I’ve suffered from depression for 32 years so I figured writing an article about it would be a piece of cake, just not quite as yummy. But now it’s 48 hours until the magazine deadline and I’m watching the cursor on my screen mock me with every blink. Why is depression so hard to write about? Perhaps it’s because it is such a difficult topic to even talk about. Discussing using cannabis for depression is even more taboo.
Until very recently depression was a condition that many people battled alone. You never mentioned it in a conversation because you felt like less of a person. You didn’t seek help because your were tired of hearing things like “suck it up” or “snap out of it.” So you suffered in silence. Perhaps you did get help and on a varying array of pharmaceutical drugs that left you feeling just as bad as, if not worse than, before the introduction of the drugs. No matter what though, you just wanted to feel “normal” and be “happy.” Who knew that could be such a difficult task?
Depression in the news
I’m not a big television watcher, but I managed to catch the first episode of “A Million Little Things” on ABC. The basic premise is that friendship isn’t about one thing, it’s about a million little things. The series starts with death (unexpected suicide) of one of the characters. It shocked everyone. “He seemed so happy.”
This show is a great example of depression going mainstream. Why wouldn’t someone create a series about a topic that so many people suffer from? We hear it in the news when celebrities like Anthony Bourdain, Robin Williams, Chris Cornell, Kate Spade, and Chester Bennington, kill themselves. (Talinda Bennington, Chester’s wife, did a 30-second PSA about depression and suicide prevention after the premier of the show.) “They seemed so happy.” Depression has silently taken so much from so many… the question is how do we fix it? First, let’s take a look at depression as it comes in many forms.
Types of Depression
It’s normal to feel a little down once in a while. That isn’t depression. But if the bad days start outweighing the good days, then that may be depression.
Major Depression (Clinical Depression or Major Depressive Disorder)
If someone has five or more symptoms that present themselves on most days for two weeks or longer, they may be suffering from major depression. Major depression affects about 6.7% of the U.S. population over age 18, according to the National Institute of Mental Health. It is estimated that between 20% and 25% of adults may suffer an episode of major depression at some point during their lifetime.
Persistent Depressive Disorder
If depression lasts for two years or longer, it’s considered persistent depressive disorder. This term is used to describe two conditions previously known as dysthymia (low-grade persistent depression) and chronic major depression.
Bi-Polar Disorder (Manic Depression)
Someone suffering from bipolar disorder has mood episodes that range from extremes of high energy with an “up” mood to low “depressive” periods. In the low phase, the person will have all the symptoms of major depression.
People with psychotic depression have the symptoms of major depression along with “psychotic” symptoms, such as hallucinations, delusions, and paranoia.
Seasonal Affective Disorder
Although we don’t see this type of depression as often in Florida, those who live in climates that have cold dreary winter can be affected by it considerably. Light therapy can help with this disorder.
Premenstrual Dysphoric Disorder
Women who suffer from PMDD have symptoms of depression right before or during the start of their period. Most times a simple anti-depressant can stave off symptoms.
This occurs when there is a particular situation that causes the depression such as the loss of a loved one or loss of a job. Many times the depression disappears if the situation positively changes. If situational depression lasts longer than six months, it may be a more serious depressive condition.
Atypical means that your depressed mood can brighten in response to positive events. Other key symptoms include increased appetite, sleeping too much, feeling that your arms or legs are heavy, and feeling rejected.
Drug Resistant Depression
If you’ve been treated for (any form of) depression but your symptoms haven’t improved, you may have treatment-resistant depression. But don’t despair… just because a medication doesn’t help doesn’t mean that there aren’t other tools that you can use.
Depression as a symptom
Depression may not be the root of the problem for some people. For instance some people suffer from chronic pain and that chronic pain can result in depressive episodes. There are also other disorders where depression can be prevalent such as autism or borderline personality disorder.
Symptoms of Depression
- Change in eating habits
- Digestive problems
- Feelings of guilt and hopelessness
- Feeling helpless
- Giving away possessions
- Insomnia or change in sleeping habits
- Lack of energy
- Loss of interest in things that were once pleasurable
- Low self esteem
- Low sex drive
- Persistent feeling of sadness
- Physical aches and pains
- Suicidal thoughts or attempts
- Trouble concentrating or focusing
- Trouble remembering details or making decisions
- Uncontrollable crying
Diagnosis and Treatment
We’ve come to rely on a world of specialized blood or lab tests to make a diagnosis of ailments. However, traditional tests aren’t very helpful when dealing with depression. In fact, speaking with the patient (and using particular screening questions) is the most helpful way of diagnosing and treating many forms of depression. Because the symptoms can vary greatly and change periodically, a depression diagnosis can be difficult. Once a diagnosis is determined the doctor will most likely recommend one of many different anti-depressant medication options.
Believe it or not, the diagnosis is actually the easy part… finding something to combat the depression is much more difficult. Again, because of the lack of tests available for depressive conditions, doctors may just have to throw a bunch of things against the wall and see what sticks. I know, I know, that doesn’t sound very scientific. It’s not. But that used to be the only option… now we have many tools to combat depression (and they aren’t all just popping pills).
There are TONS of anti-depressant type pharmaceutical drugs on the market and the only “good” one is the one that works for you. It wouldn’t be difficult to write an entire article on the different anti-depressants that are available. I could tell you about serotonin and noradrenaline reuptake inhibitors (SNRIs) like Cymbalta and Effexor. I could tell you about the most commonly prescribed selective serotonin reuptake inhibitors (SSRIs) like Lexapro, Prozac, and Zoloft.
