Herbs, Vitamins, and Supplements for Depression

Depression is a mood disorder in which people experience feelings of sadness, loneliness, and loss of interest for long periods of time. It is a fairly common condition in the United States.

As many as 1 in 13 Americans from the age 12 and older report symptoms of depression, according to the Centers for Disease Control and Prevention (CDC).

Depression can lead to many symptoms, some of which are:

• loss of interest in normal activities
• feeling sad, unhappy, or empty
• changes in appetite
• feeling worthless or guilty
• anxiety or restlessness
• difficulty sleeping, insomnia, or sleeping too much
• irrational reactions or angry outbursts
• difficulty concentrating or making decisions
• thoughts of suicide or death
• unexplained pain

Doctors don't yet entirely understand what causes depression. Several factors may contribute, including:

• Physical brain differences: People with depression may have physical changes in their brains.
• Chemical imbalances: Your brain's functions are carefully controlled by a delicate balance of chemicals and neurotransmitters. If these chemicals change, you may develop symptoms of depression.
• Hormone changes: Changes in hormones may cause symptoms of depression. Hormones may change because of thyroid problems, menopause, or another condition.
• Life changes: The loss of a loved one, the end of a job or a relationship, financial stress, or trauma may trigger depression.
• Genes: If a close relative has been diagnosed with depression, you may have a genetic predisposition to developing depression as well.

Traditional depression treatment uses a combination of prescription medicines and counseling or therapy. Antidepressant medicines can help resolve underlying physical problems, such as a chemical imbalance.

Counseling can help you address issues and situations that might be contributing to depression, such as life changes.

Though traditional treatments can be effective, you may also be interested in alternative options. Natural remedies for depression are the focus of ongoing research.

Researchers have studied numerous herbs, supplements, and vitamins to determine if they can benefit people with depression. The results are mixed. Some alternative treatments hold a lot of promise.

However, not every alternative treatment passes the rigorous tests of clinical trials. For that reason, many medical professionals may hesitate in their recommendation or support for these treatments.

In this guide, learn about the most widely studied alternative treatments for depression. Find out which ones show the best results, how they work, and how they're produced.

St. John's wort (Hypericum perforatum) is a shrubby herb with yellow flowers. It grows wild throughout Europe, parts of Asia, parts of Africa, and the western United States.

Both the leaves and the flowers are used for medicinal purposes.

For centuries, St. John's wort has been used to treat a variety of health conditions, including depression and mental health disorders.

The herb also has anti-inflammatory properties, as well as antibacterial and antiviral properties. People have used it to treat infections and wounds on the skin.

Today, St. John's wort is a popular alternative antidepressant medicine in Europe. However, the FDA hasn't approved St. John's wort as a treatment for depression in the United States.

Research is mixed on the effectiveness of this herb for depression treatment. A 2009 study published in Evidence-Based Mental Health showed the herb to be beneficial.

The study found that St. John's wort may be more effective than a placebo. The herb also appears to cause fewer unwanted side effects than traditional depression medication.

However, two studies found that St. John's wort wasn't effective in mild and severe depression. The first study, published in the Journal of Psychiatric Research, compared the herb to a placebo.

The study found that the herb failed to improve mild depression. Interestingly, this study also found that the antidepressant citalopram didn't work better than a placebo.

The second study was published in the Journal of the American Medical Association. It found St. John's wort wasn't effective in easing moderately severe major depression.

The flowers on the St. John's wort plant are used to create the supplement, often in the form of teas, tablets, and capsules. Liquid extracts and tinctures are sometimes used as well.

If you have mild to moderate depression, a standard dose of St. John's wort is between 20 to 1,800 milligrams from a tablet or capsule. The average dose is 300 milligrams two or three times per day.

People with severe depression can take 900 to 1,800 milligrams of the herb daily, according to the Mayo Clinic. If the supplement eases your depression symptoms, you may decide to take less. Talk with your doctor before changing your dosage.

If you think St. John's wort may be right for you as a treatment for depression, start a discussion with your doctor. St. John's wort interacts negatively with a variety of medications.

If you're taking prescription antidepressants, cough suppressants, birth control, or blood thinners, talk to your doctor. In many cases, the herb makes other medications less effective.

S-adenosyl-L-methionine (SAMe) is a compound made naturally by the body. An artificial form of the compound can also be made in a laboratory setting.

In the late 1990s, the FDA approved artificial SAMe as a dietary supplement. In Europe, the compound has been a prescription drug since the 1970s.

