Depression is a common condition, affecting about 121 million people worldwide, according to the World Health Organization. In the United States an estimated 21 million American adults -- or 9.5 percent of the population -- have depression at some point. Many brain regions are involved in depression, and studies show that several different types of treatment, including drugs and cognitive therapy, are usually needed before patients can be cured. More natural options include exercise, yoga, herbs, diet, better sleep suggestions, and nutritional supplements. In most patients, regular exercise may work as well as medication in improving symptoms of major depression.
Depression is a feeling of intense sadness; it may follow a recent loss or other sad event but is out of proportion to that event and persists beyond an appropriate length of time. After anxiety, depression is the most common psychiatric disorder. An estimated 10 percent of the people who see their doctors for what they think is a physical problem are actually experiencing depression. Depression typically begins in the 20s, 30s, or 40s. An episode of depression typically lasts for 6 to 9 months, but in 20 percent of the people, it lasts for 2 years or more. Episodes generally tend to recur several times over a lifetime. Craving for sweet rewards is increased by depression in both animals and humans. Exercise, proper diet, relaxation techniques, and yoga can help fight depression.
Nutrients and herbs
for depression. How would one
know which one to use?
Treating depression is difficult,
whether through drugs or supplements. Each person is unique in terms of
the causes for the depression and their response to medicines or
supplements. However, we can make some generalizations that you can discuss
with your doctor. If the depression is associated with low energy and
motivation, then SAM-e could be helpful since this nutrient can perk
someone up pretty quickly. However, high doses can cause overstimulation
and mania. If the depression is associated with restlessness, anxiety and
rapid, incessant thoughts, 5-HTP is a good option since it converts into
serotonin which has a calming effect. Somewhere between these two effects
is St. John's wort which is not as stimulating as SAM-e, but not as
calming as 5-HTP. And it's quite likely that as the depression progresses,
some people who at first benefited from one supplement may find it is no
longer helpful and another supplement is more appropriate. We think part of
the reason for the failure of depression treatment lies in the fact that
patients or doctors don't adjust the dose or medicine to reflect the
biochemical, life circumstance or lifestyle changes that are going on
within or outside the individual as the weeks and months go on. Another
nutrient that influences mood is tryptophan. Tryptophan has some aspects that are similar to 5-HTP.
There are several
supplements and herbs that can lift depression.
Our favorites are SAME-e, St. John's Wort, and
5-HTP.
5-HTP can start within hours. You can find
5-HTP
here. 5-HTP converts into serotonin,
and important brain chemical involved in mood, appetite, and impulse control.
5-HTP suits those whose depression is associated with
anxiety, restlessness, or
racing thoughts. A disadvantage of 5-HTP is that it reduces sexual drive.
SAM-e
a powerful nutrient that starts
working within hours. A recent study found SAM-e was helpful even in depressed
patients who did not respond well to Prozac and other SSRIs. SAM-e is best
suited for those whose depression is associated with low energy, low motivation,
and no anxiety. For those whose depression is associated with anxiety, 5-HTP is
a better option. There is a risk for overstimulation with SAMe use, hence
dosage should be kept low and it would be good to take a day or two off when one
notices overstimulation. SAM-e is not advised for manic depression. Find more s-adenosylmethionine
research here.
SAM-e is very potent and should be used carefully in low dosages since it
can cause insomnia or a manic phase.
St. John's wort usually
takes a couple of days. For more
St. John's
wort research.
B vitamins including pantothenic acid
have a mild influence on depression. Lower folate, lower vitamin B12 and raised
homocysteine levels are risk factors for late-life depression.
Tryptophan
has helped many people with depression symptoms
Fish Oils can help
stabalize mood. Eating fish is a good option.
Acetyl-l-carnitine
can lift mood and enhance mental activity
CDP-choline has a short mood lift effect.
DMG is short for
dimethylglycine.
