Two of the most common mental disorders in Western countries are depression and anxiety. It is not unusual for them to be talked about together, but we must not lose sight of the fact that those who suffer from them can have very different behaviors. Thus, while anxiety usually causes irritation or fear, problems maintaining sleep and even hyperactivity, in depression it is more common to feel sadness, sleep much more than usual or feel too tired to carry out any activity most of the time.
The covid-19 pandemic has had a strong impact on people's mental health and has caused these problems to surface and be more visible than before, also overcoming certain taboos that often caused those affected to hide their problem. Talking about these diseases has helped in a certain way to eliminate the stigma, but even so, it is not always easy for people who suffer from them to recognize their problem.
But this is not the same in all cases and it is important to be clear about it. “Patients with anxiety tend to ask for professional help more easily. Patients with depression sometimes feel that the problem lies with them, that it has no solution, or they do not have the energy to even ask for help. The patient usually sees that something is wrong, but perhaps does not consider it as a medical problem, with a potentially effective treatment," says Dr. Guillermo Lahera, professor of Psychiatry at the University of Alcalá in Madrid and member of the board of directors of the Spanish Society of Psychiatry and Mental Health.
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Dr. Luis Miguel Martín, director of the Community Care Process and Special Programs of the Psychiatry Service of the Hospital del Mar in Barcelona, agrees with these statements. “We also found that patients with anxiety may have a longer journey through the healthcare system. They feel that there is a problem that they think is physical and they can consult different specialties about their symptoms before reaching the psychiatric consultation.”
Exercise and nutrition, two important allies
The first thing to understand about these two disorders is that those who suffer from them need the help and advice of health professionals. A person with depression or anxiety will not heal spontaneously and going to a specialized center is an important first step in the healing process.
But in addition to medical treatment or psychotherapy sessions, it is also possible to achieve significant improvement with other care, especially aimed at achieving good hygiene in daily habits. “There is evidence of the effectiveness of physical exercise in prevention and acute treatment, along with other interventions. It is easier to prescribe it in patients with anxiety, because the depressed patient often has apathy and fatigue that make it difficult. Except in serious cases, exercise has a behavioral activating effect, which is also positive,” says Dr. Lahera.
The relationship between diet and mental health is complex. Some studies have shown that diet can aggravate the symptoms of depression or, on the contrary, attenuate them. Research in recent years is delving into the relationship between the microbiota - the set of microorganisms that are normally located in different places in the bodies of living beings, such as the intestine - and mental health, exploring what has become known as the brain-gut axis.
In this way, research is being carried out on probiotics, foods or supplements that have live microorganisms that help maintain or improve our microbiota. “There are already some studies on the use of these probiotics in depressed patients, but more research is needed. As a main action I would not recommend it, although it can serve as something complementary. It is a very interesting area to explore,” says Dr. Miguel Martín.
Use of medicinal plants
To treat depression or anxiety, empirically validated treatments must be used, which are medications approved by regulatory agencies and psychotherapies recommended by international guidelines. “However, in mild cases, phytotherapy or the use of so-called medicinal plants can play a role, especially in people who prefer it and are convinced of its usefulness. In these cases, it is worth explaining that phytotherapy does not replace the treatment, but rather complements it,” comments Dr. Lahera.
For her part, Tamara Peiró, pharmacist in the Care Services Area of the General Council of Pharmaceutical Colleges of Spain, also emphasizes the usefulness of these treatments on certain occasions and with specific patients. “For example, in initial symptoms compatible with anxiety, passionflower, California poppy, valerian, lavender and lemon balm may be useful. Or hawthorn in the relief of nervous tension with exaggerated perception of heartbeats. For symptoms of depression, St. John's wort, also known as St. John's wort, may have an effect due to hypericin, a molecule with an antidepressant effect.”
Despite their usefulness in these milder cases, Dr. Lahera insists on the possible complications and interactions of these products. “Despite being natural products, it is advisable to know their composition, the possible interaction with medications you are taking and their compatibility with your medical history. Taken indiscriminately, without expert advice, they can really be a problem.”
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