More Americans are seeking out alternative, complementary, and integrative (ACI) approaches to painful chronic conditions, such as depression. This article reviews a variety of the interventions that are potentially helpfulfor those with depression. Approaches discussed include supplements, exercise, massage, light therapy, homeopathy, and rapid rate transcranial electromagnetic stimulation. Articles in the lay press abound and herbs, homeopathic remedies, and supplements are sold in supermarkets, drug stores, and catalogs. Persons use these approaches without consulting knowledgeable providers. Information related to the use of ACI approaches is often confusing, and many approaches are not supported by research. However, most ACI interventions enhance comfort and result in few dangerous side effects. Psychiatric nurses need to become knowledgeable about these interventions and can serve as a resource to clients by assessing the usefulness of ACI interventions and prescribing them in their practice.
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References
1.
Alavi, A., LaRiccia, P. J., Sadek, A. H., Newberg, A. B., Lee, L., Reich, H., et al. (1997). Neuroimaging of acupuncture in patients with chronic pain. Journal of Alternative & Complementary Medicine, 3(Suppl. 1), s47-s53.
2.
Alexopoulos, G., Vrontou, C., Kakuma, T., Meyers, B., Young, R. C., Klausner, E., & Clarkin, J. (1996). Disability in geriatric depression. American Journal of Psychiatry, 153, 877-885.
3.
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.
4.
Astin, A. J. (1998). Why patients use alternative medicine; results of a national study. Journal of the American Medical Association, 279, 1548-1553.
5.
Barefoot, J. C., & Schroll, M. (1996). Symptoms of depression, acute myocardial infarction, and total mortality in a community sample. Circulation, 93, 1976-1980.
6.
Bender, K. J. (1998). Dietary fatty acids essential for mental health. Psychiatric Times, 15(12), 22-23.
7.
Benjamin, J. (1995). Inositol treatment in psychiatry. Psychopharma cology Bulletin, 31, 156-175.
8.
Bloomfield, H. H., Nordfors, M., & McWilliams, P. (1996). Hypericum and depression. Los Angeles: Prelude Press.
9.
Cassidy, C. M. (1998). Chinese medicine users in the United States Part 1: Utilization, satisfaction, medical plurality. Journal of Alternative & Complementary Medicine, 1, 17-27.
10.
Castro, M. (1997). The treatment of depression with homeopathy. Alternative and Complementary Therapies, 3, 300-305.
11.
Davidson, J. R. T., Morrison, R. M., Shore, J., Davidson R. T., & Bendayne, G. (1997). Homeopathic treatment of depression and anxiety. Alternative Therapies in Health and Medicine, 3(1), 46-49.
12.
DeSmet, P. A., & Nolen, A. A. (1996). St. John's wort as an antidepressant. British Medical Journal, 313, 241-242.
13.
Druss, B. G., Rohrbaugh, R., Kosten, T., Hoff, R., & Rosenheck, R. A. (1998). The use of alternative medicine in major depression. Psychiatric Services, 49, 1397-1397.
14.
Eisenberg, D. M., Kessler, R. C., Foster, C., Norlock, F. E., Calkins, D. R., & Delbanco, T. L. (1993). Unconventional medicine in the United States: Prevalence, costs and patterns of use. New England Journal of Medicine, 328, 246-252.
15.
Eisenberg, D. M., Davis, R. B., Ettner, S. L., Appel, S., Wilkey, S., Von Rompay, M., & Kessler, R. C. (1998). Trends in alternative medicine use in the United States, 1990-1997: Results of a follow-up national survey. Journal of the American Medical Association, 280, 1569-1575.
16.
Epstein, C. M., Figiel, G. S., McDonald, W. M., Amazon-Leece, J., & Figiel, L. (1998). Rapid rate transcranial magnetic stimulation in young and middle-aged refractory depressed patients. Psychiatric Annals, 28, 36-39.
17.