It is prescribed to treat a variety of conditions. It may help treat depression, osteoarthritis, heart disease, attention deficit-hyperactivity disorder (ADHD), and seizures.

In your body, SAMe plays a role in many important functions. In the brain, for example, SAMe helps produce serotonin, melatonin, and dopamine. Serotonin is an important chemical and neurotransmitter. Neurotransmitters help carry signals through your brain and into your body.

If you have been diagnosed with depression, you may have inadequate serotonin levels. Your doctor could prescribe a medicine that helps your brain produce and use more serotonin. You could also use SAMe to boost your serotonin levels.

In a 2010 study in The American Journal of Psychiatry, researchers investigated the effectiveness of SAMe. They found that people taking prescription serotonin reuptake inhibitors (SRIs) may benefit from taking SAMe.

Researchers for this study gave study participants 800 milligrams of SAMe two times a day. Compared to people who took a placebo, participants who used SAMe had fewer symptoms of major depressive disorder.

SAMe doesn't have an established dosage. A suggested dose of SAMe differs depending on how you take the supplement. In many cases, you gradually build your dosage of SAMe to reduce side effects and improve effectiveness.

A 2002 report in The American Journal of Clinical Nutrition offered effective dosing information for SAMe. The report investigated successful clinical trials of the compound. The trials showed that SAMe was more effective than a placebo.

It was also just as effective as tricyclic antidepressants in easing depression symptoms. The trials showed that doses of 200 to 1,600 milligrams per day were effective. However, the same report noted that more studies were necessary to determine the best doses.

Injections of SAMe are also possible. The average injection ranges from 200 to 400 milligrams. An injection may be needed daily for as many as eight weeks, according to the Mayo Clinic.

Injections are often administered in a doctor's office. They may not be an option unless you can visit your doctor's office daily.

Much clinical research suggests that SAMe may have short-term beneficial qualities. However, long-term studies are lacking. Many healthcare professionals would prefer greater support for SAMe before prescribing it to patients.

If you think SAMe may help you combat your depression, discuss it with your doctor or psychiatrist. The supplement is available over the counter, but it's important your doctor knows if you're using it. This will help prevent potential side effects.

SAMe can interfere with other medications. People who take blood thinners may have a higher bleeding risk if they also take SAMe. The compound itself can cause a variety of side effects, including dry mouth, diarrhea, dizziness, and insomnia.

5-hydroxytryptophan (5-HTP) is a chemical the body makes from L-tryptophan. L-tryptophan, or tryptophan, is a protein building block.

Tryptophan is found naturally in some foods, but 5-HTP isn't. Instead, your body uses tryptophan to produce 5-HTP. Dietary sources of tryptophan include:

• turkey
• chicken
• milk
• seaweed
• sunflower seeds
• turnip and collard greens
• potatoes
• pumpkins

Like SAMe, 5-HTP may help raise your brain's serotonin level. Medications that increase serotonin tend to help ease symptoms of depression.

In addition to depression, 5-HTP has been used to treat several conditions, such as sleep disorders, ADHD, premenstrual syndrome, and Parkinson's disease. Researchers believe changes in serotonin contribute to all of these conditions.

Not all research supports the use of 5-HTP, however. A 2012 analysis of 5-HTP studies found that the benefits of the chemical were largely exaggerated.

In fact, the study, published in the Journal of Neuropsychiatric Disease and Treatment, claims 5-HTP may make underlying symptoms of depression worse. Long-term use of 5-HTP may deplete other neurotransmitters.

5-HTP can be made from the seeds of Griffonia simplicifolia, an African plant. The seeds are manufactured into tablets and capsules.

The average dose of 5-HTP is 100 to 300 milligrams taken one to three times each day. However, the proper dosage for you and your condition may be different. Talk with your doctor about the amount you should take.

Once you begin having success with 5-HTP, you may be able to reduce your dose. This will help you maintain the benefits of the treatment without experiencing side effects.

Be careful using 5-HTP with other medications that increase serotonin levels, including antidepressants. You may get too much serotonin from the combination of medicines. This can lead to a condition called serotonin syndrome.

Serotonin syndrome can potentially cause negative side effects, including heart problems and anxiety.

The heart health benefits of omega-3 fatty acids are widely reported. These essential fats may be good for relieving symptoms of depression, too.

Omega-3s are also called essential fatty acids because the body needs them for normal functions.

These fats are important for neurological development and growth. However, the human body can't make omega-3s on its own.

Omega-3s are found in supplements and foods, including fish, some nut oils, and some plants. While some studies suggest omega-3 fatty acids may help relieve the signs and symptoms of depression, the overall evidence is unclear.

