disease annually. RUDN chemists with their colleagues from IPAC RAS and Lomonosov MSU synthesized new compounds that are able to stop the progression of this disease and studied their biological activity.

Alzheimer’s disease is associated with the damage of the central or peripheral nervous system. A special role in the work of the nervous system is played by a neurotransmitter called acetylcholine that helps a neural impulse move between neurons and then from neurons to muscles. Reduced levels of acetylcholine are one of the symptoms of Alzheimer’s disease. Today’s treatment methods are reduced to prolonging the activity of the remaining acetylcholine with drugs that slow down its disintegration and partially compensate for its loss.

The disintegration of acetylcholine is affected by several substances. The main role in the process is played by acetylcholinesterase (AChE) and butyrylcholinesterase (BChE). In the course of development of the Alzheimer’s it’s the activity of BChE that increases. By reducing it, one may slow down the disintegration of acetylcholine. RUDN chemists managed to achieve this effect using chromones—biologically active molecules that have been previously successfully used in the treatment of other conditions. In their previous works the authors suggested a new way of synthesizing substituted chromones compounds, and in this research demonstrated their potential as an efficient anti-Alzheimer’s therapy.

“We found chromones interesting because of their pharmacological activity. Their derivatives appeared to have anti-cancer, anti-viral (including anti-HIV), anti-microbial, anti-fungal, anti-inflammatory, anti-diabetic, and antioxidant properties. It was especially important for our studies that chromones and their derivatives played an important role as antioxidants and acceptors of radicals,” said Larisa Kulikova, a candidate of chemistry, and a lecturer of the Faculty of Physics, Mathematics, and Natural Sciences at RUDN.

To evaluate the pharmacological activity of the obtained substances, the scientists used kinetic methods and modeling. The results of screenings showed that the new substances efficiently slowed down the activity of BChE. In the future the team hopes to improve the synthesis method and to obtain chemical compounds with antioxidant as well as BChE-suppressing properties. A substance like that would be able to slow down BChE and at the same time to reduce the so-called oxidative stress—the disbalance between the number of active oxygen or nitrogen compounds and the inability of the body to process them leading to massive cell death.

More information:
Galina F. Makhaeva et al. Synthesis, molecular docking, and biological activity of 2-vinyl chromones: Toward selective butyrylcholinesterase inhibitors for potential Alzheimer’s disease therapeutics, Bioorganic & Medicinal Chemistry (2018). DOI: 10.1016/j.bmc.2018.08.010

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Should we be afraid of cancer from the mobile phone, if you are a male rat?

In connection with the completion of a major study on mobile phone cancer risk news headlines exploded with reports on the subject. Given that the study provoked a barrage of information, was not conducted on humans and used the specific type of radiation, the proposed deal that really shows this scientific work and what we can expect from their phones.

The national toxicology program (National Toxicology Program NTP) presented the final reports on the studies of the effect of radio frequency (RFID) used in mobile phones 2G and 3G, in rats and mice.

Scientists have subjected their experimental radiation exposure within two years, nine hours a day. The results of more than a decade of research has shown that strong RF exposure associated with the development of tumors. Have been provided:

  • Compelling evidence linking RFID and tumors (malignant sannam) in hearts of male rats;
  • Some evidence of connection with tumors (malignant gliomas) in the brain of male rats;
  • Some evidence of benign and malignant tumors in the adrenal glands of male rats;
  • Ambiguous (unclear) evidence linking observed in the study of tumors in female rats and mice of both sexes.

The exposure used in the studies cannot be directly compared with the impact that people experience when using a mobile phone. In our studies, rats and mice received radio-frequency radiation throughout the body. On the contrary, people are mostly exposed to certain tissues near the place where they hold the phone. In addition, exposure levels and duration in our study was higher than people, explained John Bucher (John Bucher), doctor of philosophy, senior researcher of the NTP.

Health magazine columnist , Forbes argues that it makes no sense to panic if you are not male rats. In addition to the above reservations, it should be noted that the study used the radiation, which was used only for early models of mobile phones which now practically are not applied. Also noteworthy is the fact that strong evidence that RFID causes cancer in female rats and mice that were not received.

However, to reduce exposure to RF radiation, people should take precautions:

  • Keep the cell phone away from the head and body;
  • Do not place the phone near me while sleeping;
  • Use, whenever possible, speakerphone or headset;
  • Avoid using mobile phone when the signal is weak. In this case, because of the constant attempts to connect, RFID enhanced;
  • Do not use your mobile phone to download large files or streaming video. This also leads to increased RFID;
  • Before buying, carefully study the label and information about models by phones. Different devices may have different levels of RFID;
  • Do not wear the headset when not in call;
  • Put the phone in airplane mode or even turn off, if possible;
  • Skeptical about protective screens and other devices that are positioned as reducing RFID;
  • Try as little as possible to use the phone. Shorten the length of your calls, communicate face to face.

Valeria SEMA

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What are this summer's shoe trends doing to your feet?

