Understanding Depression

An estimate of close to one billion people, including children, are affected by some form of mood disorder. The figures are staggering, and a sad reality for the times we are living in.

Depression is the most common of mental illnessesand the third most diagnosed in South Africa. Many suffer in silence out of fear of being stigmatised, and a great deal of sensitivity and empathy are required when addressing the challenge of depression in many sectors of society.

The aim of this article is to shed some light on what constitutes depression, as well as to offer hope and a holistic approach for dealing with the illness. The most important thing to remember is that you are not alone, and that depression can be managed.

Depression can take on various forms, and present with different sets of symptoms in each sufferer. Your doctor will diagnose you according to your symptoms to determine which type of depression you have. 


  1. Depressive episode 
  2. Major depression
  3. Dysthymia
  4. Bipolar mood disorder
  5. Post-partum depression 


  • Depressed mood
  • Sadness and pessimism
  • Low motivation and lack of energy
  • Little to no experience of joy 
  • Feelings of guilt, worthlessness, apathy and hypersensitivity
  • Loss of appetite/overeating
  • Weight loss/gain
  • Sleeplessness/excessive sleeping
  • Constipation
  • Low libido
  • Tiredness
  • Headaches and body pains
  • Continuous negative thoughts
  • Suicidal ideation
  • Slow thinking
  • Poor concentration
  • Poor judgement and decision-making
  • Memory loss 
  • Limited initiative and interest
  • Withdrawal from people 
  • Lack of interest in things you previously enjoyed
  • Lack of interest in work or daily tasks
  • Poor communication abilities
  • Poor use of life skills
  • Low personal worth, self-confidence and self-image


  1. Genetic factors, temperament and personality
  2. Alcohol, nicotine and drug abuse
  3. Stress caused by childhood difficulties or trauma
  4. Ongoing exposure to stress
  5. Low self-image
  6. Medical conditions such as hormonal imbalance, under-active thyroid, blood sugar challenges and prolonged illness
  7. Side effects of certain medications
  8. Nutritional deficiencies (including low levels of folic acid, niacin, vitamin B6, vitamin B12, vitamin D, zinc and essential fatty acids)
  9. Chemical imbalances in the brain. The main neurotransmitters involved in depression are: 

Serotonin – regulates mood, appetite and sleep

Dopamine – regulates motivation and the reward system 

Norepinephrine – regulates mood, arousal, vigilance, memory and stress


1. Pharmacological intervention

Classes of antidepressant medications include:

Tricyclic antidepressants

Selective serotonin reuptake inhibitors (SSRI)

Serotonin and norepinephrine reuptake inhibitors (SNRI)

Monoamine oxidase inhibitors (MAOI)

2. Psychotherapy

Commonly known as talk therapy, the aim of psychotherapy is to uncover and address the root cause(s) of depression, as well as to help manage the resulting symptoms.

3. Occupational therapy

This form of therapy aims to empower patients with the skills and healthy lifestyle options necessary for functioning optimally in all areas of life.

4. Support groups

A group of individuals experiencing the same challenges are often best equipped to offer each other comfort, community and support.

5. Nutrition

A clinical nutritionist can check for any biochemical imbalances and devise a nutritional programme to improve your mood.  


  • Regular exercise

Naturally elevate your mood through endorphins – the feel-good hormones released during exercise

  • Cognitive Behavioural Therapy

Learn to recognise and ‘re-route’ negative thinking patterns 

  • Laughter

Enjoy a good dose of one of the easiest ways to release mood-enhancing endorphins!

  • Reduction of known stressors 

Know and avoid the triggers that exacerbate the symptoms of your depression 

  • Pursue a hobby

Immerse yourself in something you really enjoy, and you’ll no doubt feel the resultant sense of presence and flow.

  • Keep a gratitude journal

Make a practice of reminding yourself of all the good in your life on a daily basis

  • Cultivate connection

Never underestimate the positive power of spending quality time with loved ones

  • Look within

Meditating, reading inspirational literature and walking in nature are all great ways of connecting to yourself and what you value most. 

  • Explore aromatherapy

Pure essential oils of bergamot, grapefruit, lavender, sweet orange and rose geranium are all said to have mood-elevating properties.


  • Eat a diet that includes plenty of raw fruit and vegetables, as well as non-GMO soya products, whole grains, seeds, nuts, brown rice, millet and legumes. A diet low in complex carbohydrates can cause serotonin depletion and depression.
  • Eat foods high in the amino acid tryptophan, which is the precursor to serotonin. These include turkey, fish, chicken, cheese, beans, tofu, oats and eggs.
  • Avoid all forms of sugar and refined carbohydrates, which can lead to fluctuating blood sugar levels and trigger imbalances of certain neurotransmitters. 
  • Avoid alcohol, which is very high in sugar and acts as a nervous system depressant.
  • Avoid all hydrogenated fats and processed foods, which are loaded with harmful additives and colourants and can lead to sluggishness, slow thinking and fatigue.
  • Eat oily fish such as sardines, salmon, trout and mackerel, which are good sources of omega 3 fatty acids, are vital for brain health, and can assist with the reduction of inflammation.
  • Check for food intolerances (wheat, gluten and dairy are the most common)


  • 5-HTP

A popular natural supplement for increasing the body’s production of serotonin 

  • St John’s Wort

One of the most thoroughly researched of all natural remedies, St John’s Wort is effective for mild to moderate depression.

  • Saffron Extract

Saffron may exert an antidepressant effect by promoting a positive mood.

  • Turmeric

The active ingredient curcumin is a potent anti-inflammatory, and appears to elevate neurotransmitters such as serotonin.

  • Rhodiola rosea

An adaptogenic herb that is said to help the body deal with various mental, physical and environmental stressors, as well as to increase serotonin levels in the brain

  • Omega 3 fish oils

Aid in the transmission of the nerve impulses needed for healthy brain function

  • Vitamin B complex

Plays a major role in the activity and metabolism of neurotransmitters

  • Vitamin D and zinc 

Low levels have been shown to contribute to depression

Note: If you are taking allopathic antidepressant medication, consult your doctor before adding any natural remedies, as some may contraindicate with your prescribed regimen. 

By Elizabeth Parsons (Wellness Consultant, Wellness Warehouse Cavendish Square)