Alternative Treatments for Depression

By John M. Grohol, Psy.D.

Alternative Treatments for DepressionThere are a wide range of alternative treatments for depression. Before seeking out a mental health professional or talking to their doctor, a lot of people turn to alternative remedies to try and combat clinical depression. Few people want to take a prescription medication (often because of the cost or side effects) when something else might work just as well.

This article will cover some of the more popular alternative remedies for clinical depression, many of which have significant research backing to support their use. In many cases, trying an alternative treatment may be sufficient to help alleviate the most distressing symptoms of depression. As with anything you try, you should always talk to your health care professional first, to ensure the treatment is right for you (this is especially true if you’re currently taking certain medications, as they may interact badly with some herbs or diets).

As with any treatment for depression, your results will vary in trying any of the below options. People with more serious or severe depression may experience the least benefit from these kinds of treatments.

You should not try more than one alternative treatment at a time, especially when it comes to herbal remedies. Be patient in waiting to experience the full, beneficial effects of any of the below treatments, as it can take anywhere from 4 to 8 weeks for you to feel it.

St. John’s Wort for Depression

Once you get past the weird name, St. John’s wort is actually one of the most effective herbal remedies to try for depression. St. John’s Wort is the common name for hypericum perforatum, an herbal remedy for the treatment of depression that has become increasingly popular over the past decade in the United States. It is widely used throughout Europe, Germany in particular, where it is licensed for depression, sleep disorders and anxiety. Herbal remedies are considered a form of alternative medicine.

St. John’s Wort is a yellow flower with five petals that grows wild in many parts of the world. It is named for St. John the Baptist because it blooms around June 24, his feast day. In ancient times, this herbal remedy was believed to have powers to ward off evil spirits.

Dozens of research studies have been conducted and published throughout the world on the efficacy of this herb. For instance, in early 2005, the British Medical Journal published an article demonstrating that in a large clinical trial, St. John’s Wort is at least as effective as a commonly-prescribed antidepressant and has fewer side effects in the treatment of moderate to severe major depression (BMJ 2005;330:503 (5 March)).

In 2008, the Cochrane Collaboration — a non-profit research organization that analyzes scientific studies to draw conclusions from them — determined that the overall body of research evidence for the effectiveness of St. John’s Wort in the treatment of depression was strong (Linde et al., 2008).

Cochrane Researchers reviewed 29 trials which together included 5,489 patients with symptoms of major depression. All trials employed the commonly used Hamilton Rating Scale for Depression to assess the severity of depression. In trials comparing St. John’s wort to other remedies, not only were the plant extracts considered to be equally effective, but fewer patients dropped out of trials due to adverse effects. The researchers said, “Overall, we found that the St. John’s wort extracts tested in the trials were superior to placebos and as effective as standard antidepressants, with fewer side effects.” In other words, it works.

When trying St. John’s wort, stick to name brands and look for tablets or capsules standardized to 0.3 percent hypericin. The usual dose is 300 milligrams is two to three times a day with food. Like almost anything you take for depression, it seems like it may take 4 to 8 weeks to experience the full positive effects of this treatment.

S-adenosyl methionine (SAMe)

S-adenosyl methionine (also known as S-adenosylmethionine or simply SAMe) appears to be an effective treatment for depression, as least for short-term use. In a meta-analytic review of 7 studies, a significant improvement was found for patients taking SAMe versus placebo in the treatment of depressive symptoms (Williams et al., 2005). Another, more recent review found virtually the same result, but also lamented that many of the studies examined were of poor scientific quality (Carpenter, 2011).

When considering taking SAMe, again, look for brand name products which typically have higher quality control standards. It’s generally recommended that you look for SAMe in enteric-coated tablets of either 200 mg or 400 mg. The effective dose varies between 400 to 1,600 milligrams a day, taken on an empty stomach. You can take lower doses (under 800 milligrams) once a day, a half hour before the morning meal. Anything over 800 mg you should split into at least two doses, taking the second one a half hour before lunch.

Omega-3 Fatty Acids (Fish Oil)

Omega-3 fatty acids such as eicosapentaeoic acid (EPA) and docosahexaenoic acid (DHA) might have an impact on depression because these compounds are widespread in the brain. The evidence is not fully conclusive, but omega-3 supplements are an option. One to two grams of omega-3 fatty acids daily is the generally accepted dose for healthy individuals, but for patients with mental disorders, up to three grams has been shown to be safe and effective.

Supplements that contain amino acids have been found to reduce symptoms, possibly because they are converted to neurotransmitters in the brain that help alleviate depression. For example, serotonin is made using the amino acid tryptophan. Dietary supplements that contain tyrosine or phenylalanine, later converted into dopamine and norepinephrine, are also available.

