View Full Version : Natural depression relief

December 4th, 2007, 07:17 PM
Most of you know all this stuff, but just thought I'd share this article I just found. (It's in a natural retailer trade magazine, so that's why it refers to "your customers")

Depression-lifting supplements that work
Linda Knittel

5/1/2006 2:52:49 PM

Solid science supports St. John's wort, SAM-e and omega-3s

Depression is big business. In any given year, an estimated 19 million people look for ways to ease sadness, anxiety and feelings of hopelessness associated with depression?a number that has made some pharmaceutical companies quite rich. But today, natural treatments for depression are giving drugs a run for their money. Thanks to loads of anecdotal evidence, as well as strong scientific evidence from clinical studies showing safety and efficacy, more people are discovering that herbs, vitamins and other supplements can be powerful enough to lift symptoms of depression without the unwanted side effects that often accompany drugs.

Although one of the strongest appeals of these natural approaches is that they can be used without a prescription, it is important to remind your customers to seek the guidance of a physician or other health care provider when beginning any treatment program. Additionally, because there are many types of mood disorders, professional help is essential to determine the nature and severity of the condition. While mild to moderate depression often responds well to natural remedies, more serious forms of mental illness?including severe depression and bipolar disorder?require the expertise of a qualified health care provider. The following natural remedies have a good track record and solid science to support their use in treating mild to moderate forms of depression.

St. John's wort
St. John's wort (Hypericum perforatum) is by far the most popular dietary supplement for depression. Because it produces effects similar to those of selective serotonin reuptake inhibitor drugs, such as Prozac, researchers believe the herb slows the rate at which brain cells use the neurotransmitter serotonin. Higher levels of available serotonin correlate to elevation in mood.

Beginning in the 1980s, a number of small studies suggested the herb was as effective for mild to moderate depression as tricyclic antidepressants, an older class of medications.1,2 Then, in 1996, the British Medical Journal published a meta-analysis of 23 randomized clinical trials conducted to investigate the effectiveness of St. John's wort's extract (standardized to 0.3 percent hypericin) in relieving depression; the trials involved a total of 1,757 people.3 The meta-analysis looked at trials that pitted St. John's wort against a placebo, as well as studies that compared the herb to standard SSRIs, such as Prozac. The meta-analysis concluded that individuals with mild to moderate depression fared better with St. John's wort (63.9 percent of patients improved) than with conventional SSRIs (58.5 percent).

Since then, several additional well-designed clinical trials have compared St. John's wort to leading antidepressants. For example, in a randomized, double-blind study published in 2000, German physicians treated 240 patients with mild to moderate depression with either 500 mg daily of St. John's wort extract or Prozac for six weeks.4 According to the Hamilton Depression Scale (a standard test used to assess depression), symptoms declined by about 12 percent in both groups. However, when using the Clinical Global Impression Scale, another test for depression, St. John's wort proved significantly more effective than Prozac.

Another double-blind, randomized study compared St. John's wort with the SSRI drug Zoloft. Thirty participants were given 500 mg to 600 mg of St. John's wort or Zoloft daily for seven weeks.5 Some improvement was seen in the St. John's wort group within two weeks, and after six weeks, symptoms of depression were reduced by an average of 47 percent in the St. John's wort group and by 40 percent among those taking Zoloft.

However, a widely publicized 2001 study cast a shadow over the promise of St. John's wort.6 Many believe the study was a charade with quite a few shortcomings. It examined the effects of St. John's wort in severe depression, not in the mild to moderate type for which it is typically recommended. Critics pointed out that no active pharmaceutical drug was used as a reference against which to compare St. John's wort and placebo, and the placebo response rates were unusually low for a depression study.7 The study was funded by Pfizer Inc., the manufacturer of the widely prescribed Zoloft. What's more, when scrutinized closely, the study results revealed that St. John's wort actually did benefit some severely depressed patients..6

St. John's wort safety
Today, most St. John's wort products are standardized to contain 3 percent to 5 percent hyperforin; most earlier studies utilized St. John's wort extract standardized to 0.3 percent hypericin. The process of standardization guarantees that a specified amount of an ingredient (presumably the active ingredient) is present in the herbal extract. Although there has been debate over the years as to exactly which constituents in St. John's wort are responsible for its activity, the Physician's Desk Reference for Herbal Medicine currently states that hyperforin?not hypericin?is likely the primary active ingredient for treating depression,8 but conclusive evidence is lacking. In addition, it is possible that other biologically active constituents of St. John's wort, such as flavonoids and tannins, also may play a role.9

