older sad looking woman

In any given 1-year period, 9.5 percent of
the population, or about 18.8 million American adults, suffer from a depressive
illness5 The economic cost for this disorder is high, but the cost in
human suffering cannot be estimated. Depressive illnesses often interfere with
normal functioning and cause pain and suffering not only to those who have a
disorder, but also to those who care about them. Serious depression can destroy
family life as well as the life of the ill person. But much of this suffering is

Most people with a depressive illness do not seek
treatment, although the great majority—even those whose depression is extremely
severe—can be helped. Thanks to years of fruitful research, there are now
medications and psychosocial therapies such as cognitive/behavioral, “talk” or
interpersonal that ease the pain of depression.

Unfortunately, many people do not recognize that
depression is a treatable illness. If you feel that you or someone you care
about is one of the many undiagnosed depressed people in this country, the
information presented here may help you take the steps that may save your own or
someone else’s life.


A depressive disorder is an illness that involves the
body, mood, and thoughts. It affects the way a person eats and sleeps, the way
one feels about oneself, and the way one thinks about things. A depressive
disorder is not the same as a passing blue mood. It is not a sign of personal
weakness or a condition that can be willed or wished away. People with a
depressive illness cannot merely “pull themselves together” and get better.
Without treatment, symptoms can last for weeks, months, or years. Appropriate
treatment, however, can help most people who suffer from depression.


Depressive disorders come in different forms, just as is
the case with other illnesses such as heart disease. This pamphlet briefly
describes three of the most common types of depressive disorders. However,
within these types there are variations in the number of symptoms, their
severity, and persistence.

Major depression is
manifested by a combination of symptoms (see symptom list) that interfere with
the ability to work, study, sleep, eat, and enjoy once pleasurable activities.
Such a disabling episode of depression may occur only once but more commonly
occurs several times in a lifetime.

A less severe type of depression, dysthymia, involves long-term, chronic symptoms that do not
disable, but keep one from functioning well or from feeling good. Many people
with dysthymia also experience major depressive episodes at some time in their

Another type of depression is bipolar
, also called manic-depressive illness. Not nearly as prevalent
as other forms of depressive disorders, bipolar disorder is characterized by
cycling mood changes: severe highs (mania) and lows (depression). Sometimes the
mood switches are dramatic and rapid, but most often they are gradual. When in
the depressed cycle, an individual can have any or all of the symptoms of a
depressive disorder. When in the manic cycle, the individual may be overactive,
overtalkative, and have a great deal of energy. Mania often affects thinking,
judgment, and social behavior in ways that cause serious problems and
embarrassment. For example, the individual in a manic phase may feel elated,
full of grand schemes that might range from unwise business decisions to
romantic sprees. Mania, left untreated, may worsen to a psychotic state.


Not everyone who is depressed or manic experiences every
symptom. Some people experience a few symptoms, some many. Severity of symptoms
varies with individuals and also varies over time.


  • Persistent sad, anxious, or “empty” mood
  • Feelings of hopelessness, pessimism
  • Feelings of guilt, worthlessness, helplessness
  • Loss of interest or pleasure in hobbies and activities that were once
    enjoyed, including sex
  • Decreased energy, fatigue, being “slowed down”
  • Difficulty concentrating, remembering, making decisions
  • Insomnia, early-morning awakening, or oversleeping
  • Appetite and/or weight loss or overeating and weight gain
  • Thoughts of death or suicide; suicide attempts
  • Restlessness, irritability
  • Persistent physical symptoms that do not respond to treatment, such as
    headaches, digestive disorders, and chronic pain


  • Abnormal or excessive elation
  • Unusual irritability
  • Decreased need for sleep
  • Grandiose notions
  • Increased talking
  • Racing thoughts
  • Increased sexual desire
  • Markedly increased energy
  • Poor judgment
  • Inappropriate social behavior


Some types of depression run in families, suggesting that a biological
vulnerability can be inherited. This seems to be the case with bipolar disorder.
Studies of families in which members of each generation develop bipolar disorder
found that those with the illness have a somewhat different genetic makeup than
those who do not get ill. However, the reverse is not true: Not everybody with
the genetic makeup that causes vulnerability to bipolar disorder will have the
illness. Apparently additional factors, possibly stresses at home, work, or
school, are involved in its onset.

