Me?? Depressed??

Depression is not generally considered a great problem in post polio.  Is it because we are so busy proving we can keep up with everyone else or is it just something we don't talk about.
 
HOW DO I KNOW IF I AM DEPRESSED?
 
According to "The Physician's Handbook of Clinical Nutrition" by H Osiecki 1998  - any 4 of the below symptoms occurring with moodiness for more than 2 weeks can be classed as depression.
 
SYMPTOMS
* emotional instability, irritable, excessive anger
* sleep disturbance
* loss of energy or fatigue
* lowered self esteem or lack of confidence
* thoughts of guilt, dwelling on the past, suicide
* loss of interest in ordinary pleasures & activities
* crying, pessimism, despair
* difficulty in performing tasks
* loss of weight or appetite
* difficulty concentrating or making decisions
 
Other sources paint the picture - silent, withdrawn, apathetic, anxious, fatigue, inactive, childishly helpless, feeling
useless, discarded, uncared for, burdensome.   At this rate we could all fit the bill sometimes!
 
CAUSES OF DEPRESSION
* tension & stress
* headaches & pain
* nutritional deficiencies
* digestive disturbances
* grain intolerance
* poor diet (incl too much sugar
* allergies
* thyroid disease/ diabetes
* winter seasons (low UV light)
* prescription and recreational drugs
* physical disorders (including lack of exercise)
 
Disability can predispose to depression simply because it reduces our ability to exercise!
 
Reduction in physical activity can lead to -
 #  reduced cardiovascular health
 #  reduced muscle & skeletal health
 #  obesity
 #  depression
 #  premature aging

EXERCISE
Exercise increases the production of endorphins in the body.  Endorphins alleviate pain, give the runner's "high" and increase feelings of happiness. (Laughter increases endorphin production too so having a good laugh helps to alleviate depression)
 
Exercise also increases catechalamine production.  These are neurotransmitters which include dopamine, noradrenaline and serotonin needed to combat depression.  (Anti-depressant drugs raise levels of these in the body too)
 
BRAIN NEUROTRANSMITTERS
Dopamine and noradrenaline increase alertness and so perk us up.  Protein foods, including red meat stimulates production of these brain neurotransmitters.  Vitamin B6, magnesium, carnitine, vitamin C are essential for these too.
 
Serotonin has the opposite effect.  It eases tension, calms the body and is derived from carbohydrate foods.  (serotonin production needs B6 and magnesium too.)  Serotonin is the precursor to melatonin production.
 
Again low melatonin leads to depression.  The reason winter and dull days are more depressing is that melatonin production is lowered with insufficient sunlight ( but needs dark at night to release it into blood stream.)  So spending time in the morning sun helps to lift depression.
 
Acetylcholine is another neurotransmitter that can cause depression if low.  Choline is a B vitamin needed for acetylcholine.  This is often low in polios experiencing increasing muscle weakness
 
Glutamine is a neurotransmitter that elevates brain function and improves mood. It increases mental alertness and is often low in post polio.  Where muscle function is under stress, glutamine may be used to supplement energy production, leaving insufficient for healthy brain function.

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