Happiness is difficult to pin down. But its approximate inverse, depression, is well-defined. Depression strikes along a continuum of severity, from feeling sad or anxious to losing interest in activities to feeling worthless and contemplating suicide. Depression is said to affect one in six people during their lifetime. For many who suffer, a range of prescription medications along with psychotherapy and cognitive behavioral therapy can be helpful.
But by some estimates, a third of people who seek treatment for depression get no relief. And then there are the many who feel a little gloomy now and then, and who wish to improve their moods without professional help or drugs.
Meanwhile, several truly natural remedies successfully battle bouts of melancholy and outright depression, including increased physical activity, improved diet or simply spending time in nature. Skip down to learn more about these.
?There is good evidence that non-drug treatments and lifestyle changes can ease the symptoms of depression,? says Dr. Michael Miller, assistant professor of psychiatry at Harvard Medical School. ?Depending on the severity of depression, any of them might work in place of or as an add-on to medication.?
Then there are the supplements.
From vitamin D to St. John?s wort, oodles of over-the-counter products promise to lift your mood, and there?s a plethora of money-hungry late-night TV hucksters and well-meaning friends and family members pitching those products, regardless of the real science behind them or the side-effects you?ll never know about until you suffer them.
That?s not to say no supplements are effective.
But the $40 billion-plus per year supplement industry is not formally regulated (though the FDA is ramping up efforts to crack down on unsubstantiated marketing claims and potentially dangerous products). There is no required product testing to determine effectiveness or safety, no standard dosages, and therefore typically little to no guidance from a doctor on how to combine (or not combine) one treatment with another.
Meanwhile, supplements are commonly promoted as ?natural,? which has zero scientific meaning whatsoever (after all, cyanide is natural), and many are known to contain ingredients that aren?t on the labels.
5 Dirty Little Secrets of ?Natural? Supplements
The supplement industry preys on consumer navet, hawking products with mystery ingredients that often don?t work and?
Further clouding things, studies that are done on supplements are often small and poorly designed, in some cases suggesting tantalizing links to effectiveness that get hyped by supplement-industry websites and believers eager to latch onto any finding that supports their hopes or personal experiences.
The Real Science of Supplements
All that in mind, let?s look at the real science behind the claims of many popular supplements purported to alleviate depression.
Vitamin D, Omega-3 Fatty Acids, Folic Acid, Calcium, Selenium
Multiple small studies have linked these five supplements to reduced symptoms of depression. But there remains no conclusive evidence of a cause-and-effect relationship. A new study offers some of the best perspective to date.
The year-long study recruited 1,025 Europeans from four countries, all of them overweight and showing signs of subsyndromal symptomatic depression, meaning they had signs of depression and were at risk for developing major depressive disorder.
The researchers tested the effects of a nutritional supplement containing vitamin D, omega-3 fatty acids, folic acid, calcium and selenium. Half the participants took the supplement daily, the other half took a placebo.
After a year, 10 percent of the participants had developed major depressive disorder: 54 of them had been on the supplement; 51 were taking the placebo. In scientific terms, that?s essentially a statistical tie.
?Daily intake of nutritional supplements over a year does not effectively prevent the onset of a major depressive episode in this sample,? said Mariska Bot, a researcher from Amsterdam University Medical Centers who worked on the study. ?Nutritional supplements were not better than placebo.
The research, part of a five-year project called MoodFOOD involving 13 organizations in nine countries, was detailed March 5, 2019 in the Journal of the American Medical Association (JAMA).
?This trial convincingly demonstrates that nutritional supplements do not help to prevent depression,? said study team member Ed Watkins, an expert in clinical psychology at the University of Exeter. That speaks only to the supplements involved in the test, of course.
Research into many other the commonly touted over-the-counter supplements and natural remedies is less conclusive. That?s not to say the supplements work or they don?t. The science simply isn?t settled on many of them, even if the marketing claims or your neighbor?s anecdotal ?proof? make it seem so. But for some of them, dangerous side-effects are known?especially in combination with other drugs?and anyone considering taking them should seek the advice of a doctor.
St. John?s Wort
A 2016 review of 35 studies involving 6,993 patients found that for mild and moderate depression, St. John?s wort, an herbal extract, ?is superior to placebo in improving depression symptoms and not significantly different from antidepressant medication.?
Translation: It seems to help. However, the researchers cautioned, they were not able to determine the safety of the herbal extract based on the results from the studies they examined, and they said ?the findings should be interpreted with caution.?
A separate study published in the journal Clinical and Experimental Pharmacology and Physiology found that St. John?s wort can cause anxiety, panic attacks, dizziness, vomiting, amnesia and aggression.
?There is a common belief that because something is natural and can be purchased from a health food shop without a prescription, it?s safe,? said study team member Claire Hoban of the University of Adelaide. ?However, people need to start thinking of St John?s wort, and other herbal medicines, as a drug and seek advice from a qualified healthcare practitioner to be sure they use it safely.?
St. John?s wort can also interfere with other medications, including blood-thinners and birth control pills, and in combination with antidepressants it ?can cause serious side effects,? according to the Mayo Clinic.
This is a synthetic form of a chemical that occurs naturally in the human body. It can cause nausea and constipation and even trigger mania in people with bipolar disorder. Research on its effectiveness at treating depression is inconclusive, according to one review of studies on the topic. The Mayo Clinic agrees, noting that studies done so far were not well designed or involved too few people.
Formally called 5-Hydroxytryptophan, this amino acid occurs naturally in the body and contributes to the production of serotonin, a chemical known to regulate mood and many other aspects of brain function. But 5-HTP hasn?t been properly studied for its potential to treat depression.
