Many Are Finding Relief in Taking Vitamins and Supplements for Depression
In trying to cope with the debilitating symptoms of depression, people often turn to vitamins, supplements, herbs, or home remedies first. And it’s no wonder — such efforts to alleviate symptoms are often far less expensive and easier to obtain. For some, it may be a part of their rationalization that their depression “isn’t all that bad,” if it can be treated with vitamins and supplements.
Please see the original post on PsychCentral.com, and written by John M. Grohol, Psy.D. on September 3, 2019, or click here.
Many people find relief in taking vitamins and supplements for depression. It is also one of the most well-researched topics, so we know what science has to say about the efficacy of such treatments. But it’s important to keep in mind that clinical depression is a serious mental illness. Left untreated or under-treated, it can cause significant harm and upset in a person’s life, impacting their family, their career or schoolwork, and even a person’s own future.
While considering this alternative, natural treatments, please keep in mind that other effective treatments also exist. These include primarily psychotherapy, such as cognitive-behavioral therapy, and antidepressant medications. While many people feel comfortable starting first with trying vitamins and supplements, a person shouldn’t also rule out the importance of seeing a mental health professional for an objective assessment and possible diagnosis if warranted.
Vitamins, Supplements & Herbs for Depression
There is quite an array of vitamins, supplements, and herbs one can try to help with depression symptoms. As with all alternative medicine and home remedies, the U.S. Food and Drug Administration (FDA) does not require testing for safety or efficacy of any of these possible depression treatments. While they are manufactured according to food-grade safety standards, some research has found that the active ingredient levels in supplements may vary. Always purchase your supplements and vitamins from legitimate sources, and try to stick to recognizable or well-reviewed brands.
SAM-e is a substance naturally produced in your body when the amino acid methionine combines with adenosyl-triphosphate (ATP), a substance involved in the synthesis of melatonin, serotonin, and dopamine — all neurotransmitter chemicals found linked to mood. SAM-e dietary supplements are a man-made, stabilized form of that substance that may help with the production of these neurotransmitters.
There have been over 40 studies that have evaluated the effectiveness of SAMe for depression (National Center for Complementary and Integrative Health, 2017). And a 2002 review (Hardy et al., 2002) by the U.S. Agency for Healthcare Research and Quality found that SAM-e was more effective than a placebo and equally as effective as antidepressant medications.
Other research, such as a 2010 study in The American Journal of Psychiatry (Papakostas et al., 2010), has found that SAM-e works well in conjunction with SSRI antidepressants, a commonly-prescribed medication for depression.
Research hasn’t clearly defined an effective dose for SAMe supplements. However, it appears that a dose of between 400 to 1,600 mg daily has been commonly reported in research (Mischoulon & Fava, 2002). The most common side effects of SAM-e include insomnia, dry mouth, dizziness, and possible diarrhea. People who take blood thinners should not take SAM-e, and this supplement can also interfere with other medications. Please talk to your doctor before you start taking SAM-e.
Omega-3 Fatty Acids
Omega-3 essential fatty acids aren’t just good for your heart. Research has suggested and people’s experiences have shown that they can also be good for your mind as well. You can get omega-3 fatty acids naturally through foods such as fish and nut oils, or through a dietary supplement.
As Mischoulon et al. (2009) noted, “Countries with high fish intake have been associated with lower rates of depression, and the n-3 fatty acids, particularly eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), are proposed to be among the protective factors.” EPA appears to be the primary omega-3 fatty acid to focus on in order to obtain the most beneficial effects.
Multiple studies have demonstrated the potential beneficial effects of omega-3 on depression symptoms. Mischoulon et al. (2009) found in a gold-standard double-blind, randomized controlled study that EPA demonstrated a distinct advantage over placebo (even though it did not reach statistical significance).
In a second 2009 study by Osher & Belmaker, they found that “Omega-3 fatty acids were shown to be more effective than placebo for depression in both adults and children in small controlled studies and in an open study of bipolar depression.” That study also did not report any significant side effects.
Look for a supplement that has at least 1,000 mg of EPA in it, according to the Mayo Clinic (Hall-Flavin, 2012).
The B vitamins are important components that help regulate your body’s ability to turn food into other chemicals that your body and brain need. Most people’s natural diets include plenty of vitamin B in them since it comes from common foods such as eggs, dairy, meat, and fish. However, if you avoid such foods, you may have a vitamin B deficiency.
You can take vitamin B (vitamin B-12 is the one you want) through a multivitamin supplement, or on its own. Research has suggested a dose of between 1,000 and 2,500 mcg per day is sufficient for most people (Coppen & Bolander-Gouaille, 2005). Side effects are rare, but because vitamin B can interfere with other medications, it’s best to talk to your doctor before starting this supplement.
The D vitamins are known as the “sunshine” vitamin because our body makes vitamin D on its own through exposure to the sun. If you don’t get regular exposure to the sun (think during the dead of winter), it may impact your mood. In fact, in a large meta-analysis of 31,424 subjects (Anglin et al., 2013), researchers found a strong correlation between low levels of vitamin D and depression symptoms.
