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9 ways to reduce the duration of the common cold

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9 ways to reduce the duration of the common cold

A common cold can make you feel tired, blocked up, sore and run down. Most colds improve on their own within about 7 to 10 days, but that does not mean you need to simply wait it out. Good self-care can help your body recover, ease symptoms and may help you feel better sooner.

It is important to be realistic. There is no instant cure for the common cold. Antibiotics do not help because colds are caused by viruses, not bacteria. The goal is to support your immune system, reduce symptom strain and avoid things that can slow recovery.

Start self-care as soon as symptoms appear

The first day or two of a cold matters. This is when symptoms often build and when your body is already using energy to fight the virus.

At the first signs of a sore throat, sneezing, runny nose or tiredness, slow down. Reduce non-essential activity, go to bed earlier and avoid pushing through a busy day if you can. Early rest may not “kill” the cold, but it can help your body use energy for recovery rather than stress, overwork and exhaustion.

Practical tips:

  • Cancel or postpone non-urgent tasks.
  • Keep warm and comfortable.
  • Avoid intense exercise while you feel unwell.
  • Work from home or rest at home if possible.
  • Start fluids, saline spray and throat care early.

Prioritise sleep and rest

Sleep is one of the most useful recovery tools you have. Your immune system works actively during sleep and being sleep-deprived can make it harder for your body to recover well.

Aim for extra sleep while you are unwell. If you cannot sleep for long stretches because of coughing or congestion, rest quietly during the day. Even short rests can reduce the load on your body.

Try this:

  • Go to bed earlier than usual.
  • Take a short nap if you feel drained.
  • Sleep slightly propped up if a blocked nose or cough is keeping you awake.
  • Avoid screens, alcohol and heavy meals close to bedtime.
  • Keep the bedroom comfortably cool, quiet and well ventilated.

Keep your fluids up

Fluids do not cure a cold, but they help your body function properly while it is fighting infection. Drinking enough can also help thin mucus, ease a dry throat and reduce the risk of dehydration if you have a fever.

Water is the best option. Warm drinks can also feel soothing, especially if your throat is sore or your nose is blocked.

Good options include:

  • Water
  • Warm water with lemon
  • Herbal tea
  • Broth or soup
  • Warm water with honey for adults and children over 1 year

Avoid too much alcohol because it can affect sleep and contribute to dehydration. If you are not passing much urine, feel dizzy or cannot keep fluids down, seek medical advice.

Use saline spray, drops or rinse for a blocked nose

A blocked nose can make sleep difficult and leave you feeling worse. Saline nasal sprays, drops or rinses can help moisten the nasal passages, loosen mucus and make breathing through your nose easier.

Saline is not a medicated decongestant, so it is often a gentle option for many people. Use it according to the product instructions. For babies and young children, ask a pharmacist or doctor about suitable saline drops and safe mucus-clearing methods.

Practical tips:

  • Use saline before bed to help with sleep.
  • Use it before meals if congestion is affecting appetite.
  • Choose drops for young children rather than strong sprays.
  • Use sterile or previously boiled and cooled water if preparing a rinse, and follow hygiene instructions carefully.

Soothe your throat and cough

Tips for reducing a cold

A sore throat and cough can interrupt sleep, and poor sleep can make recovery feel harder. Soothing the throat may help you rest better.

For adults and children over 1 year, honey may help calm a cough. You can take a teaspoon of honey on its own or stir it into warm water. Do not give honey to babies under 12 months because of the risk of infant botulism.

Other options include:

  • Gargling warm salty water for a sore throat
  • Sucking on ice chips or ice blocks
  • Using throat lozenges if age-appropriate
  • Drinking warm fluids
  • Avoiding smoke, vaping and strong fumes

Do not give lozenges or hard sweets to young children because they can be a choking risk.

Use warm moisture safely

Warm moisture may help loosen mucus and soothe irritated airways. This can make you feel more comfortable while your body recovers.

You can try:

  • A warm shower
  • Sitting in a steamy bathroom
  • A clean cool-mist humidifier
  • Warm drinks to soothe the throat

Be careful with steam from bowls of hot water because burns can happen, especially in children. A steamy bathroom or shower is usually safer than leaning over boiling water. If using a humidifier, clean it regularly so it does not spread mould or germs

Use symptom-relief medicine safely

Pain, fever, headache and sinus pressure can make a cold feel much worse. Over-the-counter medicines such as paracetamol or ibuprofen may help relieve discomfort, but they do not cure the cold.

Use medicines carefully:

  • Follow the dose instructions on the packet.
  • Do not take more than one product containing paracetamol at the same time.
  • Ask a pharmacist before using combination cold and flu products.
  • Avoid aspirin in children and teenagers unless a doctor has specifically advised it.
  • Check with a pharmacist or doctor before using ibuprofen if you have asthma, kidney disease, stomach ulcers, heart disease, are pregnant or take blood-thinning medicine.

Decongestant nasal sprays can help a blocked nose for a short time, but they should not be used for more than a few days unless advised. Overuse can cause rebound congestion, where the nose becomes blocked again when the medicine wears off.

Tips for reducing a cold

Consider zinc early, but be cautious

Zinc is one of the few supplements with some evidence that it may shorten an ongoing cold if taken early. The evidence is not strong enough to call it a cure, and it may cause side effects such as nausea, stomach upset, mouth irritation or an unpleasant taste.

If you want to try zinc, speak to a pharmacist first, especially if you are pregnant, breastfeeding, have a medical condition or take regular medicines. Timing matters. It is usually discussed as something started within the first 24 hours of symptoms, not several days into the cold.

Important safety notes:

  • Do not exceed the recommended dose on the product.
  • Do not take zinc long-term unless advised.
  • Avoid zinc nasal sprays or gels unless specifically recommended by a health professional.
  • Stop taking zinc if it causes troublesome side effects.

Food sources of zinc include seafood, meat, poultry, dairy foods, eggs, legumes, nuts, seeds and wholegrains.

Eat simply and support your recovery

You do not need a perfect diet when you have a cold. The aim is to give your body enough energy, protein and nutrients without making meals difficult.

Choose easy, nourishing foods such as:

  • Soup with vegetables and chicken, lentils or beans
  • Eggs on toast
  • Yoghurt with fruit
  • Oats with banana
  • Rice or noodles with vegetables and protein
  • Smoothies if chewing feels difficult
  • Citrus fruit, berries, kiwi fruit, capsicum and leafy greens for vitamin C

Vitamin C is important for immune function, but taking high doses after a cold starts is unlikely to make symptoms disappear quickly. It is better to focus on regular vitamin C-rich foods as part of your usual diet rather than relying on last-minute megadoses.

If your appetite is low for a day or two, focus on fluids and small meals. If you cannot eat or drink properly, or a child is not feeding well, contact a doctor.

What not to do when you have a cold

Avoid these when you have a cold

Some choices can make recovery harder or increase risk.

Avoid:

  • Taking antibiotics unless prescribed for a bacterial infection
  • Pushing through intense exercise while unwell
  • Smoking or vaping
  • Drinking alcohol to “help sleep”
  • Mixing multiple cold and flu medicines without checking ingredients
  • Giving adult cold medicines to children
  • Giving honey to babies under 12 months
  • Ignoring symptoms that are severe, worsening or unusual

When to contact your doctor

Colds - when to contact a doctor

Most mild colds can be managed at home. However, you should contact your doctor if symptoms do not improve, are getting worse or feel severe.

Seek medical advice if you or your child has:

  • Symptoms that are not improving after a few days
  • Symptoms lasting more than 10 days without improvement
  • Fever that lasts more than a few days
  • Trouble breathing, wheezing or chest pain
  • Signs of dehydration
  • Severe headache, neck stiffness or rash
  • Vomiting that continues
  • Difficulty eating or drinking
  • A cough that improves then suddenly worsens again
  • A chronic condition such as asthma, COPD, diabetes or heart disease
  • A baby under 3 months with a fever

If breathing is difficult, chest pain is severe or you are worried it may be an emergency, seek urgent medical help.

Key takeaway

You cannot force a cold to disappear overnight, but you can support your body with rest, fluids, sleep, nasal care, throat soothing and safe symptom relief. Zinc may help some people when started early, but it is not suitable for everyone. If symptoms do not improve, become severe or you are worried, always contact your doctor.

References

Abuelgasim H, Albury C, Lee JJ. (2021). Effectiveness of honey for symptomatic relief in upper respiratory tract infections: a systematic review and meta-analysis. BMJ Evidence-Based Medicine, 26(2), 57-64. doi: 10.1136/bmjebm-2020-111336

Centers for Disease Control and Prevention. (2026). Manage common cold. CDC.

Healthdirect Australia. (2024). Colds. Healthdirect Australia.

Healthdirect Australia. (2025). Medicines for colds, flu (influenza) and COVID-19. Healthdirect Australia.

Hemilä H, Chalker E. (2013). Vitamin C for preventing and treating the common cold. Cochrane Database of Systematic Reviews, 2013(1), CD000980. doi: 10.1002/14651858.CD000980.pub4

Nault D, Machingo TA, Shipper AG, Antiporta DA, Hamel C, Nourouzpour S, Konstantinidis M, Phillips E, Lipski EA, Wieland LS. (2024). Zinc for prevention and treatment of the common cold. Cochrane Database of Systematic Reviews, 2024(5), CD014914. doi: 10.1002/14651858.CD014914.pub2

Oduwole O, Udoh EE, Oyo-Ita A, Meremikwu MM. (2018). Honey for acute cough in children. Cochrane Database of Systematic Reviews, 2018(4), CD007094. doi: 10.1002/14651858.CD007094.pub5

Last reviewed and updated: 18 June 2026

8 ways to stop a panic attack

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Summary

A panic attack can feel overwhelming, but it is usually a temporary surge of the body’s alarm system. 

The most helpful approach is to check for medical danger, name the panic, slow the breath, ground in the present, stop scanning symptoms, relax the body, use steady self-talk and let the wave pass. 

If panic attacks keep happening, professional support can make a major difference.

Panic attacks can feel frightening, but they will pass

A panic attack is a sudden wave of intense fear or discomfort that can make the body feel out of control. It may cause a racing heart, chest tightness, shortness of breath, dizziness, shaking, sweating, nausea, tingling, hot flushes or a strong fear that something terrible is about to happen. For many people, the most frightening part is not knowing whether it is panic or a medical emergency.

Panic attacks are common and treatable. They are not a sign of weakness, and they do not mean a person is “going crazy”. They happen when the body’s threat system switches on too strongly, even when there is no immediate danger. This can create a loop where physical sensations feel scary, the fear increases and the symptoms become stronger.

The aim during a panic attack is not always to stop it instantly. A more realistic goal is to reduce the fear response, steady the body and remind the brain that the wave will pass. The following strategies can help many people move through a panic attack more safely and with less fear.

First, check that it is safe to treat it as panic

Panic attacks can feel similar to serious medical problems, especially heart, breathing or neurological symptoms. Call triple zero (000) for an ambulance if chest pain is severe, new or spreading to the arm, jaw, back or shoulder, or if there is fainting, severe breathlessness, confusion, weakness on one side of the body, blue lips, collapse or symptoms that feel different from a usual panic attack.

A person should also seek medical advice if they have never had a panic attack before, if attacks keep happening, if symptoms are changing or if they are avoiding normal activities because of fear of another attack. A GP can help rule out physical causes such as heart problems, asthma, thyroid disease, diabetes, medication effects, substance use or inner ear problems.

Name what is happening

The first step is to identify the attack without judging it. Try saying:

“This is a panic attack. It feels awful, but it will pass”

Naming the experience can reduce the extra fear that comes from thinking something catastrophic is happening.

This works because panic often grows when symptoms are misread as danger. A racing heart may be interpreted as a heart attack. Dizziness may be interpreted as fainting. Shortness of breath may be interpreted as suffocation. Labelling the experience as panic helps interrupt that fear cycle.

A simple phrase can help:

“I am having a panic attack. My body is in alarm mode. I do not need to fight it”

Slow the breath without forcing it

Slow breath technique Explained

During a panic attack, breathing may become fast, shallow or irregular. This can worsen dizziness, tingling, chest tightness and feelings of unreality. The aim is not to take huge breaths, as this can make symptoms worse. The aim is to breathe slowly and gently.

Try this:

Breathe in through the nose for 3 to 4 seconds.

Breathe out slowly for 4 to 6 seconds.

Let the shoulders drop as you breathe out.

Repeat for 1 to 3 minutes.

If counting makes the panic worse, use a simpler cue:

“soft breath in, long breath out”

The out-breath is especially useful because it helps signal to the nervous system that the body can move out of high-alert mode.

Ground yourself with the 5-4-3-2-1 technique

Grounding brings attention back to the present moment. This is useful because panic often pulls attention inward, making every heartbeat, breath and body sensation feel threatening.

Try naming:

5 things you can see

4 things you can feel

3 things you can hear

2 things you can smell

1 thing you can taste

This technique gives the brain a structured task and reminds it that the current environment is safer than the panic response suggests. It can be done silently, out loud or with another person guiding you.

Stop checking every symptom

It is natural to scan the body during a panic attack, but constant checking can keep the alarm system switched on. Repeatedly checking the pulse, testing the breath, searching symptoms online or asking “am I okay?” over and over can briefly reassure the mind, then restart the fear cycle.

Instead, try shifting from monitoring to allowing:

“I notice my heart is racing, and I am going to let it race while I breathe slowly.”

“I notice dizziness, and I am going to sit safely and let it pass.”

“I do not need to solve every sensation right now.”

This does not mean ignoring medical warning signs. It means that once emergency symptoms have been ruled out or the attack is familiar, symptom-checking is usually less helpful than grounding, breathing and reassurance.

Relax one part of the body at a time

Relax one part at a time

Panic often tightens the jaw, shoulders, chest, hands, stomach and legs. Progressive muscle relaxation can help the body move out of threat mode.

Try this quick version:

Press both feet into the floor for 5 seconds, then release.

Squeeze the hands gently for 5 seconds, then release.

Lift the shoulders towards the ears, then let them drop.

Unclench the jaw and rest the tongue on the floor of the mouth.

Soften the stomach on the next exhale.

The point is not to become perfectly relaxed. The point is to send the body small signals of safety. If tensing muscles makes symptoms feel worse, skip the tensing part and simply soften each area one at a time.

Use a steady coping statement

Panic attacks often come with frightening thoughts such as “I cannot cope”, “I am going to die”, “I will lose control” or “I need to escape right now”. A coping statement gives the mind something steadier to hold onto.

Helpful examples include:

“This is uncomfortable, not dangerous.”

“This is a wave. It will rise, peak and fall.”

“I have felt this before and it passed.”

“I can let my body do this without fighting it.”

“I do not have to feel calm to be safe.”

Repeat one phrase slowly while breathing out. It may not remove the panic straight away, but it can stop the fear from escalating.

Change your focus with a simple task

Once the first intense wave starts to settle, a small task can help the brain move out of panic mode. Choose something simple, familiar and non-demanding.

You could:

Count backwards from 100 by threes.

Name all the blue objects in the room.

Fold a towel slowly.

Sip water.

Step outside and describe what you can see.

Walk slowly around the room.

Listen to a familiar song.

The task should be calming rather than frantic. The aim is to redirect attention, not to run away from the panic. Avoid rushing, pacing aggressively or doing anything unsafe, especially if you feel dizzy.

Let the attack finish instead of fighting it

One of the hardest but most useful skills is learning not to fight the panic attack. Telling yourself “stop panicking” can sometimes increase pressure and make the symptoms feel more dangerous. Panic usually settles more easily when the person stops wrestling with it and lets the body complete the alarm response.

Try thinking of the attack as a false alarm:

“My body is trying to protect me, but there is no immediate danger.”

“The alarm is loud, but it is not an emergency.”

“I can ride this out.”

When the panic begins to ease, do not immediately analyse everything that happened. Give the body time to recover. Drink water, sit quietly, stretch gently or return slowly to what you were doing.

What to do after a panic attack

After a panic attack, people often feel tired, shaky, embarrassed or worried about the next one. This is common. It can help to write down what happened in a neutral way:

Where was I?

What was I thinking before it started?

What body sensations did I notice first?

What helped even a little?

Did I avoid anything afterwards?

This can reveal patterns without turning the attack into something to fear. It can also be useful to discuss with a GP or psychologist.

How to reduce future panic attacks

Reduce future panic attacks

Panic attacks are more likely when the nervous system is already under strain. Sleep loss, high stress, illness, excess caffeine, alcohol, some drugs, skipped meals and ongoing worry can all make panic more likely in some people.

Helpful prevention strategies include:

Getting enough sleep where possible.

Eating regular meals.

Reducing caffeine if it triggers symptoms.

Moving the body regularly.

Practising slow breathing when calm, not only during panic.

Reducing avoidance gradually.

Talking to a GP or mental health professional if attacks are recurring.

Cognitive behavioural therapy, often called CBT, is one of the best-studied psychological treatments for panic disorder. It can help people understand the panic cycle, reinterpret body sensations, reduce avoidance and gradually face feared situations safely. Some people may also benefit from medication, such as an SSRI or SNRI, especially if panic attacks are frequent, severe or occur with depression or another anxiety disorder. Medication decisions should always be made with a doctor.

When to see a doctor

See a GP or health professional if panic attacks happen more than once, come without a clear trigger, cause ongoing worry, affect sleep or stop you from driving, working, exercising, socialising or leaving home.

Seek urgent help if panic symptoms come with thoughts of self-harm, feeling unsafe, severe depression, substance misuse or fear that you might hurt yourself or someone else.

In Australia, call triple zero (000) if there is immediate danger.

Lifeline is available on 13 11 14, text 0477 13 11 14 or online chat if someone is overwhelmed, in crisis or needs immediate emotional support.

References

  • Andrews G, Bell C, Boyce P, Gale C, Lampe L, Marwat O et al. Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the treatment of panic disorder, social anxiety disorder and generalised anxiety disorder. Australian & New Zealand Journal of Psychiatry. 2018;52(12):1109-1172. doi: 10.1177/0004867418799453

  • Banushi B, Brendle M, Ragnhildstveit A, Murphy T, Moore C, Egberts J et al. Breathwork interventions for adults with clinically diagnosed anxiety disorders: a scoping review. Brain Sciences. 2023;13(2):256. doi: 10.3390/brainsci13020256

  • Beyond Blue. Panic disorder and panic attacks. Beyond Blue. Accessed 17 June 2026.

