Ray D’Alonzo, Ph.D., is Manager of Doctoral Recruiting & University Relations and a former Associate Director of Research and Development at Procter & Gamble Pharmaceuticals where he has worked for 30 years.  He has led research programs in bone metabolism, infectious disease, respiratory disease, arthritis, and nutrition and has published scientific papers on a wide variety of topics from the chemical composition of fats and oils to the pharmacoeconomics of osteoporosis. Dr. D’Alonzo is the recipient of the Chancellor’s Medal from the University of Massachusetts, Amherst, in part, for his contributions to the development of new pharmaceutical agents. As both a patient and scientist, he has made a personal effort to increase the awareness of Chiari in the health care sector and to assist others afflicted with the syndrome.  He has published the story of his personal struggle with Chiari in a book, Contents Under Pressure, with 100% of royalties going towards Chiari education, awareness, and research programs.

May 31, 2007

     In a paper published in 20041, Drs. Mueller and Oro found that nearly half of symptomatic Chiari patients assessed in a large prospective study presented with depression. This is almost ten-fold the incidence of depression in the general population.
     Depression is a terrible condition. It depresses mood and is often associated with problematic physical symptoms. Therapy is required by qualified medical professionals such as psychiatrists, psychologists or psychotherapists. Antidepressants are commonly prescribed to treat depression. Depression often comes along with anxiety. Antidepressants are often effective in controlling anxiety but sedatives are often prescribed in combination with antidepressants when anxiety is also present or difficult to control.
     In addition to drug therapy, professionals often employ talk therapy and attempt to uncover stressors in the patient’s environment which may be exacerbating the condition or even responsible for it.
     There are also things that a patient can do by him or her self that can effectively complement professional drug and psychotherapy. During my personal journey with Chiari, I suffered from severe depression and anxiety and at one point was even hospitalized for it. Today, almost 8 years after decompression surgery and excellent supportive care, I am completely free of depression and anxiety. I am also free of all psychotropic and pain medications. Along the way, I found the following nine self-help techniques to be highly effective.

1. Strengthen your free will. Choose not to think about anything. This may seem difficult at first. You may only be able not to think about anything for a few seconds but with practice your ability to sustain a thoughtless state will grow. The benefit of doing this is two-fold. First, it will improve your ability not to think bad thoughts. Second, during the time you are not thinking about anything, you are not thinking bad thoughts. By using your free will to choose not to think, you can break the cycle of obsessively thinking about your worries.

2. Engage in something that demands your full attention and concentration. This will be different for different people. Some activities might be computer programming, artistic painting or water coloring, or even rock climbing. This is the opposite of the above. Rather than pushing out bad thoughts with no thought, it pushes out bad thoughts with productive mental activity.

3. Talk to someone. Find a close friend or relative that you can talk to. Just talking and connecting with another person helps reduce anxiety. By requiring your mind to think about engaging in a discussion, the brain is less available to think about bad thoughts.

4. Meditate or pray. This again keeps the mind in an occupied state. Irrational thoughts of guilt often accompany depression. Prayer can help with this as can seeking the assistance of a well trained spiritual advisor. Keep in mind that seeking spiritual guidance can be controversial in the minds of some professional therapists so discuss this with the therapist first.

5. Connect with music. Don’t just listen to it, connect with it in a fashion that is inspiring. Listen to music that stirs emotions or images of strength, determination and triumph. Emotional response is compressed in depression. Doing things that force expansion of emotion like listening to good music can be helpful. Don’t listen to music that reminds you of your troubles. Listen to uplifting pieces. If you like classical music, I recommend Tchaikovsky’s 5th Symphony, Beethoven’s 5th Symphony and Copland’s 3rd Symphony. For those of you who like Country or Rock, I’m afraid you will have to find your own favorites.

6. Volunteer your time and effort to a worthy cause or charity that involves contact with people. It also helps you find purpose. Seeking purpose is the path to happiness, not seeking pleasure or comfort. By finding purpose, you will acquire happiness and with happiness, you will loosen the grip of depression.

7. Use rational thought. Anxiety often comes with irrational fears. Employ rationale thought to mitigate fears. Develop action plans around concerns you might have in advance. If “X” happens, I will do “Y”.

8. Get regular exercise and adopt a healthy diet. Aerobic exercise is highly recommended (see my article on this subject in the March 2006 issue of this newsletter). Exercise can stimulate the production of endorphins. Start small and gradually increase your level of activity. Eat a balanced diet and loose weight if possible although many antidepressants can make loosing weight challenging to say the least.

9. Get a little sunshine and fresh air every day if possible. For some people, the lack of sun light can bring on depression or worsen existing depression.

     Now, in all honesty after providing these tips, I can not assure the reader that they are proven effective. Some may have been studied in a solid fashion and others probably not at all. I am aware that well-controlled clinical studies in depression evaluating both drug therapy and drug therapy in combination with psychotherapy have been conducted showing the benefit of added psychotherapy. On the other hand, I doubt there is solid evidence in the literature demonstrating the effectiveness of listening to music. Actually, it is articles like this one that are responsible over the years in creating and perpetuating what I call medical folk lore and thus I am compelled to make this disclaimer. However, as one who has suffered from depression, I also know that not doing anything is not acceptable. These self help tips may be effective or they may only tie one over until the natural cycle of depression passes. Whatever actually goes on is up to debate but it is the human spirit to want to be well and fight back when disease strikes whether it is physical or mental.

1Mueller DM and Oro JJ, J. Am. Acad. Nurs. Pract., Vol. 16, Issue 2, pp 134-8, March 2004.
 
-- Ray D'Alonzo

 ** If you would like to share your comments, thoughts, or ideas with Ray,  please send them to dalonzo.rp@fuse.net.  Due to the volume and nature of email received, individual responses are not possible. **

[Ed. Note:  The opinions expressed above are solely those of the author.  They do not represent the opinions of the editor, publisher, or this publication.  Mr. D'Alonzo is not a medical doctor and does not give medical advice.  Anyone with a medical problem is strongly encouraged to seek professional medical care.]    
 

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