What to Do When Feeling Blue

Ruscombe Round Table on Depression

This article was prepared as collaboration between practitioners at the Ruscombe Mansion Community Health Center in Baltimore. To learn more, attend our annual free Open House event, September 18, 2011.

As we “listen to your story” at Ruscombe, we find that depression is a common complaint, often affecting people with chronic health conditions. But when depression is the sole condition, it can also be severely debilitating. One practitioner described it as walking through molasses. Your body can feel so heavy, you struggle simply to move, much less motivate yourself to follow advice on how to alleviate your depression.

When our Ruscombe practitioners compared notes, we recognized some commonalities in the way each of us -- following many different themes of training -- assesses mood health in our clients. While it goes without saying that each individual is treated uniquely, around the Ruscombe Table we often discover the tips that can help get someone started back on the road to “optimal health”: a phrase that by definition encompasses physical, spiritual, and emotional wellbeing. If you are experiencing depression or anxiety, we hope some of these tips will lead you to the right course of action for yourself.

If you are the loved one or caretaker of someone with depression, it is rather more difficult to compose a list of helpful tips, but there are several things you can do. See the sidebar of this article for a summary of caretaker tips.

Feeling depressed? Unmotivated? Sluggish? Consider some of these ideas from the Ruscombe Round Table:

• Learn how to get into the present moment with the breath. Just reminding yourself to be “present” helps a lot in any stressful situation. Easier said than done, but like with anything, practice will make this feel natural over time.
• Diet is a big part of mood. It can spur depression and aggravate anxiety. Dips in blood sugar between meals is especially troublesome for anxiety. Ask your Ruscombe practitioner to help you find the food choices right for you. If she doesn’t know, she will refer you to one of our medical doctors or nutrition experts on staff.
• There are many acupuncture points on the ear that are helpful for mood and anxiety. Tiny “Ear Seeds” can be placed in the curve of the ear for help throughout the day. They are the size of a poppy seed, or sometimes a gold or silver ball is used to apply continuous acupressure to these ear points.
• Make sure an adequate level of Vitamin D is being taken. Vitamin D is called the sunshine vitamin because your body manufactures it from exposure to sunlight, one of those curious connections between light and depression. Vitamin D helps increase seratonin, called the “feel good chemical” in the brain. Ten minutes a day of sunlight exposure to your arms and legs is the best way to get the proper amount of Vitamin D.
• Ancient healers observed that St. John's Wort (which got its name because it blossoms in the middle of the summer around St. John’s Day) demonstrates a relationship to the sun and the light. It grows straight up, branches out in the upper section and has bright yellow flowers like a sun. The leaves are opposite each other perfectly arranged, which indicates its relationship to our rhythmic system, our heart, the seat of emotions. Its milk inside is red, like the human blood.  The ancients realized this plant can be a carrier of light, and long ago began using it as a treatment for depression.  St. John’s Wort is a powerful herb that interacts with many prescription drugs, and it is advised to consult your prescribing physician and herbalist before taking it. Too much of it can make you so sensitized to light that you can get a sunburn. 
• Rescue Remedy in a Spray: Keep a bottle in your car. This popular Bach Flower Remedy tends to be mentioned regularly in our Ruscombe Round Table discussions because it is helpful in so many situations. Rescue Remedy is excellent for panic attacks, and even if you never have panic attacks, it’s still wise to keep a spray bottle in your car or handbag for emergencies. It can help you navigate calmly through a tight traffic jam, as well as be ready to use if you are ever in an accident. Several of our practitioners are known to the friends of their kids as the Mom with the “magic spray” that rescued them after many a mishap. Rescue Remedy is always kept in stock on sale in the Ruscombe Central Office.
• Aromatherapy is a pleasant and soothing treatment for depression, and anyone can experiment at home with the scents they find most appealing. Grapefruit is a good place to start, as it’s known to be especially effective as an antidepressant.
• Gardening can be so therapeutic for depression that there have developed professional schools of therapeutics called gardening or horticulture therapy. But all you really need is a plot of dirt and some seeds and sunshine. Especially if you enjoyed gardening in the past, getting into the dirt, cultivating something to life, working in nature, breathing fresh oxygen while in the sunshine, all of these activities combine to make gardening a beautiful antidote to depression. http://www.ahta.org/
• An often-overlooked contributor to depression is a possible reaction to the toxic heavy metals that surround us in our typical environment. Aromatherapist and Massage Therapist Lucy Hagan shared a tasty recipe she learned from a naturopath for a cilantro pesto which works to remove some of these toxic metals from your system when taken in a dose of 2 tablespoons a day for several months. Fortunately, it’s delicious and also high in green food vitamins. Come to the Ruscombe Mansion Open House on September 18, 2011, 1-4 PM for free samples of this Cilantro Pesto, together with other delicious healing recipes we’ll show you how you to make for yourself at home.
• Movement is tremendously helpful for depression, and a routine of yoga or getting to the gym with a trainer can be transformative. Excess oxygenation of the cells makes you feel stronger and also releases endorphins. Exercise gets the tension out.
• Along with exercise, drinking water is the other most simple and most effective of all these tips that anyone can do to alleviate depression. For therapeutic purposes, it’s advised to drink half your body weight in ounces per day, unless you have a kidney problem.

