By Dr. Mercola
Nearly 7 percent of U.S adults suffered from a depressive episode in the past year1 while, worldwide, 350 million people suffer from depression, making it a leading cause of disability.2 Despite this, only about one-third of Americans with depression get treated,3 which puts the remaining two-thirds left untreated at increased risk of suicide and with a lower quality of life.
People struggling with untreated depression are also twice as likely to die as those without depression and have worse outcomes for other health conditions.4 But while it's clear that treating depression is important, the first recommended treatment is usually a combination of antidepressant drugs and psychotherapy.
There's good reason to think twice before taking antidepressants, however, as they may increase the risk of other health problems and their effectiveness is questionable. This is where alternative treatments for depression can be veritable lifesavers, helping people with depression to regain their physical and mental health using safe, drug-free approaches.
Antidepressants Linked to Diabetes, Heart Attack and Dementia
If you're considering antidepressants, it's important to know what you're getting into before deciding on them as a treatment, especially since they're often prescribed for long periods with no end date in sight. For instance, antidepressant users have an increased risk of developing Type 2 diabetes,5 even after adjusting for other risk factors, like body mass index (BMI).6 Antidepressant use has also been linked to thicker arteries, which could contribute to the risk of heart disease and stroke.
The results of a study of 513 twin veterans, presented at the American College of Cardiology meeting in New Orleans in 2011, found that antidepressant use resulted in greater carotid intima-media thickness (the lining of the main arteries in your neck that feed blood to your brain).7 This was true both for selective serotonin reuptake inhibitors (SSRIs) and antidepressants that affect other brain chemicals.
Further, the use of antidepressants is also associated with an increased risk of heart attack, specifically for users of tricyclic antidepressants, who have a 36 percent increased risk of heart attack.8 Meanwhile, the drugs are also linked to dementia, with researchers noting "treatment with SSRIs, MAOIs, heterocyclic antidepressants, and other antidepressants was associated with an increased risk of dementia," and as the dose increased, so too did the risk.9
The drugs are also known to deplete various nutrients from your body, including coenzyme Q10 and vitamin B12 — in the case of tricyclic antidepressants — which are needed for proper mitochondrial function. SSRIs may deplete iodine and folate.10 Perhaps more importantly, studies have repeatedly shown antidepressants work no better than placebo for mild to moderate depression,11 so you're taking serious risks for a very small chance of benefit. Importantly, there are other options available.
Magic Mushrooms Show Promise for Treating 'Untreatable' Depression
The psychedelic drug psilocybin, also known as magic mushrooms, continues to show promise for treating depression. In a small study of 19 patients with treatment-resistant depression, all of them experienced improvements in symptoms one week after receiving a single dose of psilocybin, and half of them were no longer depressed five weeks post-treatment.12
Brain scans showed actual brain changes occurred in areas involved in depression, including less activity in the amygdala, which is involved in processing emotions, and more stable activity in the default-mode network (links between activity in the network and depression have been found).13 The researchers suggested the participants' brains may have been "reset" in a sense, helping them to overcome depression. As noted in Scientific Reports:14
"Psilocybin has an ancient and more recent history of medicinal-use. Administered in a supportive environment, with preparatory and integrative psychological care, it is used to facilitate emotional breakthrough and renewed perspective. Accumulating evidence suggests that psilocybin with accompanying psychological support can be used safely to treat a range of psychiatric conditions."
Other research has shown a single dose of psilocybin resulted in six-month-long anxiety and/or depression relief in 80 percent of cancer patients, with some reporting relief from anxiety four years later.15
Unfortunately, psilocybin is a Schedule 1 drug, like marijuana, so trials cost about 10 times that of other legal drugs, and in order to take the research to the level where it could potentially be turned into a psychiatric treatment, phase 3 clinical trials are needed with thousands of participants. For that to occur, psilocybin would need to be rescheduled.
London-based psychiatrist James Rucker penned a commentary in the British Medical Journal (BMJ), arguing for the reclassification of LSD and magic mushrooms — which he notes are far less addictive and harmful than heroin and cocaine — in order to make it easier to conduct much needed medical research on them.16
Self-treatment is not advised, however, because not only could it land you in legal trouble, it's possible to have a negative experience, which is why careful oversight and guidance from professionals is so important when using psilocybin.
Magnesium Supplements, Omega-3 and B Vitamins Decrease Depression
Another alternative to antidepressants could come in the form of magnesium supplements. Research published in PLOS One revealed that magnesium supplements led to improvements in mild-to-moderate depression in adults, with beneficial effects occurring within two weeks of treatment. "It works quickly and is well tolerated without the need for close monitoring for toxicity," the researchers said.17
Magnesium acts as a catalyst for mood-regulating neurotransmitters like serotonin, and research published in 2015 also revealed a significant association between very low magnesium intake and depression, especially in younger adults.18 Beyond magnesium, the animal-based omega-3 fats EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) are also crucial for brain health.
The 2001 book, "The Omega-3 Connection," written by Harvard psychiatrist Dr. Andrew Stoll, was among the first works to bring attention to, and support the use of, omega-3 fats for depression, and they've been shown to lead to improvements in major depressive disorder.19 Making sure you're getting enough omega-3s in your diet, either from wild Alaskan salmon, sardines, herring, mackerel and anchovies, or a high-quality animal-based omega-3 supplement, is crucial for optimal mental health.
B vitamins are also important, and low levels of B vitamins are common in patients with depression, while vitamin B supplements have been shown to improve symptoms.20
Further, in a study of 9,700 vegetarian (including a small number of vegan) men, vegetarians were nearly twice as likely to suffer from depression as meat eaters, even after adjusting for variables like job status, family history and number of children.21 Vegetarians tend to have lower intakes of omega-3 fats, vitamin B12 and folate, which could affect depression risk.
