Supplements and Natural Treatments for Depression
Depression is a common mental disorder that affects about 121 million people worldwide, according to the World Health Organization qq(WHO). Unfortunately, fewer than 50% of people living with depression globally get adequate treatment despite the numerous treatment options available. Below we will discuss in more detail what depression is, what causes depression, who is at risk, and various supplements and natural treatments for depression.
What is depression?
The American Psychiatric Association defines depression as a common and serious medical illness that negatively affects how you feel, the way you think, and how you act. Depression symptoms can vary from mild to severe and can include:
Feeling sad or having a depressed mood
Loss of interest or pleasure in activities once enjoyed
Changes in appetite — weight loss or gain unrelated to dieting
Trouble sleeping or sleeping too much
Loss of energy or increased fatigue
Increase in purposeless physical activity (e.g., hand-wringing or pacing) or slowed movements and speech (actions observable by others)
Feeling worthless or guilty
Difficulty thinking, concentrating or making decisions
Thoughts of death or suicide
Who is most likely to become depressed?
According to Everyday Health, one depression fact that holds true across racial and economic differences is that depression is twice as common in women as it is in men. It is thought that female hormones play a role in the development of depression. It’s also important to take into account that men are less likely to report depression than women. Furthermore, many studies have shown that depression can be passed down through families. The highest rate of first time depression occurs in adolescents and young adults aged 12 to 24. If your symptoms of depression are causing problems with relationships, work, or your family, and there isn't a clear solution, you should seek professional help.
What causes depression?
Depression is thought to be caused by altered neurochemistry. Neurochemistry involves neurotransmitters (natural chemicals that enable neurotransmission) and how they interact with neurons. There are three main neurotransmitters that play a central role in depression: norepinephrine, serotonin, and dopamine.
Norepinephrine is an excitatory neurotransmitter often referred to as a “stress hormone” because it is released into the bloodstream when the brain perceives that a stressful event has occurred. That is why sudden bursts of norepinephrine are often linked to anxiety, elevated blood pressure, and hyperactivity. Low levels, on the other hand, can cause lethargy, inattention, and lack of focus and concentration. Patients with depression often have low levels of norepinephrine.
Serotonin is often referred to as the “happy chemical” because it contributes to wellbeing and happiness. Serotonin also plays a role in appetite, sleep, memory, and learning. The “serotonin hypothesis” of clinical depression proposes that diminished activity of serotonin pathways is involved in the development of depression.
Dopamine is a neurotransmitter that helps to regulate motivation, perception, attention, movement, and regulating hormone release. Dopamine is also involved in the brain’s reward system and contributes to feelings of pleasures and satisfaction, which is why this neurotransmitter plays a part in addiction. Experts believe that some depression symptoms, such as low motivation, feeling helpless, and loss of interest, are linked to a dysfunction within your dopamine system.
Prescription medication for depression
The treatments of choice for most patients with depression include a combination of psychotherapy and antidepressants. There are many different classes of antidepressants, including:
Selective serotonin reuptake inhibitors (SSRIs); Examples include Prozac (fluoxetine) and Celexa (citalopram)
Serotonin-norepinephrine reuptake inhibitors (SNRIs); Examples include Cymbalta (duloxetine) and Effexor (venlafaxine)
Tricyclic antidepressants (TCAs); Examples include Elavil (amitriptyline) and Pamelor (nortriptyline)
Monoamine oxidase inhibitors (MAOIs); Examples include Nardil (phenelzine) and Parnate (tranylcypromine)
Atypical agents; Examples include Wellbutrin (bupropion) and Desyrel (trazodone)
The SSRIs are typically the preferred class of antidepressants used for initial treatment of depression. They are considered to be equally as effective as TCAs. Plus, they have several advantages over TCAs, such as fewer side effects and better safety profiles. The response rate to an antidepressant is usually 50% to 55%. Remission, or complete absence of symptoms, occurs in about 35% to 40% of patients. Antidepressants can sometimes cause a wide range of unpleasant side effects, including nausea, increase appetite or weight gain, loss of sexual desire, fatigue and drowsiness, insomnia, dry mouth, and constipation.