On a final note, remember: Depression is one of those conditions where the adage of “one size doesn’t fit all” is very true. As our Ruscombe practitioners say, we pick up the thread where we can. Everyone is holding a pattern, and we all brace against what is hard in different ways. If the objective is to help the client let go of a certain pattern, we help you find the thread wherever you can and, in the peaceful serenity of the Ruscombe Mansion setting, learn how to unravel it from that safe place.

Ruscombe Mansion practitioners contributing to this article:

Stacy Kargman, N.D. - 410-356-4600 
Peter Hinderberger, M.D. - 410.367.6263
Sara Eisenberg, MS: restorativeherbals@verizon.net - 410-323-9815
Tessy Brungart:Tessyb@aol.com - 410-367-4075
Denarah Ferron: denarah@gmail.com - 443-510-3701
Lucy Hagan: LucyHagan@aol.com - 443-226-0050
Shoshanna Shamberg: 410-358-7269 or email IrlenVLCMD@yahoo.com
Barry Drew: 443-695-4370 or e-mail drew.4721@comcast.net

See below for the complete transcript of the Ruscombe Round Table Discussion on Depression and Anxiety.

The Complete Transcript of Depression and Anxiety from the Ruscombe Round Table

From Sara Eisenberg, Clinical Herbalist

Assess and address mood/cognitive/stress state in the particular context of the client, as both depression and anxiety so commonly occur with many chronic conditions, chronic pain, a history of insomnia, rapid or progressive loss of function, trauma or loss, and as a side-effect of medications.  It is not uncommon to see a chronic condition improve as mood health is addressed herbally via the multiple paths below.

Included in an herbal assessment of mood are client presentation and constitutional patterns; physiological systems function; dietary, rest and activity patterns, daily energy cycle; use of supplements, prescriptions and over-the-counter products; self-medication with caffeine, sugar, alcohol, laxatives; environmental stressors; dominant emotions and psychosocial issues; resources and practices of self-care, personal and professional support systems.

Herbal approach: nourish and calm or uplift and mildly stimulate the nervous system, restore healthy recovery from stress response, balance sympathetic and parasympathetic activity, support cognitive function, and promote healthy digestion while addressing the associated conditions. Most serotonin in the body is produced in the gut, and 10 messages travel from the gut to the brain for every message traveling the other way.

Phytochemical activity: types of herbs typically used to address emotional and cognitive health:

Nervines/nerve tonics: improve nervous system tone, vigor and function through relaxation or stimulation; may have antidepressant or anxiolytic activity. Examples of specific indications, or characteristic patterns for nervines: 

Rosemary: depressed, lethargic, vegetative, debilitated, foggy brain, hard to concentrate, poor memory

Valerian: depressed, nervous, despondent, sleep not restful, foggy brain, poor memory, muscle spasms

California Poppy: anxious, physically agitated, sensitive to stimuli

Nootropic: enhance cognitive function, facilitating focus, learning, memory, and addressing “brain fog.”  Examples: Bacopa, Ginkgo.

