Natural Remedies For Depression
The Herbs, Vitamins, And Phytochemicals Which Help Ease The Symptoms Of Depression And Anxiety
May 18th, 2012By Brian Rigby, Clinical Nutrition Writer
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Depression will affect almost 2 out of every 5 people living in the United States. Women are even more prone to depression than men, with almost double the number of females as males suffering from depression at some point.Depression is serious, and should be treated seriously--the first step which should be taken towards regaining health is seeing a licensed professional, either a doctor or a mental health professional such as a psychiatrist.
There is no definitively-known cause for depression yet, though there are a number of well-researched theories. Many of the theories deal either directly or indirectly with levels of certain neurotransmitters, such as serotonin, norepinephrine, and dopamine.
Another theory links depression to inflammation and increased pro-inflammatory cytokine activity in the brain. Regardless of the definitive cause, all medications, whether natural or pharmaceutical, attempt to correct one or more aspects of our brain's physiology, reducing depressive symptoms.
The following supplements have either been found to be effective in the treatment of certain forms of depression or they are specific compounds which are often found to be deficient in those suffering from depression, making them important to consider when treating depression, according to all available research and expert opinion.
St. John's Wort
St. John's wort has been shown to be effective in the treatment of mild to moderate depression, though it does not seem to be of use in the treatment of severe depression. Its effects are comparable to other antidepressant medications, but often without as many adverse effects.
The apparent model by which St. John's wort works is through inhibition of the reuptake of serotonin, norepinephrine, and dopamine. This sounds more confusing than it is, as it simply means that St. John's wort works to keep these neurotransmitters active in our system, as opposed to letting them be re-absorbed and taken out of action.
This is the same action of many prescription antidepressants, including selective serotonin reuptake inhibitors (or SSRIs), and the end result is an increase in neurotransmitter activity.
The compound in St. John's wort which appears to be primarily responsible for this effect is "hyperforin", though a few other compounds have also been found to have a similar weak effect. Because the action is directly correlated with a specific compound, it is very important to find a high-quality extract which is standardized to 5% hyperforin, the only amount which has been clinically shown to reduce depressive symptoms.
St. John's wort interacts with a large number of medications, both over-the-counter and prescription. If you regularly take any medication, including allergy medications, cough medicine, birth control, and anti-depressants, make sure to check with your doctor before supplementing with St. John's wort. St. John's wort is also a photosensitizer, making your skin and eyes more susceptible to sun damage, so be careful of sun exposure if you use this supplement.
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Valerian Root and KavaValerian root and kava are not strictly anti-depressants, but since people suffering from depression often also suffer from an anxiety disorder (51% of the time), and since this combination results in more frequent recurrences and slower recovery time, addressing anxiety concurrently with depression may improve symptoms at a greater rate.
Treatment of patients who suffer from both depression and anxiety with kava showed significant improvement in scoring of both anxiety levels and depression levels. Treatment was standardized to 250 milligrams of kavalactones (the active constituent) per day, or 50 mg taken five times.
Similar results have been found with concurrent treatment of valerian root and St. John's wort, though no specific recommendations for dosage are given. For this reason, kava is the supplement research has shown more likely to aid in the reduction of anxiety and depression, though valerian root may still offer benefit.
There is a certain amount of disagreement in the scientific community about whether kava can damage the liver, or whether the liver damage reported can be attributed to other substances consumed concurrently with the kava.
Hepatotoxicity (liver toxicity) appears to be low and rare, but may be increased by over-dosage or combining with alcohol. To best reduce the chance of liver damage, make sure to work with your doctor when supplementing with kava. Kava may also interact with a number of drugs, so if you are currently taking any medication, check with your doctor before supplementing.
Crocus and Saffron
The extract of Crocus sativus has been found to be as effective as some common anti-depressant medications in the treatment of mild to moderate depression, with no adverse side effects. Participants in the trials took two 15 milligram capsules of the extract per day and experienced benefits to their mood in approximately 6 weeks.
The studies are very limited so far, but the good news is that unlike kava and St. John's wort, crocus extract has no known drug interactions and appears to be safe in all cases. Crocus or saffron extract may still be hard to find due to the novelty of the research on it, but if you can find it, make sure it is standardized for crocin, picocrocin, or safranal content (the active compounds).
Like St. John's wort, these compounds are suspected to act as reuptake inhibitors for serotonin, norepinephrine, and dopamine, and will increase amounts of these neurotransmitters in the brain.
