Can one treat depression without medication?

Many people ask me whether one can cure depression without medication. This question is sometimes asked because people want to get better on their own, and because they are worried about becoming chronically dependent of medication. Is treatment of depression without medication possible? Is it recommended?

Bipolar or manic depression: Lithium and antidepressants first!

Bipolar or manic depression is first of all a genetically inherited disorder, where the biological causes are important. As a result thereof, antidepressant medication combined with Lithium are the best treatment in most cases. People who suffer this way need to, first of all, get treatment from a physician-psychiatrist. Except for this medical-biological treatment, it can be useful to support the patient with EPA and DHA (Omega-3 fatty acids) and a therapeutic approach, possibly supplemented with online self-help for practising specific skills for dealing with the stress which the illness can become worse from. In short, manic depression has medication as its main treatment, and supplements of EPA or DHA and online self-help or therapy are less important than the advice given by the treating psychiatrist.

The major depression

In major depression it has been shown that antidepressant medication is very valuable, yet often not enough to heal depression. The depressed patient should also learn new strategies and techniques for seeing things in a different way, in order to deal with the depressed feelings in a different way, and to handle certain situations and activities differently. This is absolutely necessary for long-term healing of depression. Learning these strategies can be done through online self-help, in case the motivation of the depressed patient is sufficient, or in case a loved one, partner, or family member helps support the patient on those days where motivation is lacking. Psychotherapy can also be an important tool for healing depression. Our experience is that patients who combine psychotherapy with online self-help improve faster and get better results as compared to those who use psychotherapy alone. This is beautifully illustrated in an e-mail from a participant:

Hello Paul, I spoke to my therapist about 15minutes4me yesterday. She also finds it a good idea that I work with this. Told her that I feel that I am more actively working on my treatment. Regards,

Omega-3 and online self-help for minor depression and for burnout

For minor depressions, the opinions on antidepressant are divided. Some studies suggest that antidepressants do help, while others show that they do not. Most psychiatrists I know tend to say that, in minor depressions, antidepressants are not necessary, but they are an option. However, if you choose to take an antidepressant, it is important to keep taking it even several months after you have recovered, so that the risk of relapse is low. The role of learning new habits in the shape of psychotherapy, guidance, or a good online self-help program is much more important here than whether or not antidepressants are used. Also, medical literature is more and more accepting of that EPA and DHA, both special types of Omega-3 fatty acids, work both preventively and curatively in depression and burnout.

PlusEPA: The role of EPA (Omega-3 fatty acids) in the treatment of depression, stress, and burnout

Let us take a look at the role of Omega-3 fatty acids in the treatment of stress related disorders.

What is the role of Omega-3 in the treatment and prevention of depression?

Omega-3 fatty acids are part of the cell membranes of nervous cells and brain cells. So, if we have a shortage of some omega-3 fatty acids, the cell walls of our brain cells and nervous cells will be less well protected, and thus more vulnerable. Furthermore, omega-3 fatty acids are anti-inflammatory. It is this effect - which can be compared to aspirin - which explains why EPA and DHA omega-3 fatty acids reduce one's chance of heart attacks or arteriosclerosis.

Which type of Omega-3 is good?

EPA and DHA are 2 specific molecules which belong to the family of omega-3 fatty acids. These are the two which we mainly require - the other molecules from the omega-3 fatty acid family are less important. So if you want to know which products contain the right omega-3 fatty acids, you need to check the packaging to see how much EPA and DHA they contain. The rest is just marketing and has little to no effect on your health nor helps in the prevention of stress, burnout, or depression. EPA is most important in its treatment of depression. The Flemish firm Minami Nutrition has just completed a study with pure EPA solution - the PlusEPA 60 which contains 1 gram of EPA per capsule. The study took 8 weeks and showed that the antidepressant effect of one gram of EPA per day (1 capsule of PlusEPA 60 per day) is just as large as that of antidepressants, and that a combination of both scored even higher in the treatment of depression. The amount of participants to this study was small, so further research is needed to confirm these results. Meanwhile, these first results are very hopeful.

Test your level of Omega-3 in your blood

The company Minami Nutrition recently developed a simple test with which you can easily measure your blood values of EPA, DHA, and other omega-3 fatty acids. So if you think you might have a deficiency which might affect your depression, your doctor can help you to take this blood test, using a finger-stick and two drops of blood.

The balance between EPA, Omega-3, therapy, and online self-help

In any case, it is of utmost importance to work on the habits which caused you to end up in your depression, which you can do via online self-help or therapy.

How do I know if I have depression or burnout?

15Minutes4Me developed a simple list of questions which helps you to test yourself on depression, stress, or anxiety. You will receive a result which allows you to see if you are in the risk-zone, so that you can discuss this further with your doctor and take action, if necessary. Simply click this link to take the test.

Paul Koeck, MD