Adaptogens: normalize stress hormone patterns (HPA axis), and provide systemic support. Examples: Ashwagandha, Siberian Ginseng.

Digestives: support healthy functioning of the gut, or “second brain”: restore integrity of physical, immune, and chemical barriers; soothe and repair irritated tissues; prime the digestive pump; regulate motility function, balance gut bacteria. Examples: Chamomile, Globe Artichoke, Calamus Root.

Herbs should be screened for interaction with any medications, and a distinction should be made between theoretical concerns and clinical evidence of interaction. An interaction may be problematic, especially when unanticipated. Or an interaction may be beneficial, allowing a client to reap optimum benefits of a prescription at a lower dosage.

St. John’s Wort, proven effective at 900 mg/day for mild to moderate depression, has multiple effects on the metabolism of other drugs, and for a client on medications, should be screened and used with care.

A referral may be made to a mental health professional, or the herbalist, with a client's permission, may consult with a client’s physician or therapist.

From Shoshanna Shamberg, Occupational Therapist and Irlen Vision Therapist

Light sensitivity can cause major imbalances in the nervous system by increasing stress, specifically visual, which can then contribute to other types of sensory processing disorders or stress overload symptoms. Theses include attention, memory, tactile, auditory (hearing), olfactory (smell), gustatory (taste), kinesthetic (muscle memory and coordination), proprioceptive (position of body/limbs in space), and depth perception.

The stress of living with these conditional can cause feelings of depression due to chemical imbalances in the endocrine system. By eliminating one form or stress overload then others can be more easily remedied. For example: by eliminating visual stress using Irlen spectral filters which are carefully calibrated colored filters worn as glasses or contact lenses, light sensitivity can be remedied which can eliminate or minimize visual perceptual problems affecting such activities as driving, walking, reading , writing, computer use, sports, stair climbing, and many cognitive skills. Often then auditory processing can be remedied more easily, as well as, sensitivity to textures of clothing, attention, memory, depth perception, and motor planning.

Sensory integration or sensory processing disorders (SPDs) can also contribute to neurological stress and can be remedied by carefully planned occupational therapy treatment. A specially trained occupational therapist can diagnose and assess which interventions would be appropriate. Multisensory education, enjoyable leisure activites, and exercise can help alleviate some of the symptoms of depression. Swimming, crafts, dance, music (Listening Therapy and Tomatic Method), meditation, Tai Chi, Yoga, etc can help manage stress related symptoms of depression minimizing or eliminating the need for more invasive treatment like psychotropic drugs. Managing stress and maintaining a healthy balance of physical, emotional, mental and energetic living will in turn facilitate enjoyment of living.

Stacey Kargmann

Anxiety and Depression some people have both some have one or the other or extremes.

So many things I would do depend on the person: one thing, especially if the person has a combination of both anxiety and depression or a lot of things going on, is I’ll do a neurotransmitter test. It’s a urine test and I do that along with adrenal testing, to look at the levels of all their various neurotransmitters. I’ll look at serotonin and dopamine, GABA, epinephrine and neuroepinephrin, just to see what’s out of whack, and how they are in relation to each other and target what is wrong, what might be causing depression or anxiety. Once I figure that out, my approach is to give them a combination of amino acids and vitamin and minerals to make more serotonin or to make more GABA, or to calm down GABA receptors and specifically target those. Rather than simply to give someone “Lexapro” to sort of recycle what they don't necessarily have enough of. That’s just one thing that I might do with people. People like that, too. It gives them a feeling of validation in how they’re feeling, and gives us something measurable to look at while we’re treating them.

We also look at the adrenal glands as well, like cortisol, and DHEA, because that also plays a part, and they need to be addressed.