  • Centre for Clinical Interventions. When panic attacks. Government of Western Australia, Department of Health. Updated 2026.

  • Healthdirect Australia. Panic attacks and panic disorder. Healthdirect Australia. Accessed 17 June 2026.

  • Kaczkurkin AN, Foa EB. Cognitive-behavioral therapy for anxiety disorders: an update on the empirical evidence. Dialogues in Clinical Neuroscience. 2015;17(3):337-346. doi: 10.31887/DCNS.2015.17.3/akaczkurkin

  • Lampe L. Drug treatment for anxiety. Australian Prescriber. 2013;36(6):186-189. doi: 10.18773/austprescr.2013.076

  • Muhammad Khir S, Wan Mohd Yunus WMA, Mahmud N, Wang R, Panatik SA, Mohd Sukor MS et al. Efficacy of progressive muscle relaxation in adults for stress, anxiety and depression: a systematic review. Psychology Research and Behavior Management. 2024;17:345-365. doi: 10.2147/PRBM.S437277

  • National Institute for Health and Care Excellence. Generalised anxiety disorder and panic disorder in adults: management. Clinical guideline CG113. Updated 7 May 2024.

  • Pompoli A, Furukawa TA, Imai H, Tajika A, Efthimiou O, Salanti G. Psychological therapies for panic disorder with or without agoraphobia in adults: a network meta-analysis. Cochrane Database of Systematic Reviews. 2016;4(4). doi: 10.1002/14651858.CD011004.pub2

Last reviewed and updated: 17 June 2026

Eczema

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Eczema

Facts

What is eczema

Eczema is an itchy, chronic inflammation of the skin that causes it to become red, scaly and dry. The dry skin is then very vulnerable to infection from viruses and bacteria, which increases when the skin is scratched.

Eczema often occurs in infants and children and it can resolve on its own, but not in every case. Eczema can also occur for the first time in adults too. Science really is not sure what causes eczema and while there is no cure for eczema, treatment can reduce symptoms significantly in some people and help prevent further outbreaks.

There are a few different types of eczema

  • Atopic eczema – the most common type of eczema, especially in children which displays all the symptoms of eczema and can appear anywhere on the body
  • Dyshidriotic eczema – affects the palms of the hands and soles of the feet which usually produces blisters that contain fluid and are surrounded by a red rash; this condition starts before the age of 40
  • Nummular (descoid) eczema – red, itchy and inflamed round-shaped lesions form on the arms and legs; most common in older people or those adults with very dry skin
  • Seborrhoeic eczema – this is an eczema of the scalp which can affect both babies and adults
    • Adult seborrhoeic eczema – this affects adults and starts with the scalp being affected and then starts to affect the face
    • Infant seborrhoeic eczema – this is also known as cradle cap and is a very common condition affecting babies in their first year of life

Facts about eczema

  • Eczema is an inflammation of the skin which causes the skin to get itchy and dry
  • The skin has a “red” inflamed appearance where the eczema occurs
  • Eczema is derived from the Greek word that means ‘to boil over’
  • Eczema is also known as atopic dermatitis
  • Eczema affects men and women equally
  • It is not just children who develop eczema, adults can develop it too
  • It is important to treat eczema when it first occurs, especially if symptoms are mild, to prevent it from getting any worse
  • Eczema is not contagious, no matter how severe it is
  • Skin that is affected with eczema may be more susceptible to other types of infections
  • People with eczema usually have family members who have a history of eczema, or other allergic conditions such as asthma, allergic rhinitis (hay fever) or allergies
  • Eczema can affect just a small part of the body and cause relatively mild symptoms (mild eczema) or it can be more widespread, causing more severe and debilitating symptoms
  • Use natural, mild (or hypoallergenic) soaps with as little chemicals as possible to avoid drying out and irritating the skin
  • Avoid the allergen triggers that may cause eczema – these may be different for each person, but usually harsh chemicals are a problem for eczema sufferers
  • Avoid highly perfumed soaps, lotions and skin products as these may irritate the skin and exacerbate eczema symptoms
  • Wear clothes made of natural fibres
  • Wear gloves when washing dishes, clothes or cleaning
  • Use non-perfumed and natural clothes detergents and fabric softeners, as the chemicals in conventional clothes detergents may irritate the skin and cause an exacerbation of symptoms
  • Go swimming in the ocean, as seawater, having a high composition of salt is known to alleviate eczema symptoms
  • Eczema may not be cured (in most people), but the symptoms can be greatly reduces if a variety of treatment approaches are used concurrently

Symptoms

Symptoms of eczema

General symptoms of eczema

  • Blisters – small blisters can form, which ooze a liquid, if the skin is inflamed enough and especially if it has been scratched repeatedly
  • Crusty skin – once the blisters form, a crust then forms over them to help them heal
  • Itchy skin – this is the main symptoms of eczema, which generally identifies a rash as eczema. The need to scratch the affected areas is very strong
  • Lighter or darker skin tone – the eczema affected areas may become lighter or darker than the surrounding skin due to the eczema, as these areas have less pigment (known as lichenification)
  • Redness of the skin – the skin with the eczema is more red and inflamed due mainly to the scratching of the affected areas
  • Thickening of the skin – this occurs on the skin which has been inflamed for a while, usually due to the repeated scratching of the affected areas

Most common areas of the skin to be affected by eczema

  • Ankles
  • Behind the knees
  • Face
  • Feet
  • Hands
  • Neck
  • The inner part of the elbow
  • Upper chest
  • Wrist

Uncommonly, eczema can also affect the skin around the eyes, including the eyelids. If this area is scratched, it can cause redness and swelling around the eyes and can also sometimes cause patchy loss of eyebrows and lashes.

Causes

Causes of eczema

Science has not yet discovered the cause of eczema, but at this stage, it is believed that a malfunctioning immune system may play a big role in initiating eczema symptoms.

There are a number of triggers for precipitating eczema in those who are susceptible to this condition:

Genetics

Research shows that children with a family history of either eczema (or asthma or allergic rhinitis) are also more likely to develop eczema either in childhood or as adults. In addition to this, if there are family members with any of these conditions, it is another factor in likelihood of developing eczema too.

In addition to genetics, it seems that eczema is precipitated by two specific factors:

Allergens

Research suggests that many cases of eczema are caused, at least in part, to an allergic reaction to a substance, which is known as an allergen. Underlying this allergic reaction is a faulty immune system, which does not recognise the allergen as harmless and over-reacts with eczema symptoms. The most common allergens include: food, medication, dust, pets, plants, rubber, nickel.

Irritants

Research suggests that many cases of eczema can also be caused, at least in part, to an irritant that touches the skin. This causes the immune system to over-react and produce eczema symptoms. The most common irritants to the skin that can produce eczema on the skin include: environmental chemicals, laundry powders (or liquids), skin care lotions (or creams), dish washing liquids, laundry softeners, cleaning products.

Prevention

Prevention of eczema

Non-preventable risk factors

Eczema may be unpreventable in certain circumstances:

  • Age – a high proportion of eczema cases seen by doctors are in infants and young children; approximately 65% of all eczema cases occur in infants under the age of one and about 90% of all eczema cases occur in children under the age of five
  • Family history – people with other family members who have eczema or other allergic conditions such as asthma or allergic rhinitis are more likely to develop eczema than people with no family history of these conditions. Genetics seems to play a big role in the development of eczema

Preventable risk factors

There may be ways to prevent eczema from occurring or at least reduce occurrence and severity of symptoms:

  • Avoid the allergens – people who have eczema due to an allergic reaction to a specific allergen need to identify the allergen and avoid it as much as possible, to prevent recurrence of symptoms
  • Avoid the irritants – people who have eczema due to a reaction to a specific irritant need to identify the irritant and avoid it as much as possible, to prevent recurrence of symptoms
  • Breastfeed babies – some recent studies suggest that babies which are breast-fed for at least six months after birth are less likely to have babies and children that develop eczema or any type of allergic condition
  • Good nutrition – recent research suggests that certain deficiencies in certain nutrients may be a risk factor for the development of eczema. Specifically, the research suggests that deficiency in the omega-3 essential fatty acids can cause eczema to occur and this deficiency starts with the pregnant and lactating mother, who if she is deficient in these nutrients, can risk her child developing eczema as a result
  • Inadequate humidity – people living in an environment with a low humidity climate are more likely to be at risk for developing eczema, as the dryness in the air can dry out the skin, leaving it open to developing eczema
  • Reduce stress – studies show that stress can aggravate eczema or initiate it in infants, children and adults

Complications

Complications of eczema

In general and in most cases, eczema does not pose many complications other than annoying symptoms, but in some cases complications can arise, especially if the eczema is severe, or undiagnosed and untreated for a long time:

  • Depression – some people with severe eczema (or scars due to eczema) may not feel comfortable showing their eczema-affected skin in public, especially if it affects their face and other prominent body parts. If the feelings of isolation continue, this can then develop into a low mood and feelings of depression, which need further medical attention. People with severe eczema need to get appropriate treatment in order to reduce their symptoms so that flare-ups of the condition are reduced
  • Scar formation – if the eczema rash is scratched too often, this can cause the skin to develop further even inflammation and redness, making the symptoms worse. Subsequent blisters, lumps and nodules that form may develop into scars and these may be permanent
  • Skin infection – the eczema affected skin is more susceptible to any type of bacterial infection because in many cases, the skin has cracks, blisters and other openings which the bacteria can enter. Severely affected skin with eczema needs appropriate treatment to prevent this complication

Diagnosis

When to see a doctor about eczema

Many cases of eczema start in babies and infants (approximately 65% of all cases), so if your baby has a rash and eczema is suspected, then a doctor should be consulted for a diagnosis and appropriate treatment plan. Children are also quite susceptible to eczema, so any new rash in a child without fever or other visible symptoms should be taken to a doctor for diagnosis.

Adults with any of the symptoms of eczema should visit a doctor in order to diagnose this condition and get advice on an appropriate treatment plan. There are a number of options for treatment, both conventional and alternative and your doctor will advise which options are available and safe for your situation.

Diagnosis of eczema

Initial diagnosis of eczema is through the following tests:

  • Medical history of symptoms – the doctor will take notes on the duration and severity of symptoms. The doctor will also ask a series of questions about your personal history and your family history of conditions such as allergic rhinitis, asthma and eczema. The doctor may also ask questions about your exposure to environmental chemicals, cleaning and laundry products and other factors, to determine if this rash is due to an irritant or an allergen, as this is important in a determining treatment plan
  • Physical examination – the doctor will review all the areas of the rash on the skin to determine if it is eczema or if the symptoms present another condition

Diagnostic tests

If the doctor suspects that an allergen may be the cause of the eczema, the following test may also be requested:

  • Allergy (‘skin prick’) test – this involves pricking the forearm with a very small needle and allowing some of the allergen into the skin. This is done many times with various allergens that the allergy specialist uses (including dust and pet hair brought from home) to determine if an allergy exists to a particular substance. Usually, if an allergy to the substance occurs, it will cause the skin pricked to form a welt, rash or lump. The allergy specialist (or immunologist) will have taken note of each substance used to enable determination of the substances that cause the allergic response

Treatment

Conventional treatment of eczema

Conventional treatment of eczema involves a combination of avoiding the allergen (or irritant) to prevent flare-ups from occurring in the first place, other lifestyle modifications, together with medication for treating any flare-ups of symptoms. There are also some newer forms of therapy to treat eczema, which are also described.

Prevention – reduce exposure to allergens

  • Allergy testing – if it has been determined that the eczema is caused by an allergic reaction to specific allergens.
  • Avoid the allergen(s) – it is advisable to avoid any known allergens which can trigger eczema symptoms. Commonly known allergens which should be avoided are: pollen, dust mites and animal dander

Prevention – reduce exposure to irritants

  • Avoid the irritant – it is advisable to avoid any of the known irritants which can trigger the eczema symptoms. Commonly known irritants which should be avoided are: certain fabrics (especially wool), perfumes, cosmetics, cleaning products, soap, shampoo, environmental chemicals, cigarette smoke
  • Identify the irritant – it is advisable to take note of any worsening of symptoms after application of lotions and creams, or exposure to any environmental chemicals, certain fabrics as well as any other known irritants. This will help to identify the irritants and will enable avoidance of the irritant

Lifestyle modifications

  • Avoid having hot baths or showers – very hot water can aggravate the eczema symptoms by creating further inflammation and should be avoided. When eczema symptoms are visible on the skin, have a lukewarm bath or shower and bathe as quickly as possible, as the warm water will dry the skin out further and this can make the symptoms of eczema worse
  • Don’t scratch the eczema – avoid scratching or rubbing the eczema lesions/lumps/blisters as this will only make the itchiness worse, will inflame the skin further and will make symptoms worse and possibly spread the eczema over a larger area of the skin
  • Moisturise the skin – it is really important to reduce the dryness of the skin, especially after having a bath or shower. Moisturise the skin every day with a gentle, mild moisturiser that is as natural as possible (most organic skin care products contain less chemicals and are less likely to irritate the skin, but try to use one without too many perfumes as that can irritate the skin)
  • Protect the skin – in order not to irritate the eczema affected skin, it is advisable to wear light, natural fibres (not wool, unless it is lined) as this can protect the skin from rough material fibres from irritating the skin
  • Reduce stress – research suggests that stress can aggravate eczema flare-ups, so it may be beneficial to engage in stress management techniques

Helpful hints for parents of children with eczema

Babies, infants and young children tend to present with most cases of eczema and the following is useful some advice for parents:

  • Cut fingernails – always keep the child’s fingernails very short to prevent the child from being able to scratch the eczema lesions too much and make symptoms worse
  • Keep the child cool – hot weather, hot baths, hot showers and hot climates will aggravate eczema symptoms, so always bathe the child in lukewarm water (using mild, natural soap, but as little as possible) and cool the child in hot temperatures with a wet facecloth, dabbed gently on the child’s pulse points
  • Use natural moisturisers/oils – try to use only natural skin care products on the child, which have less irritant chemicals that may be better tolerated by the child’s skin and not cause further aggravation of symptoms. Consult your doctor on finding the best type of moisturisers and oils for your child

Medication

There are a number of different types of medications used to remedy the different types of symptoms associated with eczema:

  • Antibiotics – your doctor may prescribe antibiotics if aggravation of the eczema by scratching has caused a bacterial skin infection or an open sore. Your doctor may prescribe the antibiotics either for a short duration to treat a current infection or for a longer to treat a long-standing infection and to prevent recurrence of infection
  • Antihistamines – if the itching symptoms are really severe and unbearable, your doctor may prescribe oral antihistamines tablets to prevent the urge to scratch the skin and worsen the eczema symptoms. Antihistamines can cause drowsiness, so should not be used if you are driving or operating machinery, but can be useful if taken before you go to sleep as they will make you sleepier
  • Corticosteroid creams or ointments – your doctor may prescribe corticosteroid cream or ointment, which help to relieve itching and other associated symptoms, such as scaling and thickening of the skin. Some corticosteroid creams are available over-the-counter. Your doctor will advise you which type of creams are the best for your symptoms and will explain all the possible side effects from long-term use of these creams or ointments (which include skin irritation and discolouration, thinning of the skin and possible skin infection)
  • Corticosteroid tablets – if the eczema is very severe, your doctor may prescribe corticosteroid tablets to be taken over a short-term. This medication reduces the inflammation in the skin, itchiness and helps to control symptoms to a more manageable level. While corticosteroids are an effective treatment option for very severe eczema, they are not viable over the longer term as they have serious side effects, including loss of calcium from the bones (osteoporosis), more infections, thinning of the skin, cataracts and high blood pressure
  • Immunomodulators – these are a newer class of medication which affect the immune system to stop it from causing the inflammatory symptoms, to help maintain normal skin and reduce flare-up of eczema symptoms. These medications can only prescribed by a doctor and are recommended to be only used where other treatments have failed or cannot be tolerated, as there is some concern about potential adverse effects on the immune system if used over a long term. This medication can only be used in children over the age of 12 and in adults
  • Medicated wet dressing – if the skin where the eczema lesions occur cracks open, your doctor may prescribe mildly astringent medicated wet dressing, which needs to be changed on a regular basis, to prevent infection

Phytotherapy (light therapy)

Phytotherapy is a newer type of therapy for eczema which involves treatment with ultraviolet light for mild to moderate eczema in children over the age of 12 and in adults. In phytotherapy, the eczema affected skin is exposed to controlled amounts of ultraviolet light for set periods, to reduce symptoms.

Phytochemotherapy (light therapy + chemotherapy)

In some people, phytotherapy alone is ineffective, so it can be combined with Psoralen, which is a type of chemotherapy medication to more effectively treat the eczema. In phytochemotherapy, the treatment is the same as in phytotherapy, except that in this type of therapy, the medication is taken in conjunction with the light therapy, to enable it to work better.

Alternative

Alternative/complementary treatment of eczema

Most of the lifestyle recommendations which are available in the conventional treatments for eczema are also recommended by alternative/complementary practitioners. In addition to those, there are also some other treatments recommended.

People with eczema who are taking any type of medication need to consult with their doctor before trying any of the treatment options recommended here, as there could be potential for adverse side effects especially in combination with medications.

