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In BC, doctors routinely prescribe medications for people with depression, anxiety disorders and other mental disorders. But the widespread use of medications doesn't mean that drugs are the only option for treating mental illness.
"We encourage people with mental illnesses to explore both traditional and alternative forms of treatment," says Grainne Holman, from the Health Promotion Department of the Canadian Mental Health Association's Vancouver-Burnaby branch. "Some people with major depressive disorder find that antidepressants and/or cognitive therapy is the best route, but people with milder depression sometimes feel better with regular exercise or a change in diet, for example." Cognitive therapy is based on research showing that people can alter their emotions and even improve their symptoms by re-evaluating their attitudes, thought patterns and interpretations of events.
Although she doesn't advocate any specific therapy, Holman says many people with mental health needs are discovering that alternatives ranging from biofeedback to music therapy can help restore peace of mind. "People need to be aware that these alternatives exist," says Holman, but she cautions: "they also need to know how to evaluate existing information about how effective they are, and about whether there are any adverse effects when alternative treatments are taken together with traditional treatments."
Jane, a 30-year-old biologist, takes 900 mg a day of St. John's Wort, an herb that has been routinely prescribed for depression in Germany for decades. Large-scale research reviews indicate that the herb may offset physical symptoms of clinical depression. Moreover, the data shows that consumers are slightly less likely to stop taking St. John's Wort than other anti depressants, like SSRIs. The herb has undergone many safety tests that explore possible herb-drug interactions and side-effects, and these suggest that it is safe and healthy to use under the control of a physician, with only a few side-effects or interactions reported.
Consumers should also be aware that the concentration of active ingredients in herbal formulations may vary from one manufacturer to the next, therefore, it is best to seek the advice of a naturopath about the most reputable brands for a specific purpose. Jane says she likes the herb because it is inexpensive and available at local health stores unlike prescription antidepressants which she tried for two months.
"One thing that makes me feel better about St. John's Wort is the fact that I'm in control of it," she says.
Michael Koo, 34, who has had depression for at least a decade, agrees. He says the keys to his recovery are reaching out to others and expressing his feelings. He's not alone. Nearly 10% of Canadians struggling with symptoms of mental illness or addiction turn to self-help groups, telephone hotlines and Internet communities for support.
Koo also finds it helpful to take time to connect with his body. "It involves stretching, breathing, making sounds and getting up and dancing to music, especially with other people," says Koo. "It's going back to what animals already do."
Biofeedback is a technique that helps people tune into their own body sensations by providing real-time physical data about the body's processes. For example, a biofeedback machine can be used to monitor rate of breathing, depth of breathing, irregular breathing, and chest breathing—all implicated as factors in panic attacks. By attending to the data provided by a biofeedback machine, individuals with panic disorder can control their breathing based on objective measures instead of their own feelings. During a "fight-or-flight" response, monitoring biofeedback levels can help ward off hyperventilation and feelings of panic. When patients can see that their bodies are receiving enough air, this may prevent them from taking deep breaths that send alarms to the system that something is wrong, thus heightening an attack.
Other people seek religious and spiritual help for their mental health problems. Although he doesn't believe in God, Allan, 31, says developing a spiritual awareness has helped him recover from the effects of a major depression, suicide attempt and a history of physical and sexual abuse. "Basically, spiritual meditation has been really helpful in just connecting with the energy around me," he says. In Canada, around 4% of individuals with symptoms of mental health or substance use problems sought help from members of the clergy; this percentage rises to 25% in the United States. There are also a number of other studies showing an association between spiritual practices and better health and mental health.
People with more serious mental illnesses such as schizophrenia may benefit from a combination of medication, cognitive therapy, music and art therapies. Cognitive therapies provide tools for reinforcing psychoeducational concepts and dealing with persistent symptoms such as hallucinations. Once considered to be "alternative therapies," cognitive therapies for people with psychotic disorders are increasingly being supported by clinical research and incorporated into mainstream mental health care. Music and art therapies allow people to explore their feelings through art and music, make positive changes in mood and emotions and develop self-esteem through participation in creative activities.
"The body's physiology changes from one of stress to one of deep relaxation, from one of fear to one of creativity and inspiration," according to Michael Samuels, a medical doctor and art therapist. In BC, creative arts are part of treatment programs at BC's Riverview Hospital, Vancouver Community Mental Health Services and others.
Alternative treatments are not a cure-all, especially for people with more serious mental illnesses. But it is important for people to have a sense of choice when it comes to treatment, says Holman of the CMHA. "We tell people to trust themselves and trust their own physical and emotional reactions to different treatments, no matter how helpless they have been made to feel. We want them to find the combination of alternatives that works for them."
In addition to their treatment choices, people with mental illness benefit from a holistic approach to community support, she adds. Community services should address the issues of income, housing and employment, and provide services offering peer-based and self-help support.
Alternative and Experimental Treatments for Mental Illnesses
sleep deprivation for bipolar disorder (manic depression)
herbal extracts of St. John's Wort (Hypericum perforatum) for depression
music, art and play therapy
light therapy for postpartum depression
biofeedback
repetitive transcranial magnetic stimulation (rTMS)
aromatherapy
acupuncture
homeopathy or naturopathy
Ayurvedic medicine
therapeutic massage
BC's Use of Alternative Therapies in Health Care
BC and other western provinces report using higher levels of alternative therapies than Canada as a whole. The five most popular consultations with an alternative health care provider in the previous year:
Chiropractor
Massage Therapist
Acupuncturist
Homeopath/Naturopath
Herbalist
Source: Statistics Canada
Sources
Knüppel, L. & Linde, K. (2004). Adverse effects of St. John's Wort: A systematic review. Journal of Clinical Psychiatry, Vol 65(11), 1470-1479.
Meuret, A., Wilhelm, F.H. & Roth, W. (2004). Respiratory feedback for treating panic disorder. Journal of Clinical Psychology, 60(2), 197-207.
Park, J. (2005). Use of alternative health care. Statistics Canada: Health Reports, 16(2), 38-42. www.statcan.ca/english/ads/82-003-XPE/pdf/16-2-04.pdf
Samuels, M. How art heals: Mind-body physiology. www.artashealing.org/ahfw3.htm
Statistics Canada. (2003, September 3). Canadian Community Health Survey: Mental health and well-being. The Daily. www.statcan.ca/Daily/English/030903/d030903a.htm
Wang, P.S., Berglund, P.A. & Kessler, R.C. (2003). Patterns and correlates of contacting clergy for mental disorders in the United States. Health Services Research, 38(2), 647-673. www.pubmedcentral.gov/articlerender.fcgi?tool=pubmed&pubmedid=12785566
Links in the Sources section are up to date as of April 2006