The Mayo Clinic (2019) suggests a typical dose of vitamin D between 600 and 800 IU daily. However, many supplements on the market start at 1000 IU and go all the way up to 5,000 IU. As with any supplement, it’s safest to start with the lowest dose possible, and then increase it as necessary (preferably with your doctor’s knowledge) over time.
St. John’s wort (Hypericum perforatum)
This is a memorably-named herb that’s been used as a successful treatment for depression for many decades in Europe. It is a shrubby herb with yellow flowers that grows naturally throughout many parts of the world.
A 2008 Cochrane systematic research review of St. John’s wort effectiveness concluded, “the St. John’s wort extracts tested in the trials were superior to placebo, similarly effective as standard antidepressants, and had fewer side effects than standard antidepressants” (Linde et al., 2008).
Dose levels vary widely for effectiveness, so it is generally suggested to start with 300 mg, 2 to 3 times daily (600 – 900 mg total daily), and work up from that dose if needed up to 1,800 mg total daily (Mayo Clinic, 2019). Side effects are rare, but because St. John’s wort can interfere with other medications, it’s best to talk to your doctor before starting to take this herb.
Kava kava (piper methysticum)
Kava kava (piper methysticum or just plan “kava”) is a herbal supplement that comes from the roots of a shrub native to the South Pacific. Its use for depression appears related to the calming and anti-anxiety effects it has on people who take it. A gold-standard randomized, placebo-controlled study demonstrated that it substantially reduced feelings of anxiety and depression in 60 adults who took it (Sarris et al., 2009).
The suggested dose of kava is 200 to 300 mg daily and there appear to be no serious adverse effects in taking this herb (Sarris et al, 2009; Rowe et al., 2011).
“In 2001, the World Health Organization (WHO) stated that probiotics, as live micro-organisms, when taken in certain amounts, lead to health benefits for the host” (Huang et al., 2016). In more recent years, we’ve discovered that there is a definite gut-brain connection, where are gut’s microorganism makeup has an impact on our emotional state. It’s not surprising then that many people are turning to probiotics to help alleviate depression symptoms.
Research validates this connection. In a meta-analysis conducted in 2016 of five studies examining the effects of probiotics, researchers found that the use of probiotics was associated with a significant reduction in depression symptoms (Huang et al., 2016).
These effects may not hold for adults older than 65. Four of the studies included a form of bifidobacterium (breve, bifidum, lactis, or longum) in combination with one or more of the following: acidophilus, lactobacillus helveticus, or lactococcus lactis; one study only used lactobacillus pentosus.
One capsule daily for 4 to 8 weeks seems to be the dosing used most often in this analysis (Huang et al., 2016).
Could a common seasoning used for centuries in Indian and other dishes actually be a powerful antidepressant? Apparently, yes.
According to Kunnumakkara et al. (2017), “A study conducted by Sanmukhani et al. confirmed curcumin to be effective and safe for the treatment of patients with the major depressive disorder without concurrent suicidal ideation or other psychotic disorders (Sanmukhani et al., 2014).
In another randomized, double‐blind, placebo‐controlled study, it was observed that 4 to 8 weeks of treatment with curcumin was effective at improving several mood‐related symptoms in these patients (Lopresti et al., 2014).”
Researchers studied patients who took 500 mg, twice daily for a total daily intake of 1000 mg (Sanmukhani et al., 2014; Lopresti et al., 2014). There are generally no adverse side effects in taking this supplement.
5-HTP (5-hydroxytryptophan) is a chemical formed from L-tryptophan, an important protein building block for our body and mind. We get most of our L-tryptophan naturally through foods such as milk, chicken, turkey, potatoes, and collard greens. However, if you don’t eat much of these foods, you may suffer from a deficiency of L-tryptophan, and in turn, a lack of 5-HTP. 5-HTP is thought to help increase the body’s levels of serotonin, which is implicated in mood disorders and depression.
5-HTP is a complicated chemical, however, and research has found mixed results in its for the treatment of depression. Specifically, research has found that if not administered in a balanced manner with another substance (such as carbidopa), it could result in a lack of efficacy (Hinz et al., 2012).
The same researchers found that, over months of use, “administration of 5-HTP alone may deplete dopamine, norepinephrine, and epinephrine thereby exacerbating these conditions.”
In short, it is not recommended to take 5-HTP supplements for depression due to these concerns, and especially since they do not include carbidopa (a prescription medication). If you’re interested in taking 5-HTP, talk to your doctor about doing so in conjunction with a carbidopa prescription. Dosing of 5-HTP appears to typically be between 200 – 600 mg daily (Hinz et al., 2012).
Please note: While most supplements and vitamins are safe to take on your own, it never hurts to consult with your doctor first before starting any new vitamin or supplement regimen — especially if you’re currently taking a medication. Some supplements can interact in a negative manner with certain medications, something that your doctor will know and be able to offer guidance on how to proceed.
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