In one well-controlled study involving 147 people with mild to moderate depression, subjects took either placebo, St. John's wort extract standardized to 0.5 percent hyperforin, or St. John's wort extract standardized to 5 percent hyperforin.10 Only the patients who received the 5 percent hyperforin extract showed significant improvement, leading the investigators to conclude that the effect of St. John's wort in depression depends on hyperforin.

In general, St. John's wort has been shown to produce very few side effects; these include mild gastrointestinal disturbances and photosensitivity (an allergic skin reaction that can occur upon exposure to sunlight) in some people. Some studies have indicated that the herb may interact with certain medications, including digoxin (used to treat congestive heart failure),11 theophylline (an asthma medication)12 and the HIV drug indinivir.13 Thus it is essential that those taking pharmaceutical medications check with a qualified health care practitioner before taking St. John's wort.

A recent study suggests that a hyperforin-free St. John's wort extract may pose fewer risks of drug interactions,14 but it is not known whether hyperforin-free extracts will deliver the same therapeutic benefits as extracts that contain hyperforin. In a randomized, placebo-controlled study of 96 healthy volunteers, a seven-day loading phase of digoxin was followed by 14 days of either a placebo or one of 10 different St. John's wort products that varied in dose and formulation. The investigators measured digoxin blood levels before adding St. John's wort and again on day 14 of the study. Results showed that the higher the dose of hyperforin, the more dramatic the interaction with digoxin. Placebo and hyperforin-free extract caused no significant interaction with digoxin, suggesting that hyperforin-free St. John's wort might be a safer option for those taking additional medications.14 But again, whether hyperforin-free St. John's wort extracts will deliver adequate mood-lifting effects remains to be determined.

Although it may sound synthetic, S-adenosyl-L-methionine is a naturally occurring compound involved in many biochemical processes. Supplemental SAM-e is known to ease the pain and stiffness caused by osteoarthritis15,16 and has been shown to support liver function.17 In addition, a good deal of research has focused on its ability to affect mood. SAM-e appears to relieve depression by enabling the brain to manufacture neurotransmitters such as dopamine, serotonin and norepinephrine.

A research review published in the American Journal of Clinical Nutrition in 2002 concluded that SAM-e relieves depression significantly more effectively than tricyclic antidepressants.18 Other studies have shown that in addition to working as well as antidepressant drugs, SAM-e has fewer side effects and is better tolerated. For example, in a double-blind study of people with a diagnosis of a major depressive episode, participants received either 400 mg per day of SAM-e (given intramuscularly) or 150 mg per day of oral imipramine, a tricyclic antidepressant. A total of 146 patients received SAM-e, and 147 received IMI for a period of four weeks. According to results, SAM-e was comparable to IMI in terms of antidepressive efficacy, but was significantly better tolerated.19 A number of other double-blind studies have also shown oral SAM-e can ease depression symptoms.20

Omega-3 fatty acids
Considering the brain is 60 percent fat, it is no wonder it needs adequate amounts of omega-3 fatty acids to function properly. In fact, recent clinical studies have shown a strong connection between low levels of omega-3 fatty acids and depression.

Plant sources of omega-3 fatty acids, such as flax, walnuts and hemp, contain the parent omega-3, alpha-linolenic acid, which can be converted into eicosapentaenoic acid and docosahexaenoic acid in the body. However, the conversion process is not efficient, meaning that consuming EPA and DHA directly from animal sources raises levels more quickly in the body, probably leading to better results. Cold-water fish, such as sardines, salmon and mackerel, as well as algae and fish oil supplements, are direct sources of EPA and DHA. Vegetarian DHA supplements are also available.