“Lexapro” sort of recycles the serotonin, and if someone doesn’t have enough of it in first place, it doesn’t necessarily help as much, and there are side effects. So instead I try to give the body what it needs to make more seratonin, to build up their stores of it like through, amino acids, triptophan which the body needs to make serotonin.

I also use acupuncture to treat emotional stuff, and usually start by looking at the liver – if there is liver chi stagnation, clearing that up, or kidney deficiency, build up the kidneys, or any heart excess or deficiency, you can work on that through acupuncture or sometimes herbs. Also the Kidney One point is on the bottom of the foot. So a lot of times, I will stimulate those points to help ground people, to help them get connected to their body again, and to the earth.

There are a lot of acupuncture points in the ear that are good for mood things, and especially for people with anxiety, a lot of times, I’ll put little seeds in their ears, if the anxiety kicks up after they leave, they can rub on the little seeds and it helps to bring it down. It’s a little poppy seed or a B-B and it has a sticky thing on it to stick to the ear and it stays there for days. They are called “ear seeds.”

Anyone with any anxiety issues or panic attacks – keep Rescue Remedy with you in your car, in your purse, in your house. The spray is easier than the drops, if you are driving.

Another thing to look at is people’s hormones, aside from thyroid, like progesterone, estrogen, testosterone – if those are out of whack, it can really aggravate depression and anxiety, especially during PMS time and menopause time.

Also diet is a huge part of mood, it can spur depression, and it can aggregate anxiety, especially if it is tied into a food sensitivity issue, or a blood sugar issue. People who skip meals and their blood sugar drops, that can kick up the anxiety pretty easily. It’s a problem trying to talk to someone who is depressed about diet. They just can’t deal with anything. Just have them do simple things like make sure you eat three meals a day. Make sure you drink water, or cut out coffee, or cut out sodas, and just start there. They can do that because they don’t have to cook anything. And the little things can make big difference. And once they are feeling a bit better you can look at the diet some more. Now, let’s get rid of some of the other junk and start eating more vegetables, and that alone can make a huge difference. Diet would be one of the number one things I do.

What kind of food to avoid for depression – sugar and caffeine throw moods up and down. Eat more vegetable, get more color for more nutrients, B or C Vitamin deficiencies throw things off, but that’s more complicated. Sugar and caffeine are easy to address and add more water can go a long way. Depression and fatigue are closely related. If you can get their energy up and then their mood goes up and maybe they will start to exercise, and then they have more energy.

Lucy Hagan

Sometimes depression can be suppressed anger, grief, it could be the adrenals are very insufficient. It can be so many things. On a practical level, I always ask if they have had their Vitamin D checked? Sometimes I find they are unbelievably deficient. Also with women I’ll ask if they’ve had their thyroid checked.

With almost everyone who comes to me, I find that their adrenals are often over-worked, and what I find in a lot of people is that it causes the energy to ascend, because the adrenals are pumping, pumping. And the energy goes up and a person can get ‘stuck in their head’; they get stuck with these thoughts. I use different modalities in combination, often Reiki, craniosacral therapy, aromatherapy, Jin Shin Jyutsu. There are these points in Jin Shin Jyutsu, points at the base of the cheek, called “Escape from Mental Bondage”. Often people need help getting that unlocked, so that the energy can descend again. These experiences, or our perceptions about them, are stored in different places in different people in the body, and sometimes, you never know where it will be released. Someone came to me who had just lost their father, and when I was doing a combination of Jin Shin Jyutsu and craniosacral right here on the gut and nothing happened. But when we worked at the head, it popped right out of the groin and just went poof, and almost lifted her up on the table. You never know where it’s going to come out, but it’s so wonderful when it comes out, because they are so much lighter and freer. Sometimes, there are some people who won’t respond to those modalities, but will respond incredibly well to reflexology. Just doing Reiki, aromatherapy, and reflexology, holding a certain point, it can be released from a certain part of the body.

In Aromatherapy grapefruit is one of the most powerful antidepressants, of course also lemon, and “Joy”, sometimes they need a “Peace and Calming”, it just depends on the individual.

