Dr Robbins has been a contributor to Latitudes for over 20 years and is on its advisory board. Sadly, he fell ill late last summer and since then has not been well enough to see patients. Latitudes has a video of a presentation that he gave on environmental medicine in 2009. Please contact them if you would like to access it.

Depression affects more than 21 million children and adults in the U.S. each year. By understanding the potential causes of depression and approaches beyond standard medications, we can impact the prevention and treatment of this condition.

15 possible factors leading to depression:

•Low levels of endorphins, serotonin, norepinephrine, dopamine and other neurotransmitters; hormone imbalances;
• Progressive chronic illness; hidden or chronic infections;
• Negative attitudes, emotional paralysis, a history of failures or traumatic life experiences;
• Chronic personal, emotional and/or physical stresses or losses; severe financial difficulties;
• Toxic exposures in the home, community or at work;
• Hidden and masked inhalant and food allergies;
• Seasonal affective disorders (unable to go outdoors/not enough sunlight);
• Masked and undetected chemical sensitivities;
• Nutrient deficiencies; poor or inadequate diet;
• Inadequate physical activity;
• A poor social and/or family network;
• Poor sense of direction in life, unable to find work;
• Adverse reaction to medications or drugs;
• Addictions; excessive alcohol intake;
• Inadequate rest.

Ways to lift or avoid depression

These suggestions seek to balance the environment, mind, body, spirit, and emotions. Please note that if the brain is not sharp and functioning well (if the person is "drugged up") some of these suggestions will be difficult to implement and may not work ideally.

Environmental changes

• Understand that allergens and chemicals can affect brain chemistry adversely;
• Avoid toxic environments, toxic people, toxic drugs and toxic chemicals;
• Be tested for inhalant allergens, food allergens and heavy metals;
• Determine and treat or eliminate hidden allergens;
• Avoid exposures to fragrances, fabric softeners, pesticides, aerosol sprays, plug-ins, scented personal care products, hair dyes and sprays, incense, scented candles;
• Avoid air pollution, cigarette smoke, musty and moldy environments, animal dander, house dust;
• Avoid and eliminate any hidden infections in the body.

Mental factors

• Examine your thoughts and avoid all recurring thoughts that appear to weaken you and make you fearful;
• Use and repeat positive affirmations that increase your belief and faith in yourself;
• Write your goals down and review them daily;
• Decide on and focus on achieving your daily and long-term goals;
• Unclutter your mind and your life;
• Eliminate or minimize all activities that are not important to achieving your personal goals;
• Slow down and work at your own comfortable pace;
• Empty your mind of all negative thought patterns; Choose to do only those activities that make you proud of yourself;
• Increase your self discipline;
• Seek to achieve a centered or balanced vibrational mental energy state.

Physical changes

• Make an appointment with yourself for regular exercise: walking, yoga, weight training, swimming, jogging, cycling, aerobics. These increase endorphin and other brain neurotransmitter levels and give you a sense of strength, balance and well being;
• Eat wisely and develop a healthy diet;
• Get enough rest to recharge your mental and physical batteries daily;
• Set a regular schedule that your body can depend on; eat at regular times; exercise at regular times; work on a routine.

Spiritual attitude

• Pray and become stronger spiritually;
• Increase your awareness that you are a spiritual presence in an infinite universe;
• Practice living, thinking and acting more from your heart;
• Understand the healing power of love and use it more freely Recognize and use the healing power of your spiritual side or spiritual self.

Emotional awareness

• Strive to live unrestricted by your past failures, traumas or mistakes. You are what you choose to do, think, and be today;
• Be aware of and question your emotions;
• Learn to respond intelligently rather than emotionally;
• Avoid toxic emotional situations.

Recommendations for physicians

• Evaluate and test for underlying nutritional, toxic, allergic, environmental, neurological, psychological, and/or hormonal causes for depression; include thyroid function analysis.
• Write an individualized exercise prescription;
• Write an individualized diet and nutritional prescription;
• Recommend nutrients that support the nervous system and neurotransmitters;
• Evaluate the patient's habits, environment, personal relationships and goals;
Treat the whole patient in his/her environment.

A holistic approach is needed to deal with depression — a condition that is very real, distressing and heartbreaking to watch or experience. When needed, conventional medical care is most effective when combined with other efforts as indicated in this article.

First published in FM December 2011

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