In some families, major depression also seems to occur generation after
generation. However, it can also occur in people who have no family history of
depression. Whether inherited or not, major depressive disorder is often
associated with changes in brain structures or brain function.

People who have low self-esteem, who consistently view themselves and the
world with pessimism or who are readily overwhelmed by stress, are prone to
depression. Whether this represents a psychological predisposition or an early
form of the illness is not clear.

In recent years, researchers have shown that physical changes in the body can
be accompanied by mental changes as well. Medical illnesses such as stroke, a
heart attack, cancer, Parkinson’s disease, and hormonal disorders can cause
depressive illness, making the sick person apathetic and unwilling to care for
his or her physical needs, thus prolonging the recovery period. Also, a serious
loss, difficult relationship, financial problem, or any stressful (unwelcome or
even desired) change in life patterns can trigger a depressive episode. Very
often, a combination of genetic, psychological, and environmental factors is
involved in the onset of a depressive disorder. Later episodes of illness
typically are precipitated by only mild stresses, or none at all.

Depression in Women

Women experience depre


doctor with arms folded around chest( — Hallucinations and delusions are two
telltale signs of schizophrenia. According to research or other evidence, the
following self-care steps may be helpful in managing this serious mental

What You Need To Know:

  • Go for the glycine
    With a healthcare professional’s
    supervision, help improve symptoms such as depression with daily use of this
    nutritional supplement; take 0.8 grams for every 2.2 pounds (1 kg) of body
  • Rest easy with melatonin
    Improve sleep quality and
    duration with this natural hormone; take 2 mg of a controlled-release
    preparation before bedtime
  • Try megadose vitamin therapy
    Work with a healthcare
    professional knowledgeable in nutritional treatment of schizophrenia to find out
    whether large amounts of vitamin B3, B6, or C improves symptoms
  • Find a fix for low folic acid levels
    Visit your
    healthcare provider to determine if your blood is low in folic acid, and if 10
    to 20 mg a day of this vitamin might help improve symptoms
  • Uncover food sensitivities
    Work with a nutritionist to
    follow a gluten-free, dairy-free diet that may help improve responses to

These recommendations are not comprehensive and are not intended to replace
the advice of your doctor or pharmacist. Continue reading the full schizophrenia
article for more in-depth, fully-referenced information on medicines, vitamins,
herbs, and dietary and lifestyle changes that may be helpful.

Dietary changes that may be

For many years there has been speculation that
certain dietary proteins may contribute to the symptoms of schizophrenia.1 2 3
Gluten, a protein from wheat and some other grains, and to a lesser extent
casein, a dairy protein, have been the targets of research on food sensitivities
as contributors to schizophrenia.4 People with schizophrenia have been shown to
be more likely to have immune reactions to these proteins, than the general
population.5 A preliminary trial of a gluten-free/dairy-free diet found that
patients with schizophrenia improved on the diet and had shorter hospital stays
than those eating normal diets.6 The results of double-blind trials, however,
have been inconsistent. The gluten-free/dairy-free diet improved responses to
medications in one controlled trial.7 These improvements were lost and symptoms
of schizophrenia were aggravated when gluten was re-introduced in a “blinded”
fashion. Another clinical trial found similar positive responses in only 8% of
patients.8 Other controlled trials have found no improvement when gluten and
dairy were removed from the diet.9 10 In one clinical trial, blinded
reintroduction of gluten appeared to cause improvement of symptoms.11 These
results suggest that some, but not all, people with schizophrenia may benefit
from a gluten-free/dairy-free diet.

