Naturally, I Prefer Not to be Depressed
by Bradley T. Wajda, D.O.
The subject of effective “natural remedies” for depression comes up frequently, and I have learned that it is essential to first define what we are talking about. Some people define “natural” as including anything that doesn’t utilize prescription medication, while others define “natural” as pertaining to nutritional supplements. First, I would point out that “natural” medicine is still medicine- with the potential for side effects, drug interactions, and contraindications (times when it is not appropriate). Secondly, I would like to list some of the interventions that are considered “alternative therapies” or non-medication therapies: acupuncture, aromatherapy, biofeedback, chiropractic, eye movement desensitization and reprocessing (EMDR), homeopathy, hypnosis, light therapy, massage therapy, meditation, nutritional supplements, psychotherapy, transcranial magnetic stimulation (TMS), and yoga. For this discussion we will be focusing only on nutritional supplements.
When treating your depression you need to realize that seeking psychotherapy from a qualified profession is the cornerstone upon which you build your treatment. There should not be a time when you are the “doctor” because you are the patient. Having a therapist unbiasedly assist you in assessing the severity of your depression and helping you to make treatment decisions is essential. If these treatment decisions lead you toward “natural remedies” then it should still be with the advice and supervision of your physician. For example, if you are not deficient in a vitamin, amino acid, or a mineral then it isn’t going to help (and may cause problems). An excellent example is Iron. Iron deficiency has been linked to depression BUT taking excess amounts can cause serious problems. Nutritional supplements in the treatment of situational, mild, or moderate depression can work well; however, they should be considered only in a supportive role for severe depression. Also, be patient when taking nutritional supplements. They generally take as long or longer than traditional medication before you notice any effect (and like any other medication- you do need to take it as directed). Now to the list of the most popular and most studied supplements.
- St. John’s wort (hypericin is the active ingredient). There have been many double blind research studies showing effects similar to prescription anti-depressants with a lower risk of side effects; however, hypericin interacts with several conventional medications like birth control pills. Again the caution is to include your physician when taking any nutritional supplements.
- B-vitamins- B-12, B-6, and folic acid (folate). In 2011 “Deplin” was introduced to the medical community as a “medical food”. It is L-methylfolate (a B vitamin) to be used as an add-on to conventional antidepressants.
- Omega 3 Fatty acids- specifically from fish rather than flaxseed. Studies not only suggest that omega 3 fatty acids may help in depression but that combining omega 3 with antidepressant works better than using the antidepressant alone.
- S-adenosyl-Methionine (SAMe)- A natural amino acid that produces the neurotransmitters (such as serotonin and dopamine) that many believe to be responsible for our mood. Though it isn’t approved to treat depression by the FDA, it is used as a prescription antidepressant in Europe.
- 5-HTP (5-hydroxytryptophan). Many studies have been done on tryptophan as a treatment for insomnia and depression. Serious contamination issues took it off the market over 20 years ago for a period of time and thus interrupted the amount of attention it was receiving as a therapeutic agent at that time.. 5-HTP is converted to serotonin (mood) and melatonin (sleep).
- Vitamin D- is the only vitamin that is a hormone with receptors on cells in the areas of the brain linked with depression. It is important in calcium absorption and the release of neurotransmitters. Several studies have linked vitamin D deficiency to depression. This is a good time to give another reminder to include your physician in these decisions. Too much vitamin D can cause very serious problems.
Other supplements to mention in the potential treatment of depression include saffron, schisandra “Chinese Prozac”, calcium, magnesium, passionflower, and L-theanine (green tea).
If you are currently on anti-depressants, DO NOT discontinue your prescription medication without following the advice of your doctor. These nutritional supplements may be appropriate for you- and deserve consideration- but not without the advice of your physician. Remember to allow the experts to do what they do best and keep an open mind to all of the potential treatment possibilities.