SAMe
SAMe, or S-adenosyl-L-methionine, is a compound formed naturally by our body which, once created, helps in the creation of neurotransmitters, including dopamine, norepinephrine, and serotonin. To form this compound, our body utilizes a multi-step process involving folate and vitamin B12, but we can also take in the compound directly as a supplement.
SAMe has been shown to have a similar effectiveness as tricyclic antidepressants, and more impressively has a very quick rate of onset, usually working in less than two weeks and sometimes in a matter of days. Is is a well-tolerated supplement with relatively few adverse effects.
In patients with bipolar, SAMe has been linked to mania and anxiety, so care should be taken. SAMe may also interact with certain medications, especially those that also affect neurotransmitters, so check with your doctor before supplementing if you currently take any medications.
The recommended dose of SAMe varies between 400 to 1600 mg per day, though for some the dose may need to be significantly higher (up to 3000 mg). It is recommended for those with mild depressive symptoms or those who suffer from adverse effects when taking other antidepressants. As with the other supplements, it is important to work with your physician or mental health professional.
5-HTP
5-HTP is shorthand for 5-hydroxytryptophan, which is an intermediary compound in the chain which leads from tryptophan (the essential amino acid) to serotonin. Supplementing with 5-HTP skips the rate limiting step in the formation of serotonin, allowing serotonin to be much more efficiently produced than under normal conditions. The result is a significant increase in serotonin, which has been demonstrated to help relieve mild to moderate depression. In addition, 5-HTP may be as effective in treating more severe depression as conventional antidepressants.
Like SAMe, 5-HTP works much quicker than conventional antidepressants, with most patients reporting improvement in symptoms within two weeks (compared to four weeks with conventional medications). The starting dosage usually recommended by doctors is 50 mg three times daily, with food. If this dose is inadequate, it may be increased to 100 mg three times daily. The most common side effect is mild nausea, which usually goes away as supplementation continues.
As 5-HTP directly affects serotonin levels, care must be taken when combining this drug with other medications which may increase levels of this neurotransmitter, and should be done so under the supervision of a doctor or mental health professional in order to properly gauge levels of serotonin.
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Omega-3 Fatty AcidsOmega-3 fatty acids, found in fish oils and certain plants such as flax seed and chia seed, have been correlated to depression. Most evidence points to EPA (eicosapentaenoic acid) as the fatty acid primarily responsible for mood stabilizing effects, whereas DHA (docosapentaenoic acid) has been found to have little effect on mood. EPA is found in highest amounts in fatty fish, such as mackerel, sardines, herring, and tuna, though our body can also convert plant-based omega-3s (alpha-linolenic acid, or ALA) into EPA and and DHA at a reduced rate.
Most studies have pointed to high-dose EPA being the most effective, but another study describes the ratio between arachidonic acid (or AA, an omega-6 fatty acid) and EPA as being more important in depression. In this study, patients with the highest ratio of AA to EPA had the most severe symptoms of depression, suggesting that supplementation with EPA alone may not be effective for all people, and that reducing the ratio of AA to EPA may be more effective.
AA is produced by our body from linoleic acid, a plant-based omega-6 (though we can also consume it directly from meat). Far and away, omega-6s are the most common fat in processed foods, as it is extremely shelf stable and not prone to rancidity. Soybean, corn, cottonseed, safflower, and sunflower all contain mainly omega-6 fatty acids.
If your diet is high in processed food, your body produces more AA, and your AA to EPA ratio will grow larger. For this reason, one of the best things you can do to reduce your ratio of AA to EPA is to cut out processed food!
Reducing omega-6 intake while increasing omega-3 intake, particularly EPA, will provide the best results when it comes to alleviation of depressive symptoms. It should be noted, however, that there is no guarantee that this will relieve depression, as not all people suffering from depression have high AA to EPA ratios. It is hypothesized that increasing EPA intake will only help those who currently have poor AA to EPA ratios, not everyone. Still, cutting out processed food and increasing consumption of omega-3 fatty acids is always a healthy choice, even if it does not act to stabilize your mood.
Common Nutrients Which May Help Relieve Depression
Beyond the specific supplements mentioned above, there are certain nutrients which are consistently found to be insufficient in people suffering from depression.
Vitamin B12 and folate (another B vitamin) play crucial roles in the formation of SAMe in our body, which then helps to create new neurotransmitters. Deficiencies in vitamin B12, in particular, have been linked to depression, with folate deficiencies often occurring at the same time as B12 deficiencies.
Both folate and B12 play an important role in regulating levels of a compound called homocysteine--when homocysteine gets too high, production of SAMe goes down, and as a result production of serotonin, dopamine, and norepinephrine go down as well. Getting adequate intake of folate and B12 will allow the body to create enough of these important neurotransmitters, and may relieve depression in those suffering as a result of vitamin deficiencies.
