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What’s New! – A Healthy Living Newsletter

November, 2003
If you find this newsletter useful, please forward it to a friend!

Childhood Depression and Natural Medicine

Childhood depression has become a serious problem in the U.S. Approximately 2.5 percent of children and up to 8.3 percent of adolescents in the U.S. suffer from this condition. There are several reasons for this. For some, there is a genetic component. One or both of the parents have some sort of a depressive/anxiety disorder. For example, the father may be bipolar or the mother dysthymic (chronic low level depression). But that in itself is the cause in about 30% of cases of childhood depression. Additionally, there is often an environmental factor such as a death in the family, a sexual assault, an early separation such as the mother being hospitalized or shipped off as a combatant or a bitter divorce which can trigger the depression. Family dynamics also plays an important role. If the child doesn't feel safe and wanted, this can contribute to childhood depression.

What many people don't realize is that depression can look very different in children than adults. In the child the only time you see the severe tearful, sad, withdrawn nature is when the child is severely depressed. Instead, you may see
· Aggressive behavior
· Sleep disturbances
· Decreased desire to play
· A change in school grades or interaction with peers
· Physical complaints
· Loss of usual energy
· Decrease or increase in appetite

If you see two or more of these signs for at least 1 month, then your child should be evaluated for depression. A final form of childhood depression is when the child appears cheerful in public and cries when alone.

Treating Depression

If your child has depression, there are several ways to help your child. First, determine how serious it is. If your child is talking about or actively planning suicide, then immediately contact your child's physician for the correct plan of action. If things haven't reached that point, then talk to your child - find out what's wrong. With the help of a therapist, work on changing the circumstances that may have triggered the depression.

I've had the satisfaction of helping many depressed children regain a feeling of self-worth as they resume more emotionally-balanced lives. I have found that for those wanting to avoid conventional medications and their side-effects, there are many effective natural treatments. One of my clients' favorite tools is homeopathy. Homeopathy is safe, nontoxic, and helps the child regain control more quickly than conventional medications. A book that will help you understand the potential of homeopathy in treating depression is called Prozac-Free by Dr. Judyth Ullman. In addition, I make a few dietary recommendations and may use some specific vitamins (often called orthomolecular medicine) and herbs temporarily. Some of the children I treat who have already been on anti-depressants comment that homeopathy doesn't make them feel "weird" or "dopey" or just "not themselves".

One of the most important considerations in treating your child's depression is a 1992 scientific finding by Lewis Baxter. Brain scans altered by mood alteration returned to normal with treatment whether or not pharmaceutical drugs were used. The key was that the child was reached and recovery occurred. It was the result, not the means that caused the brain scans to reflect a normal state. (Baxter. Archives of General Psychiatry 1992;49:681-689 - secondary reference in Growing Up Sad)

If recognized and treated, your child can go on to have a normal life. If not, there may be multiple reoccurrences continuing on into adulthood. Whatever you and your child decide, take action.

Books

Growing Up Sad by Drs. Cytryn and McKnew
These two psychiatrists established the diagnosis of childhood depression within the field of psychiatric disorders. The book is more a vehicle for the scientific support for this diagnosis, than a manual for parents.

Prozac Free by Dr. Judyth Ullman
Dr. Ullman is both a psychologist and a naturopathic physician. This book gives the reader a good idea of how effective homeopathy is in treating depression.

Straight Talk about Your Child's Mental Health by Dr. Stephen Faraone
This is a fine how-to recognize and what to do if you suspect something is "off" with your child.

The Bipolar Child by Dr. Demitri and Janice Papolos

Bipolar disorder is a unique form of depression with both mania and depression. It's rare in children, but if you or your spouse has it and you suspect it in your child, this is a good book to read.

Internet:
NIMH (National Institute of Mental Health) http://www.nimh.nih.gov/publicat/depchildresfact.cfm

____________________________________________________

Book Review:

Straight Talk about Your Child's Mental Health
By Dr. Stephen V. Faraone

This is a powerhouse of a book. Thorough and informative, Straight Talk demystifies childhood mental health. It's aimed at parents who think there just may be a problem with their son or daughter. Equally as important, it tells the parents what's normal and what's not - such as quiet parents concerned about their outgoing child verses a truly out-of-control child heading for criminal trouble.

Dr. Faraone starts by generally categorizing 5 main types of problems: disruptive behavior (disobedience, lying, stealing, etc.), moodiness (sadness, silliness, irritability, depression), fear (nervousness and shyness), learning disabilities and abnormal development. As he explains the behaviors, he gently alludes to possible diagnoses for these behaviors. I say gently, because the good doctor knows that most parents have resistance in believing that their son or daughter may have a psychiatric problem. The parents think it's a reflection on them. Instead Dr. Faraone stresses that it is often an abnormality in the brain evidenced by a brain scan, that may be related to biology (genetics) rather than poor parenting. The idea here is that it's better to diagnose and treat a young child with a mental health problem than have a disrupted family life for years before trying to treat an often noncompliant teenager. The earlier the detection and treatment, the better the outcome.

After categorizing behaviors, Faraone offers detailed descriptions of possible diagnoses. He does an excellent job of giving examples, outlining behaviors and offering psychological and pharmaceutical treatment options. In this section, you learn that OCD (obsessive-compulsive disorder) looks a bit different than Jack Nicholson in As Good as it Gets. First, children will do their best to hide their obsessions from their parents. Instead it may involve the parent spending 45 minutes every night checking for monsters or locking and unlocking every window in the house. In some cases, OCD may develop into Tourette's syndrome (incontrollable tics, physical and/or verbal that interfere with the person's quality of life). Straight Talk lets you know that Tourette's is rare and affects only about 1 in 5000 people, but transient tics affect 10% of females and 25% of males and only lasts about one month.