Folkins, C. H., & Sime, W. E. (1981). Physical fitness training and mental health. American Psychologist, 36, 373-389.
18.
Frazure-Smith, N., Lesperance, F., & Talajic, M. (1993). Depression following myocardial infarction: Impact on 6-month survival. Journal of the American Medical Association, 270, 1819-1825.
19.
Goodnick, P. J. (1997). Introduction: Medical illness and depression. Psychiatric Annals, 27, 339-340.
20.
Griest, J. H., Klein, M. H., Eischens, R. R., Faria, J., Gurman, A. S., & Morgan, W. P. (1979). Running as a treatment for depression. Comprehensive Psychiatry, 53, 20-41.
21.
Hamilton, M. (1967). A rating scale for depression. Journal of Social and Clinical Psychology, 6, 278-296.
22.
Jenike, M. (1996). Psychiatric illness in the elderly: A review. Journal of Geriatric Psychiatry and Neurology, 9, 57-82.
23.
Karel, R. B. (1996). World impact of mental illness far more severe than assumed. Psychiatric News, 21(1), 31-35.
24.
Kessler, R. (1998). Alternative medicine update: News from NIH/OAM. Alternative Health Practitioner, 4, 93-94, 177-178.
25.
Kessler, R. C., McGonagle, K. A., Zhao, S., Nelson, C. B., Hughes, M., Eshleman, S., et al. (1994). Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States: results for the national comorbidity survey. Archives of Psychiatry, 51, 8-19.
26.
Kinzler, E., Kromer, J., & Lehmann, E. (1991). Effect of a special kava extract in patients with anxiety, tension, and excitation states of non-psychotic genesis. Arzbeim-Forsh, 41, 585-588.
27.
Lesperance, F., Frazure-Smith, N., & Talajic, M. (1996). Major depression before and after MI: Its nature and consequences. Psychosomatic Medicine, 58, 99-110.
28.
Lieberman, S. (1998). Treating depression with St. John's wort. Alternative and Complementary Therapies, 4, 162-172.
29.
Linde, K., Ramirez, G., Mulrow, C. D., Pauls, A., Weidenhammer, W., & Melchart, D. (1996). St. John's wort for depression-an overview and meta-analysis of randomized clinical trials. British Medical Journal, 313, 253-258.
30.
Maurer, K. (1996). Treatment with magnets may improve depression. Clinical Psychiatry News, 24 (1).
31.
Mischoulon, D. (1996). The role of folate in major depression: mechanisms and clinical implications. American Society of Clinical Psycbopharmacology Progress Notes, 7(2), 4-5.
32.
Moore, K. M. (1998). Exercise training as an alternative treatment for depression among older adults. Alternative Tberapies in Health & Medicine, 4(1), 48-56.
33.
Morris, P. L., & Robinson, R. G. (1995). Personality and depression after stroke. International Journal of Psychiatry, 25, 93-102.
34.
Muller, W. E., Rolii, M., Schafer, C., & Hafner, U. (1997). Effects of hypericum extract in biochemical models of antidepressant activity. Pharmacopsychiatry, 30(Suppl.), S102-S107.
35.
Muller, W. E., & Rossol, R. (1994). Effects of hypericum extract on the expression of serotonin receptors. Journal of Geriatric Psychiatry and Neurology, 7 (Suppl. 1), S63-S64.
36.
Murray, C. J. (1996). Global burden of disease and global health statistics. Cambridge, MA: Harvard University Press.
37.
Murray, M. T. (1995). Lifestyle and dietary factors in depression. American Journal of Natural Medicine, 2(10), 10-15.
38.
Panzarino, P. J. (1998). The costs of depression: Direct and indirect; treatment versus nontreatment. Journal of Clinical Psychiatry, 59(Suppl. 20), 11-14.
39.
Pascual-Leone, A., Rubio, B., Pallardo, F., & Catala, M. D. (1996). Rapid-rate transcranial magnetic stimulation of left dorsolateral prefrontal cortex in drug resistant depression. Lancet, 348, 233-237.