Herbs

There are a number of excellent herbs which may help to provide relief for symptoms:

  • Aloe vera cream – the gel inside the leaves of the aloe vera plant is soothing and cooling, providing instant reduction in inflammation and relief from symptoms, providing potent anti-inflammatory and cooling effects
  • Calendula cream – the herb calendula, when made up into a cream is soothing and provides a great reduction in inflammation symptoms over the longer term and in addition to this, it moisturises the skin, reduces dryness and reduces severity of symptoms
  • Evening primrose oil – a cream that is made with evening primrose oil as the active ingredient is very effective at reducing the inflammation of eczema and reducing symptoms of itchiness, although it works even better when taken internally
  • Tea tree oil cream – this oil of this native Australian tree has potent anti-fungal, anti-bacterial and anti-viral properties, which means it will prevent infection and it also can reduce inflammation as it has cooling properties (especially if in a cream), providing relief of symptoms

Vitamins

There are a number of vitamins which may help to provide relief for symptoms:

  • Bioflavonoids – the antioxidant bioflavonoids should be used in conjunction with vitamin C to help reduce symptoms of inflammation associated with eczema, as well as to boost the function of the immune system to prevent future flare-ups
  • Vitamin A – numerous studies show that the antioxidant vitamin A is essential for ensuring the skin is healthy and elastic and the mucous membranes are not dried out, which helps to prevent flare-ups of symptoms
  • Vitamin B complex – studies show that the B vitamins are necessary for healthy skin and proper circulation in the body. The B vitamins also assists with the proper reproduction of the cells in the body (which is needed in renewing the cells in healing) and assists with providing proper nutrition for the nerves to reduce stress
  • Vitamin C – the potent antioxidant vitamin C works to relieve the symptoms of most types of eczema, but especially for dyshidriotic eczema, which responds very well to vitamin C supplementation. Vitamin C provides support for the immune system
  • Vitamin D – studies show that vitamin D is beneficial in treating the symptoms of eczema as it helps the skin to heal more quickly from any flare-ups. It can also be useful to use a cream with vitamin D on the skin affected with the eczema
  • Vitamin E – the potent antioxidant vitamin E is very beneficial for the skin as it helps to relieve the itching symptoms and helps to moisturise the skin, preventing it form drying out. In addition to this, vitamin E also provides potent support for the immune system. A cream with vitamin E is also beneficial for any type of skin condition, as it helps to reduce dryness, which is a major factor in eczema

Minerals

There are a number of minerals which may help to provide relief for symptoms:

  • Magnesium – the mineral magnesium helps to relax the body tissues, which means it may be helpful in reducing the stress and anxiety associated with inflammation and pain of eczema
  • Selenium – the potent antioxidant mineral selenium improves elasticity of all layers of the skin and may also assist with healing the skin more quickly from eczema flare-ups
  • Zinc – the antioxidant mineral zinc helps the tissues to heal more quickly and it also helps to reduce recurrence of symptoms. In addition to this, studies show that people who have eczema may have a deficiency of zinc, which could be a part of the reason for the recurrence of all the flare-ups

Other nutrients

There are a number of other nutrients which may help to provide relief for symptoms:

  • Alpha lipoic acid – the nutrient alpha-lipoic acid is a potent antioxidant, which provides major support for the immune system to help it function better. Studies show that an improperly functioning immune system may be the major reason behind the development of eczema, so supporting the immune system’s function may reduce incidence of flare-ups
  • Coenzyme Q10 – studies show that coenzyme Q10 helps to remove toxins from the body and provides support to the immune system to function more effectively
  • Evening primrose oil – many studies show that the gamma-linolenic acid (GLA) in evening primrose oil has potent anti-inflammatory properties and seems to assist with alleviating symptoms such as itchiness and redness as well as reducing severity and duration of flare-ups
  • Fish oil – the omega-3 essential fatty acids in fish oil have well documented anti-inflammatory properties and studies show that they may be useful for reducing itchiness, redness and inflammation associated with eczema flare-ups
  • Glutathione – the amino acid glutathione is potent antioxidant, which provides a big boost to support the immune system to help it function more effectively by normalising it and helping it to react more normally
  • Probiotics – it may be beneficial to take probiotics (such as acidophilus) as they help to populate the gastrointestinal system with friendly “good” bacteria and this prevents overgrowth of yeasts and “bad” bacteria in the body, reducing risk of infection in the eczema lesions

Dietary modifications

There are a number of dietary modification strategies which may help to provide relief for symptoms:

  • Eat more fibre – the diet should include plenty of wholegrains and other plant foods to help the colon eliminate toxins more quickly out of the body. Psyllium fibre (in the form of a powder added to foods) is often useful for this function as it is well tolerated by most people. Just make sure to add it a little at first, to get used to eating more fibre
  • Eat more oily fish – the diet should include 3 portions of oily fish (salmon, mackerel, sardines or trout) each week. These types of fish contain the highest levels of omega-3 fatty acids, which reduce inflammation and this may assist in reducing eczema symptoms
  • Eat more vegetables and fruit – as long as they do not aggravate symptoms, the diet should include 5-7 portions of vegetables and 2-3 servings of fruit each day. Vegetables and fruit are full of antioxidants, vitamins and minerals, plus because they are high in water, they help to keep the body hydrated and this may help to reduce dryness of the skin

Lifestyle modifications

There are a number of lifestyle modifications which may help to provide relief for symptoms:

  • Apply a cold compress – use plain cotton fabric which has been moistened with cold water to the area on the skin which is inflamed with the eczema. This simple remedy can provide immediate (albeit temporary) relief, but enough to reduce the worst of inflammation and itchiness
  • Avoid getting over-heated – high temperatures and sweating can cause an aggravation of symptoms in some people, so try to stay cool, use a cool compress to cool down the body and only touch the affected areas gently, to avoid aggravating the eczema symptoms
  • Avoid scented soaps & detergents – perfumed soaps, shampoos, detergents, laundry liquids, softeners, cosmetics and skin care are known to aggravate existing eczema. Always use non-scented, organic soaps, skin care, cosmetics, dishwashing and laundry detergents, as well as cleaning products which are milder on the easily inflamed skin and are less likely to cause a reaction (experimentation will be necessary to find the right soap and detergent). Always read the label and avoid products that have synthetic ingredients, especially perfume and other additives that can cause irritation
  • Avoid scratching the itch – by scratching the itchy patch(es) of eczema, it only makes it worse and increases the likelihood of developing worse symptoms and spreading the eczema over more area of the skin. Use one of the methods advised to reduce the symptoms to help avoid scratching the itchiness
  • Avoid the allergen(s) – it is advisable to avoid any known allergens which can trigger eczema symptoms. Commonly known allergens which should be avoided are: pollen, dust mites and animal dander
  • Avoid the irritant(s) – it is advisable to avoid any of the known irritants which can trigger the eczema symptoms. Commonly known irritants which should be avoided are: certain fabrics (especially wool), perfumes, cosmetics, cleaning products, soap, shampoo, environmental chemicals, cigarette smoke
  • Drink more water – drink around 8-10 glasses of water each day as this will help to hydrate the body and tissue and prevent skin from drying out
  • Limit exposure to sunshine – limit exposure to strong sunlight, as it can aggravate symptoms. Avoiding sunshine is an excellent way to help reduce inflammation and other symptoms associated with eczema
  • Reduce exposure to stress – any type of meditation or calming therapy that will help to reduce stress and anxiety will help to reduce symptoms as stress is known to aggravate symptoms
  • Stop smoking – studies show that nicotine can aggravate or even initiate some types of eczema (especially if there is an allergy to cigarettes). Do not smoke and do not be exposed to second-hand smoke from other people

Alternative treatments

  • Naturopath – a naturopath can help to identify the source of the allergens or irritants. In addition to this, a naturopath can provide a tailor-made treatment plan with herbs, vitamins and other nutrients to help reduce symptoms

Always ensure that you notify your medical practitioner of any supplements that you want to take – it may interfere with other medication or conditions you have. Confirm with your doctor it is safe to take before you try it.

Self care

Living with eczema

Management of eczema is achieved best by avoiding the allergens/irritants, reducing incidence of flare-ups, reducing symptoms and supporting the immune system to prevent recurrence:

Reduce severity of existing symptoms

  • Apply a cool compress – use plain cotton fabric which has been moistened with cold water to the area on the skin which is inflamed with the eczema. This simple remedy can provide a great deal of immediate (albeit temporary) relief, but enough to reduce the worst of inflammation and itchiness
  • Avoid having hot baths or showers – very hot water can aggravate the eczema symptoms by creating further inflammation and should be avoided. When eczema symptoms are visible on the skin, have a lukewarm bath or shower and bathe as quickly as possible, as the warm water will dry the skin out further and this can make the symptoms of eczema worse
  • Avoid scratching the eczema – by scratching the itchy patch(es) of eczema, it only makes it worse and increases the likelihood of developing worse symptoms and spreading the eczema over more area of the skin. Use one of the methods advised to reduce the symptoms to help avoid scratching the itchiness
  • Eat more fish – the diet should include 3 portions of oily fish (salmon, mackerel, sardines or trout) each week. These types of fish contain the highest levels of omega-3 fatty acids, which reduce inflammation and this may assist in reducing eczema symptoms
  • Moisturise the skin – it is very important to reduce the dryness of the skin, especially after having a bath or shower. Moisturise the skin every day with a gentle, mild moisturiser that is as natural as possible (most organic skin care products contain less chemicals and are less likely to irritate the skin, but try to use one without too many perfumes as they can irritate the skin)
  • Omega-3 fatty acids – many studies show that the omega-3 essential fatty acids DHA and EPA (in fish oil) and the omega-6 essential fatty acid GLA (in evening primrose oil) are very beneficial in helping to reduce the severity and incidence of symptoms in people with eczema. Always discuss supplementation with your doctor before trying it

Support the immune system to reduce flare-ups

  • Antioxidant minerals – there are several minerals which have a potent antioxidant and immune boosting function and they also boost the healing process to occur more quickly. The best minerals for this are: selenium and zinc. These minerals enable the immune system to function more effectively and this may prevent and reduce flare-ups and reoccurrence of symptoms. Seek advice from your doctor before trying them
  • Antioxidant vitamins – there are several minerals which have a potent potent antioxidant and immune boosting function, plus they may help to prevent the skin from drying out. The vitamins most beneficial are: bioflavonoids, vitamin A, vitamin C, vitamin D, vitamin E. A multivitamin is the best way to provide adequate intake of these vitamins. Seek advice from your doctor before trying them
  • Avoid the allergens – it is advisable to avoid the known allergens which can trigger eczema symptoms and cause flare-ups. Avoiding known allergens reduces incidence of flare-ups. Commonly known allergens to be avoided are: pollen, dust mites and animal dander
  • Avoid the irritants – avoid the known irritants which can trigger the eczema symptoms and cause flare-ups. Avoiding known irritants reduces incidence of flare-ups. Commonly known irritants to be avoided are: certain fabrics (especially wool), perfumes, cosmetics, cleaning products, soap, shampoo, environmental chemicals, cigarette smoke
  • Identify the allergens – it would be most beneficial for the immune system to identify the allergens which cause the eczema in order to avoid them so that the immune system has a break from constantly working to remove them from the body
  • Identify the irritants – it would be most beneficial for the immune system to identify the irritants which cause the eczema in order to avoid them so that the immune system has a break from constantly working to remove them from the body
  • Other supplements – there are a number of other supplements which have antioxidant properties that boost the function of the immune system or which have other functions to remove toxins from the body that help the function of the immune system. The nutrients most beneficial are: alpha-lipoic acid, co-enzyme Q10, glutamine, probiotics. Seek advice from your doctor before trying them
  • Reduce exposure to stress – research suggests that stress can aggravate eczema flare-ups, so it may be beneficial to engage in stress management techniques. This is beneficial in a number of ways, as stress reduction helps to boost the function of the immune system

Caring for someone with eczema

Partner

If you have a partner with eczema, there are a number of useful strategies you can use to help them:

  • Avoid using perfumed products – most type of skin care, cosmetics, laundry and cleaning products contain some types of perfumes and other abrasive chemicals, which can irritate sensitive skin prone to eczema. Find non-perfumed, natural alternatives
  • Don’t smoke – cigarette smoke is a known irritant to the skin and this could be one of the triggers for causing the eczema. Don’t smoke around your partner as their exposure to your second-hand smoke can be a trigger for their eczema
  • Help your partner moisturise – especially if the eczema is on the back or on areas of the skin that are harder to reach, it may be helpful if you can help them with moisturising these areas
  • Remove the allergens from the home – once the allergens that trigger the eczema have been identified, ensure they are not in the home to avoid exacerbating your partner’s eczema
  • Remove the irritants from the home – once the irritants that trigger the eczema have been identified, ensure they are not in the home to avoid exacerbating your partner’s eczema

Friends and family members

If you have a friend or family member with eczema, there are a number of useful strategies you can use to help them:

  • Avoid using perfumed products – most type of skin care, cosmetics, laundry and cleaning products contain some types of perfumes and other abrasive chemicals, which can irritate sensitive skin prone to eczema. Try to ensure you have not just cleaned your home just before your friend or family member is about to arrive and don’t use air fresheners either
  • Don’t smoke – cigarette smoke is a known irritant to the skin and this could be one of the triggers for causing the eczema. Don’t smoke around your friend or family member as their exposure to your second-hand smoke can be a trigger for their eczema

Parents

If you have a child with eczema, there are a number of useful strategies you can use to help them:

  • Apply a cool compress – use plain cotton fabric which has been moistened with cold water to the area on the skin of your child which is inflamed with the eczema, but do not rub or press hard as this will cause pain. This simple remedy can provide a great deal of immediate (albeit temporary) relief, which is enough to reduce the worst of inflammation and itchiness on your child’s skin. If the child is old enough, you can teach them how to do this too (instead of scratching their skin)
  • Avoid using perfumed products – most type of skin care, cosmetics, laundry and cleaning products contain some types of perfumes and other abrasive chemicals, which can irritate sensitive skin prone to eczema. Find non-perfumed, natural alternatives
  • Bath and shower in tepid water – ensure you bathe (or shower) your child in tepid water since hot water will dry out the skin and can be painful on active eczema. If your child is old enough, teach them how to use cooler water they take their shower
  • Distract the child from scratching – you will need to use a number of strategies to prevent the child from scratching the eczema as that can spread it further
  • Don’t smoke – cigarette smoke is a known irritant to the skin and this could be one of the triggers for causing the eczema. Don’t smoke around your child as their exposure to your second-hand smoke can be a trigger for their eczema
  • Identify the allergens – there are a number of allergens that can possibly cause the eczema to occur, so work with your child to try to identify these triggers to avoid them. If an allergen is suspected of causing the eczema, discuss your options with your doctor, especially an allergy (skin prick) test, which can confirm allergens
  • Identify the irritants – there are a number of irritants that can cause eczema to occur, so try to identify so work with your child to try to identify these triggers to avoid them. Common irritants are soaps, shampoo, detergents, laundry powders/liquids, skin care, cleaning products and perfumes. Try to find more natural, less abrasive and non perfumed alternatives to determine if this makes any difference to your child’s eczema
  • Moisturise after bathing – always moisturise your child after a bath (or shower), all over, to help reduce the dryness in the skin and reduce the likelihood of aggravating the eczema. Find a very mild, unperfumed and natural moisturiser that provides adequate emollient moisture for the skin. Older children can be taught to moisturise their own skin in areas that they can reach
  • Provide fish in the diet – oily fish (mackerel, salmon, sardines, trout) contain the anti-inflammatory omega-3 essential fatty acids which studies show can be beneficial for reducing symptoms of eczema. Discuss fish oil supplementation with with your doctor
  • Use natural, soft fibres – when your child has an active eczema flare-up, ensure they dress with clothes that are natural and are made of soft fibres, such as cotton. Try to avoid any wool or wool mixes as these can irritate the skin, despite being a natural fibre

References

References

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Last reviewed and updated: 14 May 2024

Prebiotics vs probiotics

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Prebiotics vs probiotics

Prebiotics and probiotics are both linked to gut health, but they are not the same thing. The simplest way to understand the difference is this: probiotics are live beneficial microorganisms, while prebiotics are the food that helps beneficial gut microbes grow.

Both can be useful, but they work in different ways. For most people, the best place to start is not with a supplement. It is with a varied diet that includes fibre-rich plant foods and if tolerated, fermented foods.

What are probiotics?

Probiotics are live microorganisms that may provide a health benefit when taken in the right amount. They are usually bacteria, although some yeasts are also used as probiotics. The International Scientific Association for Probiotics and Prebiotics defines probiotics as “live microorganisms that, when administered in adequate amounts, confer a health benefit on the host”.

Probiotics are found in some fermented foods and are also sold as capsules, powders, liquids and other supplements. Common food sources include:

  • kefir
  • kimchi
  • kombucha
  • miso
  • sauerkraut
  • yoghurt with live cultures

Probiotics may help with some gut symptoms, including reducing antibiotic-associated diarrhoea and help some people with irritable bowel syndrome symptoms.

That does not mean every probiotic food or supplement has the same effect. Different probiotic strains can behave differently, and not every product labelled as a probiotic has proven health benefits. Not all foods and supplements labelled as probiotics have demonstrated health benefits.

What are prebiotics?

Prebiotics are substances that are used by beneficial microorganisms in the body and provide a health benefit. The current scientific definition describes a prebiotic as “a substrate that is selectively utilized by host microorganisms conferring a health benefit”.

In everyday food terms, prebiotics are often types of fibre or fibre-like carbohydrates that pass through the small intestine and are fermented by gut microbes in the large intestine. Healthdirect Australia describes prebiotics as “food” for probiotics and notes that they are found in high-fibre foods.

Common prebiotic-rich foods include:

  • asparagus
  • bananas, especially slightly green bananas
  • beans
  • chickpeas
  • garlic
  • lentils
  • oats
  • onions
  • pistachios
  • wholegrains

Prebiotics are not a single ingredient or magic gut-health shortcut. They are part of a broader dietary pattern that includes vegetables, fruit, legumes, nuts, seeds and wholegrains.

Prebiotics vs probiotics: the main difference

FeaturePrebioticsProbiotics
What they areFibres or substrates used by beneficial microbesLive microorganisms
Main roleFeed and support beneficial gut microbesAdd specific live microbes
Common sourcesOats, legumes, onions, garlic, bananas, wholegrains, nuts and seedsYoghurt, kefir, kimchi, sauerkraut, miso, kombucha and supplements
Best starting pointFibre-rich whole foodsFermented foods, or supplements when appropriate
Main cautionCan worsen bloating or IBS symptoms in some people if increased too quicklyMay not suit people who are severely unwell or immunocompromised
Prebiotics feed probiotics add

Which one matters more?

For general gut health, prebiotics are often the better starting point because they come from fibre-rich foods that also provide vitamins, minerals and other beneficial plant compounds.

Australian dietary advice encourages eating a variety of vegetables, fruit, legumes, wholegrain or high-fibre cereals, nuts and seeds. These foods support overall health, not just gut health.

Fibre is also important for normal gut function. In Australia, the recommended fibre intake is about 25 grams per day for adult women and 30 grams per day for adult men, although many Australians eat less than this.

Probiotics may be useful in more specific situations, such as when someone is taking antibiotics or managing certain gut symptoms. However, the effect depends on the strain, dose, product quality and reason for taking it.

Do you need a probiotic supplement?

A probiotic supplement may be worth discussing with a health professional if you have a specific reason for using one. For example, some people use probiotics during or after antibiotics, or as part of a management plan for IBS.

For IBS, Monash FODMAP notes that some studies suggest probiotic supplements can be safe and effective, but there is not enough evidence to recommend specific strains and doses for everyone. They suggest trying one probiotic at a time, taking it regularly for at least four weeks and stopping if there is no improvement.