Then I could even go further and mention tricyclic anti-depressants (TCAs) like Elavil, monoamine oxidase inhibitors (MAOIs) like Parnate, and noradrenaline and specific sertoninergic anti-depressants (NASSAs) like Mirtazapine… but I don’t think that explaining the medications is necessarily helpful. I will say, however, that if your doctor wants to put you on any anti-depressant, please do your homework. Almost all of them have varying degrees of side effects, some much worse than others.
Talking can help! Speaking with a psychiatrist, psychologist, social worker, or other trained mental health professional can be a game-changer (especially if your anti-depressants are working properly). You will learn new ways to handle the stress and challenges that depression can cause.
But what if you have drug resistant depression? What if none of the medications are “good?” What if you’ve talked as much as you possibly could but you are still depressed? What are your other options?
Cannabis for Depression
I tried cannabis for the first time when I was 17. Why? Because depression hurts and it made me feel better. Back in the early 90s there was no science as to “why” it made me feel good (scientists didn’t start learning about cannabis receptors until the mid-90s). I also didn’t know about my endocannabinoid system and the role it plays in mood. We knew so little about the plant that the only medical condition that cannabis was said to help was glaucoma.
Push forward 25 years and now we know the “why” and we also see cannabis helping countless people who suffer from all forms of depression. Some have also ceased using their anti-depressants altogether. (If this is something you wish to do, please consult your doctor and DO NOT abruptly stop taking any prescription medication, anti-depressant or otherwise.)
Using Cannabis for Depression
Now there are some conflicting views about cannabis and depression but most people will agree that it can aid in treating depression just as well as or even better than traditional prescription medications. Finding the strains that work best with your depression is a good place to start. We know that indicas relax and give a body high while sativas can provide energy and a more cerebral high. Both can help with depression but one may work better for you than the other and sativas are known to be a little more uplifting (if you don’t suffer from anxiety.) A hybrid strain, a mix of indica and sativa, could also be a very viable option.
When dealing with depression sometimes a low-THC, high-CBD product or even a 1:1 (one part THC to one part CBD) product can also be beneficial (especially for those who suffer from chronic pain as well). If you do not have your medical cannabis card you still have options. CBD alone is a fantastic anti-anxiety (which many people suffer from in conjunction with depression) and can help with depression as well.
As you can see, using cannabis to treat depression can be a little tricky. It’s not a one-size-fits-all scenario and there may be quite a bit of trial and error involved (but no less or no more than when dealing with traditional medications). But cannabis can help once you find what works for you.
What else can help?
Medication, therapy, and/or cannabis can definitely help with depression, but what are some other tools that you can add to your arsenal against depression?
Magnesium and B-12: Recently I learned that a magnesium deficiency can lead to depression. So can a B-12 deficiency. Adding these supplements to your daily regimen can really help. (Note: If you are going to take magnesium, stay away from magnesium oxide – it contains very little elemental magnesium. Try to find a magnesium glycinate, citrate, or another magnesium product with a high amount of elemental magnesium. Also, some forms of magnesium can act as a laxative.
5-HTP: 5-HTP is derived from the seeds of the Griffonia simplicifolia shrub native to West and Central Africa and its effects are similar to tryptophan found in turkeys (that’s what makes us fall asleep after Thanksgiving dinner). It is also said to help treat anxiety, insomnia, migraine and tension-type headaches, PMS, and ADHD. Taking this supplement at night will not only help you sleep better, but it will benefit you the next day. I notice that the “little things” don’t seem to bother me as much.
Probiotics: Studies indicate that those with healthy and diverse gut microbes are less likely to suffer from depression and anxiety. Why? Because our gut is considered a “second brain” and your real brain is only as happy as your gut.
Meditation or focusing on your breathing is a great way to practice mindfulness and help your mood at the same time. Although it may be difficult at first, practicing daily will help you feel better both mentally and physically.
The hardest part of yoga or exercise is getting the motivation to do it, which can be very hard if you are feeling depressed. But working out increases blood flow and circulation, releases endorphins (although some scientists believe that the “endorphin high” is actually caused by our body’s own endocannabinoid system), and it promotes good sleep.
In the past few years, there has been an influx of ketamine clinics across the country. Ketamine is a dissociative anesthetic that is very safe and has been used for 60 years both on and off the battlefield. In recent years it has shown promising results for those suffering from treatment resistant depression.
Psilocybin, a psychedelic compound found in “magic mushrooms,” can “reset” the brains of people with drug-resistant or untreatable depression. Research has and is being done at Johns Hopkins and NYU with extremely promising results. Although psilocybin is still considered a Schedule 1 drug, it may gain FDA approval within the next few years.
There is no definitive answer to treating depression, however, as you can see there are many options available. If you or a loved one is suffering from depression, talk about it. Discuss options. Depression can spike during the holidays and suicide rates increase. If things get that bad, please call the National Suicide Prevention Hotline at 1-800-273-8255. There is help.
"Your story is not over"
Project Semicolon explains that a “semicolon is used when an author could’ve chosen to end their sentence, but chose not to. The author is you and the sentence is your life.”
Project Semicolon’s Mission: Within the belief that suicide is generally preventable, the mission of Project Semicolon is to help reduce the incidents of suicide in the world through connected community and greater access to information and resources. We believe that suicide prevention is the collective responsibility of each and every person on the planet.