Journal of Evidence-Based Integrative Medicine

This two-part series presents an integrative model for understanding and treating depression, encompassing the biological, psychological, social, and spiritual levels of the human being. Major depressive disorder may be seen as a dysregulated form of an adaptive response. Theories regarding the adaptive functions of depression drawn from psychology, evolutionary biology, ethology, neuroendocrinology, dream research, the philosophies of naturopathy and homeopathy, and the spiritual traditions of the Native Americans and other cultures are reviewed and synthesized. This model provides the basis for the rational application of a variety of complementary and conventional therapies.

Depression, anxiety, and similar disorders are the most commonly encountered women’s health problems in Western countries with women experiencing higher rates of depression than men. Alternative and conventional medical practitioners are consulted for the treatment of mild to moderate and even severe depression perhaps more than any other mood and affective disorder, mood disorders being the primary emotional imbalance encountered in clinical herbal practice. The medical definition of depression provides a narrow parameter against which a wide range of human sadness and grief is measured and categorized. This unfortunately may lead to the inappropriate labeling, medicating, and potential stigmatization of many who appear to fit the diagnosis of depression and the marginalization and exclusion from diagnosis of those who do not necessarily fit neatly into this category, yet who truly suffer from this malady of emotion. The causes of depression are multifactorial. A truly comprehensive holistic approach must consider physical pathologicetiologies (e. g., endocrinologicdysregulation) as well as social, emotional, and psychological factors ranging from availability of support networks to issues of selfesteem, gender issues faced by women in contemporary times, socioeconomic factors, as well as diet, nutrition, and exercise levels. This article addresses many of these multifactorial issues, providing the reader with both evidence-based and traditional information on the use of complementary and herbal the rapeutic approaches to depression in women.

Severe depression is common during pregnancy. It is associated with more negative pregnancy outcome and is a risk factor for postpartum depression. Treatment options available for depressed women during pregnancy are limited. Preliminary data suggest acupuncture as an effective treatment for depression. This article presents a systematic and standardized approach to acupuncture treatment, and its implementation is demonstrated using two case reports selected from a larger pool of participants in an ongoing study testingthe efficacy of acupuncture in treating depression during pregnancy. Baseline characteristics and outcome are presented from the integrated perspective of Western psychiatry and Chinese medicine.