Movement is tremendously helpful, and I recommend, depending on who it is and their capabilities: yoga or even getting to the gym with a trainer who can help. Drinking water, drinking half your body weight in ounces unless you have a kidney problem. Years ago, I remember NPR announced a study on depression that said that of all the things they had researched, the two most effective things for depression are drinking water and exercising. Think of depression as getting stuck. It helps move things. Exercise oxygenates the cells, you feel stronger, and it releases endorphins, and helps get the tension out.

Reaching out to help others with grief is also a powerful part of the healing process: helping others.

One size doesn’t fit all – depression is so very individual. Sometimes, it’s just such suppressed anger. A lot of the work is relieving the liver meridian.

I had one client with depression and the nutritionist took her off dairy and she had a remarkable turn around in just one week. Another thing is heavy metals that we get from eating fish, aluminum pans, deodorant or exposure to environmental toxins, and it doesn’t go away until you take measures. One way to help it release is through cilantro pesto.

2 cups of cilantro and 2/3 cup of flax seed oil organic, 1/3 cup organic sunflower sees, 1/3 cup puking seeds. 4 tbs lemon juice and a teaspoon o dulce powder, 4 cloves of garlic. Food processor eat with vegetables, break, don’t miss a day, for 3 weeks will make a difference. Depended on what the heavy metal is.

Tessy Brungardt

What I do doesn’t address depression exactly though I certainly get plenty of depressed people, and people on medications in my practice. Anxiety is easier to address by helping people learn how to breathe and slow down and get an experience of their body as a physical reality and breathing will help to tune down highly anxious people. Just getting right into the present moment with the breath helps with that a lot.

All these things have behavioral patterns that go with them and accumulate over time and then become part of the structure, the connective tissue gets thicker along the certain line. What I do is help shift those things by helping those patterns release. I recommend people get biochemical support or therapy. I don’t do that part. What I help to release is the manifestation in the structural part of it. There always is a long-term postural, habitual or behavioral pattern that goes with these things.

You pick up the thread where you can. So if they have a certain pattern that always goes with their anxiety, you can help them to let go of that, and you can start to unravel the pattern from that place. We all start out with some kind of holding pattern we acquire probably by the time we’re two years old. How we brace against what is hard in life. And then you layer in all the things you learn, so you’ll have postural adaptations that go along with that bracing, and then you add in a trauma and that twists you that way now, so each one is unique. Breath holding is chronic, and when people get under stress, usually the first thing people do is either inhale and hold or exhale and hold. People are holding their breath all the time. If we could just get people to breath, and eat right and sleep enough, and drink and exercise, they would feel so much better. I do a lot of breath education. Most people think about their lungs like little balloons on the front just puffing up with air. They have no idea that the whole body is breathing. The whole thorax is moving.

Peter Hinderberger

Often a really depressed person cannot apply his/her will forces and go for a walk or do chores. He/she feels heavy, lethargic. That is related to the liver, call stagnation of the bile. These people say thinking is like through molasses, walking and everything is an effort. Saying cheer up does no good. You have to take a person where she is.

Others have an existential depression. That would be more related to the lungs. The lungs are the organs for incarnation and excarnation (the first thing we do on this earth is breathing in– the last thing we do on this earth is breathing out). Saying just cheer up! Look at this beautiful day. It's not going to work. They just don't have the instrument to cheer up.

Depression related to the kidneys: I look at the kidneys as a system, not just as an organ for urination. The kidney system includes the excretory function (urination) of the kidneys, but also the adrenal aspect. The kidneys are smaller than your fist and have a huge artery that feeds them. The kidneys crave oxygen, and that's where breathing comes in. Kidney functions may look great on paper, but if they are not getting enough oxygen, they will also feel anxiety of not being able to breathe. If kidneys are not being oxygenated, or this person is not utilizing oxygen, the result is anxiety with depression.