A probiotic supplement is not automatically better than food. It is also not a general cure for bloating, constipation, diarrhoea, poor immunity or fatigue. If symptoms are ongoing, severe or changing, it is better to speak with a doctor or dietitian.

Can prebiotics make symptoms worse?

Yes, they can for some people.

Prebiotic-rich foods are healthy for many people, but some are also high in FODMAPs. This means they can trigger bloating, wind, abdominal pain or diarrhoea in people with IBS or sensitive digestion.

Examples include onions, garlic, legumes and some wheat-based foods. This does not mean these foods are bad. It means some people may need a slower increase, smaller serves or personalised advice.

A good approach is to increase fibre gradually and drink enough fluid. Going from a low-fibre diet to a very high-fibre diet too quickly can cause discomfort, even when the foods are nutritious.

Can you take prebiotics and probiotics together?

Yes. A product or meal that combines both is sometimes called synbiotic. For example, yoghurt with oats and berries can provide probiotics from the yoghurt and prebiotic fibres from the oats and fruit.

However, more is not always better. Some synbiotic supplements contain prebiotic ingredients such as inulin or fructo-oligosaccharides, which may be poorly tolerated by some people with IBS. Monash FODMAP specifically notes that synbiotics may contain FODMAPs that can trigger symptoms in sensitive people.

Food-first ways to support gut health

For most adults, a food-first approach is a practical place to begin.

Try adding one or two of these habits:

  • add oats, chia seeds or psyllium to breakfast
  • choose wholegrain bread, brown rice or barley more often
  • eat legumes such as lentils, chickpeas or beans a few times a week
  • include yoghurt with live cultures if you tolerate dairy
  • add fermented foods such as kimchi, sauerkraut or miso if you enjoy them
  • include a wider variety of vegetables across the week
  • increase fibre slowly rather than making sudden large changes
Simple gut health bowl

When to be careful with probiotics

Probiotics are generally considered safe for many healthy adults, but they are not risk-free for everyone. The risk of harm is greater in people who are severely ill, immunocompromised or medically fragile. Possible risks include infection, harmful substances produced by microorganisms and product contamination.

Speak with a doctor before using probiotic supplements if you:

  • are immunocompromised
  • are undergoing cancer treatment
  • have a central venous catheter
  • have recently had major surgery
  • are seriously unwell
  • are buying probiotics for a premature baby, infant or medically vulnerable person

The bottom line

Prebiotics and probiotics both matter, but they are not interchangeable.

Prebiotics feed beneficial gut microbes. Probiotics add live microorganisms that may provide a benefit in the right situation.

For everyday gut health, the most useful first step is usually a varied, fibre-rich diet with vegetables, fruit, legumes, wholegrains, nuts and seeds. Fermented foods can also be included if you tolerate and enjoy them.

Supplements may help in some situations, but they should be chosen for a specific reason rather than taken as a cure-all.

References

  • Australian Government Department of Health and Aged Care / Eat for Health. Australian dietary guidelines 1–5.
  • Erhardt R, Meyer-Gerspach AC, Beglinger C. (2022). Prebiotics, gut microbiota and functional constipation: Current evidence and future directions. Nutrients, 14(23), 5067. https://doi.org/10.3390/nu14235067
  • Gibson GR, Hutkins R, Sanders ME, et al. Expert consensus document: The International Scientific Association for Probiotics and Prebiotics consensus statement on the definition and scope of prebiotics.Nature Reviews Gastroenterology & Hepatology. 2017. https://doi.org/10.1038/nrgastro.2017.75
  • Goodman C, Keating G, Georgousopoulou EN, Hespe C, Levett K. (2021). Probiotics for the prevention of antibiotic-associated diarrhoea: A systematic review and meta-analysis. BMJ Open, 11(8), e043054. https://doi.org/10.1136/bmjopen-2020-043054
  • Goodoory VC, Sharma A, Chua A, Ford AC. (2023). Efficacy of probiotics in irritable bowel syndrome: Systematic review and meta-analysis. The American Journal of Gastroenterology, 118(10), 1776–1788. https://doi.org/10.14309/ajg.0000000000002361
  • Hill C, Guarner F, Reid G, Gibson GR, Merenstein DJ, Pot B, Morelli L, Canani RB, Flint HJ, Salminen S, Calder PC, Sanders ME. (2014). The International Scientific Association for Probiotics and Prebiotics consensus statement on the scope and appropriate use of the term probiotic. Nature Reviews Gastroenterology & Hepatology, 11(8), 506–514. https://doi.org/10.1038/nrgastro.2014.66
  • Holscher HD. (2017). Dietary fiber and prebiotics and the gastrointestinal microbiota. Gut Microbes, 8(2), 172–184. https://doi.org/10.1080/19490976.2017.1290756
  • International Scientific Association for Probiotics and Prebiotics. ISAPP elaborates criteria for prebiotics.
  • Makki K, Deehan EC, Walter J, Bäckhed F. (2018). The impact of dietary fiber on gut microbiota in host health and disease. Cell Host & Microbe, 23(6), 705–715. https://doi.org/10.1016/j.chom.2018.05.012
  • Monash FODMAP. IBS treatments.
  • Monash FODMAP. Probiotics for IBS.
  • Vinelli V, Biscotti P, Martini D, Del Bo’ C, Marino M, Riso P. (2022). Effects of dietary fibers on short-chain fatty acids and gut microbiota composition in healthy adults: A systematic review. Nutrients, 14(13), 2559. https://doi.org/10.3390/nu14132559
  • Yoo S, Kim K, Nam Y, Lee D. (2024). The role of prebiotics in modulating gut microbiota. Nutrients, 16(10), 1466. https://doi.org/10.3390/nu16101466

Depression

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Depression

Facts

What is depression?

Depression is a mental health disorder which affects the brain and causes dysfunction with mood, thoughts and feelings. Depression can seriously impact a person’s ability to have a good quality of life, as it causes a number of symptoms which cause the person to isolate themselves from the world around them.

Depression is not a passing low mood, nor is it a sign of weakness or an inability to cope. People who are depressed cannot just “snap out of it”, as it isn’t a normal low mood (which everyone experiences from time to time). It can be a serious disorder which is characterised by a number of symptoms, many of which are serious and can be life threatening (suicide) if not diagnosed and treated early.

Depression is one of the most common disorders that brings people to see a doctor. Depression can be triggered by a stressful event or it can be due to some type of imbalance in the brain’s chemistry.

There are a few different forms of depression:

  • Bipolar affective disorder – this type of depression is characterised by alternating depressive and euphoric episodes, which can change without any warning. Bipolar disorder causes severe mood swings. Bipolar disorder was previously known as manic depressive disorder
  • Dysthmia – this type of depression has symptoms which lie somewhere between reactive depression and major depressive disorder. It has less symptoms with less duration than major depressive disorder, but it is not as mild as reactive depression. Dysthmia is generally not biological in origin (unlike major depressive disorder)
  • Major depressive disorder – this type of depression is characterised by major depressive episodes, which occur more frequently and more severely than just feeling depressed due to a reaction to a stressful event in life. This type of depression is commonly genetic in origin and causes depression symptoms even without any stressful life events
  • Post-partum depression – this type of depression affects women directly after giving birth and is characterised by an inability to bond with the baby, as well as other debilitating symptoms. Post-partum depression can be severe and requires medical intervention to prevent serious complications for both mother and baby
  • Reactive depression – this type of depression is characterised by having a strong reaction to a stressful event(s) in life (such as losing a job or ending a long term relationship). While this type of depression has few or mild symptoms, it can become quite intense, so it should treated appropriately to prevent complications (such as suicide). This depression is also known as adjustment disorder with depressed mood and is the most common type of depression

Facts about depression

  • Many people (5-10% of the population) experience major depression at any given point in time
  • Around 15-20% of all people will develop some form of depression in their life. This is approximately 1 in 5 people who will feel depressed at some point in their life
  • Depression may occur due to a reaction to an intensely stressful situation(s) in life, which is the most common form of depression
  • The tendency to develop major depression is an inherited disorder, which means that there may be a genetic component to it
  • People who are depressed tend not to seek treatment
  • Sixty percent of cases of clinical depression are considered to be treatment-resistant depression
  • There are several different types of depression, which are characterised by the different symptoms that are present with each condition
  • Depression is a real illness which can impact a number of areas in a person’s life
  • Men tend not to see their doctor (compared to women) about feelings of depression, as they seem to see it as a sign of weakness and an inability to cope with their life
  • Feeling low, blue or sad after a particularly stressful event is normal, it is only when that low mood continues and is accompanied by other symptoms when depression can be diagnosed
  • Some forms of depression are due to dysfunction in the chemicals (neurotransmitters and other substances) in the brain and this form of depression is hard to predict
  • Depression can co-exist with a number of other disorders, which may precede the depression, trigger it, or be a consequence of it
  • Alcohol and substance abuse often co-exist with depression
  • Depressive illness is a disorder of the brain
  • Studies of people with depression show their brains look different than people without depression
  • People with depression have unbalanced levels of a number of important neurotransmitters, which regulate mood, thinking, sleep, appetite and behavior

Symptoms

Symptoms of depression

The symptoms of depression are varied and many and are classed as physical, emotional and mental symptoms, as the body, thoughts and feelings are affected:

Emotional symptoms

  • Crying and feeling sad for no reason
  • Feeling angrier than normal
  • Feeling down, sad or depressed
  • Feeling generally guilty (not related to anything specific)
  • Feeling less hopeful than usual
  • Feeling less loving to your family and friends
  • Feeling more anxious than usual
  • Feeling very helpless and not in control
  • Feeling suicidal
  • Losing the will to live
  • Unable to feel much pleasure in anything
  • Worrying more than normal

Mental (thought) symptoms

  • Avoiding other people, isolating yourself
  • Concentration levels decline
  • Difficulty making any decisions
  • Less optimistic than usual (more pessimistic)
  • Lowered self-esteem
  • Not as interested in your normal activities
  • Thinking about death a lot

Physical symptoms

  • Appetite changes – either eating more or less than normal
  • Less interest in normal activities
  • Lowered energy levels
  • Lowered libido, less interested in sex
  • Sleeping less or more than what was normal previously
  • Symptoms are worse at certain parts of the day

Causes

Causes of depression

The cause of depression is not known. It is thought to be due to a combination of a number of different factors.

Biochemical

The neurotransmitters in the brain control mood, thinking, sleep, appetite and behaviour and if these neurotransmitters become unbalanced, depression can be the result. The main neurotransmitters affected are: serotonin, dopamine, GABA, but there are many others which play a part in the brain’s function.

Environmental

The most common reason for depression is experiencing a stressful life event, such as the loss of a loved one, divorce, break-up, losing a job, trauma. Even positive events can cause depression, if they are significant enough – getting married, buying a home for the first time, having a baby, promotion or getting a huge pay rise.

Genetic

Researchers have determined that some types of depression tends to run in families, which suggests that in these people, there is a genetic link which has been a factor in causing the depression, but this genetic link is not the sole factor.

Research into the genetic cause of depression suggests that people who have certain genes that are a risk factor for depression will develop it, if there are environmental or other factors which trigger the genes to cause depression to start.

Psychological

Some people seem to have a more negative or pessimistic view on life, so when stressful events occur, this may trigger depression, from a mild case, to a more severe one.

Prevention

Prevention of depression

Non-preventable risk factors

Depression may be unpreventable in certain circumstances:

  • Genetics – some forms of depression seem to have a genetic link (due to a number of linked genes), which means certain family members will be affected by depression. Even though there is a genetic link, researchers think that the faulty genes need to be triggered by either an external event (environmental factor) or another factor to cause the depression to start. Just having the faulty genes does not seem to be enough in most cases to cause the depression
  • Illness – certain illnesses, especially if they are serious and life threatening, are associated with a risk of triggering depression in some people. The illnesses most associated with depression are: AIDS/HIV, cancers, Alzheimer’s disease, heart disease and all forms of degenerative conditions (fibromyalgia, etc). Serious illness is a potential major stressful situation, which is a trigger for depression in some people
  • Neurotransmitter problems – if the neurotransmitters in the brain are not in proper balance, this means the brain chemistry is not healthy and normal, which could lead to depression. The main neurotransmitter which is affected is serotonin, which is normally too low in people with depression. Serotonin is responsible for regulating mood, as well as appetite and sleep. It is not known at present what causes the serotonin levels to drop in people with depression
  • Low levels of serotonin – people who have depression tend to have much lower levels of the neurotransmitter serotonin, which is important as it regulates mood, appetite and sleep. In fact, many anti-depressant medications work on keeping serotonin at a certain level, to reduce depression symptoms
  • Long term use of certain medications – people who use certain medications over a long term, may be more likely to develop depression as the medications may cause depression as a side effect, or trigger it, due to biochemical changes in the brain. The medications most likely to trigger depression are: sedatives (sleeping pills), blood pressure medications and sometimes even the contraceptive pill (although this is quite uncommon)
  • Low self-esteem – people who have low self esteem may be a higher risk for depression because their self-talk tends to be more negative, self-critical and pessimistic, which only serves to make them feel even more unhappy about themselves, so they may be prone to become more depressed or have depressive episodes than people who feel okay about themselves. Researchers are not sure what the reason behind this is, but they think it could be that the constant negative thinking causes imbalances in the brain chemistry or other problems in the neurons or pathways in the brain which make it more likely that depression develops
  • Low socioeconomic background – research suggests that people from a low socioeconomic background are more likely to develop depression. This may most likely be due to the conditions of their existence (poor quality of life)
  • Stressful events – stressful events, especially if they are major can precipitate depression, irrespective of whether the event is a positive one (marriage, new baby, new house, promotion at work) or a negative one (death of a loved one, marriage break up, separation, illness). Stressful events do not affect everyone in the same way, because everyone’s brain chemistry, outlook on life and past history are different

Preventable risk factors

There may be ways to prevent depression from occurring or reduce severity and duration of symptoms:

  • Early recognition of symptoms – depression is a really treatable condition especially when symptoms have just started and are quite mild and not too severe. It is advisable to understand the symptoms of depression so that if you feel that you may be experiencing them you see your doctor to be properly diagnosed and to be given advice on the best treatment options, which may allay worsening of symptoms (which can be quite debilitating) and any possible complications. You can even discuss alternative options to medication with your doctor at this stage, as early symptoms of depression tend to respond quite well to alternative/complementary treatment options
  • Healthy diet – if a person eats foods that are in the recommended diet guidelines, this may help prevent depression in some cases by providing the nutrients which are required to synthesise the important neurotransmitters (serotonin, dopamine, GABA) which are responsible for regulating mood, appetite, sleep and other functions. If these neurotransmitters are unbalanced, or too low, depression can be the result. While in some people this may be genetic, for the majority, it is not, so a healthy diet may prevent imbalances in the neurotransmitters and ultimately may prevent depression (or at least may prevent it from being severe)
  • Negative or pessimistic outlook – research shows that people who have a negative or pessimistic outlook on life, tend to be more depressed, or more prone to episodes of depression. Researchers are not sure what the reason behind this is, but they think it could be that the constant negative thinking causes imbalances in the brain chemistry or other problems in the neurons or pathways in the brain which make it more likely that depression develops
  • Social interactions – social isolation, loneliness and being away from other people is one factor which may lead to depression in some people. Try to ensure that you have regular contact with your friends and participate in activities that are fun and enjoyable, to help prevent one factor that may lead to depression
  • Regular exercise – regular exercise help to reduce the stress hormones (adrenaline, noradrenaline), increases the levels of the “happy hormones”, endorphins, which increase pain threshold and create a better mood. Regular exercise may help to prevent depression, or worsening of symptoms in some people

Complications

Complications of depression

There are some significant complications of depression, especially if it has not been diagnosed, or it continues unabated and untreated:

  • Alcohol (or other substance) abuse – people who abuse alcohol (or other substances) tend to be depressed. The depression can cause some people to turn to alcohol (or other substances) to try to numb their pain and other symptoms. Unfortunately, abusing alcohol (or other substances) will only lead to a number of other health problems, which only become more adverse with the longer the excessive drinking continues
  • Anxiety – depression and anxiety go hand-in-hand usually, with one precipitating the other. People with depression, who do not also have some type of anxiety disorder, tend to develop it during the course of their depressive episodes, especially if the depression continues over a long term without proper treatment
  • Heart disease – some recent research showing a link between depression and heart disease development. The research suggests that depression that is untreated, continues for a long time or does not respond well to treatment, is linked to heart disease developing, especially life threatening arrhythmia. Other research shows that people who have depression and heart disease, have a poorer prognosis of both their conditions and respond much less positively to their medication
  • Relationship problems – people who are depressed may have major relationship problems with their family, their partner, children or friends, due to their symptoms. Depression causes people to isolate themselves from others, so loved one may not understand why they are being cut off from the depressed person’s life, additional, depression makes it hard for the depressed person to relate in a healthy way with other people and this can potentially cause a great deal of conflict in the person’s relationships. Conversely, relationship problems can cause depression in some people, so the continuation of the relationship problems in someone who is depressed may further exacerbate their symptoms, creating a vicious cycle that continues seemingly unabated
  • Social isolation – people who are depressed tend to feel alone, they tend to isolate themselves from their family, friends and loved ones, which only makes them more socially isolated and much less likely to reach out to make connections with people. The social isolation only further serves to exacerbate the symptoms of depression (feeling more lonely) and can increase the severity of symptoms
  • Suicide – the ultimate adverse complication of depression is suicide, taking one’s life because the pain inside is too hard to bear. Anyone who attempts suicide is crying out for some help, because they may be overwhelmed with all the symptoms of depression, which can be quite awful and adversely impacts so much on life, reducing quality of life, when it is severe

People who feel so down that they are having thoughts of taking their life should call Lifeline on – 131114.

Diagnosis

When to see a doctor about depression

People who are experiencing any of the symptoms of depression, especially if they continue for a number of weeks, months or years, need to see their doctor to be diagnosed and to be advised of treatment options.

You need to understand that you are not weak or less of a person because you are seeking treatment for depression. You are actually being strong and smart and taking care of your health.

While it is normal to feel sad and upset at the stressful or negative events in life, it is not normal for these feelings to continue or to have these feelings impair you in any way or cause you to start to behave differently, in a way that reduces your quality of life.

Depression, even the most severe cases, is a highly treatable disorder. As with many illnesses, the earlier that treatment can begin, the more effective it is and the greater the likelihood that recurrence can be prevented.