A 2003 study in European Neuropsychopharmacology found that people who took omega-3 fatty acid supplements had reduced depression symptoms. This study also suggests omega-3 may be beneficial for people taking traditional antidepressants.

A 2009 review of three other major studies on omega-3 in depression found that the supplements yielded better results in both children and adults compared with a placebo.

However, a later study found that the promise of omega-3 as a treatment for depression is largely unfounded. This analysis concluded that many of the studies were too small or improperly researched.

Taking fish oil supplements for depression

Omega-3 supplements are made from two sources: fish or plants. The omega-3 fatty acids from fish are called eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). The omega-3 fatty acids derived from plant sources are called alpha-linolenic acid (ALA).

It's important you have a balance of both types in your diet. For supplement use, the oils are manufactured to make capsules. Some ALA omega-3 sources are sold as oils.

EPA and DHA omega-3 fatty acids are most often recommended for people with depression. One gram of omega-3s derived from fish may be effective at reducing depression symptoms.

According to the National Institutes of Health (NIH), most people can take up to 3 grams of omega-3 fish oil supplements each day without side effects or complications.

For depression, the Mayo Clinic reports that a 1,000 milligram capsule with EPA has proven effective in depression treatment. These are taken once a day. If you can't swallow one large pill at once, your doctor might recommend a smaller dosage taken twice a day instead.

Despite the potential benefits, you should talk with your doctor before beginning these supplements. Aside from the possibility of a lack of efficacy, fish oil supplements can interact negatively with other medications.

They can interact with birth control pills and some high blood pressure medicines. They can also increase the risk of bleeding. People on blood thinners should avoid taking it without supervision.

As a 2009 study from The Journal of Clinical Psychiatry states that omega-3s are helpful when used to bolster other treatment. But the study also noted there wasn't enough evidence to recommend omega-3s as a sole treatment for depression.

If you want to add omega-3s to your treatment routine, discuss it with your doctor. Overall, this complementary treatment seems to be most promising in people with mild or moderate depression.

B vitamins are important to your brain health. Vitamins B-12 and B-6 are particularly significant.

They help produce and control the chemicals that influence mood and other brain functions. Indeed, low levels of these vitamins are linked to depression.

To diagnose a vitamin B deficiency, your doctor may draw a blood sample for testing.

If your levels are low, you can increase your vitamin B through your diet. B-rich foods include meat, fish, eggs, and dairy.

If your vitamin B levels are really low or your doctor wants to increase them quickly, they may suggest a daily vitamin B supplement. In cases of severe deficiency, your doctor may recommend a B-12 shot.

Boosting vitamin B levels may help end depression symptoms. However, studies of vitamin B have mixed results.

For example, a 2005 study in the Journal of Psychopharmacology found that a combination of vitamin B-12 and folic acid (another type of vitamin B) reduced depression symptoms.

However, other research, such as a 2005 study in Family Practice, cast doubt on the benefits of vitamin B. More research is needed before most doctors will support vitamin B supplements as an alternative to traditional antidepressants.

Most multivitamins contain sufficient amounts of the most important B vitamins. If you begin using a daily multivitamin, you may not need additional supplementation. However, you can buy supplements that contain only vitamin B.

Most vitamin B supplements are made from manufactured bacteria. The bacteria synthesize the vitamin, which is then put into tablets or capsules.

Doses for depression range between 1 and 25 micrograms per day. The NIH recommends that adults over the age of 14 get 2.4 micrograms per day. Higher doses may be both safe and effective.

However, it's important to discuss this with your doctor before you begin using vitamin B in large doses.

Vitamin B supplements are generally handled well, if taken appropriately. Side effects include diarrhea, blood clots, and itching. These are rare, however.

As with many alternative treatments, vitamin B supplements can interfere with other medications and treatments. Discuss taking vitamin B with your doctor before you begin using it. They will consider possible interactions and changes that may be necessary.

Vitamin D has many health benefits. Adequate levels of the 'sunshine vitamin' help your body absorb calcium, which keeps your bones strong.

Vitamin D may also protect against cancer, high blood pressure, and other diseases.

It may even help ease symptoms of depression. The link between vitamin D and depression isn't as well supported as with other diseases, however.

People with depression tend to have low vitamin D levels, but most people in the United States are deficient in vitamin D. Increasing your levels of the vitamin might ease depression symptoms.

A report published in Issues in Mental Health Nursing suggests maintaining adequate vitamin D levels may help reduce depression. The vitamin may have some effect, but more studies are needed to determine just how effective it may be.

