Depression and natural therapies

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Depression, for the purposes of this article, refers to the illness known as major depressive disorder. This kind of depression is a recognised clinical condition and is becoming a common illness in developed countries, with up to 20% of the population affected by this illness at some stage of their lives.^[1]

The medical profession and drug companies have responded with a vast arsenal of antidepressant medications, which have been used effectively since the 1960s. In addition to these medications, there is also an array of natural or alternative therapies that are claimed to have various benefits. These therapies have not been shown to be as effective as antidepressants, and have not always been researched sufficiently. They may have a role in helping a patient cope with depression while waiting for an antidepressant to start working (antidepressants can take anything from one week to five weeks to take effect, and life can be difficult for the patient in the meantime). They may also have a role as complementary therapies.

Contents 1 Therapies 1.1 Acupuncture 1.2 Amino Acids 1.3 B-Vitamins 1.4 Coffee 1.5 D-Vitamins 1.6 Eleutherococcus senticosus 1.7 Flower remedies 1.8 Hypericum perforatum (St. John's Wort) 1.9 Inositol 1.10 Kanna 1.11 Liver/gallbladder flush 1.12 Meditation 1.13 Omega-3 fatty acids 1.14 Reiki 1.15 Saffron 1.16 Tissue Salts 1.17 Visible light therapy 2 See also 3 References

[edit] Therapies

[edit] Acupuncture

Acupuncture is a technique originating in traditional Chinese medicine wherein fine filiform needles are inserted into specific acupuncture points on the body. A 2004 Cochrane Review concluded that based on the low quality of the evidence base there is "insufficient evidence to determine whether acupuncture is effective in the management of depression."^[2]

[edit] Amino Acids

The natural therapies that most closely resemble antidepressants in their action are certain amino acids. Tryptophan (L-tryptophan) is the precursor of the neurotransmitter serotonin, and thus has an affect that is similar to those antidepressants that replenish the supply of serotonin in the brain cells. In particular, tryptophan showed considerable promise as an antidepressant alone,^[3] and as an "augmenter" of antidepressant drugs.^[3][4] Tryptophan may appeal to patients who are prejudiced against antidepressants or dislike the side-effects. Effective dosage range is 4-6 grams daily. It can take trytophan ten days to start working. It can also improve sleep because the brain creates melatonin from serotonin, and melatonin tells the brain to switch off and go to sleep. Too much tryptophan causes dizziness. Normally, it should not be combined with antidepressants; this can cause serotonin syndrome, a problem which can cause death in extreme cases.^[5]

Another amino acid that can help with depression is tyrosine (L-tyrosine), which is the precursor of adrenaline, noradrenaline and dopamine. By replenishing these important neurotransmitters, tyrosine can lift the mood of a depressed patient, especially patients who have had a "breakdown" through overwork or are burned out for the same reason (a condition which comes about because of a depletion of the adrenal system). Like tryptophan, tyrosine takes approximately ten days to start working. The effective dosage range is 1-2 grams daily. Excess use causes insomnia. Tyrosine can be combined with tryptophan but not antidepressants.^[6][7][8]

S-adenosyl methionine (SAMe) has also been shown in clinical studies to fight depression,^[9][10][11] among other ailments. SAMe can be purchased over-the-counter, usually in 200mg enteric-coated tablets at a suggested dosage of 400mg per day.

[edit] B-Vitamins

It has been shown that some people with depression have an impaired folate metabolism and that taking a daily B-vitamin complex tablet can help with depression.^[12]

[edit] Coffee

It has been shown that coffee drinkers have a lower incidence of suicide than the rest of the population.^[13] Caffeine is a stimulant which, in moderate amounts, helps with fatigue associated with depression. Coffee has been shown to contain small quantities of monoamine oxidase inhibitors (MAOIs),^[14] which are antidepressants.

[edit] D-Vitamins

Some patients have shown improvement with increased doses of Vitamin D.^[15]

[edit] Eleutherococcus senticosus

Eleutherococcus senticosus (formerly Acanthopanax senticosus), is called cì wǔ jiā (刺五加) in Traditional Chinese Medicine. The plant is an adaptogen, which has been shown to have significant antidepressant effects in rats.^[16][17]

[edit] Flower remedies

Bach flower remedies and Australian bush flower essences are dilute extracts of various flowers. Current clinical evidence does not support any hypothesized action or efficacy beyond placebo effects.^[18]