Suicidal thoughts are normal in people with depression, just as long as you do not do anything about it.

People who feel so down that they are having thoughts of taking their life should call Lifeline on – 131114

People with existing depression need to see their doctor on a regular basis, to monitor their treatment, to discuss any side effects to medication, to adjust their medication and to discuss any other alternative/complementary treatment options (instead of medications). People who are taking any type of medication should not try alternative/complementary treatments without discussing them with their doctor, as the combination may have a very serious outcome, that could even be dangerous.

Suicidal thoughts are normal in people with depression, just as long as you do not do anything about it.

Diagnosis of depression

Initial diagnosis of depression is conducted through the following tests:

  • Medical history – you doctor will ask a series of questions about the history of the symptoms, including the severity, duration of symptoms, as well as the exact date they started and if anything unusual or stressful occurred prior to the onset of the symptoms
  • Physical examination – your doctor will perform a physical examination of your eyes, ears, lungs and heart, to check your overall health

Since depression could be due to a number of other illness (or can be exacerbated by any number of other illnesses), your doctor may do the following tests to rule them out:

  • Blood test – a blood test is usually requested to rule out the following conditions:
    • Low blood sugar levels – the condition hypoglycaemia can cause depression-like symptoms, due to the lowered blood glucose levels
    • Low iron levels – if there are lowered blood levels of iron or haemoglobin, this can also present with depression-like symptoms
    • Thyroid disorder – in particular, hypothyroidism, which may cause depression as one of the symptoms
  • CT scan – a CT scan can be requested if your doctor suspects an underlying problem with the brain, in particular to rule out brain tumour as the cause of the depression symptoms, especially if other symptoms point to this condition

If the initial diagnosis and blood test rule out any other disorders, then the following further tests may also be requested, to properly diagnose and confirm depression:

  • Psychological evaluation – your doctor may request you undergo psychological evaluation of your symptoms to determine (a) the type of depressive illness you are experiencing, (b) the treatment options recommended and (c) the possible duration of symptoms

The doctor, psychologist or psychiatrist will use certain diagnostic criteria to diagnose depression in the psychological evaluation.

These criteria include the following symptoms:

  • Agitation or restlessness
  • Difficulty concentrating, making decisions or thinking properly
  • Fatigue or lacking in energy
  • Feeling worthless or guilty, for no apparent reason
  • Loss of interest or pleasure in most activities
  • Symptoms that cause distress or impair ability to function in daily life
  • Symptoms that have been present for most days in a period of 2-3 weeks
  • Thoughts of death or suicide
  • Weight gain or weight loss that was unintentional

Treatment

Conventional treatment of depression

Treatment may include a combination of medication, individual therapy and community support. Some medical experts believe that electroconvulsive therapy (ECT) can be helpful for depression that has been unresponsive to any type of medication therapy.

The conventional treatment of depression depends on the severity of the symptoms.

Treatment for mild depression

Mild depression is often only treated with the following therapies (medication is not normally given for people with mild depression that has not occurred previously):

  • Counselling – your doctor may recommend you engage in some counselling with a qualified psychologist or psychiatrist and depending on your income level, Medicare (in Australia) covers a proportion of the costs of counselling for a specific number of counselling sessions
  • Online Cognitive Behavioural Therapy (CBT) course – CBT helps you lean to think differently, in a less negative way about yourself and your life. CBT teaches that negative thinking can be a “bad habit” that needs to be untaught. The Australian National University provides an excellent and free CBT course for people who suffer from mild to moderate depression
  • More exercise – your doctor may recommend you engage in more exercise each day (depending on your fitness level and health) as exercise can help reduce feelings of depression more quickly than other therapies and is especially beneficial for people with mild depression
  • Self Help Books – your doctor may recommend a self help book on depression to provide more in-depth strategies for reducing symptoms

Treatment for moderate depression

Moderate depression is often treated with the following therapies, either independently or in combination, based depending on diagnosis of symptoms:

  • Medication – your doctor may try to prescribe some form of anti-depressant medication for your symptoms depending on the severity and duration. The most commonly prescribed anti-depressant medications are:
    • Benzodiazepines – these drugs have a mild tranquillising effect, which is why they are often prescribed for people with depression and who have severe insomnia associated with their condition. Benzodiazepines also help to reduce anxiety associated with depression. Benzodiazepines are prescribed at a low and regular dose, but only for a short period. This class of drugs have relatively few side effects (compared with some other types of medications) other than rebound wakefulness in some people, but if taken long term, they can become highly addictive. People who become addicted to benzodiazepines become dependent on them just to feel normal and without taking this drug, they often feel worse than they did prior to when they starting to take it. Examples of benzodiazepines: Lorazepan (Ativan®), Chlordiazepoxide (Librium®), Oxazepam (Oxazepam®), Diazepam (Valium®), Alprazolam (Xanax®)
    • Monoamine Oxidase Inhibitors (MAOI) – these medications are the oldest class of anti-depressant medications and they should not be taken in combination with any type of SSRI drugs or St John’s Wort as the combination can produce serious (and fatal) side effects. MAOIs can produce serious side effects and their use must be strictly monitored to prevent this from occurring. People are often prescribed MAOIs when other types of anti-depressants have not worked to reduce symptoms. MAOI are the least often prescribed anti-depressants as they have such a large range of side effects and a restrictive diet needs to be followed when taking them. Examples of MAOIs are: Phenelzine (Nardil®), Tranylcypromine (Parnate®), Isocarboxazid (Marplan®),
      People taking MAOIs should avoid the following food (to reduce possible adverse effects):

      • Alcohol
      • Avocados
      • Broad beans
      • Cheese (any type)
      • Fermented soy extract
      • Salami
      • Meat or yeast extract
      • Pickled herring
      • Food that is stale or going off, especially meat, fish, offal, poultry or game
    • Mood stabilisers – these medications are normally prescribed for people with depression in bipolar disorder to help reduce symptoms. Examples of mood stabilisers are: Valproate (Epilim®), Valproate Semisodium (Depakote®), Carbamazepine (Tegretrol®)
    • Selective Serotonin Reuptake Inhibitors (SSRIs) – these drugs are a newer class of anti-depressant medications which alter the levels of serotonin in the brain (they increase the levels of serotonin to control mood) and to reduce low mood symptoms. SSRIs were a recent anti-depressant medication development, only available from around 30 years ago. These drugs can also produce side effects but these are usually milder in comparison to older antidepressants (MAOI) and side effects normally decrease after some time, for most people. Examples of SSRIs are: Citalopram (Cipramil®), Fluvoxamine (Faverin®), Paroxetine (Seroxat®), Fluoxetine (Prozac®), Sertraline (Lustral®).
      SSRI should not be taken in combination with St John’s Wort, or any other type of anti-depressants, or MAOI as they can cause a fatal reaction
    • Tranquilisers – these drugs are another classes of tranquilisers that can be prescribed (which are different to benzodiazepines) that can reduce anxiety symptoms associated with depression very quickly. Some of these different types of tranquilisers may also have fever side effects than benzodiazepines. These tranquilisers are best when used over a short-term, should not be used with MAOIs and should not be used with alcohol. Examples of other tranquilisers are: Buspirone (Buspar®), Hydroxyzine
    • Tricyclics – these drugs are an older type of anti-depressant medication which work as well as SSRIs for reducing symptoms of depression. Tricyclics help to increase levels of serotonin and norepinephrine which help to stabilise the mood. These drugs have some side effects which can usually be reduced by lowering the dose or changing to another type of tricyclic medication, but even despite this, a great number of people abandon this medication due to the side effects that they produce. Examples of tricyclics: Amitriptyline (Triptafen®), Clomipramine (Anafranil®), Dosulepin/Dothiepin (Prothiaden®), Doxepin (Sinequan®), Imipramine (Tofranil®), Nortriptyline (Motival®)
  • Psychotherapy – this involves any or all of the following treatment options which can be provided by a psychologist, psychiatrist, or qualified counsellor, or through self-help means:
    • Cognitive Behavioural Therapy (CBT) – CBT helps you lean to think differently, in a less negative way about yourself and your life. CBT teaches that negative thinking and even depression can be a “bad habit” that need to be untaught
    • Mindfulness and acceptance – mindfulness acceptance therapy is about being present in the moment and relishing it for what it is without stressing about the past or the future. Mindfulness is about allowing yourself to experience a situation and to observe how it makes you feel without judgement, without worry and without negative thinking. It is one way to help accept yourself and be less negative
    • Online CBT Therapy – the Australian National University provides an excellent and free CBT course for people who suffer from mild to moderate depression
    • Self help books – another useful strategy for people with mild to moderate depression is to use self-help books by qualified authors who can provide detailed advice on how to conquer the symptoms of depression step-by-step, usually through some form of CBT or mindfulness therapy

Treatment for severe (major) depression

People with severe (or major) depression will be offered the same medications as people with moderate depression (above), but at higher doses.

People with really severe depression that has not responded to any form of medication or other therapy can also be offered electroconvulsive therapy (ECT).

Electroconvulsive therapy (ECT)

Electroconvulsive therapy (ECT) is a procedure where the person’s brain is hooked up to electric wiring and a level of electric currents is passed through the wires to the brain. This form of “electric shock” therapy will cause a brief seizure, which also causes some changes in the brain chemistry. The person will be anaesthetised first, to prevent any pain from this procedure before the electric current is allowed to pass through the brain. ECT normally occurs over two to three treatments (sometimes more for really severe cases).

Proponents of ECT suggest that it helps to alleviate symptoms of certain mental illness in people, as it uses precisely calculated electrical currents that are administered carefully by specialists and aims to provide benefits with little risk.

Despite this, ECT remains a very very controversial therapy, even since it was introduced over 70 years ago as there are a number of possible side effects and risks following the procedure, including:

  • Cognitive impairment – straight after an ECT treatment people experience confusion in the though processes, they wont know where they are, or why they are there. This cognitive impairment last seconds to minutes after the ECT procedure but usually goes away after ECT treatment has been totally completed
  • Medical complications – in any procedure where anaesthesia is used, there is a small risk of death and prior to the ECT there are a number of tests that are performed to determine eligibility for this procedure
  • Memory loss – ECT can cause memory loss, ranging from inability to remember events (from weeks to months) leading up to the procedure, to inability to recall events after the procedure and for a very rare few, these memory loses are permanent
  • Physical pain – many people experience a range of physical problems after the procedure, including nausea, vomiting, headache, muscle ache or jaw pain

The depressed people who are in any of the following groups only are offered electroconvulsive therapy (ECT):

  • People who are severely depressed and have major psychosis
  • People who are severely depressed and are suicidal or refuse to eat at all
  • People who are severely depressed, have bipolar disorder and whose mania hasn’t improved with any type of medication or other treatment

Alternative

Alternative / complementary treatment of depression

Alternative / complementary medicine treats not just the symptoms of depression, but the underlying cause.

People who are taking any type of medications for their depression should not try any of these herbal treatments especially, but also not any of the other supplements without first consulting their doctor, as the results of the combination could be life threatening.

Herbs

There are a number of herbs which can help to reduce symptoms:

  • Ginkgo (ginkgo biloba) – the herb ginkgo biloba helps to stimulate circulation to be normal and it protects the nerves against damage, plus it also has anti-depressant activity, so it may be a useful adjunct in alternative/complementary therapy for depression
  • Schisandra (schisandra chinensis) – the herb schisandra has been used in Chinese medicine as a nerve tonic to help improve memory and mental performance and Chinese medicine practitioners use it together with other herbs and supplements to help relieve symptoms of depression
  • St John’s Wort (hypericum perforatum) – a number of studies have shown that hypericum perforatum was safe and more effective than a placebo in the treatment of mild to moderate major depression. Other studies have shown that hypericum perforatum was just as effective, but better tolerated than a particular anti-depressant (paroxetine) in the treatment of moderate to severe major depression. A recent scientific review of anti-depressants has suggested that anti-depressants are not effective in any type of depression other than severe major depression. Note: never take St John’s Wort if you are also taking any type of anti-depressant medications
  • Vervain (verbena officinalis) – the herb vervain has been traditionally used to treat depression, by reducing the mood problems associated with depression. One animal study showed that vervain had some sedative effects, but more studies are needed to confirm this one study. Consult with your doctor if you want to try vervain, never self-prescribe any herb, particularly if you are already taking anti-depressants or any other medications

Vitamins

There are a number of vitamins which are especially useful to help reduce symptoms associated with depression:

  • Folic acid – in numerous studies of people who were depressed, around 35% had a folic acid deficiency and in depressed older people this deficiency is even higher (up to 96%). Depression is the most common symptoms of a folic acid deficiency and supplementation normally improves symptoms dramatically. Only a blood test can determine if there is a folic acid deficiency
  • Vitamin B1 (thiamin) – vitamin B1 (thiamin) is one of the vitamins that is important for a healthy functioning nervous system. Any mild deficiency in this vitamin may exacerbate depression symptoms
  • Vitamin B2 (riboflavin) – vitamin B2 (riboflavin) is one of the vitamins that is important for a healthy functioning nervous system. Any mild deficiency in this vitamin may exacerbate depression symptoms
  • Vitamin B3 (niacin) – vitamin B3 (niacin) is one of the vitamins that is important for a healthy functioning nervous system. Any mild deficiency in this vitamin may exacerbate depression symptoms
  • Vitamin B5 (pantothenic acid) – vitamin B5 (pantothenic acid) is one of the vitamins that is important for a healthy functioning nervous system. Any mild deficiency in this vitamin may exacerbate depression symptoms
  • Vitamin B6 (pyridoxine) – studies show that many people with depression have lowered levels of this B vitamin, especially women who are also taking the contraceptive pill. Vitamin B6 (pyridoxine) is involved in the synthesis of serotonin, the neurotransmitter responsible for regulating mood, so supplementation may be required if there is a deficiency. Only a blood test can determine if there is a vitamin B6 (pyridoxine) deficiency
  • Vitamin B12 (cyanocobalamin) – many studies show that while it may be less common, a deficiency in vitamin B12 (cyanocobalamin) can cause symptoms of depression and that symptoms improve dramatically with supplementation. Only a blood test can determine if there is a vitamin B12 (cyanocobalamin) deficiency
  • Vitamin C – some of the symptoms of vitamin C deficiency are depression and lethargy and while most people will get enough vitamin C in their diet, some people may have a mild deficiency (especially older people, people who do not eat enough food or people with certain health conditions). Only a blood test can confirm if there is a vitamin C deficiency, even a mild/borderline one
  • Vitamin E – the antioxidant vitamin E is necessary for good circulation and proper functioning of the immune system and all the cells. Vitamin E is also required to improve the level of oestrogen in

Minerals

There are a number of minerals which are especially useful to help reduce symptoms associated with depression:

  • Calcium – several studies show that people with depression have lowered calcium levels and that supplementation helps to improve symptoms. Women seem to be more affected by the low calcium levels, especially women of child-bearing years who may also have severe PMS (or PMDD) symptoms due to the calcium deficiency. A blood test can confirm a calcium deficiency
  • Magnesium – the mineral magnesium is important for people with depression as it helps to relax smooth muscle tissue in the body and induces a sense of calmness and relaxation. There may be a deficiency of magnesium in some people with depression and in fact several studies have shown that people who have depression tend to have lowered levels of magnesium when they are going through a depressive episode. A blood test can confirm a magnesium deficiency
  • Selenium – a deficiency in the antioxidant mineral selenium is though to be linked to depression and other low mood states. Studies show that people who have a mild selenium deficiency that is the cause of their depression symptoms receive the most benefit from supplementation. Only a blood test can determine if there is a selenium deficiency
  • Zinc – a deficiency in the antioxidant mineral zinc can present with lethargy, depression and anxiety symptoms, as well as impaired immune system function (frequent infections), which means zinc is very important to good mental function and mood. Studies have shown that people with depression tend to have low levels of zinc and supplementation tends to improve symptoms without any of the side effects associated with anti-depressant medications. It is important to determine if zinc deficiency is the cause of depression and low mood symptoms

Other nutrients

There are a number of other nutrients which are especially useful to help reduce symptoms associated with depression:

  • GABA – the amino acid GABA is used by the body to produce a neurotransmitter that relaxes and calms the mind and balances the mood
  • Omega-3 fatty acids – there is some evidence that the omega 3 fatty acids may help with people who have depression, as they are necessary to ensure the membranes on the nerve cells are healthy and function properly. Since depression may be due to imbalanced brain chemistry, it could be useful to ensure omega-3 fatty acids are topped up either in supplements, or by eating more oily fish (mackerel, salmon, sardines, trout, tuna) about 2-3 times a week
  • Phenylalanine – the essential amino acid phenylalanine is important as it is a precursor to enable the synthesis of noradrenaline and adrenaline, the two neurohormones which are required to allow the body to better deal with stress and tension, which may be deficient in people with depression
  • SAMe – the substance S-adenosylmethionine is a naturally occurring molecule in the body which has been successfully used to help reduce low mood and anxiety symptoms that people with depression normally experience. SAMe is a precursor of the very important neurotransmitter serotonin, which is implicated in many mood disorders when it is at levels that are too low
  • Tryptophan – the amino acid tryptophan is a precursor to the important neurotransmitter serotonin, which regulates mood and helps ensure feelings are more balanced and calm, so it is used to help reduce anxiety and depression symptoms. Foods rich in tryptophan, include bananas, warm milk and turkey. To help with sleep, try some warm milk with honey about 30-60 minutes before bed

Dietary modifications

There are a number of dietary modifications which are especially useful to help reduce symptoms associated with depression:

  • Add linseed oil or cod liver oil to the diet – both linseed oil and cod liver oil contain vital essential fatty acids (omega-3), which are beneficial for normal brain health. People taking any type of medication for their depressive disorder should consult their doctor before trying either of these natural oils, to avoid possible adverse effects
  • Avoid alcohol and drugs – while it may feel that alcohol and some types of drugs help to relax you and make the symptoms go away for a little while, they are just numbing the depression and make the problems worse in the long run
  • Avoid sugar and all refined foods – this is because high intakes of sugar and highly processed (take-away, junk) foods may cause a rapid rise in blood glucose levels and then another rapid fall (just soon after), which may interrupt the body so much that it can cause anxiety and depression if the blood sugar levels are not quickly increased again. This not only affects low mood, but can cause weight gain, which may further increase depression
  • Certain foods induce calm – studies show that certain foods can create a more calmer mind and body, due to the nutrients they contain. The foods most recommended for a calmer and less anxious state are: asparagus, avocado, beetroot, carrots, eggs, oily fish, onions, paw paw, spinach, stone fruit
  • Certain foods increase serotonin – food that are high in the amino acid tryptophan help to increase the levels of serotonin in the brain, which is one of the neurotransmitters associated with risk for depression. Foods rich in tryptophan are: turkey, chicken, soy beans, tuna, mozzarella cheese, milk
  • Eat more egg yolks – organic egg yolks (about one per day) is highly recommended to increase intake of lecithin (phosphatidyl choline). Many studies show that lecithin helps the brain neurons and in particular, the dopamine neurotransmitters, function more effectively, which may help reduce symptoms in people with depression