You can get omega-3 from a variety of sources, both natural and supplemental. Naturally occurring omega-3 can be found in large amounts in beans (kidney, navy or soy), walnuts and flaxseeds. Fish, winter squash and olive oil also can act as a rich source of omega-3. Omega-3 supplements can usually be found as “fish oil” supplements. There has been no recommended standard doses of such supplements.

Vitamins and Minerals

Deficiencies of magnesium and vitmains B and D have been linked to depression. Research suggests that patients treated with 0.8mg of folic acid per day or 0.4mg of vitamin B12 per day will have reduced depression symptoms. Patients treated with 125 to 300mg of magnesium with each meal and at bedtime have shown a more rapid recovery from major depression.

Hoang and colleagues (2011) found that low vitamin D levels are associated with greater depressive symptoms — especially in people with a prior history of depression. Taking between 1,000 and 2,000 IU of vitamin D each day may help with keeping depression at bay.

Exercise for Depression

Although it’s mentioned all the time, people still seem often reluctant to try one of the easiest ways of helping to improve depressive symptoms — exercise. This is not surprising, however, since some of the symptoms of depression that many people experience include lethargy and a lack of motivation and energy. How can one exercise when one feels so unmotivated to do anything?

There’s no easy answer, but study after study has demonstrated the beneficial effects on mood of even occasional, moderate exercise. For instance, simply walking for 20 to 30 minutes per day, every other day, is sufficient to gain some mood-lifting benefits. If outdoor exercise isn’t possible, find a physical activity you can do at home or even consider joining a gym.

Other Herbs

There have, as of this writing, been only a small number of studies conducted on other possible herbal remedies for depression (Sarris et al., 2011). Therefore, based upon the evidence to date, none of these herbs are recommended as potential treatments for depression. In two randomized controlled clinical trials of C. sativus extract, beneficial effects were found in alleviating depression symptoms. These studies also noted that anxiety, tachycardia, nausea, dyspepsia and changes in appetite are possible side effects of this herb. Rhodiola (Rhodiola rosea) has had only a single study demonstrating its effectiveness in depression, and is therefore not recommended. Echium amoenum also has had only a single study that has examined its effectiveness in treating depression symptoms and is also not recommended.

Are Herbal Remedies Safe?

In general, yes, herbal remedies are safe when purchased from a major retail outlet and are a name brand product. Herbal remedies have come a long way in the past decade, as their formulations have become more standardized across manufacturers. Since herbal remedies are considered “food” by the U.S. government, they are not regulated in the same manner as prescription medication, so they may not adhere to the same stringent manufacturing requirements.

You should always carefully read the herbal packaging and ensure you understand the specific type and amount of the herb you’re intending to take. As pointed out in a recent medical journal article, contamination, mislabeling, and misidentification of herbs are important problems. In general, if you are taking an herbal remedy or thinking about it, discuss it with your physician. This is particularly important if you have several medical illnesses and are taking prescription medications.

References

Carpenter, DJ. (2011). St. John’s wort and S-adenosyl methionine as “natural” alternatives to conventional antidepressants in the era of the suicidality boxed warning: what is the evidence for clinically relevant benefit? Altern Med Review, 16, 17-39.

Hoang MT, Defina LF, Willis BL, Leonard DS, Weiner MF, Brown ES. (2011). Association between low serum 25-hydroxyvitamin d and depression in a large sample of healthy adults: the cooper center longitudinal study. Mayo Clin Proc., 86, 1050-5.

Linde K, Berner MM, Kriston L. (2008). St John’s wort for major depression. Cochrane Database of Systematic Reviews 2008, 4. DOI: 10.1002/14651858.CD000448.pub3.

Sarris J, Panossian A, Schweitzer I, Stough C, Scholey A. (2011). Herbal medicine for depression, anxiety and insomnia: A review of psychopharmacology and clinical evidence. Eur Neuropsychopharmacol.

Williams AL, Girard C, Jui D, Sabina A, Katz DL. (2005). S-adenosylmethionine (SAMe) as treatment for depression: a systematic review. Clin Invest Med., 28, 132-9.

 

APA Reference
Grohol, J. (2011). Alternative Treatments for Depression. Psych Central. Retrieved on September 22, 2014, from http://psychcentral.com/lib/alternative-treatments-for-depression/00010045
Scientifically Reviewed
    Last reviewed: By John M. Grohol, Psy.D. on 30 Jan 2013
    Published on PsychCentral.com. All rights reserved.