Lifestyle changes that may be helpful
Exercise has long been recognized
for its benefits in treating mild to moderate depression and there is some
evidence that it may also be helpful in reducing anxiety.12 In one reported
case, physical activity improved the functioning of a man diagnosed with
schizophrenia.13 In another reported case, aggressive outbursts in a
schizophrenic patient were reduced after he began exercising.14 A preliminary
trial of an exercise program for hospitalized psychiatric patients with varying
diagnoses resulted in significantly reduced symptoms of depression and an
insignificant trend towards reduced anxiety.15 Additional research is needed to
determine the specific benefits of exercise in people with schizophrenia.

Other therapies
counseling or electroconvulsive therapy (electrical current applied to the
brain) may also be recommended.

Vitamins that may be
People with schizophrenia may have a greater tendency
to be deficient in folic acid, than the general population16 and they may show
improvement when given supplements. A preliminary trial found that, among
schizophrenic patients with folic acid deficiency, those given folic acid
supplements had more improvement, and shorter hospital stays than those not
given supplements.17 In a double-blind trial, a very high amount of folic acid
(15 mg daily) was given to schizophrenic patients being treated with psychiatric
medications who had low or borderline folic acid levels. The patients receiving
the folic acid supplements had significant improvement, which became more
significant over the six-month course of the trial.18 The symptoms of folic acid
deficiency can be similar to those of schizophrenia, and two cases of wrong
“schizophrenia” diagnoses have been reported.19 20 In one of these cases, an
initial supplement of 20 mg daily of folic acid and a maintenance supplemental
intake of 10 mg daily, led to resolution of symptoms.21

In another double-blind study, daily supplementation with folic acid (2 mg),
vitamin B6 (25 mg), and vitamin B12 (400 mcg) for three months improved symptoms
of schizophrenia compared with a placebo.22 All of the participants in this
study had elevated blood levels of homocysteine, which can be decreased by
taking these three B vitamins. Based on this study, it would seem reasonable to
measure homocysteine levels in people with schizophrenia and, if they are
elevated, to supplement with folic acid, vitamin B6, and vitamin B12.

There have been several reports of glycine reducing the symptoms of people
with schizophrenia who were unresponsive to drug therapy.23 Large amounts of
glycine (0.8 gram per 2.2 pounds of body weight per day) have been shown to
reduce negative symptoms of schizophrenia and improve psychiatric rating scores
in one preliminary trial;24 however, these results have not been repeated in
later trials using similar (very high) amounts.25 26 Earlier double-blind trials
found significant improvements in depression and mental symptoms in people with
schizophrenia who took glycine for six weeks.27 28 Most trials demonstrated a
moderate improvement in schizophrenia symptoms in those taking glycine
supplements.29 Long-term supplementation with high amounts of glycine may be
toxic to nerve tissue, however. Some preliminary successes have been reported
using smaller amounts of glycine, such as 10 grams per day.30 Long-term studies
on the safety of glycine therapy are needed.

The term “orthomolecular psychiatry” was coined by Linus Pauling in 1968 to
refer to the treatment of psychiatric illnesses with substances (such as
vitamins) that are normally present in the body. In orthomolecular psychiatry,
high amounts of vitamins are sometimes used, not to correct a deficiency per se,
but to create a more optimal biochemical environment. The mainstay of the
orthomolecular approach to schizophrenia is niacin or niacinamide (vitamin B3)
in high amounts. In early double-blind trials, 3 grams of niacin daily resulted
in a doubling of the recovery rate, a 50% reduction in hospitalization rates,
and a dramatic reduction in suicide rates.31 In a preliminary trial, some
schizophrenic patients continued a course of vitamins (4 to 10 grams of niacin
or niacinamide, 4 grams of vitamin C, and 50 mg or more of vitamin B6) after
being discharged from the hospital, while another group of patients discontinued
the vitamins upon discharge. Both groups continued to take their psychiatric
medications. Those who continued to take the vitamins had a 50% lower
re-admission rate compared with those who did not.32 Several later double-blind
trials, including trials undertaken by the Canadian Me