Lifestyle modifications

There are a number of lifestyle modifications which are especially useful to help reduce symptoms associated with depression:

  • Cognitive behavioural therapy (CBT) – this therapy is used by many clinical psychologists, psychiatrists and counsellors to help people with depression understand, manage and change their thoughts and behaviours. Many studies show that CBT is just as effective as using only anti-depressant medications. CBT works by helping to identify and change negative thinking associated with depressed feelings, focusing on positive things and managing problems in life
  • Exercise – studies have shown that regular exercise is often as effective as medication (anti-depressants such as selective serotonin re-uptake inhibitors SSRIs) and people engage in physical activity report less symptoms of depression than the control group (who did not engage in any exercise or take any medication). Aim to engage in about 30-45 minutes of exercise most days, some of which should be cardiovascular and some resistance training
  • Mindfulness therapy – a newer form of psychotherapy is mindfulness, which aims to prevent relapse and assist with regulating mood by aiming to create more focus and self-awareness. Mindfulness is about becoming aware in the present moment without any judgement on whether it is “good” or “bad”, instead just to “be” in the moment and observe it and then let it go. Mindfulness is adapted from specific Buddhist meditation
  • Relaxation techniques – it is really important to engage in some type of relaxation techniques, in order to help calm the mind, reduce negative thinking and release some of the negative emotions that are caught up in the mind. Relaxation techniques can help instill a sense of calm and feeling of contentedness Some good relaxation strategies are: mediation, tai chi and visualisation
  • Regulate activities – it is important for people with depression to have regular activities planned for each day, especially if they are not working, as the lack of direction and lack of life goals could reduce motivation and cause a relapse
  • Sleep – make sure you have enough sleep each night and try to go to sleep and wake up around the same time each day to get a regular sleeping pattern going, which helps set the body clock (and assists with regulating many processes in the body)
  • Yoga – this is a great way to control breathing, the negative emotions and to also help control the body, which can provide more confidence and a reduction in symptoms. There are many forms of yoga, from the very vigorous to the more relaxing, meditation types

Alternative treatments

  • Acupuncture – studies have shown that acupuncture may be beneficial for people with depression to help reduce symptoms and is even more significantly beneficial when it is combined with some form of psychotherapy (cognitive behavioural therapy) to reduce symptoms and help with a better quality of life
  • Massage – the benefits of a relaxing massage are significant for people with depression. A therapeutic massage can relax tension in the muscles and reduce a great deal of the low mood symptoms in people with depression (but this is only temporary, a massage cannot cure the condition, but it can provide temporary relief of symptoms)
  • Meditation – this is way of calming the mind and relaxing the body by using various breathing and visualisation techniques. Meditation has shown to be very beneficial in many people to combat the low mood symptoms of depression and be inducing a state of calmness and contentedness without any medication

Always ensure that you notify your medical practitioner of any supplements that you want to take – it may interfere with other medication or conditions you have. Confirm with your doctor it is safe to take BEFORE you try it.

Self care

Living with depression

There are a number of strategies which are recommended to help you better deal with depression:

  • Avoid alcohol and drugs – while it may feel like alcohol or drugs take you away from your depression, they are actually a temporary crutch which hide your problems for a short while, only to come back in full force when you are dealing not only with a hang-over but your reality too. To often substance abuse and depression go hand-in-hand, so talk to someone about your reliance on alcohol or drugs, so they can help you
  • Exercise – while it may be difficult to drag yourself outside (or even to get up and put in an exercise CD into the CD player), it is so beneficial for your mental health to try. So many studies show that regular exercise is often just as effective as medication for relieving depression symptoms. It would benefit you to try a little exercise each day (or at least as much as you can handle) and build up to be exercising for between 30-45 minutes each day, including some cardio and resistance training. Exercise releases endorphins, the substances which make you “feel good” and can greatly improve symptoms of depression because you feel as though you are achieving something worthwhile and not only that, exercise gives you an opportunity to stop focusing on your negative feelings
  • Increase intake of nuts and seeds – especially try to eat more almonds and sunflower seeds, as they contain high levels, respectively of, magnesium/calcium and zinc, which may be lower in people with depression. All nuts and seeds are good, as they all contain some level of magnesium, calcium and zinc, plus they have excellent levels of the omega-3 fatty acids (especially walnuts and pecans), so include a large handful of raw, organic nuts and seeds into your diet every day
  • Increase intake of vegetables and fruits – especially the dark green leafy vegetables (lots of folic acid and magnesium) and all the bright or dark coloured fruits (lots of antioxidants). As a lack of folic acid and magnesium are thought to cause depression symptoms, it may be really beneficial to increase intake of vegetables and fruit in the diet. Try to aim for 5-7 portions of vegetables and about 3-5 portions of fruit each day
  • Limit intake of processed foods – any type of junk or processed foods will have very little nutritional value, be too high in fat, calories, sugar, salt and may make your symptoms worse. Try to limit your intake of these types of food as you will not receive much in the form of nutrients and as people who are depressed may have deficiencies in certain nutrients, you are not helping your condition to eat foods which will only exacerbate your symptoms, rather than making you feel better
  • Monitor your medication side effects – if you have any side effects to the anti-depressant or other medications you are prescribed, make sure you monitor these and advise your doctor, so that he/she can either adjust your dose or prescribe a different type of medication
  • Regular activities – it is important to make sure you have some order and structure in your life, without which, your depression can regress and get worse. With some regular activities planned for each day, it can help you get structure and meaning in your life, so plan what time you get up, what you will do during the day and what time you will go to bed. Write yourself a list of activities each day to aim for and don’t be too hard on yourself if you don’t achieve everything on your list; just be kind on yourself for trying
  • Relaxation strategies – your doctor will have recommended this as useful for a more calmer and relaxed state of mind and to release the negative emotions, or at least to stop focusing on them and focus on something else instead, which can really give you great relief. Some good strategies for relaxation including: meditation, tai chi, visualisation and yoga
  • Socialise – while it is exceeding difficult to socialise when you are depressed, you need to do the very thing that is hard for you, in order not to feel so isolated, as that can make depression symptoms worse. Even if it’s only for a short while and not on a regular basis, it is something you should try to engage in. Being around other people will give you a little more perspective and a way to distract yourself from your depression. Try it. At least once
  • Talk to your doctor about nutrient deficiencies – there is a lot of evidence that depressive illness may be at least partly due to nutritional deficiencies, as low levels in a number of vitamins/minerals and other nutrients can cause depression-like symptoms associated with low mood and emotional problems. Do not try to self-prescribe as it can cause severely adverse symptoms to mix certain supplements and prescription medications

People who feel so down that they are having thoughts of taking their life should call Lifeline on – 131114

Caring for someone with depression

Partner

If you have a partner who has been diagnosed with depression, there are a number of strategies you can use to help them:

  • Avoid alcohol – try not to have too much alcohol in the house, as alcohol can be detrimental to your partner’s symptoms, which may become much worse during the hangover the next day. Besides this, alcohol is only a salve that your partner uses to try to cover his/her problems and this is only going to prolong the depression
  • Encourage your partner to eat healthily – a number of nutrient deficiencies have been identified that can cause depression and low mood symptoms, so try to encourage your partner to eat a healthy diet with lots of fresh produce, nuts, seeds, legumes and olive oil and ensure they have enough fish each week (about 3 times a week and only the deep sea, ocean oily fish such as salmon, sardine, trout). Make sure you help your partner cook (or cook for them) to encourage the healthier diet. Use processed foods as little as possible and you should see an improvement in their symptoms (plus a more healthy family)
  • Encourage your partner to socialise – if you have a partner who is depressed, they may feel very isolated, even if they are living with you and the rest of the family, so you need to gently, but insistently encourage them to socialise with other people; with you, the family and their friends. This will help your partner because they know that they have your support and it will help them feel less isolated and alone, which in turn can help to reduce their symptoms of depression
  • Inform yourself about depression – try to get as much information about depression from your partner’s doctor (go with your partner to some of their appointments), from your partner and from qualified resources (both books and online) to help you understand what your partner is going through, so you can be as sensitive to them as much as you possibly can be
  • Support – it is really important that your partner has your complete support and understanding. Depression is a very debilitating illness, irrespective of whether it is caused by nutritional deficiency or due to abnormal brain chemistry and your understanding is needed so that you do not make them feel worse for suffering from depression
  • Talk to your partner – ask your partner if they would like to talk over any issues with you and try not to judge, as that will only make your partner less inclined to talk to you and feel more isolated from you. Just listen and let your partner talk out their issues. If you feel overwhelmed by this strategy, you can always encourage your partner (in a gentle and non-confronting way) to talk to a professional, which is now partly covered by Medicare, who may be in a better position to help your partner deal with their issues and depression

Friends

If you have a friend who has been diagnosed with depression, there are a number of strategies you can use to help them:

  • Encourage your friend to socialise – it would be really beneficial for your friend if you gently, but insistently encourage them to socialise with you and their other friends. This helps your friend in two ways: (1) they know that you care and (2) they feel less isolated. Encouraging your friend to socialise with you may help them on their road to recovery
  • Inform yourself about depression – especially if you are not familiar with depression yourself, it would be useful if you can inform yourself about depression from books and reputable online resources, so that you can try to understand at least a little of what your friend is going through with this illness
  • Support – it is important that your friend has your support, that you are there if they need you and that you wont judge them harshly or tell them to “get over it”, because that is unhelpful. Just be there for your friend, to help them on their road to recovery from this illness

Parents

If you have a child who has been diagnosed with depression, there are a number of strategies you can use to help them:

  • Encourage healthy eating – as there are a number of nutritional deficiencies associated with depression, it would be very beneficial for your child if you encourage healthier eating by preparing more fresh food and using fresh produce daily. Try to encourage your child to eat a healthy diet with lots of fresh produce, nuts, seeds, legumes and olive oil and ensure they have enough fish each week (about 3 times a week and only the deep sea, ocean oily fish such as salmon, sardine, trout)
  • Inform yourself about depression – especially if you are not familiar with depression yourself, it would be useful if you can inform yourself about depression from books and reputable online resources, so that you can try to understand at least a little of what your child is going through with this illness
  • Side effects to medication – if your child has to take any medication, make sure you reinforce the need for reporting any side effects they may experience, irrespective of how insignificant they may be
  • Support – it is important that your child has your support, that you are there if they need you and that you wont judge them harshly or tell them to “get over it”, because that is unhelpful. Just be there for your child, to help them on their road to recovery from this illness
  • Talk to your child – make time to talk to your child, but don’t try to force them to make conversation with you if they are not ready to do so, just let them know that you are available to talk in a non-judgmental, non-confrontational manner, so that it encourages your child to open up to you. Talking to your child will help improve your relationship and create a really nice bond between you

Support numbers

National support numbers (Australia)

The following are the main mental health support numbers in Australia. If you are feeling suicidal, call an ambulance on 000.

  • Lifeline Australia – 13 11 14
  • Beyond Blue – 1300 22 4636
  • Suicide Call Back Service – 1300 659 467
  • Kids Helpline – 1800 55 1800
  • MensLine Australia – 1300 78 99 78
  • Aboriginal & Torres Strait Islander support – 13YARN

References

References

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  • Bylund DB, Reed AL. Childhood and Adolescent Depression: Why do Children and Adults Respond Differently to Antidepressant Drugs? Neurochem Int. 2007 October; 51(5): 246–253
  • Christensen H, Leach LS, Barney L, Mackinnon AJ, Griffiths KM. The effect of web based depression interventions on self reported help seeking: randomised controlled trial. BMC Psychiatry. 2006; 6 : 13. Published online 2006 April 5. doi: 10.1186/1471-244X-6-13
  • Chung DJ, Kim HY, Park KH, Jeong KA, Lee SK, et al. Black Cohosh and St. John’s Wort (GYNO-Plus®) for Climacteric Symptoms. Yonsei Med J. 2007 April 30; 48(2): 289–294. Published online 2007 April 30. doi: 10.3349/ymj.2007.48.2.289
  • Eby GA 3rd, Eby KL. Magnesium for treatment-resistant depression: A review and hypothesis. Med Hypotheses. 2009 Nov 26. [Epub ahead of print]
  • Griffith HW. Minerals, Supplements and Vitamins: The Essential Guide. Fisher Books, USA, 2000
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  • Kemper KJ, Shannon S. CAM Therapies to Promote Healthy Moods. Pediatr Clin North Am, 2007 December; 54(6): 901
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  • Szegedi A, Kohnen R, Dienel A, Kieser M. Acute treatment of moderate to severe depression with hypericum extract WS 5570 (St John’s wort): randomised controlled double blind non-inferiority trial versus paroxetine. BMJ, doi:10.1136/bmj.38356.655266.82 (published 11 February 2005)
  • Szewczyk B, Poleszak E, Sowa-Kućma M, Siwek M, Dudek D, et al. Antidepressant activity of zinc and magnesium in view of the current hypotheses of antidepressant action. Pharmacol Rep. 2008 Sep-Oct;60(5):588-9
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Last reviewed and updated: 10 June 2026

Gastritis

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Gastritis

Facts

What is gastritis

Gastritis is an inflammation of the lining of the stomach, which can cause a great deal of irritation and discomfort.

Gastritis can be acute (sudden onset) or chronic (occurs gradually over time), but the effects are basically the same – an irritated stomach lining that causes pain, sometimes quite severe. Severe pain normally indicates that there is quite a lot of damage of the stomach lining and this needs to be treated quickly to prevent further damage and complications.

If gastritis becomes too severe or does not heal properly, it can cause ulceration of the stomach lining, which eventually can erode the lining and cause a peptic (or gastric) ulcer, which is a more serious condition.

Facts about gastritis

  • Recurrent, long-term gastritis can develop into stomach cancer in some people
  • Gastritis can lead to severe ulceration and erosion of the stomach lining from the stomach acid if it is not treated
  • Sometimes gastritis can lead to the development of a peptic ulcer (an ulcer in the stomach)
  • It is estimated that around 50% of the world’s population could be infected with higher than normal levels of the helicobacter pylori bacterium
  • Slippery elm powder, an excellent herb for gastritis, can interfere with the absorption of some medications so ensure the herb and medication are taken at least 2 hours apart
  • Many vitamins and minerals may not absorbed properly in people with gastritis so supplementation may be required
  • Mild gastritis may not even produce any symptoms, but it still needs to be treated

Symptoms

Symptoms of gastritis

General symptoms of gastritis are:

  • Bloating
  • Burping
  • Feeling of fullness (even when not a lot of food has been eaten)
  • Gas
  • Heartburn
  • Indigestion
  • Loss of appetite
  • Nausea
  • Stomach pain
  • Upper abdominal pain

More serious symptoms of gastritis

The symptoms which need to be investigated are:

  • Inability to sleep or lie down due to the stomach (gastric) pain
  • Severe stomach pain
  • Vomiting (of blood) may occur if there is ulceration
  • Weight loss (not eating due to the pain)

Causes

Causes of gastritis

Gastritis can be caused by a number of factors:

  • Alcohol (in excessive amounts) – heavy drinking causes a great deal of damage to the body and in particular damages the lining of the stomach
  • Backflow of bile – if there is a back-flow of bile from the small intestine into the stomach, this can irritate the stomach lining, especially if this occurs often
  • Bacteria overgrowth – certain bacteria can overgrow in the stomach (and other parts of the gastrointestinal system) which can damage the delicate pH balance of the stomach and allow them to proliferate even more. The bacterial overgrowth can be caused by a number of reasons, but ultimately the results is the same, an irritated stomach lining and gastritis symptoms. The bacteria most often responsible are: Helicobacter pylori and e.coli bacterium
  • Constipation – excessive constipation can put an immense pressure on the whole gastrointestinal system, from the constant straining and dryness of the colon, which can weaken the function of the gastrointestinal system and enable infection and inflammation to occur
  • Medications – certain medications can irritate the stomach lining, causing symptoms of gastritis. The medications that most commonly cause problems are: aspirin, non-steroid anti-inflammatory drugs (NSAIDs), naprogesic, but there are many others that can cause gastritis (including antibiotics)
  • Stress – some people who are stressed, especially if the stress is excessive or prolonged, can have an overproduction of acid in the stomach, which can really irritate the lining, when there is no food in there to digest and no protection for the stomach lining from the stomach acids
  • Vomiting – people who vomit excessively can cause a great deal of damage not just to the stomach, but also to the esophagus, when the stomachs acids are continuously being sent up from the stomach up the esophagus and through the mouth and expelled out. People who are the most likely to vomit excessively, are bulimics, but it can occur in people who have a severe gastrointestinal infection (bacterial gastroenteritis)

Prevention

Prevention of gastritis

Non-preventable risk factors

Gastritis may be unpreventable in certain circumstances:

  • Backflow of bile – a back-flow of bile from the small intestine back into the stomach can irritate the stomach lining and cause gastritis
  • Bacterial overgrowth – if the helicobacter pylori bacteria overgrows in the stomach, it can cause severe irritation to the lining of the stomach, erosion in the lining of the stomach (gastritis) and even gastric ulcer. Overgrowth of the helicobacter pylori bacteria in the stomach is the most common risk factor for developing gastritis. Certain ethnic groups tend to have more incidence of helicobacter pylori overgrowth and subsequently gastritis
  • Food poisoning – bacterial gastroenteritis, which is also known as food poisoning, can cause vomiting, irritation to the stomach lining and a number of of other symptoms associated with gastritis
  • Gastric infection – people who get a really severe bacterial gastroenteritis (food poisoning) infection may vomit repeatedly. If the vomiting continues unabated, it can cause gastritis symptoms, which may be difficult to prevent
  • Medications – there are a number of medications which cause an over-production of stomach acids and irritate the stomach lining. This effect is often temporary, but it can continue unabated in some people and continue to produce gastritis symptoms over the long term. The medications that most commonly cause problems are: aspirin, non-steroid anti-inflammatory drugs (NSAIDs), naprogesic, but there are many others that can cause gastritis (including antibiotics)

Preventable risk factors

There are ways to prevent gastritis from occurring:

  • Adequate fibre in the diet – a low fibre diet is associated with poor digestive health as it helps the digestive system to function properly. Fibre, from plant sources, is essential for a healthy digestive system
  • Healthy digestion – a healthy digestive system is less likely to be at risk for developing any gastrointestinal disorder, including gastritis. Ensure you eat adequate amounts of natural, unprocessed foods and have proper fibre intake.
  • Limit alcohol intake – excessive alcohol intake is a known factor which causes gastritis, so limit alcohol intake to 1-2 drinks per day, with at least 2 days alcohol free each week. People with an addiction to alcohol should seek treatment to limit alcohol intake and to prevent gastritis (as well as a number of other health conditions asssociated with excessive alcohol intake)
  • Reduce processed foods – a diet high in processed foods, with very little natural foods can cause an excess of stomach acid production, which can irritate the stomach lining, especially when it occurs over the long term and this can result in gastritis
  • Reduce stress – excessive or prolonged stress can cause an overproduction of acid in the stomach, which can irritate the stomach lining and produce gastritis symptoms. People who feel stressed need to engage in stress reduction strategies to control their emotions and feel calmer

Complications

Complications of gastritis

There are several complications of undiagnosed, uncontrolled or long term, recurrent gastritis:

Gastric (or peptic) ulcer

If the gastritis becomes really severe or does not heal properly, even when medication or alternative/complementary treatments are recommended and applied, it can cause major ulceration of the stomach lining, which can eventually erode the stomach lining and cause a gastric (or peptic) ulcer.