NADH to be used occasionally,
not daily, more
nadh info
TMG
trimethylglycine a
cheap methyl donor similar in some ways tof SAM-e, does not work as well, but it's good
DHEA
in low doses in older individuals who are hormone deficient
Pregnenolone
in low doses in older individuals who are hormone deficient
Cordyceps mushroom
extract
Maca is an herb from the
Andes, you can buy
Maca
here.
Muiria Puama takes two
or three days
Rhodiola herb
Schisandra plant
Diet and depression
Many people do not realize the crucial role diet plays in depression and mood disorders.
If a patient goes to their doctor and reports feelings of depression, it
is quite unlikely that their physician will do a dietary history. Most
likely the prescription pad will be taken out and
the words Prozac, Zoloft, Paxil, or another antidepressant will be jotted
down before you can even spell 'd e p r e s s i o n.' There are many causes for
depression, and diet is one cause that is often overlooked. As we
understand the complexity of brain biochemistry, scientists are realizing
that inflammation in the brain plays a role in depression. Certain chemicals called
cytokines cause inflammation in the brain which influences mood. If you
ever had low mood or felt depressed during or after a bad case of the flu,
then you realized first hand how these cytokines released by the immune
system effected your brain. It is interesting to note that this is a
typical case of a body-brain influence. The body, in this case the immune
system, releases chemicals called cytokines into the bloodstream. These in turn enter brain
tissue cause inflammation, leading to low mood. In
addition to depressed mood cytokines also cause loss of appetite, altered sleep patterns and fatigue.
Fortunately cytokines, and other substances that cause
inflammation, are influenced by diet. When you eat lots of fish or foods with
omega-3 fatty acids, your body will make fewer inflammatory cytokines.
Exercise for depression
Exercise can lift depression. Exercise enhance activity in the gene for a nerve
growth factor known as VGF. Nerve growth factors are small proteins important in
the development and maintenance of nerve cells. When researchers infused a
synthetic version of VGF into the brains of mice, it produced an antidepressant
effect. Nerve growth factors are small proteins important in the development and
maintenance of nerve cells.
The causes of Depression
The causes of depression aren't fully
understood. A number of factors may make a person more likely to experience depression,
such as a heredity, side effects of certain medications, an introverted personality, poor
self image, and emotionally upsetting events, particularly those involving a loss.
Depression may also arise or worsen without any apparent or significant life stress.
Having a mother who has experienced depression can double a child's chances of becoming
depressed.
Depression that follows a traumatic event, such as the death of a
loved one, is called situational depression. Some people become temporarily
depressed in reaction to certain holidays (holiday blues) or meaningful
anniversaries, such as the anniversary of a loved one's death. Depression
without an apparent precipitating event is called endogenous depression. Football players who have repeated
head concussions are more likely to have depression.
Poor health
habits as cause for depression
Depression and anxiety are associated with obesity and poor health behaviors
like smoking, drinking, and physical inactivity.
Childhood abuse
Depression in young adulthood is an
important consequence of childhood abuse and neglect. For many abused or
neglected children, depression sets in during childhood.
Situational
depression
Depression that follows a traumatic event, such as the death of a
loved one, is called situational depression. Some people become temporarily depressed in
reaction to certain holidays (holiday blues) or meaningful anniversaries, such as the
anniversary of a loved one's death. Depression without an apparent precipitating event is
called endogenous depression.
Medical
conditions predispose depression
A combination of heart disease, obesity, and diabetes risk factors known as the
metabolic syndrome is a predisposing factor for the development of depression.
Depression may also occur with, or be caused by, a number of physical diseases or
disorders. Physical disorders may cause a depression directly (such as when thyroid
disease affects hormone levels, which can induce depression) or indirectly (such as when
rheumatoid arthritis causes pain and disability, which can lead to depression). Various
prescription drugs, most notably drugs used to treat high blood pressure, can cause
depression. A number of psychiatric conditions can predispose a person to depression,
including certain anxiety disorders, alcoholism and other substance abuse disorders,
schizophrenia, and the early phase of dementia.
