Dr. Pizzorno's naturopathic approach to treating depression identifies five primary determinants of mood: physical factors; social factors (family and social patterns), mental factors (a person's thinking patterns), emotional factors and spiritual factors. For example, on the physical level we may need to eliminate toxins, normalize endocrine function and neurotransmitter metabolism, increase exercise and light exposure, and utilize natural mood elevators. On the mental and emotional levels we may need to deal with family of origin issues, employ psychodynamic approaches when necessary, or even follow a prescription for having fun if we are in need of lightening up our lives.

Dr. Pizzorno offers a fascinating case study to illustrate naturopathic medicine's comprehensive and effective approach to dealing with depression that first provides the necessary and immediate symptomatic relief while treating the primary causes.

Women's Depression: An Integrative Approach -- Hyla Cass, M.D.
Psychiatrist and author Hyla Cass, an expert in integrating leading-edge natural medicine with innovative psychotherapy, and Assistant Clinical Professor at the UCLA School of Medicine, encounters many women in her private practice with typical psychiatric complaints: depression, addiction, impaired concentration, eating disorders, weight gain, insomnia, anxiety, fatigue, and sexual dysfunction. Rather than approaching her patients from a standard psychiatric, drug-prescribing perspective, Dr. Cass examines other possible underlying causes for their depression and related symptoms: genetic predisposition, hormonal imbalances, food and chemical sensitivities, chronic fatigue syndrome, candidiasis, toxic reactions, and nutritional deficiencies.

Her integrative approach to treating depression and mood disorders in women utilizes a wide range of therapies depending upon the specific history and biochemistry of the patient as determined by laboratory tests. These therapies include dietary therapy and nutritional medicine, amino acid therapy, herbal medicine, and natural hormone therapy, as well as mind/body therapies, leading-edge forms of psychotherapy including Voice Dialogue, and when necessary, conventional antidepressant medications. Dr. Cass' integrative approach to treating depression and its underlying metabolic causes is also relevant to men, with the exception of the specific hormonal imbalances.

A Comprehensive Approach to Depression: Nutritional Medicine and Biofeedback -- Melvyn Werbach, M.D.
Psychiatrist Melvyn Werbach presents a "new" model for looking at depression based on the natural and holistic principles of Hippocrates, the ancient Greek physician/healer recognized as the father of Western medicine. Depression can be viewed in three different ways according to Dr. Werbach: as a failure of a body system, a psychological defense, and a physical or psychological warning of the imbalance between mind and body. Optimal treatment involves a holistic approach which integrates the best of psychiatry, nutritional medicine and mind/body therapies.

Dr. Werbach, an internationally recognized authority in nutritional medicine, an early pioneer in biofeedback research at UCLA, and Assistant Clinical Professor at the UCLA School of Medicine, provides a clear and in-depth explanation of the nutritional treatment of depression through diet and nutritional supplementation, based on solid scientific research. Dietary factors and common foods associated with depression are examined such as caffeine, sugar and alcohol, as well as specific nutrient deficiencies including vitamin B-Complex, folic acid, vitamin B6, vitamin B12, and vitamin C, as is neurotransmitter precursor therapy to raise serotonin levels. A case study emphasizes the importance of integrating therapies such as biofeedback and relaxation response training into a more comprehensive model of treating depression.

The Natural Pharmacy: Herbal Medicine and Depression -- Janet Zand, O.M.D., L.Ac.
Depression is an enigmatic and complex phenomenon according to Dr. Janet Zand, a Doctor of Oriental Medicine, author, and a nationally known expert in herbal medicine. In fact, many of the numerous symptoms of depression--chronic fatigue, insomnia, loss of appetite, headaches, backaches, bowel disorders, and feelings of worthlessness and inadequacy--can, in other circumstances, be the cause of depression. Herbal medicine has a long and respected history, and holds a valuable place in the treatment of mental/emotional disorders such as anxiety and depression as well as the vast majority of health problems. The proper use of herbs not only helps to alleviate symptoms, but also helps to treat the underlying problem and strengthen the overall functioning of a particular organ or body system.

Dr. Zand profiles the Western and Chinese herbs herbs that have proven effective in treating depression, anxiety and mood disorders, including St. John's wort, kava, Siberian ginseng, Ginkgo biloba, astragalus, Dong quai, bupleurum, milk thistle, ginger root, and valerian. She also provides a list of essential oils that are helpful in alleviating depression as well as a useful herbal chart for quick reference. This chart lists the herbs and the corresponding symptoms of depression that it addresses, along with how the herb is taken, plus any possible side effects.

Homeopathy and Depression -- Jacquelyn Wilson, M.D.
Homeopathic remedies use minute doses of a medicinal agent that stimulate the body's own natural powers of recovery to restore balance and health rather than to simply suppress symptoms. Dr. Wilson, a nationally recognized authority in homeopathy and past President of the American Institute of Homeopathy, has found this system of natural medicine to be consistently effective in treating mental and emotional problems, as a method of individual self-care, and in more serious cases, when administered under the care of a health professional. In classical homeopathy, however, there are numerous forms of depression, as depression is not considered to be a single disease but a specific symptom-picture. Classical homeopathic prescribing matches a single remedy with a patient's detailed symptom profile. The keyto the homeopathic approach to treating depression, therefore, is to find the medicine that corresponds or is similar to the depressed person's mind and body traits, and complaints.