Natural remedies for depression
Since prescription drugs for depression can have many side effects, patients often seek natural remedies to help improve their symptoms. Fortunately, there are supplements and nutraceuticals that have been clinically proven to help with depression. Two of the best supplements for depression are St. John’s wort and SAMe.
St. John's wort has a mechanism similar to conventional antidepressants. It inhibits the reuptake of serotonin, norepinephrine, and dopamine, and also affects other neurochemicals such as glutamate and gamma-aminobutyric acid (GABA). The antidepressant effects of St. John’s wort are due to a compound known as hyperforin. The majority of studies evaluating the efficacy of St. John’s wort demonstrate that this supplement is effective for improving mood and reducing insomnia and somatic symptoms of depression in patients with mild to moderately severe depression. One problem with St. John’s wort is that it can cause a lot of drug interactions. Thus, it is important to check with your pharmacist before taking St. John’s wort in order to ensure this supplement does not interact with any other medication you are taking.
SAMe (S-adenosyl-L-methionine) is made in the body from a reaction between methionine, which is an essential amino acid, and adenosine triphosphate (ATP). SAMe works differently than most conventional antidepressants. It is thought to work by influencing neuronal membrane fluidity. Membrane fluidity refers to the viscosity (thickness) of the lipid bilayer of a cell membrane. SAMe is also thought to increase serotonin turnover, as well as increase norepinephrine and dopamine levels.
While St. John’s wort and SAMe are considered to be the most effective natural treatments for depression, there are many other supplements that have shown potential benefits. Examples include the following:
NADH (Nicotinamide adenine dinucleotide hydrate)
L-tryptophan and 5-HTP (5-hydroxytryptophan)
Non-drug treatments for depression
There are numerous non-drug treatments and lifestyle modifications that can help improve your mood and treat depression. Some examples include diet, exercise, massage, herbs, sunlight, and many more. Exercise in particular has been shown in multiple studies to help with depression. In fact, for some people it works as well as antidepressants. This is because the brain releases endorphins (a type of neurotransmitter) when you physically exert yourself. Physical activity also stimulates the release of dopamine, norepinephrine, and serotonin.
Another non-drug treatment for depression that you most likely have not heard of is a machine by Fisher Wallace called the Stimulator®. The Stimulator® is a wearable neurostimulation device that is regulated by the FDA for the treatment of depression, anxiety, and insomnia.
Using this device once or twice a day for 20 minutes stimulates serotonin production, alpha wave production, and lowers cortisol. According to the Wall Street Journal, Columbia University psychiatrist Richard P. Brown says he has used the device with 400 severely depressed patients and that more than 70% find relief -- about twice the rate of antidepressants. Unlike conventional antidepressants, the Fisher Wallace Stimulator® has little to no side effects, with less than 1% of patients experiencing a temporary headache or dizziness. However, if you have an implanted, electronic device such as a pacemaker, you should not use the Fisher Wallace Stimulator®.
As you can see, depression is a complex illness that involves many different types of neurotransmitters in the brain. Fortunately, there are many available treatment options that are clinically proven to help improve depression symptoms. If you are looking for a natural treatment for depression, always check with your physician or pharmacist first to ensure that there are no contraindications.
Natural Medicine Journal, “Natural Depression Remedies” Dec 2009 Vol. 1 Issue 12
American Psychiatric Association, “What is Depression?”
Integrative Psychiatry, “Low Norepinephrine - Depressed, Inflamed, & In Pain” Jan 2015
World Psychiatry. 2015 Jun; 14(2): 158–160.
Healthline, “What’s the Difference Between Dopamine and Serotonin?”
Everyday Health, “Facts About Depression: Who's at Risk?”
Wikipedia, “Membrane Fluidity”
Healthline, “Exercise, Depression, and the Brain”