People who have any of the symptoms of gastritis need to seek their doctor’s advice about their treatment options, in order to reduce symptoms and prevent serious complications such as a gastric (or peptic) ulcer.

Stomach cancer

In some cases of people who have recurrent and long-term gastritis, the damage to the stomach lining can initiate cancer of the stomach, which is a more serious condition.

People who have gastritis need to get it treated, either with conventional treatment or alternative/complementary treatment in order to reduce the symptoms and reduce risk of serious complications such as stomach cancer.

Diagnosis

When to see a doctor about gastritis

People who have any of the symptoms of gastritis, should seek the advice of their medical practitioner, to determine if their symptoms indicate they have gastritis through a thorough diagnosis and for their doctor to recommend treatment options.

People with existing gastritis need to see their medical practitioner if:

  • their symptoms get worse
  • they start to get new symptoms not experienced previously
  • medication (or alternative therapy) does not help reduce symptoms in the same way as previously

Diagnosis of gastritis

Initially, a doctor will perform the following tests to diagnose gastritis:

  • Medical history – the doctor will ask a series of questions about the nature, duration and intensity of the symptoms and also when the symptoms started. The doctor will also ask if any activities make the symptoms specifically worse or better
  • Physical examination – the doctor will examine the stomach area for pain or discomfort, by pressing down (gently to firmly) on various parts of the upper and lower abdomen while the patient is lying down
  • Breath test – if overgrowth of the helicobacter pylori bacteria is suspected, then a breath test will be requested. In this test, the technician provides you with a special liquid to drink, which has a substance that is broken down in the stomach if the helicobacter pylori bacteria is present. This is tested by breathing into a breath analyser to detect if there is an infection of the helicobacter pylori bacteria and how much of the bacteria is present

Diagnostic tests

If conservative treatment does not resolve symptoms, then a special test will need to be performed by a specialist (gastroenterologist) to have a thorough look at the stomach, take a biopsy and to determine if there is another underlying condition:

  • Endoscopy (or gastroscopy) – this is a diagnostic test which is performed under light sedation to definitely diagnose the cause of the stomach pain and the procedure is as follows:
    • Light intravenous sedation is given to the patient
    • Gastroenterologist inserts a sterile, flexible tube with a camera at one end inside the mouth and through the eosophagus into the stomach
    • Images are taken of the stomach lining
    • A small amount of the stomach lining is taken to perform test to determine cause of gastritis and to ensure it is not due to a malignancy
    • The procedure is usually performed on a day patient basis with patients spending only a few hours in the surgery
    • Follow-up includes a breath test to determine if treatment has killed off all the helicobacter pylori bacterium

Treatment

Conventional treatment of gastritis

Initially, conservative treatment will be recommended for gastritis:

Dietary advice

  • Avoid alcohol – drinking of any alcohol needs to be eased, or at least greatly limited to give the stomach lining a chance to heal properly
  • Avoid the food triggers – spicy food, citrus fruit, acidic foods, chocolate, coffee, fatty foods, can all cause gastritis symptoms to get worse, so it will be recommended to limit intake of these foods (and any others that are known to the patient to trigger symptoms)
  • Dietary modification – it is normally recommended, when there is a severe gastritis flare-up to eat very bland foods which are easily digested and do not cause much acid to be produced in their digestion. Foods such as cracker, rice, toast, ripe bananas, clear soup, baked or boiled potatoes, plain pasta are recommended until symptoms have cleared. It is advisable to avoid meat and other high protein foods during a severe flare-up as these foods can cause a great deal of acid to be produced to break down their proteins in order to be digested and absorbed by the body

Lifestyle advice

  • Reduce stress – stress can cause excessive acid production which greatly irritates the stomach lining because if it is happening too much, the mucous lining gets eroded by the acid which gets to the lining to cause erosion and pain ensues
  • Stop smoking – smoking causes problems with the stomach lining by irritating the mucous lining of the stomach, making symptoms worse and preventing complete healing

Medication

Different types and combinations of medications are prescribed depending on severity and duration of symptoms, which is part of conservative, first line conventional treatment for gastritis (usually with the dietary and lifestyle advice):

  • Antacids – these are the first line of defence for mild to moderate gastritis, most contain calcium to provide protection for the stomach lining and help with healing. There is some controversy with their use, especially as most contain aluminium, which has been implicated in Alzheimer’s disease
  • Histamine-2 receptor antagonist – these drugs work to inhibit acid production in the stomach, inhibiting histamine from switching on acid production. These drugs help to heal the irritation and damage to the stomach lining
  • Proton pump inhibitors (PPI) – these drugs work to inhibit acid production in the stomach, to help enable healing of the irritation of the lining more quickly
  • Other drugs – there are a number of other drugs that work to reduce stomach acid production and promote healing. Some of these medications that are used are: Sucralfate and Misoprostol

Diagnostic tests

If conservative treatment does not work, then a gastroscopy will be performed and further treatment of gastritis will depend on the findings of the endoscopy:

  • If no bacterial infection is found, then usually no treatment advice is given other than the same dietary advise and to learn to relax (as stress causes more acid production in the stomach, which can damage the lining)
  • If bacterial infection is found, especially if it is of the Helicobacter pylori bacterium, a combination of antibiotics and other stomach medications is recommended to eradicate the bacteria. After the medication protocol is completed, a follow-up course of treatment may be required if the first treatment did not work (or didn’t work adequately enough to reduce bacterium levels, which will be determined with a breath test)

Medication for helicobater pylori infection

Medication for gastritis caused by Helicobacter pylori bacterium infection is through a combination of antibiotics (to heal the bacterial infection) and proton pump inhibitors (PPIs), to reduce the acidity in the stomach so that the bacteria can be more effectively reduced and the stomach lining healed.

  • Antibiotics – these are prescribed in combination with the PPI or H2 blocker drugs to get rid of the helicobacter pylori bacterium
  • Proton pump inhibitors (PPI) – these drugs (H2 blockers) work to inhibit acid production in the stomach, to help heal the irritation of the lining more quickly

Alternative

Alternative / complementary treatment of gastritis

Anyone who suspects they may have gastritis, should never try to self-medicate

Any type of medical condition needs to be diagnosed by a medical professional as the same symptoms could be confused with many other gastric disorders.

Always talk to your doctor about any supplements you want to take before trying them as they could interfere with the actions of any prescription medications.

Herbs

There are a number of excellent herbs which may help to provide relief for symptoms:

  • Chamomile – the herb chamomile has calming and also has anti-inflammatory properties which can be used in cases of mild to moderate gastritis to relieve symptoms and relax the digestive system so that it can heal more quickly. In addition to this, chamomile tea is used to help the body relax, which can help reduce the symptoms associated with stress
  • Marshmallow – a mucilaginous herb which provides protection of the stomach lining in the same way as slippery elm does; one caution is that it can lower blood sugar levels and cause “avitaminosis” (prevent proper absorption of vitamins and minerals) if used for prolonged periods
  • Peppermint – as a tea, peppermint can help to calm the stomach and helps with proper digestion, especially if taken after a meal
  • Slippery elm – this is an excellent herb which provides a protective mucilaginous (mucous-like, moist and sticky) layer around the stomach lining, protecting it from the acid in the gastric juices and greatly relieving symptoms and allows the stomach lining to heal and can assist with all types of gastritis, from mild to severe. Slippery elm is available in tablet or powder form – the powder needs to be mixed with water (or a little juice) and quickly drank to get the most benefits. This is a very safe herb that is not known to produce any adverse side effects when it is used correctly

Vitamins

There are a number of vitamins which may help to provide relief for symptoms:

  • Folic acid – studies show that folic acid, the B-vitamin cofactor may be especially not properly absorbed in people with gastritis, so supplementation may be advised
  • Vitamin A – the antioxidant vitamin A is essential in keeping the mucous membranes of the stomach lining healthy, which are damaged by the gastric acids and supplementation may be necessary
  • Vitamin B12 – this B vitamin is required as it particularly stimulates the immune system to work properly and repair damage caused by helicobacter pylori. In addition to this, vitamin B12 may be not be able to be absorbed properly as the intrinsic factor may not be produced adequately
  • Vitamin C – the antioxidant vitamin C is lowered when conventional medication is used to treat gastritis that is caused by helicobacter pylori. In addition to this, supplementation is advised as this vital nutrient may help to heal the tissues of the stomach lining more effectively and more quickly. Studies have shown that vitamin C (together with the bioflavonoids) can heal gastritis caused by helicobacter pylori in some people who may not be absorbing enough of this vitamin in the first place
  • Vitamin E – studies have shown that vitamin E may be beneficial in preventing malignancies of the gastrointestinal tract, especially in those people with chronic gastritis

Minerals

There are a number of minerals which may help to provide relief for symptoms:

  • Magnesium – this is an excellent mineral to calm muscles and other body tissue, which are inflamed and may be tense due to gastritis. Magnesium is required not just by the stomach, but every smooth muscle in the body, in order to function properly
  • Zinc – the antioxidant mineral zinc has been shown in studies to help promote quicker healing of gastritis (and also ulcers) and provides a quicker reduction in symptoms, especially if it is combined with carnosine

Other nutrients

There are a number of other nutrients which may help to provide relief for symptoms:

  • Bromelain – this is an enzyme which is found naturally in pineapples and can help with proper digestion. Bromelain is found to reduce stomach pain and other gastritis symptoms, especially if it is used with other digestive enzymes
  • Digestive enzymes – these enzymes may be beneficial to assist with digestion in the stomach and intestine
  • Essential fatty acids – the essential fatty acids omega 3 and GLA especially, provide anti-inflammatory properties to reduce severity of symptoms and promote healing
  • Probiotics – the ratio of “good” and “bad” bacteria may be disturbed by gastritis and supplementation is required to rebalance the intestinal flora with the probiotic acidophilus

Dietary modifications

There are a number of dietary modification strategies which may help to provide relief for symptoms:

  • Avoid alcohol – alcohol is a known irritant to the stomach lining and should be completely avoided until symptom are resolved; heavy drinking can cause gastritis
  • Avoid certain foods – some foods can make symptoms worse in some people – coffee, tomato and tomato products, chocolate, citrus foods and juices and in some really sensitive people the herbs peppermint and spearmint can also aggravate symptoms
  • Cabbage juice – the juice of cabbage contains “substance U” which has proven ulcer healing properties and it can help to reduce the ulceration of the stomach (or even eosophagus) mucosa and provide relief for symptoms, reducing their severity and duration
  • Chew food properly – chewing allows the food to be broken up into smaller portions which do not require as much gastric juices to be produced in the stomach to break them down further for absorption
  • Eat easily digested foods – to prevent high acid production in the stomach, it is advised to eat foods which are easily digested – bananas, rice, thin porridge, toast, crackers – while symptoms are at their worst
  • Eat small meals – while the stomach lining is inflamed it is recommended to eat small meals to prevent the high and prolonged acid production required to break down a large meal
  • Increase fibre intake – fibre can help with symptoms of chronic gastritis especially the soluble and mucilaginous fibres which protect the stomach lining from further damage (such as those in oats and psyllium). Try adding a small amount of fibre each day, to build up tolerance and help relieve symptoms slowly
  • Limit liquids with meals – do not drink lots of water with a meal, drink it about 15 minutes before or 30 minutes after the end of a meal; the excessive water may dilute gastric juices which can cause insufficient digestion and abortion which can cause chronic gastritis and other digestive disorders

Lifestyle modifications

There are a number of lifestyle modifications which may help to provide relief for symptoms:

  • Avoid reclining after meals – it is important to sit up straight after meals to allow proper digestion to take place; lying down can interfere with this process in a gastrointestinal system that is compromised and cause acid to come into the oesophagus which can burn
  • Relax – stress is a trigger that can cause over- production of the acidic gastric juices, which make gastritis symptoms worse. Learn to relax by utilising any type of relaxation strategy – deep breathing, qi gong, meditation, tai chi, visualisation, yoga
  • Stop smoking – smoking irritates the mucous lining of the stomach, making symptoms worse and preventing complete healing

Alternative treatments

  • Naturopath – a naturopath can provide a regimen of dietary and lifestyle changes, as well as a herbal tincture (or tablets) to help heal symptoms. Each person’s symptoms are different, so you will need to consult a naturopath in person, to get a proper diagnosis and be provided treatment options

Always ensure that you notify your medical practitioner of any supplements that you want to take – it may interfere with other medication or conditions you have. Confirm with your doctor it is safe to take before you try it.

Self care

Living with gastritis

Self care strategies

Gastritis requires some diligence in maintaining a healthy diet and some supplementation may be required to help heal the digestive system and reduce severity and duration of symptoms. The following are the strategies most recommended to achieve this:

  • Avoid artificial additives – any type of artificial colour, flavour or preservative is potentially a trigger to worsen gastritis symptoms. Read food nutrition labels and avoid foods which have any numbers in the ingredient list, as these will invariably be some type of artificial additive
  • Avoid artificial sweeteners – these can trigger severe diarrhoea symptoms so should be avoided. Always read food labels and avoid foods that are labelled “diet” or “no sugar”, as this invariably means they contain some type of artificial sweetener, such as: sorbitol, aspartame, saccharin (but there are others)
  • Avoid cigarette smoke – people who smoke have to give up. This is just another reason to help with the decision to stop smoking. Cigarette smoke causes a number of problems with digestion and should be avoided. People who do not smoke should avoid exposure to second hand smoke from people who smoke around them
  • Avoid coffee – it is advisable to avoid coffee as it can cause abdominal cramping and diarrhoea in many people with gastritis. There are a number of alternatives to coffee which are actually good for the digestive system (such as roasted dandelion root). There are a number of alternatives to coffee which are actually good for the digestive system (such as roasted dandelion root)
  • Digestive and pancreatic enzymes – the digestive and pancreatic enzymes are released by the digestive to help digest foods that are eaten so that their nutrients can be absorbed through the bloodstream. Digestions starts mainly in the stomach and ends in the small intestine. The digestive and pancreatic enzymes help to increase the amount of food digested by reducing the load on the digestive system
  • Essential fatty acids – the essential fatty acids, especially the omega 3 (DHA/EPA) and omega 6 (GLA) are vital for a properly functioning gastrointestinal system as they reduce inflammation that may be associated with this digestive disorder and this reduces severity and duration of symptoms. The best way to get adequate levels of the essential fatty acids is to eat 3-4 servings of oily fish each week and ensure it is deep ocean, wild fish (not farmed). The fish with the highest levels of omega-3 fatty acids are: mackerel, salmon, sardines, trout, tuna. People who cannot eat fish should try a supplement with balanced levels of each of the essential fatty acids and ensure it has been tested for mercury
  • Exercise regularly – physical activity is a must for anyone with a digestive disorder as it helps to increase blood and lymphatic circulation. This helps to eliminate any toxins or unwanted substances more quickly out of the body. Exercise also increases the endorphins released and reduces stress
  • Fibre – increasing the amount of fibre in the diet is vital for ensuring healthy digestion. The best types of soluble fibres is psyllium, which helps the intestinal flora digest food properly. The best ways to add psyllium or slippery elm to the diet are in: smoothies, milkshakes, sauces, yoghurt, breakfast cereal, muesli, dips. Suggested dosage is up to 2-3 teaspoons per day, but add it gradually if fibre hasn’t been an integral part of the diet previously, start with 1/2 teaspoon for a few days and add another 1/2 teaspoon every 4 days until at the 2-3 teaspoons a day level
  • Food intolerances or sensitivities – these can be confirmed (if not known) through either an elimination diet or a blood test. An elimination diet involves removal of all the suspected allergens (such as dairy, gluten) as well as all processed foods and associated food additives and then re-introducing these foods, one at a time to determine if they have an adverse effect on digestion, or any other part of the body
  • Limit alcohol – it may be necessary to stop drinking any alcohol while the intestines and the rest of the digestive system are in the process of healing and this is because alcohol is known to irritate the intestines
  • Organic – another strategy to reduce the stress on the gastrointestinal system is to avoid foods which are not grown organically (without the use of pesticides and other chemicals and antibiotics). This helps the digestive system because it does not have to also try to detoxify the chemicals in the food in addition to trying to digest foods normally (which is not occurring in this condition). Not only this, but studies show that organic food has higher levels of all their nutrients than food not grown organically
  • Probiotics – the “good” bacteria may be in short supply in the digestive system which could be contributing to the symptoms. Acidophilus and other probiotic bacteria are required to help re-populate the intestines with “good” bacteria, which help to properly digest foods and reduce the amount of undigested food that escapes the gut. People who are not lactose intolerant should also include yoghurt that has live cultures
  • Reduce stress and relax – prolonged and unrelenting stress is not good for healthy digestion. While stress is not known to cause leaky gut syndrome, it certainly can make symptoms worse because it causes the parasympathetic nervous system to remain in stress mode, which means digestion and absorption is not effective as the nerve that controls it prevents it from happening properly
  • Slippery elm – the herb slippery elm is necessary for intestinal health as it is required to heal the intestinal mucosa by providing a mucilaginous layer over the intestinal wall, which reduces the stress on the intestines and helps to heal the intestines more quickly
  • Smaller meals – eat smaller meals to help reduce the load on the digestive system, which is not working properly and cannot handle larger meals, which can cause worsening of symptoms when the stomach and intestines struggles to handle the large amount of food eaten. Aim to have around 6 smaller meals each day
  • Supplements – certain supplements may be required to help in the healing process by reducing the load on the intestines and reduce symptoms

