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Henry Quant,
7, left, who has been on antidepressants for two
years, plays hide-and-seek with his brother Roger,
6, in the family's Minneapolis home, September 11,
2008. Quant has had a history of health problems
that caused depression and anxiety. Recently, his
parents starting weaning him off the antidepressants
and using alternative medicine instead.
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MINNEAPOLIS -
Henry Quant was just 5 years old and bedridden with chronic
fevers when he began taking pills for anxiety and
depression.
His mother
knew that the drugs helped, but they made her nervous.
"The
really scary part," Elizabeth Quant said, "is we
don't know what these do long term."
This summer,
under the watchful eye of his physician, Henry, now 7,
replaced his antidepressants with vitamins and learned some
stress-relief exercises to calm himself.
"Now
he's doing better and better," said his mother, who
lives with her husband, Shawn, and three children in south
Minneapolis. If Henry, a second-grader, starts to relapse,
his mother says she won't hesitate to change course. But
after two months, she's thrilled. "He's happy and he's
healthy, that's Henry."
At one time,
psychiatrists might have cringed at the thought of using
alternative medicine instead of "real" treatments
for mental health care. But a growing number of doctors are
adding herbs, nutritional supplements and meditation to
their arsenal of psychiatric drugs, as evidence mounts that
natural therapies can help. Even stalwarts of the medical
establishment, from the University of Minnesota to Allina
Hospitals & Clinics, are exploring ways to use mind-body
therapies to treat depression and anxiety.
In part, it's
an effort to recapture the human touch in mental health
care, which some say has been lost since antidepressants
became the most widely prescribed drugs in the land.
"I think
it is a backlash to the whole push for antidepressants, and
I think maybe a reasonable one," said Dr. Gary Oftedahl,
who helped design a depression treatment program for the
Institute for Clinical Systems Improvement, a Bloomington,
Minn., health policy group. "We've tried to medicalize
depression almost to the point of not looking at the simpler
things that can be done."
Few dispute
that antidepressants can be lifesavers, and that many people
are alive today because of them. Yet Sue Abderholden, who
heads the National Alliance on Mental Illness, Minnesota
chapter, said she is delighted to see more attention to
mind-body therapies. "We've never said a pill's going
to cure it. It just takes more than that."
FROM PASSIVE
TO ACTIVE
At Children's
Hospitals and Clinics of Minnesota, kids are being taught
how to manage depression and anxiety with everything from
scented oils to deep-breathing, exercise, prayer and
"quiet reflection."
"I think
people are fed up with having their kids medicated as the
only option," said Dr. Timothy Culbert, head of
integrative medicine at Children's, and Henry's doctor.
Last year,
Culbert co-wrote a series of self-care books for children
("Be the Boss of Your Body" by Free Spirit
Publishing) on ways to cope with pain, stress and sleep
problems - all linked to depression.
Several
patients have been able to get off medication, while others
have cut their dosage, Culbert said. His goal is to teach
kids to help themselves, not just passively receive therapy.
Henry Quant
started showing signs of depression at age 2. He had a rare
condition, called periodic fever syndrome, that caused
chronic high fevers and left him sad and listless. By the
time he was 5, his mother recalled, one bout of fever lasted
months. "He was so sick, and he didn't understand. He
was sobbing a lot."
Eventually,
doctors found a treatment - removing his tonsils and
adenoids - for the fevers. With antidepressants, the
youngster's spirits began to lift, his mother said.
This summer,
Elizabeth Quant took Henry to Culbert's integrative medicine
program. Culbert recommended vitamins, massages and other
calming therapies, as Henry's medication was tapered off.
The boy also
was taught self-help techniques. "One of them is to sit
quietly for about two minutes and just think of something
happy," his mother said. With those techniques, and a
strict diet-and-exercise routine, she says, "I believe
we have it under control now."
Dr. James
Gordon, a Harvard-trained psychiatrist, insists that many
people struggling with depression could do without
mood-changing drugs. But he says doctors have been cowed by
insurers and drug companies into writing prescriptions at
the first sign of depression.
"Many
feel trapped in a system that tells them their patients have
to be on drugs (or) they're not doing their job," said
Gordon, who heads the Center for Mind-Body Medicine in
Washington.
Gordon
travels the world preaching that depression isn't really a
disease, but a life out of balance. He makes that case in
his latest book, "Unstuck." In July, he brought
his message to a workshop in Minneapolis, hosted by Allina.
"The
dominant issue in depression in stress," he said.
"Why not teach people how to deal with stress?"
Gordon's solution: A mix of meditation, dance therapy, deep
breathing, exercise, herbs, nutritional supplements and
self-help strategies, which he has packaged into an
eight-week course.
"I do
not say never take antidepressants. What I say is,
antidepressants are a last resort, not a first choice,"
said Gordon. "It may turn out that it's far less
expensive, economically as well as humanly, to help people
help themselves." Most people have to pay for
alternative mental-health treatments out of pocket, because
insurers generally don't.
Snake oil or
happy medium
Dr. Paul
Goering, who heads Allina's mental health program, calls
himself a skeptic. To some fellow psychiatrists, he admits,
a treatment is no better than snake-oil if it's not
"exhaustively tested."
Yet he
invited Gordon to Minnesota to share his views as part of an
Allina project exploring alternative treatments in mental
health.
Goering notes
that there's growing evidence that practices such as yoga
and exercise can promote mental health. More studies are
underway, in Minnesota and around the country. "I think
we will be very cautious about introducing it," he
said. "But I think there's something there."
He's not
alone.
The Mayo
Clinic has been weaving mind-body therapies into all fields
of medicine, including psychiatry, for several years. Even
the University of Minnesota psychiatry department, which has
long focused on the biology of brain diseases, is taking a
fresh look at alternative medicine, said its chairman, Dr.
Charles Schultz.
"If it
leads to a better outcome, then I think it's our obligation
to look at it," he said.
His main
concern, he said, is that patients who really need
medication won't get it. Untreated depression, he notes, is
a leading cause of suicide. "I will not say that every
single person needs to start on an antidepressant medication
as soon as they describe feeling sad or hopeless," he
said. "On the other hand, we can't ignore how severe
depression is."
Dr. Jeffrey
Sawyer, a self-described holistic psychiatrist in St. Louis
Park, says the problem lies at the extremes - insisting
drugs aren't necessary, or that they're the only thing that
works.
"I
think," he said, "there's a happy medium in the
middle that blends both worlds."