According to one study, the lower one's level of EPA, the more severe the clinical depression.21 What's more, people diagnosed with depression have been shown to have up to 35 percent less DHA in fat storage cells than healthy individuals.22 In one double-blind study of 70 patients with persistent depression, supplementation with 1 g, 2 g or 4 g of EPA per day for 12 weeks was significantly more effective than a placebo in relieving symptoms of depression.23

A recent study published in the British Journal of Psychiatry tested the efficacy of EPA supplementation in the treatment of bipolar depression, a much more severe mood disorder.24 In the 12-week, double-blind study, 26 participants with the condition were randomly assigned to take placebo, 24 to take 1 g of EPA and 25 to take 2 g of EPA daily. People who took either dose of EPA had a significantly greater improvement in symptoms of depression than those who took placebo, although there was no apparent benefit to the higher 2 g dose.

Chromium picolinate
While chromium picolinate has not been proven to lift mild to moderate depression on its own, recent studies have shown the mineral can have an impact in the treatment of a specific type of depression known as atypical depression. Despite its name, atypical depression is quite common and is generally associated with symptoms such as weight gain, carbohydrate cravings and appetite increase.

In a small, placebo-controlled, double-blind study published in Biological Psychiatry, 15 individuals with atypical major depression were given either 600 mg chromium picolinate or a placebo for eight weeks.25 Results showed 70 percent of chromium-treated participants experienced improvement in symptoms of depression; none of those taking placebo experienced improvement (an extremely low placebo response rate). Chromium was well-tolerated.

Another study demonstrated that chromium might have the ability to assist in insulin regulation, helping to stabilize blood sugar and curb cravings that often accompany depression. In a recent double-blind, placebo-controlled study published in the Journal of Psychiatric Practice, 113 people with atypical depression were randomly assigned to receive 600 mg a day of chromium picolinate for eight weeks, or a placebo.26 Although the chromium did not significantly improve overall symptoms of depression in all participants, it did cut carbohydrate cravings in those who had them. In addition, chromium seemed to improve depression symptoms in those individuals with such cravings.

The discovery of chromium's ability to ease mood-related cravings is likely a foreshadowing of what is yet to come in the realm of natural treatments for mood disorders. For example, a recent double-blind, randomized study showed an extract of Echium amoenum (a plant in the borage family) was significantly better than placebo in relieving symptoms of mild to moderate depression.27 In other words, we can likely expect to see an even larger array of powerful mood-lifting supplements on store shelves soon.

Linda Knittel is a Portland, Ore.-based freelance writer. She is the author of User's Guide to Natural Remedies for Depression (Basic Health Publications, 2003).

What to recommend

Because individual nutrient needs and restrictions vary, remind your customers to seek the guidance of a trained health care practitioner before starting any treatment program. The dosages below are general guidelines that have proven effective and safe in clinical studies.

St. John's wort: Clinical studies have used a daily dose of 900 mg of St. John's wort extract standardized to 3 percent hyperforin. This herb may interact with some medications, so advise your customers to be sure to consult a physician if they are taking any medication, pregnant, nursing or scheduled for surgery. Occasionally St. John's wort will cause photosensitivity (an allergic skin reaction to sunlight).

SAM-e: Clinical studies have used a daily dose of 400 mg of SAM-e. Take on an empty stomach. People who are on any type of medication or are pregnant, nursing or scheduled for surgery should consult a physician.

Omega-3 fatty acids: A daily dose of 300 g of EPA plus 200 g of DHA has been used in clinical trials. That may require 10 g of fish oil, because most fish oil contains only 18 percent EPA and 12 percent DHA. Concentrated products have succeeded in squeezing this amount into one capsule. Consumers should consult a physician if they are taking any medication, scheduled for surgery, pregnant or nursing. Look for products that have been tested for heavy-metal content.

Chromium picolinate: A daily dose of 600 mg has been used in clinical studies. Chromium picolinate has not been shown to cause toxicity when taken at recommended levels. Because chromium can influence insulin levels in the body, anyone with blood sugar issues should consult a health care practitioner before taking this mineral.

December 4th, 2007, 09:26 PM
wow! so interesting...thanks MOW.

December 4th, 2007, 10:10 PM
Thanks for posting that MOW.

I especially fing the omega 3 research interesting.

One thing I would add to the list (I realize it is a supplement list though) for natural relief is cognitive behavioral therapy.

About John's wort, I am glad the article addresses dose because the instructions on the packaging do not match the levels used in clinical trials. But I took this supplement once and found that to match the trial levels I had to take tons of pills, three times a day, which is inconvenient. Are once a day formulations available?

