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Tested Antidepressant Alternatives

"If placebo can help depression, then, anything given with the patient believing it will help, is likely to work."

If you are one of those who prefer to try something natural before going the traditional pharmaceutical route, this article is for you.

Nobody said that it is impossible to treat depression naturally. So why not to try?

However, as it is often with such treatments, they require more time, persistence and patience to bring results.

1. Cognitive behavioral therapy (CBT)

Cognitive Behavioral Therapy is a scientifically well-established and effective treatment for depression.

Cognitive therapy seeks to help people change how they think about things. Unlike more traditional forms of therapy, it focuses on the “here and now” problems and difficulties.

How effective is Cognitive behavioral therapy for depression?

Numerous clinical studies throughout the world have consistently demonstrated that cognitive behavioral therapy is as effective as antidepressants in the treatment of major depression9-11.

Within 20 sessions of individual therapy, approximately 75% of patients experience a significant decrease in their symptoms. The combination of cognitive therapy with antidepressant, in some studies, increases the efficacy to 85%. Moreover, most patients in cognitive therapy maintain their improved mood on follow-up two years later. This advantage of “maintaining gains” is due to the fact that in cognitive therapy the patient should not only reduce his symptoms, but he should learn to understand the distortions in thinking and behavior which are associated with the depression and learn self-help rather than dependence.

Cognitive Behavioral Therapy on DailyStrength.

2. St John’s wort

St John’s wort (Hypericum perforatum) is commonly used for depression. It is a reasonable choice for patients who prefer natural medicines over standard antidepressants. St John’s wort is available in several forms from supermarkets and health food shops.

Research suggests that St. John’s wort exerts its action by inhibiting the reuptake of the neurotransmitters serotonin, norepinephrine, and dopamine. Its therapeutic action is attributed to hypericin, hyperforin and several flavonoids.

How effective is St John’s wort for depression?

There is good evidence that St John’s wort improves symptoms of mild to moderate depression.

Numerous double-blind, placebo-controlled studies have examined the effectiveness of St. John’s wort for the treatment of mild to moderate major depression, and most have found the herb more effective than placebo2.

St John’s wort can be at least as effective as paroxetine in moderate to severe depression in the short-term3.

User ratings of St. John’s Wort (Hypericum perforatum) for Depression on Revolution Health.

3. S-Adenosylmethionine (SAMe)

Another potential alternative antidepressant is S-Adenosylmethionine (SAMe). SAMe is an amino acid derivative that occurs naturally in all cells.

SAMe plays a role in many biological reactions by transferring its methyl group to DNA, proteins, phospholipids and biogenic amines. This could result in SAMe indirectly influencing neurotransmitter metabolism and receptor function.

How effective is S-Adenosylmethionine (SAMe) for depression?

Several scientific studies indicate that SAMe may be useful in the treatment of depression4. However, it is not clear exactly how SAMe works to relieve depression. It appears to be uniformly distributed in the brain, where it acts as a major methyl donor for the synthesis of neuronal messengers and cell membranes.

4. Light Therapy

For years, light therapy has been used for seasonal affective disorder, a type of depression that afflicts about one in 10 people who live in places with short winter days and extended darkness.

A lack of exposure to sunlight is responsible for the secretion of the hormone melatonin, which could trigger a dispirited mood and a lethargic condition. Light therapy helps to regulate the body’s internal clock (sleep-wake cycles) in the same way that sunlight does.

How effective is Light therapy for depression?

Light therapy is an effective treatment for seasonal affective disorder and it may reduce the symptoms of non-seasonal depression12. Research suggests that some women who suffer from antepartum or postpartum depression may benefit from light therapy as well13.

Overall, the effectiveness of light therapy for depression depends on a number of things, including the type of depression, the brightness of the light, the duration of light exposure, and other factors.

5. Exercise

Exercise is an effective antidepressant. Exercise has the extra benefit of improving physical functioning as well.

Researchers have found that regular exercise, and the increase in physical fitness that results, alters serotonin levels in the brain and leads to improved mood and feelings of wellbeing. Some research indicates that regular exercise boosts body temperature, which may ease depression by influencing the brain chemicals.

How effective is Exercise for depression?

There is increasingly strong evidence for its use for depression.

Study after study has shown that regular physical exercise promotes mental health and reduces symptoms of depression18-19.

6. 5-Hydroxytryptophan (5-HTP)

5-Hydroxytryptophan (5-HTP) and tryptophan are also natural alternatives to traditional antidepressants.

When the body sets about manufacturing serotonin, it first makes 5-HTP. The theory behind taking 5-HTP as a supplement is that providing the one-step-removed raw ingredient might raise serotonin levels.

How effective is 5-HTP for depression?

The evidence suggests 5-HTP and tryptophan are better than placebo at alleviating depression8.

