Five to ten per cent of patients visiting their GP will be suffering from “clinical” or “major” depression. This means that as a GP, two to three of the patients I see in a normal working day will be experiencing debilitating and disabling symptoms of feeling down, depressed or hopeless and will have little interest or pleasure in doing things. Too many people still think that depression is “all in the mind” and there is a great deal of guilt felt by sufferers that they cannot just snap out of it. Having a “nervous breakdown” still carries a stigma, especially if symptoms are severe enough to need a hospital admission or referral to a psychiatrist. I spend a great deal of my professional life reassuring people that they are not going mad and their symptoms do have a rational explanation.
As well as clinical depression, where symptoms are severe enough to affect day to day living, 15 to 30 per cent of my patients will have depressive symptoms but still manage to continue with work or home life without serious problems. This situation is referred to as “subthreshold” or “mild” depression, depending on the severity and number of symptoms. This is probably the largest group of patients with a psychological problem that I see in my surgery every day. People come with a variety of complaints, including a feeling of persistent fatigue, lack of appetite or excess appetite resulting in comfort eating, not being able to look forward to enjoyable events such as holidays or family celebrations, poor sleep, feelings of anxiety and low selfesteem, guilt for “not really being ill”, feelings of not coping, lack of interest in activities or relationships, loss of sex drive and generally feeling cut off from the world. Whilst most of us can experience all of these feelings at some time to a greater or lesser extent, it is when they last for weeks on end that we start to feel unwell and out of balance. It is in these circumstances that the body starts to need a little help to recover.
What causes depression? Most people know that our brain produces a “good mood” hormone called serotonin. If we do not produce enough of it or it gets broken down too quickly, then a low mood results. Quite what triggers off this chemical imbalance is the subject of hot debate by scientists, but its results are only too clear to sufferers of this common condition. There may be an inherited element to depression, possibly a genetic factor but scientists are unsure whether depression is due to nature or nurture. I suspect it is a mixture of both. Certainly I come across some people whose brains permanently seem to produce low levels of good mood hormone, meaning they always feel somewhat under par mentally.
In the past, people with symptoms of depression or anxiety were often treated with tranquillizers, or benzodiazepines like diazepam (Valium). This is because depression is really a mixture of feeling low combined with symptoms of anxiety. The latter can range from waking up with a sinking feeling or butterflies in the stomach or panic attacks to full blown physical symptoms of acid indigestion, problems with swallowing, diarrhoea, a feeling of tightness in the throat, difficulty breathing, weight loss, and a sureness that “something serious is wrong with me”. Although tranquillizers may still be used by the medical profession if symptoms of anxiety are very severe, they are now generally recommended only for short term use (up to two weeks at a time).
It is whilst waiting to see a therapist that I find homeopathy has a place for my patients. It can also be used as a sole treatment if patients do not feel that they want to see, or need to see a counsellor or therapist but nevertheless want some help to recover from their illness. I would emphasise that I am not suggesting that homeopathy should be used as the only treatment in serious depressive illness where there are feelings of wanting to die or a risk of suicide, or in mental health problems such as bipolar disorder (manic depression), schizophrenia or severe postnatal depression. These are complex and potentially life threatening illnesses and need advice from a psychiatrist alongside the GP and other healthcare professionals. Homeopathy may have a part to play as an additional or complementary treatment but NOT as a stand alone therapy in these situations.
