Darker Times

It is perfectly normal, to feel ups and downs in our enthusiasm for life. That is part of being human. However, when the downs are overwhelming or if they happen a lot, it is time to look at what's going on and to reach out to others for professional help. The self-help suggestions below may help with periods of low mood and non-severe depression. Read on to understand the importance or getting professional support and please contact Lynn, if you want to discus anything related to the topic.

The scent of oranges and cloves can cheer us in midwinter

Steps of healing
Many of the suggestions here are forms of lifestyle medicine. These include story medicine (Step 1), energy medicine (Step 2) and nourishment (Step 3). Also included are several wonderful herbs which can support our mental health. Some are nourishing, others are stimulating or sedating (Step 4). Those move beyond lifestyle medicine and can be very helpful at times but should not be relied upon. Also included for completeness are a few Step 5 herbal options which may be useful in severe cases but should be used under professional (e.g. medical herbalist) guidance. These are the herbs which "break and enter". They really shake things up and need to be treated with incredible respect.

With mental health issues, it can be difficult to see from the inside, just how serious things have become, until quite late on. This means that very often we need someone else to help us, even when we think we are coping fine. Mental health professionals and doctors and therapists with counselling training, can help us to unlock what is causing our issues and can help us to overcome or manage them safely. Counselling and psychology interventions generally start at Step 0. The practitioner somehow helps us to express our current situation, helps us listen to it and to pick out the core issues which can then be addressed.

Birch trees - Winter in Amsterdam

Mental Health First Aid
We learn in the wise system of healing to start with the simplest form of help. We learn to give it an appropriate amount of time and then move on to the next step, if a problem persists. As with any disorders, we should not wait too long between taking the next step. Step 0 here could be simply talking to a friend who has a good listening ear. That may be enough to help us climb out of a dip and get back on our feet.

Those supportive ears should be thought of as Mental Health First Aid. The friend may be able to recognise when the dip is serious and will encourage us to quickly get professional help. But many people are not confident about suggesting that a friend or colleague seeks specialist support. If you are that listening ear, don't hesitate to recommend a friend speaks to their GP / Huisarts or a counsellor / psychologist if you feel they need more help.

Would you try to fix a broken arm, just with a cup of tea and a chat? I doubt it. I guess you would notice the affected person was suffering from something, then help make them more comfortable and then would encourage them to see a bone specialist, to check what's going on and treat them properly.

Winter blues
The darker months of the year can be very difficult for many people. One reason for this is a hormone called Serotonin. Commonly known as the "feel-good hormone", when blood serotonin levels are too low you’re more likely to become irritable, anxious, and perceive the world as unfriendly. You may feel depressed, pessimistic, and have irregular appetite and sleep.  Reduced serotonin often leads to panic attacks, anxiety, eating disorders, chronic pain, and low mood.

Serotonin is released when we:

  • are touched in a caring way
  • digest carbohydrates
  • exercise or move around
  • spend time in nature, in natural light
  • eat or drink herbs and foods which promote a serotonin response

Strategies - Relax, Eat, Sleep, Move

RELAX
Dealing with change
We are currently dealing with change caused by corona virus regulations. The measures in place to combat the spread of coronavirus, mean that we might not be able to do the things we want to, like see friends and family. They have also caused financial issues for many and of course there has been many forms of loss and change. This change is worldwide and was unexpected. Other changes come along in our lives periodically. Some have clear positive effects on our lives, others are hugely challenging and can seem unsurmountable. One thing that is a truth - Change always comes and life is never constant.
(Step 0 and Step 1)

Decrease screen time
We generally watch more and do less during the winter months. The blue light from screens negatively affects our eyesight and sleep patterns. So that impacts our health and well being. Added to that, endless use of social media can lead to very serious decrease in sense of self-worth.

Connect - build or join community
Increase social connections. Strong social connections reduce our rates of depression and anxiety. For social connections to help us, they must be genuine and make us feel supported. Less connections but better connections wins over many superficial "friends". While face-to-face contact is still off the cards, virtual socials and team Zoom calls outside of work-related topics can increase your employees’ sense of belonging and help to continue to build a great company culture. Share your burdens. Let others know when you are finding life tough.

Contemplation, Meditation & Journaling
When we feel down, spending time just being and thinking about what is going on, or planning how to change a situation, can be a challenge. Sometimes, we will spiral further downward through having too much opportunity to think about the situation. But at other times, it can really help to take some time to just be.

It is worth trying simply lying flat on the floor for 5 minutes, or taking out a pen and notebook to sit quietly write down your thoughts. For many people, this can help to clear the mind and help them to shift gear.

If you want to take it further, meditation can really help. This does not involve emptying the mind, as many think, but it involves training the mind and that training can be a lifelong skill which can help enormously when life is tough.