While we make so much fuss about children's school shoes, the footwear adult women spend most of their time in tends to be less heavily scrutinised. Your typical women's shoe is often flimsy, occasionally blister-inducing and, concerningly, can be capable of causing some serious damage to your foot.

So, with new season styles now in stores – and the weather too warm for your trusty ankle boots (alas) – which shoes are best for regular wear over the summer months? Sydney podiatrist Charlotte Bodell gives her verdict.

Mules are not a good option for daily wear.

Mules are not a good option for daily wear.Credit:Shutterstock

Mules

Mules in every style and hue are certainly this summer's default. Gucci's black Princetown mules (with the gold bar on the front – you know the ones) have trickled down from Zara, to Kmart, to the feet of every woman looking for a slightly casual corporate shoe.

But, what effect does wearing a shoe with no back support have on your feet? Quite a large and unpleasant one, says Bodell, who does not recommend mules as an everyday shoe.

"What you will definitely get is hammered toes from [your foot] clawing forward, corns on the apex of your toes [underneath the toes], and you will get corns on the tops of your toes, because the shoe is tapering down."

There is also a slightly more cosmetic problem which can result from the frequent wearing of mules, which Bodell says she has been observing in her clients since the '90s throwback shoes reached mainstream popularity last summer.

"Because there's no back to the shoe, the fat pad of the skin is hanging over the heel itself, and people are getting hard skin and cracks on the heel," she explains, adding there is an easy fix.

"Get a foot file and file the skin off, then put some heel balm cream on a nighttime with a pair of socks."

Slingbacks

Throw a strap around the back of a mule and you have the slingback. Often seen with a flat or a kitten heel, slingback styles are everywhere.

"It's good that there is a strap, because it's keeping the shoe on," Bodell says, although there is a catch.

The slingback is a slightly better option for daily wear, provided the fit is right.

The slingback is a slightly better option for daily wear, provided the fit is right.Credit:Shutterstock

"For [the strap] to stay on, you need to push your foot forward in the shoe. So, if the shoe is a little bit too small for you, your toes are going to be crunched up, and hammered, and curling under."

If that happens, you can end up clawing onto the front of the shoe with your toes, just like in a pair of mules. The key is to make sure your slingbacks are a nice fit.

Pointed-toe shoes

Shoe trends tend to oscillate between blunt and pointy (a helpful quirk to ensure we part with our money regularly and unnecessarily). A scan of the shops reveals it's currently pointy season. Unfortunately, this is not a season known for comfort.

"You're more likely to get the bunion formation on your big toe joint," Bodell warns of shoes which make your toes squish close together.

In more extreme cases, putting your non-triangular foot in a triangular shoe can lead to a painful condition called Morton's neuroma, which feels like you permanently have a rock stuck under the ball of your foot.

"You've got nerves on your metatarsal joints," Bodell explains. "And, when they're pushed together you get fibrous tissue that forms on the nerves. Then, when you squeeze the foot, it brings on a nerve pain."

Ouch.

Kitten heels

We might think that heels are worse than flats for our feet, but Bodell says a slight heel, like a kitten heel, can actually be better than a totally flat shoe.

"It helps the ankle joint get into position," she says. "If you have tight calves, it helps to take the pressure off your arch and off your calf."

However, the stiletto style of most kitten heels on the market is not ideal.

"They can be quite unstable; you're better off with a block heel. And, if you're prone to rolling your ankle, these will increase the likelihood of that."

Plastic shoes

"But, what about my favourite see-through plastic shoes?" I hear literally no one ask.

Probably popularised by Kim Kardashian (who wore high, transparent plastic boots from her husband Kanye West’s fashion line two years ago, prompting a number of knock-offs), shoes with transparent plastic uppers are around again this summer. And, as will probably not shock, they are neither comfortable nor sanitary.

"[The plastic] doesn't bend and it doesn't soften, so if you're using those shoes and it's hot in the afternoon, your feet will swell and you will get blisters," Bodell says, adding that "all the moisture and the sweat" can also create a nasty fungal situation.

The ideal summer workday shoe

So, which shoes should you be wearing this summer?

Bodell recommends a heel somewhere between 2-5cm high, ideally in the 2-3cm range.

"If you're wearing a flat shoe, the mid foot will roll through because you haven't got any cushioning or support on your arch," she says.

A strap across the front of the foot is also a good feature ("so you don't have to do any clawing"), while arch support and a little platform on the front should also help your feet wear a style for a long period.

"You want a little platform on the front to give you a bit of padding on the ball of your foot, which should prevent any sort of stress fractures if you're prone to pounding the streets."

But, if you are pounding the streets – either on your commute or your lunch break – Bodell says the best thing to do is to bring a pair of sneakers.

"There are lots of trendy ones out there now," she says. "You don't need to wear your boring trainers. But, if you're going to walk longer than 15-20 minutes in the morning, do not wear your regular strappy shoe you would wear to work: you will get problems."

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