40.
Piscatelli, S., Burnstein, A. H., Chaitt, D., Alfaro, R. M., & Fuloon, J. (2000). Indinavir concentrations and St. John's wort. Lancet, 355, 547-548.
41.
Regier, D. A., Boyd, J. H., Burke, J. D., Jr., Rae, D. S., Myers, J. K., Kramer, M., et al. (1988). One month prevalence of depressive disorders in the United States. Based on five Epidimeologic Catchment Area sites. Archives of General Psychiatry, 45, 977-986.
42.
Reid, P. D., Shajahan, P. M., Glabus, M. F., & Ebmeier, K. P. (1999). Transcranial magnetic stimulation in depression. British Journal of Psychiatry, 173, 449-452.
43.
Reilly, D., Taylor, M. A., & Beattie, N. G. M. (1994). Is evidence for homeopathy reproducible?Lancet, 344, 1601-1606.
44.
Rosenthal, N. E. (1993). Diagnosis and treatment of seasonal affective disorder. Journal of the American Medical Association, 270, 2717-2720.
45.
Rosenthal, N. E. (1996, March). Light therapy: Past, present, and future. Paper presented at the New York University Psychopharmacology Conference, New York, NY.
46.
Ruschitzka, F., Meier, P. J., Turnia, M., Luschee, T., & Noll, G. (2000). Acute heart transplant rejection due to St. John's wort. Lancet, 355, 548-549.
47.
Schieszer, J. (1998). Depression goes undiagnosed in elderly. Clinical Psychiatry News, 26(5), 32-32.
48.
Schlager, D. (1995). Annual meeting review: Society for Light Treatment and Biological Rhythms. Journal of Alternative and Complementary Medicine, 1, 107-109.
49.
Schleifer, S. J., Keller, S. E., Bartlett, J. A., Echoldt, H. M., & Delaney, B. R. (1996). Immunity in young adults with major depression. American Journal of Psychiatry, 153, 477-482.
50.
Sherman, C. (1998) St. John's wort may soothe severe depression: Particularly valuable for the elderly. Clinical Psychiatry News, 26(4), 32-32.
51.
Steefel, L. (1996). Treating depression: Helping the body heal the mind. Alternative and Complementary Therapies, 2, 1-4.
52.
Tao, D. J. (1993). Research on the reduction of anxiety and depression with acupuncture. American Journal of Acupuncture, 21, 327-329.
53.
Terman, M., & Terman, J. S. (1995). Treatment of seasonal affective disorder with high output negative ionizer. Journal of Complementary Medicine, 1, 87-92.
54.
Terman, M., & Terman, J. S. (1999) Bright light therapy: Side effects and benefits across the symptom spectrum. Journal of Clinical Psychiatry, 60, 799-808.
55.
Ullman, D. (1989). Discovering homeopathy. Medicine for the 21st century. Berkeley, CA: North Atlantic Books.
56.
Villaire, M. (1998). NIH consensus conference confirms acupuncture's efficacy. Alternative Therapies in Health and Medicine, 4(1), 21-22.
57.
Wagner, H., & Bladt, S. (1994) Pharmaceutical quality of Hypericum extracts. Journal of Geriatric Psychiatry Neurology, 7(Suppl. 1), S65-S68.
58.
Weil, A. (1995). Dr. Andrew Weil's self-healing relieving depression simply. Watertown, MA: Thorne Communications.
59.
Zahourek, R. R. (1997). Practice issues: Complementary and alternative approaches to depression. Alternative Health Practitioner, 3(1), 7-10.
60.
Zajecka, J. (1996). Update on depression. In Decade of the brain, Vol. VII. Publication of the National Alliance for the Mentally Ill.
61.
Zoler, M. L. (1998) Tackling psychological factors in heart patients. Clinical Psychiatry News, 26(3), 16-16.