Patients with more severe depression within a few weeks of myocardial infarction or other acute coronary syndrome, as well as those whose depression does not improve shortly after the event, are at increased risk of dying over the next several years. Arch Gen Psychiatry 2009;66:1022-1029.
Depression in women
Women are twice as likely as men to experience
depression, though the reasons aren't entirely clear. Studies show that women
tend to respond to adversity by withdrawing into themselves and blaming themselves. In
contrast, men tend to deny adversity and throw themselves into activities. Of biologic
factors, hormones are the ones most involved. Changes in hormone levels, which can create
mood changes shortly before menstruation (premenstrual tension) and after childbirth
(postpartum depression), might play some role in women. Similar hormonal changes may occur
with the use of oral contraceptives in women who have experienced depression. Abnormal
thyroid function, which is fairly common in women, may also be a factor.
Depression and
diabetes
Elderly people who have depression are more likely to become diabetic than those
who are not. Depression may play a role in causing the most common form of
diabetes.
Depression is associated with physical
changes in the brain. There is decreased blood flow in the brain's emotional
centers, abnormal metabolism, shrinking of certain brain regions, and changes in neurons
and dendrites. Therefore, it is unrealistic to tell someone with depression to "just
snap out of it." Depression is as much of a physical illness as diabetes and heart
disease.
Depression may also occur with, or be caused by, a number of physical diseases or
disorders. Physical disorders may cause a depression directly (such as when thyroid
disease affects hormone levels, which can induce depression) or indirectly (such as when
rheumatoid arthritis causes pain and disability, which can lead to depression). Various
prescription drugs, most notably drugs used to treat high blood pressure, can cause
depression. A number of psychiatric conditions can predispose a person to depression,
including certain anxiety disorders, alcoholism and other substance abuse disorders,
schizophrenia, and the early phase of dementia.
Medical Therapy for
Depression
The most commonly used pharmaceutical agents to fight depression, the SSRIs such as
Prozac, Paxil, Zoloft, and others, are often effective in fighting depression but have a
high rate of side effects including headache, loss of sex drive and sensation, nausea,
insomnia, and upper gastrointestinal bleeding.
Depression and
heart disease
Depression appears to increase the development of blood vessel plaques,
known as atherosclerosis, a condition that can lead to heart attack, stroke, and
a host of other cardiovascular problems.
Treatment of
depression during pregnancy
The choice of depression medication options in women who are pregnant is
limited. Doctors can recommend psychotherapy and bright light therapy in the
winter. Bright light therapy has been found to be effective for seasonal
affective disorder. Prescription drugs are widely used for depression and
include antidepressants from various drug classes. Some examples include
selective serotonin reuptake inhibitors (SSRIs), serotonin and norepineph rine
reuptake inhibitors (SNRIs), and tricyclic antidepressants. All available
antidepressants are considered to be equally effective for uncomplicated
depression, and the choice of agent depends on safety, side-effect profile,
potential drug interactions, patient preference, and cost. Treatment goals
should focus on remission of patient symptoms and restoration of function. A
doctor may also consider recommending natural supplements such as 5-HTP, SAM-e,
and St. John's wort, and the lowest dosages should be used for the briefest
period of time necessary for these natural supplements to be effective. The
safety of the fetus have to be balanced with the wellbeing of the mother.
Postpartum
depression
First-time mothers remain at risk of postpartum depression and mental illness 4
or 6 weeks or longer after the length of time suggested in reference manuals.
Furthermore, although new fathers are exposed to some of the same stressors as
mothers -- lifestyle changes, sleep deprivation -- their risk of psychiatric
illness and depression does not increase during this time.
Close female
friends help women through depression --
Nearly all women say they get depressed, stressed
or anxious at some point in their lives, and most turn to their female friends
for support during these and other tough times. For information on
suicide.
