Cures For Depression Without Medication

A Schizophrenic, a Slain Worker, Troubling Questions

For over a year, Mr. Chappell, a schizophrenic with a violent criminal record, had seemed relatively stable in a state-financed group home in Charlestown. But after a fight with another resident, Mr. Chappell was shuttled from home to home, and his mother believed that he had fallen off his medication along the way.

Ms. Chappell said she had tried to communicate this concern to his caretakers, but it was not until mid-January that she found somebody who listened.

The woman introduced herself as Stephanie and said she would be Mr. Chappell’s counselor at his new group home in Revere. She confirmed that Mr. Chappell had stopped getting his antipsychotic injections but made his mother a promise: “She said: ‘Don’t worry. I’m going to get Deshawn back on track.’

“I thought everything was going to be O.K. because he had somebody who cared,” Ms. Chappell said, her voice breaking.

Two days after that conversation, Stephanie Moulton, a petite, street-smart 25-year-old, was dead, and Mr. Chappell was accused of murdering her. They had been alone at the Revere home, where, her family said, Ms. Moulton generally worked a solo shift. Mr. Chappell beat her, stabbed her repeatedly and then dumped her partially nude body in a church parking lot, prosecutors said.

The killing on Jan. 20 stunned the mental health care community in Massachusetts. The “shattering event,” as one former state mental health official called it, occurred days before Gov. Deval Patrick, a Democrat, released his proposed budget, which would slash mental health spending for the third year in a row. And it raised the timely but uncomfortable question of whether such continuous belt-tightening had played a role in Ms. Moulton’s death.

Many people wondered aloud whether the system had failed both the suspect and the victim. How had Ms. Moulton ended up alone in a home with a psychotic man who had a history of violence and was off his medication? How had Mr. Chappell been allowed to deteriorate without setting off alarms? Should he have still been living in a group home, or did he need the tighter supervision of a hospital?

“People are reeling right now,” Dr. Kenneth Duckworth, a former medical director for the State Department of Mental Health, said after the killing. “Will this case be the canary in the coal mine? Will it signal that we’ve gone too far in reducing client-staff ratios, in closing hospitals, in pushing independence for people who may still be too sick?

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Get some exercise most days of the week. Research shows that exercise of any kind is as good as psychotherapy or antidepressants for treating depression. Exercise can increase feel-good brain chemicals like serotonin and endorphins and reduce stress and anxiety. Walk, swim, run, bike, do yoga or dance.

Get enough vitamin D . Supplemental vitamin D has been shown to improve mood in older people who aren’t getting enough in their diets or from sunshine. While sunlight can help, you may need more than the sun can provide. Take 1,000-2,000 IU a day. Plus, get your blood level of 25(OH)D level checked. It should be above 35 ng/mL (87 nM/L). Try melatonin. If you have sleep problems or seasonal affective disorder (SAD), take 1-3 mg a day of melatonin, a hormone that helps to correct your body’s internal “clock.” Night owls need to take it in the afternoon or evening, while morning larks (people who wake up too early) should take it in the morning. Melatonin is also affected by light exposure, so try to minimize exposure to bright light at night.

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