Your body makes vitamin D when your skin is exposed to sunlight. You can also get vitamin D from certain foods, including cod liver oil, milk, sardines, and eggs.

For many people, supplements are the safer choice. Routine sun exposure can increase your risk for skin cancer. Also, the sun's rays aren't strong enough in areas north of the 37th parallel. Many people in these regions aren't able to make enough vitamin D through sun exposure.

Studies supporting the use of vitamin D for depression are limited, so dosing information is limited too. You can take the recommended daily intake, which is 600 international units (IU) each day.

You may be able to take a larger dose, but the suggested average dose is between 400 and 800 IU each day, according to the Mayo Clinic. Some people are able to take much larger doses with success, but you should do this only under a doctor's supervision.

Vitamin D toxicity is a possible complication if you take too much for too long. Symptoms of vitamin D toxicity include weight loss, heart arrhythmias, and excessive urination.

However, you can't get too much vitamin D from sun exposure. Toxicity is only a concern if you get vitamin D from supplements.

Saffron (Crocus sativus) is a rare spice made from the dried stigma of the Crocus sativus flower.

Saffron has been used for centuries to strengthen digestion, smooth menstruation, improve mood, and increase relaxation.

Today, it holds promise as a potential alternative treatment for depression.

A 2013 study in the Journal of Integrative Medicine found that saffron supplements actually improve mood and reduce symptoms of major depressive disorder more than placebo supplements.

The study also concluded that more research is needed before saffron can become a widely used alternative.

To make saffron supplements, powder from the dried Crocus sativus stigmas is turned into a capsule. One study, published in Phytotherapy Research, found the spice to be effective when subjects used 30 milligrams per day.

If you take too much saffron, you may experience side effects and symptoms, such as vomiting, dizziness, and diarrhea.

Saffron is generally very expensive because many plants are needed to make a tiny amount of the spice. Therefore, saffron supplements aren't easy to find, and they can also be costly.

Kava kava (Piper methysticum) might offer people with depression some relief from their symptoms.

The kava plant is a tall shrub that is native to the South Pacific. Its root is used commonly for medicine.

Kava can make people feel intoxicated, so teas and tinctures made from the root have been used for centuries to help increase relaxation and reduce anxiety.

Kava doesn't necessarily treat depression or the underlying causes. Instead, it may help patients who use it feel more relaxed and calm.

One study published in Psychopharmacology investigated the effectiveness of kava kava. Researchers found that a water-based version of kava produced anti-anxiety and antidepressant activity in people with depression.

Researchers also noted the extract brought up no safety concerns in the amount and duration studied (250 milligrams of kavalactones per day).

Kava roots can be ground to a pulp and added to water to create a thick mixture that may be consumed for medicinal purposes.

For over-the-counter supplements, dried kava root is crushed and then turned into a capsule. Kava is measured in kavalactones, which are the chemical compounds derived from the root.

A report published in Advances of Pharmacological Sciences analyzed multiple studies on kava treatment. The method used most commonly was 300 milligrams per day for four weeks.

The report pointed to a study that used 280 milligrams per day. The study showed effects or symptoms of using that amount were no worse than the placebo provided.

Most people can only take kavalactones for a short period of time because of the risk of overdose and side effects. Your doctor should help you decide the right duration for you.

Kava may cause kidney damage, especially if it is used for long periods of time. Interactions between kava and other medicines may also cause serious side effects.

Because studies are limited and results are inconclusive, it's best to talk with your doctor before you consider kava as a treatment option.

The medical community supports the use of some herbs and supplements more than others. Studies of these alternative treatments are limited, and the results are sometimes inconclusive.

Before doctors will recommend an herb or supplement as a treatment, multiple studies need to return favorable results. One positive study is rarely enough to persuade the medical community.

If you're interested in using herbs, vitamins, or supplements to treat or help treat your depression, consult your doctor or psychiatrist first. Many of these treatments hold promise, but some come with side effects.

Some of these side effects and complications are very serious. Your doctor can help you decide if one of these alternative treatments is right for you, your symptoms, and your lifestyle.

If you think someone is at immediate risk of self-harm or hurting another person:

• Call 911 or your local emergency number.
• Stay with the person until help arrives.
• Remove any guns, knives, medications, or other things that may cause harm.
• Listen, but don't judge, argue, threaten, or yell.

If you or someone you know is considering suicide, get help from a crisis or suicide prevention hotline. Try the National Suicide Prevention Lifeline at 800-273-8255.