Natural Treatments for Depression: Can They Help?

Depression is a state of mind that is sad, persistent and leads to issues in your everyday life. It is pervasive; The National Institute of Mental Health (NIMH) estimates that 21 million people in the United States have had at least one major depressive episode. That’s about 8.4% of the population. It’s also damaging. In 2017, depression was deemed the “leading cause of disability worldwide” by the United Nations. Most crucially, it is deadly. Depression can lead to suicidal thoughts and actions resulting in over 700,000 deaths every year. 

Due to the stigma attached to experiencing mental health issues, many people feel like they should “tough it out.” As a result, they don’t get the treatment they need, which can lead to a worsening of their symptoms and even long-term brain damage. It’s important to speak to a mental health professional who might recommend medication and/or forms of therapy. There are complementary and alternative options that can be beneficial as well, such as natural supplements and physical therapies. 

Symptoms of Depression

It may be difficult for a person to know when they are experiencing depression because everyone experiences it in a different way. There are a number of symptoms of depression; even if you only experience a few of these, you could be having a depressive episode.

• Feeling sad, empty or hopeless
• Not feeling interested in or enjoying things that you used to like
• Difficulty concentrating on everyday tasks
• Low self-esteem or excessive guilt about things
• Pessimism about the future
• Thoughts about death
• Insomnia or oversleeping
• Overeating or undereating, which can lead to weight changes
• A constant feeling of fatigue

How Does Depression Affect Health?

It’s important to get treatment for depression because if your symptoms go untreated for a long time, they may actually lead to changes in the brain. Some of those changes include:

• Shrinkage: Certain parts of the brain, such as the hippocampus, the thalamus, the amygdala and the prefrontal cortices might shrink as a result of depression. As a result, memory, learning, navigation of space, attention span and impulse control can be impaired.
• Inflammation: Brain inflammation is also associated with long-term depression. Inflammation can damage brain cells, which can affect thinking and memory.

These changes can lead to increased depressed episodes per year and worse outcomes when finally treated. With prompt and proper treatment, these changes can be reversed. 

Additionally, untreated depression can contribute to and/or worsen physical health conditions. Some examples are below:

• Pain syndromes can be exacerbated by depression
• Depression is linked with poorer outcomes for endocrine, musculoskeletal and vascular diseases, such as the following:
  • Diabetes
  • Obesity
  • Arthritis
  • Heart disease

Common Treatments for Depression

In general, depression is best treated with a combination of medication and psychotherapy. Additional forms of treatment can also be effective, like transcranial magnetic stimulation.

Medications for Depression

There are many medications that can be prescribed for depression. It’s a good idea to work with your provider to find the one that works best for you. First-line treatment for depression are medications that work on increasing the availability of certain neurotransmitters in the brain, specifically serotonin, norepinephrine and dopamine. These neurotransmitters play a role in emotional regulation, appetite, impulsivity, ability to learn, anxiety, sleep, pleasure, concentration, energy and motivation. Below are an overview of these types of medications: 

1. SSRIs or selective serotonin reuptake inhibitors, such as Celexa, Lexapro, Paxil, Prozac and Zoloft are commonly prescribed for depression and work by increasing the availability of serotonin in the brain.
2. SNRIs or serotonin and norepinephrine reuptake inhibitors, such as Cymbalta, Effexor and Pristiq, work by increasing the availability of serotonin and norepinephrine in the brain.
3. Atypical antidepressants, such as Wellbutrin, Viibryd, Trintellix, Remeron and trazodone, work on dopamine, norepinephrine and/or serotonin as well.

Sometimes augmentation with additional medications are needed for full symptom improvement. Strategies include adding on an atypical antidepressant (such as Wellbutrin or trazodone), a neuroleptic (such as Abilify, Rexulti, Vraylar, Seroquel, Zyprexa and Risperdal), or a mood stabilizer (such as lithium).

Psychotherapy for Depression

Psychotherapy alone or in conjunction with medication can vastly improve symptoms of depression. Working with a therapist can be beneficial for processing past traumas that contribute to symptoms, learning skills to manage symptoms directly, and change thought patterns that perpetuate depressive episodes. There are several types of psychotherapy that can improve depressive symptoms, including cognitive behavioral therapy, interpersonal therapy, dialectical behavior therapy and psychodynamic therapy.

Natural Depression Treatments

There is some evidence for improving symptoms of depression using herbs, hormones, and supplements. To note, these remedies are not regulated for consistent quality and research is not conclusive on the effect of their benefits. Additionally, some can interact negatively with medications. Thus, it is important to discuss these options with a provider before initiating treatment.

St. John’s Wort

If you’re thinking about taking a supplement to treat depression, here’s what you need to keep in mind about St. John’s Wort:

• St John’s Wort or Hypericum Peforatum is a flowering shrub whose flowers and leaves contain the ingredient hyperforin.
• You can get St. John’s Wort in tea form, tablet form and liquid form.
• John’s Wort has been shown to be effective in treating mild or moderate depression but not severe depression.
• Taking St. John’s Wort may also help to reduce hot flashes during menopause.
• John’s Wort can be taken orally for up to 12 weeks.
• Side effects of St. John’s Wort include agitation, anxiety, dizziness, diarrhea, constipation, stomach upset, dry mouth, fatigue, insomnia, headache and photosensitivity (sensitivity to light).
• John’s Wort may reduce the effectiveness of many medications that are used for heart conditions, cholesterol, bleeding disorders, and birth control. Additionally, when taken with an antidepressant, it can increase the amount of serotonin in the brain to toxic levels, which results in a condition called serotonin syndrome. So it’s best to consult your physical and mental health providers before using it.