Depression study
Close female
friends help women through depression --
Nearly all women say they get depressed, stressed
or anxious at some point in their lives, and most turn to their female friends
for support during these and other tough times.
Depression Gene
A gene associated with depression and other forms of mental illness may enlarge
an area of the brain that handles negative emotions. The study is one in a
number which shows that the brains of people with depression are structurally
different than the brains of people who are not depressed. Writing in the
journal Biological Psychiatry, researchers from the University of Texas
Southwestern Medical Center looked at a serotonin transporter gene, which has
two forms, or variants -- short, or SERT-s, and long, SERT-l. People with two
SERT-s genes had pulvinars, a brain region which handles negative emotions, that
were 20 percent larger and contained 20 percent more nerve cells than people
with either one or two SERT-l genes. The gene also affects serotonin, a
message-carrying chemical or neurotransmitter associated with mood, and one
targeted by certain classes of antidepressant drugs, said the researchers, who
had studied the brains of 49 people who had died. The gene is a serotonin
transporter since when brain cells release serotonin, the gene brings it back
into the cell. Depression drugs slow this process down, making serotonin
available to the cells for longer. Dr. Dwight German, a professor of psychiatry
who worked on the study, said similar studies have shown that certain other
areas of the brain are smaller in people with the SERT-s gene. German's team
estimated that about 17 percent of the population has two copies of the SERT-s
gene. These people appear to be more sensitive to emotional stimuli and more
likely to experience depression than people with one or no SERT-s genes, they
said.
Depression emails
Q. This past year I decided to go to a naturopath for treatment of
depression and anxiety that I've had trouble with for most of my life. I had
been going to counselling and taking prescription medications for depression for
a long time but found the drugs caused either really uncomfortable side effects
or a kind of emotional numbness. Exercise and diet changes, especially cutting
out any refined sugars and overly processed food has definitely helped some, but
a lot of the symptoms are still there. The doctor I went to see for depression
recently prescribed Fish oil (2 grams daily), SAMe (200mg daily), Tyrosine
(1000mg daily), 5htp (200mg daily), acidophilous (1 capsule daily), a
multivitamin ( once daily),
Canchelaqua (10 drops daily), and Bach Mustard flower ( 4 drops daily). I was
also supposed to take 1 gram of L-theanine a day. It seemed like way too much
stuff and then pretty high doses of some of them too, which it sounds like,
after reading on your website, was the case with the 5htp especially. I know you
can't give any dosage recommendations for depression or anything, but I'm
wondering if you have any advice or insight?
A. We suggest you mention to your naturopath to read some of the
information on the natural supplements for depression discussed on the website.
Perhaps your naturopath may not be fully aware that sometimes lower dosages work
well, too. We wish you optimal healing, sometimes it takes trial and error to
find the right supplements in the right dosages and combinations.
Q. This past year I decided to see a naturopath for
treatment of depression and anxiety. It's been a lifelong problem and I've
already tried some different antidepressants, Effexor being the most recent and
longest. I wanted to try something different as the pharmaceuticals tended to
either cause a lot of uncomfortable side effects, or as with Effexor a kind of
emotional numbness. The naturopath I recently went to see recommended Fish oil,
SAMe, Theanine, L-Tyrosine, 5htp, Mustard flower, a multivitamin and acidophilus
for every day! It seemed like a lot, and as I'm reading on your website, I'm
seeing my suspicions are justifiable, especially with the amounts of 5htp (200mg
daily), Tyrosine (1000 mg daily), SAMe (200mg daily). I haven't been taking
anything lately because it just seemed kind of crazy to take all of that.
Exercise and diet are definitely helping some, but I'm still having a lot of
trouble with mood, difficulty concentrating, making decisions, staying focused,
and poor sleep. I know you can't really make any recommendations about what to
take or dosages, but I'm wondering if you can offer any advice or insight.