Caring for someone with gastritis

Partner

The best way to help a partner with gastritis is to be supportive and sympathetic, but the following can be beneficial as well:

  • Avoiding smoking inside – people with gastritis need to be away from any cigarette smoke, as it can exacerbate their symptoms
  • Eating smaller meals – help your partner to eat smaller meals by joining them in eating smaller meals, as this helps support your partner a great deal. Cooking and eating smaller meals is one way to help reduce the load on the digestive system by reducing the amount of food that needs to be digested and absorbed
  • Encourage a healthy diet – a healthy diet is one which has adequate amounts of fresh fruit and vegetables, wholegrains, legumes, protein and healthy fats and has little or no processed foods
  • Encourage exercise – going for walks (or joining a gym together) with your partner is a great way to bond. Exercise helps to improve circulation, reduces stress and encourages better health overall

Friends

People who have a friend who has gastritis can support their friend by the following:

  • Dinner parties – if you invite your friend to a dinner party, try to ensure there is food that they can eat. The best way to do this is to ask what foods are off limits for them and ensure to let them know beforehand which foods they should avoid
  • Discourage alcohol – if your friend has gastritis, they should be limiting alcohol intake as it can cause a worsening of symptoms, so try to make your social meetings ones that are alcohol free

Parents

Parents of a child who has gastritis can support their child by:

  • Avoid smoking inside – people with gastritis need to be away from any cigarette smoke, as it can exacerbate their symptoms
  • Cooking smaller meals – this is one way to help reduce the load on the child’s digestive system by reducing the amount of food that needs to be digested and absorbed
  • Probiotics – introduce some probiotics to the child’s diet, preferably in powder form as it can be more easily assimilated into other foods, but the tablets can also be taken if this is not successful
  • Psyllium – find creative ways to add psyllium to foods (smoothies, breakfast cereal, muesli, sauces, shakes) in the child’s diet. Psyllium is a soluble fibre which has a gel-like consistency in the digestive tract and helps to promote the health of the whole gastrointestinal system
  • Slippery elm – find creative ways to add slippery elm to foods (smoothies, breakfast cereal, muesli) in the child’s diet. Slippery elm is one of the herbs most beneficial for any type of digestive disorder, but especially one in which there is irritation and damage to the intestinal wall and the intestinal mucosa

References

References

  • Fahey JW, Haristoy X, Dolan PM, Kensler TW, Scholtus I, Stephenson KK, Talalay P, Lozniewski A. Sulforaphane inhibits extracellular, intracellular, and antibiotic-resistant strains of Helicobacter pylori and prevents benzo[a]pyrene-induced stomach tumors. Proc Natl Acad Sci U S A. 2002 May 28;99(11):7610-5
  • Grieve M. Slippery Elm. Accessed 14 August 2007 at: http://www.botanical.com/botanical/mgmh/e/elmsli09.html
  • Harju E. Dietary and supplementary intake of nutrients by patients with gastrointestinal diseases. J Clin Gastroenterol. 1986 Dec;8(6):661-3
  • Hoffman D. Marshmallow. Accessed 14 August 2007 at: http://www.healthy.net/scr/mmedica.asp?MTId=1&Id=245
  • Lipsy RJ, Fennerty B, Fagan TC. Clinical review of histamine2 receptor antagonists. Archives of Internal Med (1990) 150:4
  • Matzke G. Doses of histamine-2-receptor antagonists should be reduced in patients with low glomerular filtration rate. Nature Clinical Practice Nephrology (2006) 2, 298-299
  • Metagenics, OneMedicine. Slippery Elm. Accessed 14 August 2007
  • Osiecki H. The Physicans Handbook of Clininical Nutrition, 6th Edition. Bioconcepts Publishing QLD, 2001
  • Ruiz B, Rood JC, Fontham ET, Malcom GT, Hunter FM, Sobhan M, Johnson WD, Correa P. Vitamin C concentration in gastric juice before and after anti-Helicobacter pylori treatment. Am J Gastroenterol. 1994 Apr;89(4):533-9
  • Russell RM, Krasinski SD, Samloff IM, Jacob RA, Hartz SC, Brovender SR. Folic acid malabsorption in atrophic gastritis. Possible compensation by bacterial folate synthesis. Gastroenterology. 1986 Dec;91(6):1476-82
  • Talalaj S, Czechowicz AS. Herbal Remedies: Harmful and Beneficial Effects. Melbourne; Hill of Content Publishing; 1989:213-214
  • Tratter R, Jones A. Better Health Through Natural Healing: How to Get Well Without Drugs or Surgery, 2nd Edition. McGraw Hill, 2001
  • Vonkeman HE, et al. Proton-pump inhibitors are associated with a reduced risk for bleeding and perforated gastroduodenal ulcers attributable to non-steroidal anti-inflammatory drugs: a nested case-control study. Arthritis Research & Therapy 2007, 9:R52
  • Yang Y-X, et al. Long-term Proton Pump Inhibitor Therapy and Risk of Hip Fracture. Journal of Medical Association (2006) 296:24

Last reviewed and updated: 14 May 2024

Sweet chilli sauce

VItalHealthZone
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Sweet chilli sauce
Diabetes friendly recipe
Low GI recipe
Low fat recipe
Low carb recipe
Dairy free recipe
Gluten free recipe
Heart healthy recipe
Vegetarian recipe
Vegan recipe


This is an excellent natural sweet chilli sauce, which can be used as a dipping sauce or as a sauce over a variety of dishes. It has far less salt and not sugar compared to commercially available ones.

The sweet chilli sauce will keep in the refrigerator, covered, for up to 1 month.

Nutrition rundown

  • Very low in calories at just 6.8 kcal per serving, making it a light flavour enhancer without significantly impacting overall energy intake
  • Extremely low fat content (0.1 g total fat, virtually no saturated fat), supporting heart-healthy dietary patterns
  • Zero cholesterol, ideal for cardiovascular-conscious eating
  • Low sodium (36.3 mg per serve) provided salt is used sparingly which is far lower than most commercial sweet chilli sauces
  • Low carbohydrate content (1.6 g), with only 1.2 g natural sugars coming mainly from honey and chillies
  • Provides a small amount of dietary fibre (0.3 g) from fresh chillies and garlic
  • Contains modest plant-based protein (0.2 g) from garlic and chillies
  • Vitamin C (high) – Fresh chillies and lime juice provide a strong antioxidant boost, supporting immune function, collagen production and skin health
  • Capsaicin (bioactive compound in chillies) supports metabolism, may assist with fat oxidation and has anti-inflammatory properties
  • Allicin (from garlic) is linked to improved heart health, antimicrobial activity and immune support
  • Flavonoids & polyphenols are present in chillies and lime juice, contributing antioxidant protection
  • Potassium (small amount) supports blood pressure regulation
  • Manganese (trace amounts) is involved in metabolism and antioxidant enzyme function
Recipe information
Serves: 8 (0.5 cups)
Prep time: 10 mins
Cooking time: 0 mins
Recipe nutrition (per serving)
Calories: 6.8
Carbs: 1.6 grams
Protein: 0.2 grams
Fat: 0.1 grams

Ingredients

  • 6 large fresh chillies, finely chopped
  • Juice of 2-3 limes
  • 3 cloves garlic
  • 1 Tspn honey (amount can be adjusted to taste)
  • Salt

Method

  1. Combine all ingredients (except the salt) in a mortar and pestle and grind until they are all smoothly combined. Alternatively they can be added to a food processor and mixed until smooth.
  2. Season with the salt to taste.

Nutrition information

  Nutrition InformationAmount% Daily
Value
Calories6.80.3%
Calories from fat0.50.1%
Total fat0.1 g0.1%
Saturated fat0 g0%
Cholesterol0 mg0%
Sodium36.3 mg1.6%
Carbohydrate1.6 g0.6%
Dietary fibre0.3 g1.1%
Sugars1.2 g2.4%
Protein0.2 g0.4%

The % daily values are based on a diet of 2000 calories per day
These are approximate values.

Tahini, hazelnut, almond spread

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Tahini, hazelnut, almond spread
Diabetes friendly recipe
Low GI recipe
Low carb recipe
Dairy free recipe
Gluten free recipe
Heart healthy recipe
Vegetarian recipe
Vegan recipe


This delicious spread is healthy, has no additives and is delicious.

The tahini, hazelnut, almond spread can be kept in the fridge in an airtight container for 2-3 weeks.

Nutrition rundown

  • High in healthy fats (18.1g per serve) primarily monounsaturated and polyunsaturated fats, which support heart health and cholesterol balance
  • Provides 198.4 calories per serve, making it an energy-dense, nutrient-rich spread ideal for sustained energy
  • Excellent source of plant-based protein (5.8g), supporting muscle repair, satiety and metabolic health
  • Delivers 2.9g dietary fibre (10.4% DV), promoting gut health, blood sugar regulation and fullness
  • Extremely low in sodium (1.8mg)** and naturally heart-friendly and suitable for low-sodium diets
  • Contains zero cholesterol, supporting cardiovascular wellness
  • Rich in Vitamin E (from almonds and hazelnuts), a powerful antioxidant that protects cells from oxidative stress
  • Excellent source of magnesium, supporting nerve function, muscle relaxation and blood pressure regulation
  • Provides calcium and iron (especially from tahini), contributing to bone strength and oxygen transport
  • Good source of zinc, important for immune function and skin health
  • Contains B vitamins (especially folate and B6), supporting energy metabolism and brain health
  • Provides potassium, helping maintain fluid balance and healthy blood pressure
  • Naturally rich in sesamin and lignans (from tahini), compounds linked to anti-inflammatory and antioxidant benefits
  • Lemon juice adds Vitamin C, enhancing iron absorption and immune support
Recipe information
Serves: 12 (1.5 cups)
Prep time: 10 mins
Cooking time: 10 mins
Recipe nutrition (per serving)
Calories: 198.4
Carbs: 12.3 grams
Protein: 7.0 grams
Fat: 4.2 grams

Ingredients

  • 125g blanched hazelnuts
  • 125g blanched almonds
  • 1/4 cup tahini
  • 2 Tbsp lemon (or lime) juice

Method

  1. Place hazelnuts and almonds on an oven tray.
  2. Roast the nuts at 200°C for about 5-10 minutes or until they are slightly golden brown.
  3. Add the hazelnuts, almonds, tahini, lemon juice and about 1/2 cup of water to a food processor until a smooth paste is formed.
  4. Season the spread with some salt to taste.

Blanched nuts

This means that the skin has been removed by adding the nuts the boiling hot water for 5 seconds and then immediately removing them from the hot water, so that it makes the skin easy to remove. The nuts then need to be squeezed with absorbent paper to remove any excess water before being roasted.

Nutrition information

  Nutrition InformationAmount% Daily
Value
Calories198.49.9%
Calories from fat162.944.7%
Total fat18.1 g23.2%
Saturated fat1.9 g9.5%
Cholesterol0 mg0%
Sodium1.8mg0.1%
Carbohydrate6.2 g2.3%
Dietary fibre2.9 g10.4%
Sugars1.4 g1.8%
Protein5.8 g11.6%

The % daily values are based on a diet of 2000 calories per day
These are approximate values.

Yoghurt dressing

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Yoghurt dressing
Diabetes friendly recipe
Low GI recipe
Low fat recipe
Low carb recipe
Dairy free recipe
Gluten free recipe
Heart healthy recipe
Vegetarian recipe
Vegan recipe


This is a great dressing which can be used for many main course dishes or just as an accompaniment for crackers or vegetables.

The yoghurt dressing will keep in the refrigerator, covered, for up to 5 days.

Nutrition rundown

  • Low calorie at only 29.3 kcal per tablespoon, making it a light, nutrient-dense dressing option
  • Contains 2.2 g healthy fats, largely from extra virgin olive oil, providing heart-supportive monounsaturated fats
  • Only 0.8 g saturated fat, keeping it balanced and suitable for heart-conscious eating
  • Very low sodium (12.4 mg) especially since salt is added sparingly, making this ideal for blood pressure management
  • Provides 1.4 g protein per tablespoon, mainly from yoghurt, supporting muscle maintenance and satiety
  • Contains live probiotics (if using natural yoghurt) to support gut microbiome health, digestion and immune function
  • Provides small amounts of calcium (~40 mg per serving, 4% daily value) supporting bone strength
  • Garlic contributes allicin, known for cardiovascular and immune-supportive properties
  • Fresh herbs (mint, oregano, thyme) provide polyphenols and antioxidants, helping reduce inflammation and oxidative stress
  • Lemon juice adds vitamin C (~1.5 mg per serving, 2% daily value) supporting immune function and collagen production
  • Olive oil contributes vitamin E (~0.3 mg per serving, 2% daily value), an antioxidant that protects cells from damage
  • Paprika adds carotenoids including beta-carotene, supporting eye health
  • If using plant yoghurt instead of dairy, the dressing becomes cholesterol-free and lower in saturated fat, while still providing protein
Recipe information
Serves: 1 cup – 1 tbs per serve
Prep time: 35 mins
Cooking time: 0 mins
Recipe nutrition (per serving)
Calories: 29.3
Carbs: 1.6 grams
Protein: 1.4 grams
Fat: 2.2 grams

Ingredients

  • 200g plain organic yoghurt (coconut, almond, rice, goat, soy or cow’s milk yoghurt – your choice)
  • 3 cloves organic garlic, finely chopped
  • 1 Tbsp fresh organic mint, finely chopped
  • 1 Tbsp fresh organic oregano, finely chopped
  • 1 Tbsp fresh organic thyme, finely chopped
  • 2 Tbsporganic lemon juice
  • 1 Tbsp extra virgin, cold pressed organic olive oil
  • Sweet paprika (organic)
  • Salt to taste

Method

  1. Combine all ingredients (except olive oil, sweet paprika and salt) in a bowl.
  2. Season with salt to taste.
  3. Leave the sauce to stand for about 30 minutes in the fridge, covered so that the flavours can develop properly.
  4. Serve with a drizzle of olive oil and sweet paprika.

Nutrition information

  Nutrition InformationAmount% Daily
Value
Calories29.31.5%
Calories from fat19.514.7%
Total fat2.2 g2.8%
Saturated fat0.8 g4.0%
Cholesterol3.1 mg1.0%
Sodium12.4mg0.5%
Carbohydrate1.6 g0.6%
Dietary fibre0.1 g0.4%
Sugars1.2 g0.9%
Protein1.4 g2.8%

The % daily values are based on a diet of 2000 calories per day
These are approximate values.

Leafy green salad

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Leafy green salad
Diabetes friendly recipe
Low GI recipe
Low fat recipe
Low carb recipe
Dairy free recipe
Gluten free recipe
Heart healthy recipe
Vegetarian recipe
Vegan recipe


This salad is a wonderful green salad (plus it has tomatoes and capsicums) that is a great accompaniment to any meal.

Any type of leafy greens (or purple) can be used and substituted instead of the ingredients below.

Nutrition rundown

  • Heart-Healthy Fats, the extra virgin olive oil provides monounsaturated fats, which help support healthy cholesterol levels and reduce cardiovascular risk.
  • Rich in Antioxidants: Packed with vitamin C, vitamin E, carotenoids and polyphenols, this salad helps combat oxidative stress and inflammation.
  • Extremely high in vitamin K, with over 200 mcg per serving, this supports bone strength and proper blood clotting.
  • Excellent source of vitamin A, the mixed greens, rocket and spinach deliver high levels of beta-carotene, supporting eye health, skin repair and immune function.
  • Immune-boosting nutrients, vitamin C from capsicum, tomatoes and lemon juice helps enhance collagen production and immune defence.
  • Gut-friendly fibre, natural plant fibre supports digestive health, beneficial gut bacteria and stable blood sugar levels.
  • Blood pressure support as potassium-rich vegetables help balance sodium levels and assist in maintaining healthy blood pressure.
  • Low in carbohydrates, with only around 5–6 g carbs per serving, this salad has a very low glycaemic load, making it ideal for blood sugar control.
  • Naturally cholesterol-Free and completely plant-based and free from cholesterol.
  • Plant-based iron & folate provides non-heme iron and folate to support energy production and healthy cell function.
  • Hydrating & nutrient-dense, high water content vegetables help with hydration while delivering concentrated micronutrients.
  • Anti-inflammatory compounds, extra virgin olive oil and leafy greens contain natural compounds that support reduced systemic inflammation.
  • Naturally low in sodium (unless extra salt is added), making it suitable for heart-conscious diets.
Recipe information
Serves: 4
Prep time: 5 mins
Cooking time: 0 mins
Recipe nutrition (per serving)
Calories: 137.8
Carbs: 5.6 grams
Protein: 1.8 grams
Fat: 13.5 grams

Ingredients

  • 150g mixed green organic salad leaves (mignonette, oak leaf, butter leaf, cos)
  • 12 organic snow peas, cut julienne
  • 1 small bunch (handful) organic rocket leaves
  • 1 small bunch (handful) organic baby spinach
  • 1 green or red organic capsicum, sliced finely in 5cm strips
  • 2 organic tomatoes, roughly chopped
  • 3 Tbsp organic extra virgin, cold pressed olive oil
  • 2 Tsp organic lemon juice or balsamic vinegar
  • Salt

Method

  1. Add all ingredients into a large bowl.
  2. Add dressing and toss the salad until all vegetables are covered.
  3. Season with salt to taste.

Nutrition information

  Nutrition InformationAmount% Daily
Value
Calories137.86.9%
Calories from fat121.53.6%
Total fat13.5 g20.8%
Saturated fat1.9 g9.5%
Cholesterol0 mg0%
Sodium52.3mg2.3%
Carbohydrate5.6 g2.0%
Dietary fibre2.0 g7.1%
Sugars3.0 g1.2%
Protein1.8 g3.6%

The % daily values are based on a diet of 2000 calories per day
These are approximate values.

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