The most important homeopathic remedies for depression are described in this chapter, along with the appropriate Bach Flower remedies and cell salts, including each remedy's matching symptom profile. Dr. Wilson also distinguishes between the advantages and disadvantages of the two primary forms of homeopathy--classical single remedy prescribing, and complex homeopathy which uses combination remedies. She provides a fascinating account of a serious depressed woman who did not respond to antidepresssants and conventional medicine, but significantly benefited from a specific homeopathic remedy.

Qigong, Chinese Medicine and Depression: Roger Hirsh, O.M.D.
Chinese medicine as well as the many Chinese healing arts and martial arts are based on the concept of Qi or vital force. Chinese philosophy believes that the free and unobstructed flow of qi throughout the organ meridian system of the body brings radiant health, whereas its blockage or stagnation results in reduced energy that can lead to health problems. There is a strong recognition in Chinese Medicine of the role of the emotions in health and illness. When the body and mind move in harmony, positive emotions prevail. Depression, however, is due to a stagnation of emotional Qi within an individual's internal organs, especially the liver, kidneys and lungs. If the Qi is deeply stagnated for a period of time it can affect every organ meridian system and cause severe depression.

Dr. Hirsh, a respected doctor of Chinese herbal medicine, acupuncture, and a longtime teacher of Qigong and taiji (tai chi), leads the reader in a journey into the secrets of Qigong, an ancient Chinese art of energy training and rejuvenation. Qigong is increasingly utilized in health care settings worldwide, and is used in both the prevention and treatment of depression. For those experiencing either acute or deep-seated depression, Hirsh provides some simple Qigong exercises which involves breathing, visualization and movement to stimulate and energize. The first set of Qigong exercises are warm-ups that can be performed either individually or as a group to help deal with mild to moderate depression. The second group, "The Eight Silken Brocades" is a set of ancient exercises that help to stimulate and tonify the whole biomechanical system of the body in order to relieve stress, maintain youthfulness, and promote general well-being.

Ayurveda for Depression and Mental Health -- Shri Kant Mishra, M.D., M.S., Doctor of Ayurveda
Ayurveda, the traditional system of medicine in India practiced continuously for over 5,000 years, literally means the "Science of Life." The principal goal of Ayurveda is the preservation and promotion of health with special emphasis on preventing illness. The secondary goal of this form of medicine is the treatment of physical, mental and spiritual illness, according to Dr. Shri Kant Mishra, an internationally renowned neurologist, and the only western-trained M.D. working in the U.S. with a formal degree in Ayurveda from Benares University in India. In addressing one's overall heath, Ayurveda embraces a holistic perspective, integrating all aspects of life--nutrition, hygiene, sleep, seasonal changes, lifestyle, and physical, mental and sexual activities. Diagnosis and treatment in Ayurvedic medicine revolves around determining the individual's constitutional profile, which is based upon the unique combination of the three doshas or humors (vata, pitta and kapha). Illness and depression results when there is a dosha imbalance.

This ancient system of natural medicine has a long history in the areas of mental health, rejuvenation, and longevity through the use of diet and lifestyle practices, herbs, massage, yoga, and meditation. Dr. Mishra explores the Ayurvedic approach to attaining a balanced state of mental health and focuses on specific approaches to treating vata, pitta and kapha forms of depression. He also provides yogic practices such as pranayama (breathing practices) and meditation to help promote optimal health and mental clarity and balance.

The Spiritual Dimension of Depression -- Carlos Warter, M.D., Ph.D.
The great spiritual traditions of the world tell us that pain and suffering are rooted in the forgetfulness of our true divine nature-- our separation from the universal source. Psychiatrist Carlos Warter, M.D., Ph.D., a pioneer in spiritual psychology and psychospiritual integration, shows us how depression can manifest through ignoring or forgetting our true identity as spiritual beings. In treating hundreds of individuals with symptoms of depression, Dr. Warter recognizes the validity of each treatment modality, and the importance of looking at the physical, biochemical, mental and emotional causes of depression. To be really effective, however, he has discovered that one must cross into the realm of the spiritual to create a truly comprehensive treatment approach. "In the majority of depression cases that I have treated," says Warter, "the essential problem is that the individual's identity is firmly established in the smaller story of the personality and their larger, divine identity has been 'forgotten.' "

The solution, according to Warter, is to help the individual to move from the small, contracted story where depression is able to develop, to the awareness of a larger dimension of one's being, the large or big story of human life. This elevation in awareness entails a fundamental shift in the very notion of who one is, thereby undercutting very basis of the existing depression. In this final chapter, Dr. Warter charts out the spiritual terrain of healing, by combining both eastern and western spiritual traditions, and providing many practical tools and exercises to help us reclaim our wholeness and spiritual birthright.