Melancholic depression treatment without medication with natural cures and remedies  

Melancholic Depression 

© 2010 Peter Smith –Holistic Medicine Practitioner- (updated February 2015)

Melancholic depression probably involves a significant deficiency of the neurotransmitter serotonin or possibly dopamine, without adequate serotonin dopamine the mind is practically incapable of constructing positive thoughts. Melancholic depression may constitute a little over 20% of all cases of major depression.

Although I always recommend psychotherapy for anybody with depression, in the case of melancholic depression I suggest this will be ineffective unless simultaneously coupled with or preceded by treatment to build up the levels of serotonin and dopamine in the brain.

In melancholic depression the condition is absolute; the depressed state completely controls the person’s mind so that they do not experience any joy or temporary reprieve in response to positive events.  Tell a person with melancholic depression the good joke and they won't even solicit a smile.

Key Features of melancholic depression along with general symptoms of depression:

Absence of mood reactivity, i.e. the depression is constant and never lifts. Good news, jokes, support and contact have no impact on the person’s mood even momentarily.

Treating Melancholic Depression

To treat this severe potentially life-threatening condition with natural remedies you going to need to pull out all the stops and hit it with everything in the book. I’ve had melancholic depression as part of my bipolar condition and I remember feeling that it wasn’t possible for anything to make a difference, but that feeling is part of the condition and I also remember that as soon as I came out of it I couldn’t understand that imprisoned bleak feeling any more.
Melancholic depression is a very separating or isolating place, when I’ve been on the inside of it it’s a painful, bleak, isolating, desolate and all-encompassing reality, nothing anyone says or does could make any difference, no matter how close they are to me I’m in a separate, remote, isolated and hopeless place. I think it’s impossible to comprehend what that place feels like and how bad it is when you’re not in it. Even though I’ve been in that place several times before and would think I should be able to understand what it feels like but whenever it returned I was shocked at how much worse it was than I remembered; conversely I was always surprised and perplexed going the other way, as soon as it stopped I couldn’t really make sense of why just a short time ago I had felt so bad, why I was so trapped, so incapable of doing things, of feeling joy and death seemed the only way out.

Natural Remedies and Therapies for Melancholic Depression

I would use all of the following that the same time:
Serotonin and dopamine boosting remedies: tryptophan, tyrosine, DL phenylalanine, Rhodiola, SAMe, methylcobalamin, B6, L-methyl folate (and no folic acid) St John’s wort, EPA, magnesium, zinc et al.
NB don’t take tryptophan without B6 and magnesium supplements otherwise it may not make serotonin but instead make a neurotoxin.
There is however potentially a problem with starting on the above remedies straightaway, if the serotonin and dopamine pathways in the brain are damaged (see the BDNF hypothesis of depression) and exhausted because they already working at their full capacity and you then stimulate them to work harder you may only exhaust them further then crash and burn. To prevent this you should start with at least a few weeks on a brain regenerated protocol including:
Lithium orotate, curcumin, zinc, marigold or calendula, see my Brain Regeneration protocol.
For the brain regeneration protocol to work it’s also essential to eliminate:
Inflammatory foods including meat from the pig and wheat.
Foods containing lots of free radicals especially free radicals that damage the delicate omega-3 oils in the brain i.e. fried foods.
Foods containing trans-fatty acids i.e. ready-made foods/meals and margarines.
A high GI diet that causes first high blood sugar promotes inflammation in the brain swiftly followed by low blood sugar that starts the brain of the ability to manufacture neurotransmitters.
Elevated levels of stress hormones that promote damaging inflammation in the brain and prevent regeneration, see The Stress Solution.

In addition to the above I would use bright light therapy with one of the new blue/cyan LED bright light therapy devices.
HIIT or high-intensity interval training especially if you preload phenylalanine into the brain first see PEA Deficient Depression.
Transcranial magnetic stimulation.
I normally only discuss natural nondrug therapies however if the condition becomes imminently life-threatening to potentially very fast acting anti depressant treatments are:
Medically prescribed ketamine which I’m told at therapeutic doses does not destroy the bladder and
The combination of low dose selegiline and phenylethylamine (PEA) See PEA Deficient Depression

Psychotherapy for Melancholic Depression

This section and mainly intended for psychotherapists.
In my opinion psychotherapist and councillors whose training and techniques involve finding the positive strengths within the client, getting the client to focus on positive experiences and stop focusing on negative experiences/feelings, to projecting the mind into positive future experiences etc etc should not work with clients with melancholic depression.
At the right time in the right place those techniques can be helpful and healing, with atypical depression for example that has the aspect of mood-reactivity whereby the person is capable of briefly experiencing the concept of “positive” these techniques could be helpful especially combined with working on rejection-hypersensitivity aspect of atypical depression. However people with melancholic depression can’t relate to those concepts, that’s the nature of melancholic depression, they need to spend time perhaps a long time focusing on and working from within the negative state, thoughts and feelings that therein before even contemplating anything positive. For a person with melancholic depression a high aspirational goal may be to feel slightly less depressed, or at a stretch not depressed, so a therapist trying to evoke the concept of a happy positive place isn’t understanding the nature of the condition.
You can’t just inject positive affirmations with melancholic depression. I understand the belief that many therapy schools of thought have that whatever you focus on you develop, therefore if you focus on negative feelings you feed them and they grow so you must only ever focus on positive feelings and I understand how neuro plastic works within the brain and that you do actually physically grow the parts of the brain you use, but the therapy and a therapist must first and foremost connect to where the client is, melancholic depression is not serious unhappiness it’s inconceivably worse than that.
Let me try and explain this with a simple illustration: would you straightaway after the death of someone’s life partner that they were truly madly and deeply in love with or perhaps a parent whose child has just died try to cheer them up, take them out to party or on holiday? Would you in the early stages of their bereavement try to get their mind to focus on a positive future? Of course not that just wouldn’t be connecting to them, you would empathically acknowledge their pain, you wouldn’t try to stop it or change it or distract them from it, they need to feel it, they need to talk about it and work through their feelings at their own pace.
When the client themselves brings or focuses on something positive that’s the moment to introduce the therapy techniques that focus on the positive, but only gently in the beginning; correct timing in therapy is essential.
If you’re suffering with depression and you feel that your therapist is encouraging you to attain a positive mental state that either seems to far or too soon for you, you should probably change therapists. 
Unfortunately the almost total lack of hope is likely to prevent most people with melancholic depression going into talking therapy in the first place and if they do somehow arrive in therapy then the therapist doesn’t understand and acknowledge the deeply negative nature of the melancholic depression they may make the person feel even more isolated.
See also:

Major Depression

Dysthymic Depression
Atypical Depression
Melancholic Depression
Postpartum Depression
Seasonal Affective Disorder
Bipolar Depression
© –Holistic Medicine Consultant-
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