A. One recommendation is to try each supplement by itself for a
period of time to see how it works by itself for depression before mixing it
with another one. Only through trial and error will you find the best supplement
or the best combination. Ask you doctor to read some of the cautions on high
dose use of supplements.
Q. I consulted with my GP and he prescribed Zoloft for my depression. The dosage was increased from 50mg /day to 250mg /day by doubling at roughly one month intervals (i.e., 50, 100, 200). At the highest dosage I finally discerned a therapeutic effect; in fact, I felt like a sack of cement had been lifted from my chest. Nothing, however, until the highest dosage was reached. At approximately the same time I read a book which raised concerns with me about Zoloft and other SRI drugs used for depression. I researched on the internet and decided to switch to a regimen of amino acids instead: glucosamine and phenylalanine. When my prescription for Zoloft ran out I simply declined to refill it; I experienced none of the withdrawal symptoms which I later came to realize were common with SSRIs. More importantly, I lost none of the perceived depression therapeutic effect, and I believe continued to experience improvement. I also began taking 5-htp and melatonin. I take one capsule of 5-htp (50 mg L-5-Hydroxytryptophan and 10 mg. B6) and one 650 mg. capsule of inositol in the morning and evening. I take 1 mg of melatonin if I want to ensure an optimum evening of sleep; I have not noticed any effect from a lower dose. I took SAM-e for a period of time, then stopped to evaluate; I may go back to it in order to address some anxiety issues (more accurately, short temper) but that's just me. I applaud your efforts to educate on the natural and wholistic approaches to addressing the effects of depression. I tell people to set aside their preconceptions and think of it as depression of normal neurotransmitter levels; that stress depletes neurotransmitters just as heat and exertion deplete hydration levels. No amount of "will power" or "strong character" will rehydrate you when you've been walking through the desert for 10 hours.
Q. I was under suspected depression treatment for the last 18 years. All the while I knew I didnt have any mental problems. I was always mentally stable and oriented. I tried many Ayurvedic treatments but all in vain. I was taking prescription tablets for depression. It put me to sleep for long hours but nothing else. 5HTP is really a miracle tablet for my depression.
Q. Several nutrients and herbs that have an influence on
depression. How would one
know which one to use?
A. Treating depression is difficult,
whether through drugs or supplements. Each person is unique in terms of
the causes for the depression and their response to medicines or
supplements. However, I can make some generalizations that you can discuss
with your doctor. If the depression is associated with low energy and
motivation, then SAM-e could be helpful since this nutrient can perk
someone up pretty quickly. However, high doses can cause overstimulation
and mania. If the depression is associated with restlessness, anxiety and
rapid, incessant thoughts, 5-HTP is a good option since it converts into
serotonin which has a calming effect. Somewhere between these two effects
is St. John's wort which is not as stimulating as SAM-e, but not as
calming as 5-HTP. And it's quite likely that as the depression progresses,
some people who at first benefited from one supplement may find it is no
longer helpful and another supplement is more appropriate. I think part of
the reason for the failure of depression treatment lies in the fact that
patients or doctors don't adjust the dose or medicine to reflect the
biochemical, life circumstance or lifestyle changes that are going on
within or outside the individual as the weeks and months go on. Another
nutrient that influences mood is tryptophan, which is similar to 5-HTP.
Q. I have dealt with depression for too long and need the following tests done
before I go down another dead end
road. Could you direct me to the right resources? I need a muscle biopsy
measuring the level of ATP. I need a brain scan to determine my neurotransmitter
levels.
A. We have not seen any medical research that would indicate how
the results of a muscle biopsy for ATP would help determine the course of
therapy. A brain scan does not determine neurotransmitter levels.
Neurotransmitter levels can be measured by scientists through a spinal tap, but
it is difficult to determine what medicines or supplements are useful based on
neurotransmitter levels which can fluctuate during different times of day,
changes in diet, stress levels, etc.