December 4th, 2007, 10:15 PM
Good general summation of alternatives.

However, I am a bit concerned about the indicated dosages of EPA, and DHA. The article indicates 300 g of EPA, and 200 g of DHA. In most standard docs, "g" is used to indicate a gram. 1 US pound is 454 grams, so the combination would indicated over a pound of oil per day!!

Is this a typo, as I would think that mg (or milligrams, or 1/1000 of a gram) would be more reasonable dosage.

Not nit-picking, but want to be clear on what you conveying here.

Many times, levels of these types of lipid supplements are indicated in IU's, or International Units, such as vitamin E. Vitamin E is frequently dosed in terms of IU, and 300 to 400 IU is a standard dosage.

So, I would think 300 IU of EPA, and 200 IU of DHA would be found in 10 grams of fish oil. Is this indeed the case here?

Just concerned.


Finding Me
December 4th, 2007, 10:18 PM
Great Info MOW!
I have just recently began taking the omega-3 (1000 mg. twice a day)because I read that it helped with hot flashes. I added it to my supplement routine and take it at noon and dinner. Great to know that it gives the depression a little added boost. Thanks!

December 5th, 2007, 12:08 AM
Hi Neil - I just cut and pasted the article, ,so can't clarify.

December 5th, 2007, 03:26 AM
Very interesting. I knew about this all from before, but this was the most detailed explanation I have seen. I also heard about St John's Wort being debunked so it was very interesting to find out how (and why).

One important addition: Lithium orotate. This is the only alternative "medication" I have found that I can tolerate and helps with depression. Studies show it to be more effective than SSRIs and it is natural, with few, if any, side effects. It is also a natural sedative, and can be used at night for sleep problems.

December 5th, 2007, 11:40 AM
xtexan;234348 wrote: Good general summation of alternatives.

However, I am a bit concerned about the indicated dosages of EPA, and DHA. The article indicates 300 g of EPA, and 200 g of DHA. In most standard docs, "g" is used to indicate a gram. 1 US pound is 454 grams, so the combination would indicated over a pound of oil per day!!

Is this a typo, as I would think that mg (or milligrams, or 1/1000 of a gram) would be more reasonable dosage.

Not nit-picking, but want to be clear on what you conveying here.

Many times, levels of these types of lipid supplements are indicated in IU's, or International Units, such as vitamin E. Vitamin E is frequently dosed in terms of IU, and 300 to 400 IU is a standard dosage.

So, I would think 300 IU of EPA, and 200 IU of DHA would be found in 10 grams of fish oil. Is this indeed the case here?

Just concerned.

you are right. one should not take more than 1.8 grams of EPA or DHA.
if taking more you need to be supervised by a doctor.
also it's a must to make sure that the omega-3 does not contain contaminants.

December 15th, 2007, 11:39 PM
Fresh oily fish is good for omega 3 and tastes wonderful - we have it at least 3 times a week.


December 17th, 2007, 02:39 PM
If you eat fish more that 3 times a week, be very careful of what type of fish it is. tuna and some salmon contain high amounts of hard metals that can't be removed form your system.
stick to fresh fish that come from clean sources.
I had a friend who was eating a lot of raw tuna she loved it. she got mercury poisoning from over eating tuna she was buying from her local fish store.

Roberta Jewell
December 17th, 2007, 03:54 PM
Great thread

And don't forget about exercise. So SO important, with clinical studies to back up its efficacy. Here's an excellent overview (http://www.holisticonline.com/remedies/Depression/dep_exercise.htm). :)


December 20th, 2007, 12:47 AM
I am glad to say that I believe that Australia has better health standards and testing than that - mercury in fish is tested for here.

Is there any thing we can actually eat without harming something??? Bad science creates scares, not good science - like caffiene can stave of Parkinsons - yay!

But seriously - if the food's that polluted why bother at all - let's just all take supplements shall we - what's in the pills is so pure right?

Not happy - can't even eat fish now - silly me for thinking that making a simple statement would not immediately give me a comeback of "be careful of fish, or drugs or what bloody ever".


December 20th, 2007, 04:09 PM
Does anybody know, does SAMe or St Johns Wort totally kill sex drive like we all know SSRIs do? Please share!!!!!