?This nutrient has a large and strong following who advocate exaggerated and inaccurate claims relating to its effectiveness in the treatment of depression and a number of other serotonin-related diseases,? according to one review of 5-HTP studies. ?These assertions are not supported by the science.?
As with many supplements, 5-HTP may be unsafe in large doses. Since supplements are unregulated, it?s nearly impossible for an individual to guess what a proper dose should be, or to know if the product they buy online or from a grocery store has the dosage it claims.
Formally called dehydroepiandrosterone, DHEA is a hormone the body produces that, in turn, helps produce testosterone and estrogen. DHEA peaks in early adulthood and then declines. By age 70 or so, most people don?t naturally produce it anymore.
Widely available DHEA supplements are pitched as a cure-all for aging, cancer, sexual-performance issues and more. Some research does suggest it can lift moods over the short run, but there?s no conclusive evidence whether it offers any long-term benefits.
DHEA can have serious side effects and should not be taken without the advice of a doctor, the Mayo Clinic advises.
A common spice, saffron may help with depression, but large studies have not been done. There are side effects, including anxiety. (For some reason, anxiety keeps popping up as a potential side effect of supplements intended to treat depression, for which anxiety is one of the symptoms.) The risks of high doses or long-term use are not known.
Lavender and Aromatherapy
Many swear by both, as well as the benefits of other essential oils. Some studies suggest lavender and aromatherapy can reduce anxiety and other depressive symptoms, but large-scale studies are lacking. A study on mice indicated lavender might reduce anxiety, but what happens in rodents doesn?t always equal what might happen in humans.
Smell is unquestionably powerful for the human psyche, and if certain scents help a person relax, it?s hard to argue they may have value. And of all the supplements touted for depression, this may be the least risky. But the jury is decidedly out on whether aromatherapy has any long-term effect on depression.
Truly Natural Remedies That Really Work
If you?re looking for truly natural remedies for depression?the sorts of things that came naturally to our ancestors?there are many proven options. That doesn?t mean each is guaranteed to work for a given individual, but across large numbers of test subjects and in study after study, they?ve been shown to be effective.
Multiple studies find spending time in nature, whether going for a walk or just sitting and doing nothing, improves physical and mental well-being.
One study found that just living in an area with more green space had a significant effect. Of 24 diseases researchers considered, the prevalence of 15 was lower for people living in areas with more green space. ?The relation was strongest for anxiety disorder and depression,? the researchers reported in the Journal of Epidemiology & Community Health. Here?s a deep dive into this topic:
The Amazing Benefits of Being in Nature
Better health. Lower stress. Enhanced creativity. Sheer joy. It?s all out there, and it doesn?t take long.
Volunteer and Socialize
In our increasingly disconnected society, more and more people are isolated, and loneliness is on the rise. The percentage of Americans living by themselves has risen from less than 15 percent in 1960 to more than 25 percent today, part of a global epidemic of loneliness I?ve written about, a scourge of solitary living linked directly to depression and increased risk of early death.
The prescription is twofold: If you know someone who might be lonely ? a neighbor or relative ? pay them a visit. If you?re alone, seek new friends or social situations. And yes, that can sound like hollow advice to someone whose symptoms discourage socialization. One science-based suggestion: Volunteer.
Research shows that volunteering to help others, so long as the motives are altruistic, benefits both mental and physical health. A 2018 study of widowed older people found volunteering regularly reduced their level of loneliness.
?We found that for people in general, widowhood was associated with increased loneliness over time,? said study team member Ben Kail, an assistant professor of sociology at Georgia State University. ?Among people who became widowed, if they started volunteering 100 hours per year, which is about two hours per week, this reduced loneliness to an extent that they almost look exactly like those people who never became widowed at all.?
Diet can affect not just physical health but also mental well-being, much research has shown.
Eating more fruits, vegetables and whole grains and less highly processed junk food ?can boost peoples? mood,? says Joseph Firth, a University of Manchester researcher whose study in the journal Psychosomatic Medicine earlier this year compiled data from 16 separate research efforts involving 46,000 people.
?Highly-specific or specialized diets are unnecessary for the average individual,? Firth said. ?Instead, just making simple changes is equally beneficial for mental health.?
The broader conclusions of the MoodFOOD research project, beyond discounting the value of several popular supplements, suggested that a healthy, Mediterranean-style diet ? high in things like fruit, vegetables, whole grains, fish, olive oil, and low in red meat and full-fat dairy products ? ?may reduce the risk of developing depression.?
The researchers produced a pamphlet titled ?Eating for Mental Health.? I?ve written more about diet and mood here:
Eating Your Way to Happiness
If long-term health benefits don?t motivate you to eat better, maybe the promise of a near-term mood lift will.
Get Active, Even if Only Modestly
Given the sheer number of large studies revealing the mental-health benefits of just about any physical activity, with the research so robust, it?s a wonder health care professionals don?t routinely prescribe exercise, or at least a bit of movement, before pills, for treating depression.
As just one example, a review of 25 studies back in 2013 showed that moderate physical activity ? such as walking or gardening for 20 to 30 minutes a day ? can help battle depression for all age groups.
A more recent study, published in the Jan. 23, 2019 issue of the journal JAMA Psychiatry, involved thousands of people and found that ?higher levels of physical activity reduce risk for depression.?
The benefits of exercise go well beyond battling clinical depression, of course. But what?s striking about the science of it all is how little effort is required to see some benefit, along with new evidence showing that it?s never too late to start. Just brisk walking, 2.5 hours a week, is known to improve mood and mental well-being (plus lower blood pressure and cholesterol levels and help with sleep and cognitive abilities).
?The link between exercise and mood is pretty strong,? says Michael Otto, a professor of psychology at Boston University, speaking to the broad body of research. ?Usually within five minutes after moderate exercise you get a mood-enhancement effect.?
Sounds like a pretty good supplement.