Holistic Approach Provides Relief From Decades-Long Depression
June 08, 2021
Depression hit Shaynee Novak in high school, but it wasn’t until adulthood that she had a name for it. All she knew was that she felt different from her friends. They were able to take disappointments in stride, but Shaynee’s emotions were so big and intense; even little things never seemed little to her.
During her first two years of college, she continued to struggle with big emotions. She also started feeling like she didn’t fit in anywhere, even though she had close friends. The feeling of not belonging filled her with self-doubt and she retreated into herself.
“By my junior year, I couldn’t find any place where I felt good. I felt trapped inside myself,” Shaynee says. “It didn’t matter where I turned, I couldn’t escape the feeling of dread that seemed to have wormed its way into my entire being.”
That year, in the middle of winter quarter, Shaynee abruptly left her apartment at Ohio State University and drove to her parents’ house. She didn’t tell them she was coming and she doesn’t know how or why she decided to leave at that time.
“My actions were really hard to understand or explain because in 1993 depression wasn’t a term my parents or I had heard of yet,” she says. “Even with this unexpected trip home, there was no help sought. The best we could come up with is that I was just going through a hard time because my parents were divorcing.”
Feelings of not belonging and being trapped became Shaynee’s norm. She took the typical antidepressants, Zoloft and Prozac, for about 10 years. They initially helped and gave her a sense of relief, but eventually that relief waned.
Two days before her 40th birthday, Shaynee checked herself into an outpatient partial hospitalization program. During the 15-day program, she met with a psychologist and psychiatrist, both of whom she’d continue to work with for the next five to six years. Throughout those years, she tried many different cocktails of medicines for many different and sometimes incorrect diagnoses: depression, anxiety, insomnia, ADD and a host of others.
She found relief on and off during that time, but eventually the outcome was the same – everything stopped working.
The years 2016 and 2017 were so bad that Shaynee says she wanted to vanish, or run away, so that no one had to deal with her. She felt like she was the worst mom and wife and had nothing to offer her family except sadness and misery. At times the depression was so suffocating and unrelenting she hoped for a way out.
In October 2018, Shaynee stumbled upon an article about a possible new breakthrough medicine for depression: intravenous ketamine. It was in the trial stage and she was accepted into the program. The treatments helped some, but she was still feeling down most of the time and not sleeping.
Around this time, through tests ordered by one of her doctors, Shaynee discovered she has the MTHFR gene mutation, which is linked to a variety of health problems including depression and anxiety. Antidepressants don’t tend to work well for people with this mutation. That’s what sent Shaynee looking for an integrative specialist. She searched and found UH Connor Integrative Health Network and Kristin Kaelber MD, PhD.
At their first appointment in February 2020, Dr. Kaelber took a thorough history and ordered blood tests to get a baseline and try to determine where to start.
“Shaynee’s blood work revealed she had vitamin B12 and D deficiencies. Learning this is critical because people with depression can sometimes be helped when these levels are improved with supplementation,” Dr. Kaelber says. “But in my experience, patients do not improve from supplementation or pills alone. They must make a commitment to changing their daily habits if they want to have significant, substantial improvements. These lifestyle changes are much harder because patients must commit to changes in their daily habits rather than just taking a pill. Shaynee was up for the task and we worked together to make changes at her pace.”
Dr. Kaelber says the best treatment for depression involves delving into who the person truly is and applying a holistic approach. She believes Shaynee’s depression was being worsened by some of her lifestyle choices, so she started with educating her about how making certain changes could help her, especially in light of her MTHFR mutation. They began to address things like adding more fruits and vegetables into her diet, especially high-folate foods, getting enough exercise, working on strategies to sleep better without medication and beginning to quiet her mind with meditation. They even discussed Shaynee’s fondness for red wine and how she may benefit from cutting back.
“I almost didn’t go back after that first appointment. I couldn’t imagine implementing those lifestyle changes for a day, let alone a prolonged period of time. I don’t know who was more surprised that I came back for a second appointment – me or Dr. Kaelber,” Shaynee says.
After months of working with Dr. Kaelber, Shaynee has implemented many of her suggested changes, and she’s still working on others that she says she needs to do with more frequency. Shaynee exercises, meditates and takes vitamin supplements somewhat regularly. She has significantly cut back on alcohol and is doing her best to make better food choices. Shaynee continues to take antidepressants, and has decreased the frequency of her ketamine infusions. Shaynee calls applying Dr. Kaelber’s plan “an exercise in patience” for both of them. They both want Shaynee to succeed, yet acknowledge it can be a slow and not always steady process.
“It is Dr. Kaelber’s investment in my recovery and ability to understand my limitations that keep me coming back,” Shaynee says. “Her standard question as we discuss my goals between appointments is, ’What do you think you can comfortably do between visits to move you forward?’ ”
Today, at age 49, Shaynee has seen significant positive changes and has experienced the greatest number of “good days” of her adult life. She now sleeps through the night without medication. She credits Dr. Kaelber’s suggested modifications and finally addressing the depression with a holistic plan.
“Shaynee has had a beautiful transformation,” Dr. Kaelber says. “Instead of only taking medicine, she has worked very hard to treat her depression with changes to her lifestyle and her daily habits. This has resulted in an incredible outcome. She and her family are enjoying the benefits. I am so grateful to have been able to help.”
“It’s hard to believe with how I’m feeling now, that I felt so bad back then. It’s so distant,” Shaynee says. “All of these pieces work together to change the way I think. One piece wouldn’t have been enough, but I think all of it together is making me into the most mentally healthy person I have ever been.”