December 22nd, 2007, 11:42 PM
not in my experience Jossy.

December 22nd, 2007, 11:44 PM
I'd bet that if we simply cut sugar and simple/bad carbos out of our diet that it would really help stave off depression. I'd guess a large percentage of Americans are on mental rollercoasters due to diet and don't even know it.

December 23rd, 2007, 02:06 AM
I agree with you determinator...

and don't forget caffeine...

Dolly Sunshine
December 23rd, 2007, 09:32 AM
I'm doing the Atkins Induction right now and have NEVER felt better. I think simple carbs for SOME people are the kiss of death. Or at least the kiss of depression. It has actually helped me not drink. Day 5 of induction and day 5 A/F and no cravings. I'm only taking a B complex, Cromium and magnesium.

December 23rd, 2007, 09:48 AM
Keep tellling me your progress, Dolly. Do you think no sugar makes your cravings go away? Isn't alcohol all sugar?
I take Zoloft for SAD, and Trazedone to sleep. I've been 'stressed' - I hate that word, used too much. I shipped my beloved kids off to their dad's for Christmas. Now I have a week to really focus on MWO, and getting healthy.
Also, for the SAMe/SJW crowd, do you take them both together? Or do they get drug interactions?

Dolly Sunshine
December 23rd, 2007, 10:19 AM
I really think no sugar cuts the cravings. My boyfriend has even had beer in the house and it hasn't phased me at all. Beer was never my drink of choice but the last year or so it hasn't really mattered to me what it was as long as it was alcohol. I've been home alot the past week getting ready for the holidays and being home was always a big trigger for me and I've been fine with just herbal tea. I hope it continues this way.

Good luck this week :)

December 23rd, 2007, 06:36 PM
Det........tell me more about "simple/bad carbos" please.........I want to feel great in 2008.
Don`t know anything much about diet........only know how to count calories to lose weight. lol Would be good if ousting all the junk food from our diet could considerably boost mood. So, what are bad carbs?........`cos I would hazard a guess that my kitchen cupboards are full of them.....no kidding!!! :H


Starlight Impress x

December 23rd, 2007, 06:39 PM
D, I could not agree with you more. I truly believe that the majority of people that are so-called depressed are really feeding their bodies crap in terms of food and their brain and blood sugar are on a wild rollercoaster. And sadly the pharma companies take advantage of that and come up with pills for us to take.

December 25th, 2007, 08:48 AM
I am very new to this program, but it's inspiring me to get healthy again. Yesterday, I took half my Zoloft pill; tapering down, and in a few days I'll start with SAMe. What is the best way to go to sleep? 5htp makes me nauseous, or maybe that was because I combined it with alcohol.

Dolly Sunshine
December 25th, 2007, 09:05 AM
I like 6 mg of Melatonin. Seems to work for me once the initial alchohol w/d was over.

December 26th, 2007, 06:37 PM
Hey Starlight - I just saw your post asking for more info about "bad carbs". Generally that would refer mostly to simple sugars (sugar, corn syrup, etc), refined flours (as in white bread and pasta), and white rice.... and then all the processed foods that use these - which is just about all processed foods.

If you really want to "feel great in 2008" you need to start cooking yourself some good food girl! (I remember you saying that you eat easy-to-reheat foods)

December 30th, 2007, 12:00 PM
I wanted to let you all know what a major turnaround I've had in my mood this week, after just a few days of taking my supps consistently!!!
The day after Cmas I was deeply depressed again, nearly at the "i wish i were dead" point yet again. So I went to the HF store and got higher dosage of 5htp and GABA than I had tried before, and began taking them and St Johns Wort, fish oil caps and All One very consistently.

I am AMAZED at the difference in myself!!
Yesterday my daughter and i had such a wonderful time together, lots of chattering and laughter, whereas for too long we haven't been like that, not for a whole day anyway, because i'm so blue and cranky.
And usually on the Sunday morninigs that she is with her dad I lie in bed after waking up dreading the 14 hours ahead, of being alone and miserable. But this morning I woke and got excited for the day and all the things I'm gonna do - like clean the house, and exercise, and write, etc.

I feel GOOD!! So I"m sharing this cuz if anyone out there has depression issues and hasn't given a really shot at using supps to correct it, I highly encourage you to give it a try!!