Magnesium is also a nutrient which appears to play a strong role in the treatment of depression. In treatment-resistant depression magnesium is a common deficiency, and one effect of many prescription antidepressants is to cause increases in brain magnesium levels. One study found magnesium to be as effective as the antidepressant imipramine, without any side effects.
Magnesium acts like a doorman for certain gateways in our brain--when it is deficient, there are not enough doormen, and the doors tend to stay open for too long, letting too much through. The end result is "neurological dysfunction", which may present itself as depression. Furthermore, magnesium appears to affect serotonin levels--lower magnesium equates to lower serotonin. More studies need to be conducted, but at this time it appears that magnesium may not only help with treatment-resistant depression, but may be of benefit in all forms of depression!
Vitamin B6 is one other vitamin which may play a role in certain forms of depression, but the evidence is much weaker for this particular vitamin than it is for folate, B12, and magnesium. In certain hormonal-type depressions (such as premenstrual depression), B6 appears to play a small role in improving depressive symptoms, but it does not appear to be effective in the treatment of any other form of depression.
B6 does play a role in the formation of neurotransmitters, but for people suffering from depression, the regulation B6 provides does not appear to be off. If you supplement with a high-quality B vitamin, to augment folate and B12 levels, the same supplement will also supply you with adequate B6.
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The Role Phytochemicals Play In DepressionA review of natural herbal antidepressants would be incomplete without regarding the potential role phytochemicals such as curcumin play in reducing depressive symptoms. Not a lot of research has been done in this area because the effects of phytochemicals are notoriously difficult to isolate. Whereas prescription antidepressants (and prescription drugs in general) may affect one specific receptor, phytochemicals often affect numerous receptors, making them like a master key for the pathways in your body.
Studies done on curcumin (a powerful phytochemical found in turmeric) impressively showed that it increased neurogenesis in the hippocampus--it helped our brain create new cells, which the study showed ultimately mature into neurons. In addition, it turns up the expression of serotonin receptors, effectively opening more doors for serotonin to enter. This allows serotonin to have a faster and more powerful effect!
Curcumin isn't the only phytochemical with potential benefits to people suffering from depression; there is a long list of compounds found naturally in foods which may help the brain resist and recover from stress and prevent neurological dysfunction. While some of these compounds can be found in supplement form like curcumin, many are only available from food.
For this reason, healthy eating is one of the best ways to fight and prevent depression! Eating a wide array of colorful fruits and vegetables, and using plenty of herbs and spices, will ensure you are taking in a diverse amount of neuroprotective phytochemicals.
Treating Depression Naturally
Before considering any natural treatment for depression, go see a doctor first. While all the remedies above may help, depression is too serious to try and treat on your own. In addition to seeing a doctor, take a high-quality multivitamin and B vitamin supplement if you are not already.
Not all depression is caused by a nutrient deficiency, but there is no good reason to not be taking these supplements. Also consider taking a high-quality magnesium supplement as this is another nutrient commonly deficient in those suffering from depression.
Change your diet to one higher in fruits, vegetables, and other plant-based foods and lower in processed foods. Use a lot of spices for flavor! Increasing your intake of phytochemicals has demonstrable effects on the ability of your brain to heal itself. Decreasing your intake of processed foods will significantly cut your consumption of omega-6 fatty acids, decreasing the arachidonic acid load in your body and increasing the potentially antidepressive effects of omega-3 fatty acids.
In addition, a diet higher in whole foods and lower in processed foods will give you a natural source for vitamins B6, folate, and magnesium (B12 is only commonly found in animal products, though sea vegetables and some fermented products have some as well).
St. John's wort is an effective antidepressant, but it may interact with other drugs, so work with your doctor if you are taking any medication. If your depression is coupled with anxiety, concurrent treatment with valerian or kava can be more effective than just treating the depression. Saffron (another source of phytochemicals) works in a very similar way to prescription antidepressants, but with no known side effects or contraindications.
SAMe and 5-HTP can directly improve your neurotransmitter levels, and often work much quicker than conventional medications for depression. As with the other treatments, these may affect other medications, so work with your doctor.
All of the above are most effective in the treatment of mild to moderate depression as studies have not demonstrated many of them to be effective in the treatment of severe depression. Most of herbal and supplemental remedies above have been shown to be as effective as prescription antidepressants in certain cases, without the adverse side effects. In all cases, a doctor or mental health professional should help you find the treatment best for you, helping you treat and recover from depression.
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