In the case of folate, it helps your body produce mood-regulating neurotransmitters, including serotonin and dopamine. One 2012 study found people who consumed the most folate had a lower risk of depression than those who ate the least.22 Addressing nutrient deficiencies, as well as optimizing your diet, are keys to mental health and should be first-line strategies to treating depression.
What You Eat Can Make or Break Your Mood
It's not an exaggeration to say "you are what you eat," and dietary choices can and do have a significant effect on your mood. Men consuming more than 67 grams of sugar per day were 23 percent more likely to develop anxiety or depression over the course of five years than those whose sugar consumption was less than 40 grams per day, for instance, so limiting sugar is one strategy to boost your mood.23
This will help you support your gut health, another important factor for mental health. Eating fermented foods regularly, or taking a probiotic supplement, can also help toward this end.
Consider a small study involving adults diagnosed with IBS (irritable bowel syndrome) and depression that found the probiotic Bifidobacterium longum provided depression relief. At six weeks, 64 percent of the treatment group had reduced depression scores compared to 32 percent of the control group that received a placebo.24 The book "The Happiness Diet" notes some other foods that can affect your mood, such as diet soda.25
The aspartame in many diet sodas contains the amino acid phenylalanine, which may disrupt serotonin production. On the other hand, a handful of almonds provides 80 milligrams of magnesium which, as mentioned, has a calming effect on your brain.26 Other foods that are good for your mood include dark chocolate, bananas, turmeric and even organic black coffee.
Light Therapy for Depression
Another option that shows promise is light therapy. Full-spectrum light therapy is often recommended over antidepressants for the treatment of seasonal affective disorder (SAD), but it may be preferable even for major depression. Light therapy alone and placebo were both more effective than Prozac for the treatment of moderate to severe depression in an eight-week long study.27
Further, in a study of patients with bipolar disorder, who have recurrent major depression, bright white light therapy was also effective in boosting mood, with 68 percent achieving a normal mood after four to six weeks of treatment compared to 22 percent of those who received a placebo treatment.28
Along these lines, exposure to sunlight is also important, not only because it will help optimize your vitamin D levels (another factor linked to depression29) but also because via other mechanisms, like regulating your circadian rhythm and production of serotonin, which is released in response to sunlight exposure.
Exercise — Even One Hour a Week — Is Crucial
Even a minimal amount of exercise may be enough to combat depression in some people — as minimal as one hour a week, according to an 11-year study in which people who engaged in regular leisure-time exercise for one hour a week were less likely to become depressed.
On the flipside, those who didn't exercise were 44 percent more likely to become depressed compared to those who did so for at least one to two hours a week.30 "The majority of this protective effect occurred at low levels of exercise and was observed regardless of intensity," the researchers said, adding that, "assuming the relationship is causal, 12 percent of future cases of depression could have been prevented if all participants had engaged in at least one hour of physical activity each week."31
In my 2008 interview with Dr. James Gordon, a world-renowned expert in using mind-body medicine to heal depression, he stated that physical exercise is at least as good as antidepressants for helping people who are depressed, in part because it increases serotonin in your brain and in part because it increases brain cells in your hippocampus, which are sometimes reduced in people with depression.
In addition to aerobic activity, mind-body exercise like yoga has also shown promise. For instance, Iyengar yoga, which focuses on detail and precise alignment of posture combined with deep breathing, reduces symptoms of depression in those who are not taking medication or who have been taking the same medication for at least three months.32
Still more research, this time involving nursing students, a population among which depression is common, found that both physical exercise and mindfulness meditation were effective in managing depression (with the meditation being even more effective than the exercise in this case).33
Please keep in mind that physical activity should include not just "exercise" but also plenty of nonexercise daily movements, such that you're in motion more so than not (except while you're sleeping). Nonexercise movement is a foundational piece of optimal health — even more so than a regimented fitness routine, but ideally you should strive to do them both.
Tend to Your Emotional Health
Energy psychology uses a form of psychological acupressure, based on the same energy meridians used in traditional acupuncture to treat physical and emotional ailments for over 5,000 years, but without the invasiveness of needles. One such form is the Emotional Freedom Techniques (EFT), which has proven effectiveness in improving mental health, including depression.
In a study of 30 moderately to severely depressed college students, the depressed students were given four 90-minute EFT sessions. Students who received EFT showed significantly less depression than the control group when evaluated three weeks later.34
For serious or complex issues, seek out a qualified health care professional that is trained in EFT to guide you through the process. That said, for many people with depression symptoms, this is a technique you can learn to do effectively on your own. In the video above, EFT practitioner Julie Schiffman shows you how.
Another tool that's one of my new favorites is the book "Letting Go: The Pathway of Surrender" by Dr. David Hawkins. It is one of the best books I have read this year and helped teach me the useful tool of how to free yourself of painful emotions. It is well worth the read if you're struggling with depression, and keep in mind that most people will benefit from trying a variety of alternative treatment methods, as well as lifestyle strategies like paying attention to healthy sleep hygiene, to improve their mental health.
Remember, too, that you needn't suffer in silence. Seek help, from a counselor, a holistic psychiatrist or another natural health practitioner to start the journey toward healing.
That said, if you are feeling desperate or have any thoughts of suicide, please call the National Suicide Prevention Lifeline, a toll-free number: 1-800-273-TALK (8255), or call 911, or simply go to your nearest hospital emergency department. You cannot make long-term plans for lifestyle changes when you are in the middle of a crisis.