7. Massage

Massage is one of the oldest of health practices, found in ancient Chinese medical texts written some 4,000 years ago. It has been practiced as a healing therapy for centuries in nearly every culture around the world.

One of the most known benefits of massage therapy is its ability to enhance feelings of well-being. Massage produces chemical changes in the brain that result in a feeling of relaxation, calm and well-being. It also reduces levels of stress hormones – such as adrenalin, cortisol and norepinephrine – which in some people can trigger depression.

How effective is Massage for depression?

Massage therapy lowers levels of stress hormone cortisol by average 30%. Massage also increases serotonin and dopamine, neurotransmitters that help reduce depression20.

Massage therapy may be quite beneficial for pregnant women suffering from depression21.

8. Acupuncture

Acupuncture is a traditional Chinese treatment in which needles are inserted at specific points in the body and either manipulated or electrically stimulated (electroacupuncture).

Research suggests that acupuncture can decrease or eliminate the symptoms of depression. The main benefit of acupuncture is the absence of unwanted effects.

How effective is Acupuncture for depression?

Evidence for acupuncture’s effectiveness for depression has been mixed.

In a study of 151 depressed patients, twelve sessions of acupuncture failed to prove more effective than fake acupuncture15. In a mathematical review of the results of 8 randomized trials1, the impact of acupuncture on depression was unconvincing.

Another 2008 review of 8 small-randomized controlled trials supported that acupuncture could significantly reduce the severity of depression16.

9. Yoga & Meditation

Yoga is an ancient discipline with origins in Indian philosophy. It practices relaxation, exercise, and healing and trains the consciousness of spiritual insight and tranquility.

Practicing yoga can alter your brain chemistry. Some yoga positions are effective in stimulating the release of endorphins and reducing the level of stress hormone cortisol.

How effective is Yoga for depression?

Several human studies support the use of yoga for depression in both children and adults22. In addition, yoga postures have been specifically shown to increase levels of the neurotransmitter GABA, which may alleviate depression23.

10. B Vitamins

B vitamins play a role in the production of certain neurotransmitters, which are important in regulating mood and other brain functions.

However, the results of the recent 2008 Australian study showed that treatment with vitamin B12, folic acid, and B6 is no better than placebo in reducing the severity of depressive symptoms over a period of 2 years in older men6.

Folate

Folic acid deficiency has been noted among people with depression. It is interesting to note that in Hong Kong and Taiwan, where people consume traditional Chinese diets rich in folate, there is a low incidence of depression.

Recent UK study suggests that lower blood folate levels may be a consequence rather than a cause of depressive symptoms7.

Vitamin B6

Vitamin B6, or pyridoxine, is the cofactor for enzymes that convert L-tryptophan to serotonin and L-tyrosine to norepinephrine. Consequently, vitamin B6 deficiency might result in depression.

Vitamin B12

There is some evidence that people with depression respond better to treatment if they have higher levels of vitamin B12. It’s possible that vitamin B12 is needed to manufacture substances called monoamines. Another theory is that vitamin B12 deficiency results in the buildup of the amino acid homocysteine, which may enhance depression.

A study published in the American Journal of Psychiatry in December 2002 reported that older adults with vitamin B-12 deficiency were more likely to have depressive symptoms than those who were not deficient in vitamin B125.

11. Transcranial Magnetic Stimulation

Transcranial magnetic stimulation (TMS)24 is a new non-invasive technique that delivers highly focused magnetic field pulses to the nerve cells in the brain. TMS doesn't require surgery or implantation of electrodes. And it does not affect concentration and memory.

During transcranial magnetic stimulation, magnetic pulses create painless electrical currents in the brain. These currents stimulate cells in area of the brain involved in mood control and depression.