Q. I have used Prozac, Paxil, Celexa, Effexor XR over a 15 year period. I am presently 61 and my sexual desires have decreased gradually from the time I started using the drugs. Now, I have almost none. I still have never gotten to a place where the depression is eliminated completely.
Q. I am a long time sufferer of moderate
depression that co-insides with some anxiety. I have tried Lexapro, Zoloft,
Serzone, Paxil, Celexa, Trazedone and Remeron. NONE of these ever had a benefit
because I cannot tolerate any of the side effects which always include (some
worse than others) Nausea, spacey feel, weight loss, diarrhea, insomnia, weird
dreams etc. I have a large family history of depression and for most of them
they have found a medication that works. I REALLY have tried all of them giving
them a couple of months. I have been reading for a couple weeks about 2 natural
products used for depression that "may" have fewer side effects. SAM E and 5 HTP.
It looks to me that SAM E has a better profile, but states that should not be
taken if you have anxiety because it makes it worse. I think my anxiety is a
result of my depression though. You don't know me, and cannot prescribe.
However, given what I told you above, would you suggest one above the other?
A. It is not possible to know for sure which supplement will work
for depression and in what dosage until they are tried. It is a good idea to use
low dosages at first, not exceeding 50 mg of 5htp taken in late afternoon or
early evening on an empty stomach for a week then higher dosages if needed. With
SAM-e, the dosage would be half a 200 mg tablet daily in the mornings for a week
or so. It is best to try them separately rather than together.
Does tongkat
ali help with depression?
We don't this this herb would be helpful, it can cause
aggressiveness.
I have to admit to being overwhelmed by all the information on the web site
and while I understand the need to caveat information I was hoping you could
help guide me. I suffer from moderate chronic depression and atypcial
situational anxiety. I was put on Clonazepam, Lexapro and Wellbutrin at the same
time, high dosages of each. Between sexual side effects, weight gain and
dizziness it was not a good combination and I would much rather
take natural supplements. What is considered a reliable non-stimulant
anti-depressant and/or anti-anxiety supplement? I have read SAM-e is good but is
a powerful stimulant while Kava can be good for anxiety but can cause
depression? Please help in any way you can. Also, what are the general thoughts
around Holy Basil and rhodiola
regarding anxiety and depression?
It is difficult to predict which product a person will respond
to. SAM-e is stimulating, 5-HTP is not stimulating and can also help with
anxiety. We have not seen much research on holy basil and depression. Rhodiola
may help some people but it could also be stimulating.
I take choline and inositol for depression
and it gives me loose stools. I take tumeric, ginger, acidolphilus / bifudus,
and cinnamon - is there anything else that I can take?
We suggest reading the options on this
depression natural alternatives herbal therapy page and discuss the options with
your doctor.
About 3 days ago I began taking
Serelax for mild depression (ingredients being: GABA, Passion flower powder,
valerian root extract, l-theanine, kava kava, skullcap powder, chamomile powder,
jujube date powder, wood betony powder, griffonia simplicifolia bean extract). I
do not take other prescription meds but I do have a history of allergies. After
taking it for 2 days I've been noticing I'm a quite itchy - obviously common
when I'm allergic to something I ingest. I'm trying to figure out which one of
these ingredients might be the most common allergen. The only one I know I don't
have a problem with is Valerian. The other problem...I also had 2 glasses of
wine yesterday and I'm assuming the combo was the reason I wanted to sleep for
about 14 hours. Clearly not the smartest choice on my part. I'm not a huge
drinker but I do enjoy the glass or 2 of wine once or twice a week. I'm looking
to relieve a bit of depression, not take an intense sleeping pill. I suppose my
overall question would be... do you have any advice on which of these herbal
supplements would be a suitable combo that wouldn't produce such an intense
drowsiness / allergic skin reaction?
It is not possible for us to predict which herb or the
combination caused such symptoms, or whether the fillers or additives in the
product may have caused it.
Home - Tribulus terrestris
extract
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