Four Bach flower remedies are described in connection with depression: gentian for very mild depression or pessimism; gorse for more serious depression; sweet chestnut for severe depression; and mustard for depression that comes from within and is not related to external circumstances.^[19][20][21] Two Australian bush flower essences are described in connection with depression: waratah for depression; and Sunshine Wattle for pessimism and defeatism, especially after a long run of bad luck.^[22]

[edit] Hypericum perforatum (St. John's Wort)

In some countries, such as Germany, Hypericum is commonly prescribed for mild depression, especially in children, adolescents, and where cost is a concern.^[23] Some research and experience there has shown that Hypericum can help with mild depression, but not necessarily clinical depression. Hypericum treatment for depression is approved by and paid for by the German government. St. John's Wort can be combined with amino acids but not antidepressants. Recent research has shown that Hypericum can combine adversely with a range of medications.^[24]

[edit] Inositol

Inositol has been shown through various studies to be an effective treatment for depression, Bipolor Disorder, Obsessive-Compulsive Disorder^[25][26][27] and panic attacks. The therapeutic dosage of inositol seems to be between 6-20 g/day, with 12-18 g/day being more likely an effective dosage.^[28]

[edit] Kanna

Main article: Sceletium tortuosum

Kanna (Sceletium tortuosum) is a succulent herb commonly found in South Africa. In doses as low as 50 mg, users have reported improvements in mood, decreased anxiety, relaxation and a sense of well-being. The alkaloids contained in S. tortuosum are believed to possess psychoactivity include: mesembrine, mesembrenone, mesembrenol and tortuosamine.^[29]

Mesembrine is a major alkaloid present in Sceletium tortuosum, which has been shown to be a potent serotonin reuptake inhibitor (more so than imipramine),^[30] and a PDE4-inhibitor (less so than rolipram).^[31]

Sceletium tortuosum contains about 1-1.5% total alkaloids. There is about 0.3% mesembrine in the leaves and 0.86% in the stems of the plant.^[32]

[edit] Liver/gallbladder flush

Flushing the liver and gallbladder has provided some relief for depression in some people.^[33]

[edit] Meditation

Meditation has been proved to be of benefit in a number of ways, including lowering blood pressure and stress levels. Using meditation for clinical depression, however, is fraught with danger, because one of the main symptoms of depression is the inability to concentrate. If a severely depressed person tries to meditate, there is a real danger that they will make themselves worse because of their inability to concentrate. The most helpful and gentle form of meditation for a clinically depressed person may be the repetition -- silently or out aloud -- of a mantra, providing it is not overdone.^[34][35]

[edit] Omega-3 fatty acids

Omega-3 fatty acids have been shown to help many people with depression, the theory being that Omega-3 helps nourish brain cells that release serotonin into the brain. Omega-3 fatty acids are present, for example, in cold-water fish such as salmon, in flax seed, in fish oil capsules and in flax seed capsules.

"Several epidemiological studies suggest covariation between seafood consumption and rates of mood disorders. Biological marker studies indicate deficits in omega-3 fatty acids in people with depressive disorders, while several treatment studies indicate therapeutic benefits from omega-3 supplementation. A similar contribution of omega-3 fatty acids to coronary artery disease may explain the well-described links between coronary artery disease and depression. Deficits in omega-3 fatty acids have been identified as a contributing factor to mood disorders and offer a potential rational treatment approach." (American Journal of Psychiatry 163:969-978, June 2006)^[36]

[edit] Reiki

Reiki is a form of energy medicine originated in 1922 by Mikao Usui. A 2008 systematic review of the current scientific research concluded that any recommendation of Reiki for the management of depression is not evidence-based.

[edit] Saffron

Saffron, the flowers of Crocus sativus have been shown to have definite antidepressant properties.^[37] Two of the active ingredients are crocin and safranal.^[37]

[edit] Tissue Salts

Developed by the biochemist Dr. William Schuessler, tissue salts are twelve alkaline salts used in homoeopathic strengths. Kali. Phos. (potassium phosphate) is the tissue salt that is claimed to bring some short-term relief to depressed patients.^[38]

[edit] Visible light therapy

Main article: Seasonal Affective Disorder

Individuals with Seasonal Affective Disorder (seasonal depression, seasonal bipolar) are often helped with light therapy.^[39] A special lamp or a set of lamps is used, which does not emit ultraviolet light, so as not to damage the eyes. The treatment is usually done between the hours of 6-8 a.m. for at least an hour. Some psychiatrists prescribe "light boxes" for treatment of Seasonal Affective Disorder. Full-spectrum light is traditionally used, however more recently blue light technology has been introduced.

[edit] See also

• Depression
• Bipolar Affective Disorder

[edit] References