Dry brushing

Touch
If possible get some massage and hugs from someone else. When massage from a therapist or friend is not possible, self massage also works to release serotonin and boost our circulation and mood.

Dry brushing - Swedish style dry body brushing sloughs away the top dry dead skin cells and boosts our circulation. It can be invigorating!

Roasted sweet potatoes - Photo credit Cafe Delites.

EAT
Take care of your digestive system and your mind will thank you! Drink plenty of water, eat probiotic foods, and eat a brain-healthy diet. Constipation can quickly cause low mood and can be avoided by drinking plenty of water and eating fruits and vegetables.

Complex carbohydrates
We know that serotonin is released when carbohydrates are digested. Eating fast carbs (white pasta, rice, sugar etc) is addictive in part because of the feel-good serotonin release. This happens about 30 minutes after eating a carb-rich meal. They are broken down, cause an insulin level spike and allow more tryptophan (the natural amino acid building block for serotonin) to enter the brain. The brain cells then convert it to serotonin.

So avoid quickly digested carbs but favour slow-release complex carbohydrates such as sweet potato, apples, blueberries, carrots, and beans, as a healthier way to boost serotonin.

Brain serotonin levels can also be raised by eating foods rich in L-tryptophan, such as chicken, eggs, cheese, turkey, beef, salmon and tuna, tempeh, beans, lentils, spinach and other dark green leafy vegetables, pumpkin and chia seeds, and nuts. Many people may unknowingly cause mood problems by eating diets that are low in L-tryptophan.

Vitamin D
Studies have shown a link between vitamin D deficiency and depression. In 2013 it was noticed that people with depression also often had low vitamin D levels. Low vitamin D levels greatly increase the risk of depression. Vitamin D is found in some oily foods and oil based supplements are widely available. Vitamin D is also made by our skin when exposed to sunlight. Supplementation can have an enormous impact on individuals. Look out for dropper bottles of oil dissolved vitamin D3.

SLEEP
Sleep pattern
Make sleep a priority. We cannot have lasting good health without good sleep. Don't take your phone to bed with you and make your sleep area a calm, relaxing space. Break screen time at least 2 hours before going to bed.

A minimum of 20 minutes movement each morning, spent outside in daylight can really help us to fall asleep at a good time in the evening. Avoid really bright lights in your home around bedtime. They keep us awake and make falling asleep difficult. Candle light, as bedtime approaches, can be a nice option. As can a simple routine such as drinking a cup of chamomile tea an hour or so before you plan to retire to bed.

Aim to get to bed at the same time each evening to create a rhythm but be aware that this time is very likely to become earlier, as the hours of daylight reduce. Our bodies need more sleep in the darker months.  

MOVE
Movement fights and prevents low mood and depression. It works really well at this and even helps when we feel really miserable before starting to exercise. So when feeling blue, get up and move! Move to another part of the room, go make a cup of herb tea, stretch, dance to some music, sing, simply move.

Outdoor exercise
Exposure to sunlight is the quickest way to raise your serotonin levels. Exercising regularly is seen by many as the most efficient antidepressant but working out in a gym is not always very interesting or fresh. We also know that Vitamin D levels need to be kept up and that sunlight on skin can enable this. You may also have heard of nature deficiency - many of us do not get enough exposure to green nature. So regular outdoor exercise is very powerful because it combines all of these mental health boosting things.

What form of outdoor exercise suits you? Choose anything that you can. It does not need to be intense exercise and having a variety of options to choose from helps to keep us engaged. How about:

  • Cycling
  • Open-water swimming
  • Outdoor community gym equipment
  • Walking along leafy streets
  • Park exercise - from walking to stretching to something more dynamic
  • Simply looking at trees

Some helpful herbs

Oat straw
(Step 3)
To rebuild frazzled nerves. Increases dopamine levels.
Order a big bag from a herb supplier (500g or 1kg) then try making a daily infusion.
1 cup of the herb in 1 litre of boiled water, in a covered saucepan for 8 hours infusion time. Strain and drink within 24 hours.

Here is an interesting link about nootrophics.

Turmeric
(Step 3)
Turmeric is part of usual Southeast Asian cuisine and has been used for thousands of years in Ayurvedic and Traditional Chinese Medicine. It regulates neurotransmitter activity in the brain and re-establishes normal neurotransmitter levels, thus reducing symptoms of depression. Turmeric protects the stomach from ulcers and digestive issues that can arise due to depression. It combines well with ginger and its efficacy is greatly enhanced by adding a pinch of black pepper to any remedies you make from turmeric.

Experiment with fresh or dried turmeric. Try making golden milk, tumeric and ginger coconut oil and kunjit asem (a type of Indonesian jamu).