The most common depression is from the loss of a loved one or a career or an animal, and that is related to the heart. What rules over all of this is what we call "light metabolism": We take in light and process it. The pineal gland and the heart are the main organs for light metabolism. Many substances and herbs are associated with light metabolism: melatonin, serotonin, 5-HTP, magnesium, phosphorus, iron, Vitamin D, homeopathically prepared gold, St. John’s Wort, etc. All plants, with very few exceptions, plants are heliotropic -- they reach for the sun. The root of the words “light” and “levity” and “liver” and “life” is the same. When you contemplate the qualities of the sun you feel warmth, light, life, levity, reliability/consistency. For the past 5000 years on any given day, the sun will go up and the sun will go down. When you look at depressed persons they lack these qualities: warmth, uprightness, consistency ("I don't know what I will do tomorrow, because I don't know how I will feel tomorrow.") So if you can support their light metabolism, that they can process light you will address the core of their depression. However a substance is the mere carrier of imponderable forces. They are beyond the physical laws and cannot be measured. When someone lacks Vitamin D, yes you give them Vitamin D so they can process light.

Look at St. John's Wort, the plant is called that because it blossoms at St. John's Tide in the middle of summer. There is this relationship to the sun, to the light. It grows straight up, branches out in the upper section and has bright yellow flowers like a sun. The leaves are opposite each other perfectly arranged, which indicates its relationship to our rhythmic system, our heart, the seat of emotions. Its milk inside is red, like the human blood. The ancients realized this plant can be a carrier of light, and long ago began using it as a treatment for depression. St. John's Wort is a powerful herb that interacts with many prescription drugs. It is advised to consult your prescribing physician and herbalist before taking it. Too much of it can make you so sensitized to light that you can get a sunburn.

Barry Drew

Depression is a little out of my scope, other than trying to recognize and meet the client where they are, and I certainly have had people who have had emotional release on the table, or even some who have hyperventilated from anxiety of their emotions. I usually resort to Reiki or energy work. To address the light issue, I didn’t know the clinical reasons, but it just seemed natural to me. Whenever I sensed a client having issues, or was depressed, I would adjust the louvers on the window to make it brighter in the office, not obtrusive, just brighter than normal. I may adjust the music to suit the mood, try to help them through compassion and gentle touch and listening. That’s what I do as a practitioner. As a patient, I can speak to depression. I was diagnosed with clinical depression about two years ago, and what worked for me was psychotherapy and counseling worked well, but acupuncture worked the best as a treatment for my body. Over many treatments, I had the holding patterns, I had the cells of energy, and I knew they were all emotionally bound, and just about every time, acupuncture rechanneled or released that energy, whatever it does, it did it. If I sensed anyone needed referral to a therapist or something, I would always suggest acupuncture.

Denarah Ferron

Massage, of course, makes you feel good, but it’s not really a treatment for depression. Really what I focus on is Quantum Touch (very light touch energy work). It’s based on universal love and light and pulling earth light up to and above the head and then down to heart center. It has been really effective for a lot of my clients with anxiety. Sometimes it dissipate quickly, sometimes it takes a half hour. I’ll check in every five to ten minutes, but you can usually tell, though. You can see releases and breath and expressions change and the amount of energy going through. Really listening to what is going on what is the core issue, and meeting it with compassion.

To help someone with depression who “likes” being depressed

Stacey Kargmann

Sometimes that is all tied into depression, because they can’t move. They can’t even imagine moving because you’re too tired or depressed. Not that you don’t want to, you just can’t wrap your brain around it. If you’re looking at neurotransmitters, if dopamine is low, oftentimes people have lack of motivation. They kind of want to do something, but they kind of don’t. If you can get the dopamine up you can get the motivation coming back.

Lucy Hagan

Some people don’t want to get better. If we could see the energy of our thoughts about where they are, we could see the energy entangling with it. When we worry about a loved one we contribute to puncturing holes in their aura and magnify their misery. When someone doesn’t want to get better, I have to shift gears and put them in a “grid of love”, and then I feel better and my thoughts are not contributing any more. Also imagine how they would feel if they felt self love, and focus on that and then my space is supportive. Sending Reiki if they are okay with that.