References

  • 1. Wang H, Qi H, Wang BS, Cui YY, Zhu L, Rong ZX, Chen HZ. Is acupuncture beneficial in depression: a meta-analysis of 8 randomized controlled trials? J Affect Disord. 2008 Dec;111(2-3):125-34. PubMed
  • 2. Linde K, Berner MM, Kriston L. St John’s wort for major depression. Cochrane Database Syst Rev. 2008 Oct 8;(4):CD000448. PubMed
  • 3. St John’s wort versus paroxetine for depression. Jurcic J, Pereira JA, Kavanaugh D. Can Fam Physician. 2007 Sep;53(9):1511-3. PubMed
  • 4. Williams AL, Girard C, Jui D, Sabina A, Katz DL. S-adenosylmethionine (SAMe) as treatment for depression. Clin Invest Med. 2005 Jun;28(3):132-9. PubMed
  • 5. Tiemeier H, van Tuijl HR, Hofman A, Meijer J, Kiliaan AJ, Breteler MM. Vitamin B12, folate, and homocysteine in depression: the Rotterdam Study. American Journal of Psychiatry. 2002 Dec;159(12):2099-101.
  • 6. Ford AH, Flicker L, Thomas J, Norman P, Jamrozik K, Almeida OP. Vitamins B12, B6, and folic acid for onset of depressive symptoms in older men: results from a 2-year placebo-controlled randomized trial. J Clin Psychiatry. 2008 Aug;69(8):1203-9. PubMed
  • 7. Kendrick T, Dunn N, Robinson S, Oestmann A, Godfrey K, Cooper C, Inskip H; Southampton Women’s Survey Study Group. A longitudinal study of blood folate levels and depressive symptoms among young women in the Southampton Women’s Survey. Journal of Epidemiology and Community Health. 2008 Nov;62(11):966-72.
  • 8. Shaw K, Turner J, Del Mar C. Tryptophan and 5-hydroxytryptophan for depression. Cochrane Database Syst Rev. 2002;(1):CD003198 PubMed
  • 9. Hollon SD, DeRubeis RJ, Shelton RC, Amsterdam JD, Salomon RM, O’Reardon JP, Lovett ML, Young PR, Haman KL, Freeman BB, Gallop R. Arch Gen Psychiatry. 2005 Apr;62(4):417-22.
  • 10. Melvin GA, Tonge BJ, King NJ, Heyne D, Gordon MS, Klimkeit E. A comparison of cognitive-behavioral therapy for adolescent depression. J Am Acad Child Adolesc Psychiatry. 2006 Oct;45(10):1151-61.
  • 11. DeRubeis RJ, Gelfand LA, Tang TZ, Simons AD. Am J Psychiatry. 1999 Jul;156(7):1007-13.
  • 12. Tuunainen A, Kripke DF, Endo T. Light therapy for non-seasonal depression. Cochrane Database Syst Rev 2004;(2):CD004050. PubMed
  • 13. Corral M, Wardrop AA, Zhang H, Grewal AK, Patton S. Morning light therapy for postpartum depression. Arch Womens Ment Health. 2007;10(5):221-4.
  • 14. Wang L, Sun DW, Zou W, Zhang JY. Systematic evaluation of therapeutic effect and safety of acupuncture for treatment of depression. Zhongguo Zhen Jiu. 2008 May;28(5):381-6. Chinese. PubMed
  • 15. Allen JJ, Schnyer RN, Chambers AS, et al. Acupuncture for depression: a randomized controlled trial. J Clin Psychiatry. 2006;67:1665-1673.
  • 16. Wang H, Qi H, Wang BS, Cui YY, Zhu L, Rong ZX, Chen HZ. Is acupuncture beneficial in depression: a meta-analysis of 8 randomized controlled trials? J Affect Disord. 2008 Dec;111(2-3):125-34. PubMed
  • 18. Brenes GA, Williamson JD, Messier SP, Rejeski WJ, Pahor M, Ip E, Penninx BW. Treatment of minor depression in older adults: a pilot study. Aging Ment Health. 2007 Jan;11(1):61-8. PubMed
  • 19. Knubben K, Reischies FM, Adli M, Schlattmann P, Bauer M, Dimeo F. A randomised, controlled study on the effects of a short-term endurance training programme in patients with major depression. Br J Sports Med. 2007 Jan;41(1):29-33.
  • 20. Field T, Hernandez-Reif M, Diego M, Schanberg S, Kuhn C. Cortisol decreases and serotonin and dopamine increase following massage therapy. Int J Neurosci. 2005 Oct;115(10):1397-413. PubMed
  • 21. Field T, Diego MA, Hernandez-Reif M, Schanberg S, Kuhn C.Massage therapy effects on depressed pregnant women. J Psychosom Obstet Gynaecol. 2004 Jun;25(2):115-22. PubMed
  • 22. Kozasa EH, Santos RF, Rueda AD, Benedito-Silva AA, De Ornellas FL, Leite JR. Evaluation of Siddha Samadhi Yoga for anxiety and depression: a preliminary study. Psychol Rep. 2008 Aug;103(1):271-4. PubMed
  • 23. Streeter CC, Jensen JE, Perlmutter RM, Cabral HJ, Tian H, Terhune DB, Ciraulo DA, Renshaw PF. Yoga Asana sessions increase brain GABA levels: a pilot study. J Altern Complement Med. 2007 May;13(4):419-26.
  • 24. Janicak PG, Nahas Z, Lisanby SH, et al. Durability of clinical benefit with transcranial magnetic stimulation (TMS) in pharmacoresistant major depression. Brain Stimul. 2010

Comments

Comment from Jen @ Your Stressed Life
January 10, 2009 at 5:10 pm

Very good post. CBT is a great way to “rewire” your brain and throw in some exercise and you can change the way you feel.

Comment from HerbyourLife
January 12, 2009 at 7:08 am

Great article, suffering from depression many years, tried all available therapy.