Blending fresh turmeric, coconut oil, fresh ginger, salt and black pepper - Golden butter

Avocado
(Step 3)
Avocados are consumed all over the world due to their fresh taste and many health benefits. Avocados are rich in tryptophan, protein, magnesium, Vitamin E and K, and potassium.

Chocolate avocado smoothie. Photo credit Nathalieshealth.com

Green Tea
(Step 3/4)
This natural supplement increases serotonin levels through the action of the amino acid L-theanine. Studies have shown that elderly people who consume green tea on a daily basis showed fewer signs of depression. Drinking between 2 and 5 cups of green tea a day balances serotonin and dopamine levels and this helps in keeping depression away. A pleasant and even more boosting way to drink it, is in combination with peppermint.

Dark Chocolate
(Step 3 and Step 4)
Aside from it being a tasty treat, dark chocolate contains serotonin and precursors to serotonin such as L-tryptophan. Aim for dark chocolate that is 85% or above cacao. Consuming dark chocolate regularly can lower symptoms of stress, anxiety, and depression. Dark chocolate also lowers blood pressure and improves blood flow to the brain and heart. Consuming too much dark chocolate may lead to excess serotonin in the body, which results in anxiety, insomnia, and gastrointestinal issues.

St. John's Wort
(Step 4)
St John’s Wort (SJW), Hypericum perforatum, is a medicinal herb with antidepressant qualities. The most important herbal constituents in SJW are hypericin and hyperforin. Hyperforin boosts many mood-related brain chemicals and helps serotonin bind to serotonin receptors. St. John’s Wort increases brain serotonin synthesis and is one of the most widely studied natural treatments for depression. The Cochrane review (of 29 international studies) found that St John’s Wort can be as effective as pharmaceutical antidepressants.

SJW can be taken as a tea, from dried herb or take drops of tincture. The plant grows in sunny, open spaces. It grows in quantity in some Amsterdam parks.

SJW should not be taken by those who are on medication, without the express permission of their healthcare providers. Chemicals in SJW speed up liver breakdown and removal of other chemicals which are in the bloodstream. So if you take any medication (such as the contraceptive pill, anti-depressants, any meds!), SJW should be expected to speed up the medication breakdown (meaning the medication will not be as effective in your body). Tinctures (older than about 3 months) have less of this liver effect and yet can still help with low mood.

Those taking SJW should always inform their medical specialists, to ensure that other medications and treatments are not compromised.

St John's Wort - Hypericum perforatum

Panax Ginseng
(Step 4)
Panax Ginseng is one of the most popular self-medicated herbs on the planet and is mostly used by those that want to boost their immune system, overall well-being, and energy levels. Panax means “all-heal” and it’s quite accurate given its many health benefits. Ginseng increases the level of serotonin and rejuvenates the mind. It’s also beneficial for those who suffer from diabetes, unclear thinking, and erectile dysfunction.

Bacopa monnieri - Bramhi

Bacopa monnieri
(Step 4)
Bacopa Monnieri (Bramhi) is an herb with a long history within Ayurvedic medicine. It is widely used around the world as a treatment for brain disorders, poor memory, ADHD, and anxiety. Bacopa Monnieri improves brain activity and increases cognition skills and memory. Bacosides are responsible for regulating serotonin and dopamine in the brain. Bacopa Monnieri is also an adaptogen. Adaptogens block stress signals at a neurochemical level, preventing a response in the body.

Griffonia simplicifolia

Griffonia simplicifolia
(Step 4)
Griffonia contains a chemical called 5-HTP. This has the structure is tryptophan with a hydroxy group added to C5 of the aromatic ring. The seeds of Griffonia simplicifolia from West Africa are one of the few plant sources of 5-HTP. 5-HTP is easily absorbed and able to cross blood brain barrier after which it is metabolised directly into serotonin (5-hydroxytryptamine). It is used by some as a supplement to treat fibromyalgia, insomnia, depression, migraine. It can also help combat overeating and other conditions associated with low serotonin levels. Studies have found that 5-HTP is as effective as certain antidepressants.

Kava kava - Piper methysticum

Kava-kava - Piper methysticum
(Step 4/5)
Kava-kava is a plant of the western Pacific that is widely consumed throughout Polynesia, Micronesia, and Melanesia. Kava has been shown to have a positive effect on cognition and attention by relaxing the mind. Kava extracts bind to GABA, dopamine, serotonin, and opiate receptors. This herb typically contains around 18 types of kavalactones, each having various psychoactive effects; there are a number of strains with varying profiles of kavalactones. As a result, effects vary slightly across strains. Kava helps those that suffer from insomnia and it has also been used to treat breast, bladder, colon and prostate cancer.