5-HTP

5-Hydroxytryptophan or 5-HTP is yet another supplement that claims to help with depression. Here’s what you need to know:

• 5-HTP is a chemical that is produced by an amino acid in the body and can produce an increase in serotonin in the brain. 
• 5-HTP can also be beneficial for weight loss, migraines, sleep and pain.
• Research suggests that 5-HTP works better in conjunction with other medications for depression rather than by itself.
• You can take 400 mg of 5-HTP daily for up to a year. But taking larger doses might be unsafe.
• Side effects of 5-HTP include heartburn, stomach ache, vomiting, diarrhea, sleepiness, sexual problems and muscular problems. A serious condition known as eosinophilia-myalgia syndrome has also been linked with 5-HTP.
• This compound can also lead to toxic levels of serotonin in the body, thus it is important to discuss with your mental health provider before taking it.

SAMe

S-adenosyl-L-methionine is a naturally produced compound in the body but is also available as a supplement.

• SAMe helps to produce neurotransmitters like dopamine, serotonin and norepinephrine in the body, which can help to alleviate symptoms of depression.
• In Europe, SAMe is a prescription medication while in the US, it is available as a supplement.
• SAMe is generally considered safe, with mild side effects, such as digestive issues, mild insomnia, dizziness, irritability, anxiety and sweating.
• SAMe might increase risk for mania in people with a mood disorder.
• Taking SAMe with other antidepressants might result in too much serotonin in the brain. Consult your provider before taking this supplement.

DHEA

Dehydroepiandrosterone (DHEA) is a hormone naturally produced in the body. It is also available as a supplement.

• DHEA might be helpful in treating people with depression, especially if they have low DHEA levels.
• It is also supposed to be anti-aging and might help with osteoarthritis and vaginal atrophy.
• There are quite a few safety concerns when it comes to taking DHEA which might have a steroid effect. It can also increase the risk of prostate cancer, breast cancer and ovarian cancer.
• DHEA might increase risk for mania in people with a mood disorder.

Saffron

Saffron is often used as an aromatic spice in various cuisines; it also has some antidepressant properties.

• Saffron can help increase the amount of serotonin in the brain.
• Saffron can also help people with weight loss and premenstrual syndrome. It also has positive sexual side effects and a positive effect on digestion.
• You can cook with saffron or take it as a supplement.
• Saffron may have some mild side effects such as anxiety, changes in appetite, stomach upset, headache and a sleepy feeling. There are also some people who are allergic to saffron.
• If you are taking blood pressure medicine or blood thinners, then check with your doctor first because saffron can interact with these medications.

Exercise

One of the easiest ways to relieve depression is to exercise. Any form of exercise results in the release of endorphins in the brain. These are chemicals which have a feel-good effect. Whether you’re just going for a walk, doing yoga or lifting weights, your brain produces these chemicals that can make you feel good, not just while you’re exercising but for several hours afterwards. Exercise also releases neuroprotective chemicals that can improve brain function and protect the brain from damage. 

Physically, exercise increases strength, stamina and flexibility. This can have a positive effect on mental health. When you can perform your daily chores without any difficulty and keep working through the day without feeling fatigued, your self esteem improves. This can also help to alleviate depression.

Healthy Diet

Eating healthy is important for physical well-being, but it can also help with brain health.

• The brain needs certain vitamins, such as vitamin C, D and B, as well as certain minerals, such as magnesium, selenium and zinc to perform at its best. If you can’t get these from your diet, it’s a good idea to take a multivitamin every day.
• Omega-3 fatty acids have evidence of improving symptoms of depression. We absorb omega-3 fatty acids when we eat seafood, nuts, seeds, and oils. Additionally supplementation may be beneficial by taking fish oil that includes both DHA and EPA.
• Research has also shown that there is a correlation between folic acid deficiency and depression. Folic acid is a B vitamin that is important for brain function, however some people cannot absorb it well when eating foods that contain it. Thus, an alternative form, L-methylfolate, is another form of folic acid that can be better absorbed. To see if supplementation with L-methylfolate would be beneficial, work with your provider about having a gene test completed to confirm poor folic acid absorption.

Light Therapy

Light therapy has historically been used to improve symptoms of depression that are seasonal. However, it may also have benefits for all types of depression. In particular, light therapy can help improve energy, mood, and concentration symptoms of depression. You’ll need to buy a light therapy box or lamp which emits a bright light (over 10,000 lux) and sit in front of it for about 30 minutes per day. It’s important not to look directly at the lamp; keep your eyes averted. 

Crisis Helplines and Resources

Substance Abuse and Mental Health Services (SAMHSA) National Helpline

National Alliance on Mental Illness

Anxiety and Depression Association of America

National Suicide Prevention Lifeline

American Psychological Association

Depression is a serious condition affecting millions worldwide, and natural treatments can be beneficial when used alongside professional help. While St. John’s Wort, exercise, and a healthy diet show promise, it’s essential to consult a mental health provider before trying supplements. Remember, you are not alone, and reaching out for help is a sign of strength and courage. There are resources available to support you on your journey to recovery. Contact us to learn more about treating depression through medication, psychotherapy and natural treatments.