The third section distinguishes among the various mental health providers. For example a psychiatrist is a physician who specializes in mental health and prescribing medications, while a PsyD (Doctorate of Psychology) has a 4 year post-graduate degree, cannot prescribe medications but can administer diagnostic tests. Faraone also gives the reader a very clear idea of what a mental health evaluation office visit would be like.

Finally, the book ends with working with the mental health care system. That section should be subtitled "when at first you don't succeed, don't give up - ever".

Faraone is a psychiatrist and therefore has trouble thinking beyond pharmaceutical drugs. He even goes so far as to warn the reader about fads like removing sugar from the diet which may delay proper (read pharmaceutical) treatment but suggests experimental drugs if the pharmaceuticals don't work. I agree with him to a point. If your child is actively suicidal (has a plan and means of carrying through with the plan), is a violent teenager, has a serious substance abuse problem, is down to 60 pounds from anorexia, don't visit a natural physician first. Get your child emergency help. But for the majority of OCD, Tourette's, ADHD, Asperger, depression, and eating disorder cases, specialists among the various natural medicine providers can really help - most often working alongside therapists with or without the use of pharmaceutical medications. I worked several years in a natural mental health clinic and saw first hand how natural medicine helped this group of people.

So, if you suspect a problem with your own or a close friend's child, read Straight Talk about Your Child's Mental Health. It just may shave 10 years of unhappiness and disruption from both the child's and the family's life.

____________________________________________________

Book Review:

The Everything Menopause Book
Ramona Slupik, MD

It had a clever cover and as I flipped through the book, I liked the casual format. It was a discussion of menopause in sound bites rather than a lengthy dissertation. So, I checked it out of the library to read for this newsletter. Three hundred pages later, I can report that the book could easily be condensed into 100 pages - would have taken less time to read and still would give the reader the same information.

The Everything Menopause Book jumps all around, repeats itself continuously, contradicts itself repeatedly and yet somehow manages to have a reasonably thorough discussion of menopause. Author Ramona Slupik, has a dilemma. In light of the seriously negative HRT (hormone replacement therapy) studies that were splayed all over the press just as this book was in its final stages of writing, she quickly dashes off caution after caution about HRT while simultaneously telling the reader that it is the only viable choice in most situations. For example, on page 144, she quotes a large 2000 study which concludes that women both on the pill and HRT are more likely to report problems with memory loss. And follows this 4 pages later with HRT will help memory problems.

Despite about 10 instances of similar contradictions, the book does give useful information to the average perimenopausal woman. (Perimenopause often occurs in the mid-forties and is the period when a woman's estrogen levels decrease.) For example, she covers not just hot flashes, but sleep disturbances. Did you know that the glass of wine that you had before bed may help you fall asleep, but is just as liable to wake you several hours before morning? She also discusses osteoporosis, incontinence (involuntary urination), mood swings, weight gain, waning concentration, depression, headaches, sexuality, and heart palpitations.

To remedy these situations, Slupik brings in the arsenal of prescriptions medications. Sometimes, she omits their side-effects and other times, she includes them. She ever-so-briefly mentions natural alternatives and then only with strong cautions about the lack of research. I would politely venture to suggest that the research is there, but not necessarily from the USA. It's a bit myopic to ignore the valid international research on natural medicine that has been ongoing for decades.

So why am I including this book in this newsletter? Because it has a homey style and covers a wider assortment of conditions than most books on perimenopause. And it ends with a lovely suggestion - each woman write a menopausal journal. I've decided to do this - not so much for me, but for my daughter when she goes through perimenopause. It's the end of one phase of a woman's life and the beginning of another - and frankly, I'm looking forward to it.

 

Health and herb tip

This month's health tip is in response to the many phone calls I've received from sick patients wanting to know how I avoid (knock on wood) getting ill from colds and flu year after year. I'm extremely proactive. First, I watch out for my exposure to sick people and second, I listen to my body.

On the days when I have many people with active colds and flu in my office, I conclude the visit, wish them well and head to the back room for herbs to boost my immune system. I tend to use Echinacea, Andrographis, Usnea (Old Man's Beard), and licorice for taste. I also take 1000 mg of Vitamin C every 2 hours for the one or two days of maximum exposure. You could also get the excellent Wellness product from Source Natural and take that very often for 1-2 days. Two other great products that I keep at home for my husband and children are Andrographis from Mediherb and Wise Woman's Phytoguard. Like the Wellness Formula, I encourage them to take 2 pills every 1 to 2 hours for 1 day and to dramatically decrease it the next day when they start to feel better.

At the same time, I try to get more sleep, avoid all sugar and try to eat very lightly. My goal is to give my immune system nutrients to support it as well as decreasing the metabolic load of digestion. I want my body to concentrate on keeping my immune system up.

Sometimes, the illness has gone too far to be treated in this manner. You can't start this after you have been hacking, shivering with fever, and have a sore throat for 10 days - and expect to see a dramatic improvement in 1 day. In those cases, it's better to consider seeing a naturopath or conventional doctor for stronger medicine or antibiotics.

Interesting health-related site: http://www.consumerlab.com/index.asp
This is a great site for learning more about the quality of herbs and vitamins - for both humans and pets. My sister suggested that I check out this site over 6 months ago. I should have done it then. It's an excellent site. My only complaint is that I wish they would include Costco and Centrum products in their analysis.

For readers in the Portland, Oregon area, if you have or know of any children with Asperger's Syndrome or childhood depression, ask them to visit my new resource pages on these conditions.

 

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Snail Mail: Dr. Suzanne C. Lawton
11825 SW Greenburg Road, Suite A2
Tigard, Oregon 97223
503-443-2332