Nutritional Supplements for Depression: A Brief Overview

A quick stroll down the supplement aisle in any health food store or vitamin shop reveals a vast number of products and many grandiose claims. DHEA, SAM-e, 5HTP, vitamins, minerals, amino acids…they are worth taking, but what do they do?

Before You Buy Anything

  • Be sure of your diagnosis. This means talking with your doctor and/or therapist in some depth about your symptoms and being sure that your depressive symptoms are not part of a different medical or psychiatric disorder. Bipolar disorder can be difficult to diagnose and easily confused with major depressive disorder-with disastrous results if you start supplementing with products that cause manic episodes in people who have bipolar disorder.
  • Cast a critical eye upon your current diet and lifestyle. If you are living on fast food, prepared foods, take out, and junk food, and keeping an erratic sleep schedule, no supplement will repair the damage that stress on your system is causing. If your work or family life is not flexible enough to allow you to eat and sleep well, then choose one small area to address and make changes there. For example, choose one meal each day that will improve and start there.
  • Ask you doctor about any specific supplement you would like to try. Some substances interact with a number of different medicines and could create serious health problems if taken together.
  • Do some research. Check reputable sources on the internet, and be wary of any site that provides information as a sales tactic. Look for references to academic journals if a study is mentioned, and don’t hesitate to ask your doctor and/or therapist for help in your research if you feel overwhelmed. There are many websites addressing depression with a tremendous amount of information to sift through. Learning to be appropriately critical and careful takes time and patience.

Baby Steps

So you’ve addressed the worst aspects of your diet and you’ve managed to change your schedule so that you’re no longer working the night shift. You aren’t abusing alcohol or any other substances. You’ve talked it over with your doctor. You’ve scanned the websites and the health food store aisles. Most likely you’ve narrowed down your options to the following supplements-let’s take a closer look at them individually.

  • SAM-e: This supplement is a naturally occurring chemical found in the body and used as a prescription medication for depression in some European countries. SAM-e is short for S-adenosylmethionine and is related to amino acids. It is believed that SAMe (pronounced “sammy”) works much like the prescription medications called serotonin-specific reuptake inhibitors (SSRIs) in that it helps increase the amount of serotonin available to the brain. There has been some real success documented in treating depression with SAMe, and multiple clinical studies show promising results. However, as effective as SAMe seems to be, it also comes with numerous and sometimes serious side effects. In addition, SAMe can interact with a number of prescription medications, most importantly antidepressants. Do not take SAMe without discussing it with your doctor, and if you use this supplement, make sure all your medical providers know about it.
  • DHEA: Dehydroepiandrosterone (DHEA) is also a naturally occurring hormone manufactured in the adrenal glands. This supplement is marketed as an anti-aging and sex drive booster, and is sometimes promoted as an aid for menopause symptoms. One study by the National Institute of Mental Health indicated that DHEA was effective in easing symptoms of mild to moderate depression. This is potentially good news, as SSRIs have been shown to be effective in treating more severe depression, but less effective when the condition is only mild to moderate. However, research is still in early phases, and DHEA does have some downsides: it is very expensive compared to other supplements and is reported to cause a number of both annoying and potentially dangerous side effects.
  • 5-HTP: This supplement is related to the amino acid L-tryptophan and suffers from its same bad reputation it earned back in 1989 when it was removed from the market due to a contamination problem. 5-HTP is thought to work on the serotonin system, much like SSRIs and SAMe. In addition, 5-HTP can be sedating and promotes sleep, which can be a boon for depression complicated by insomnia or anxiety. Research on this supplement has also been promising, as effectiveness has been rated as comparable to or better than SSRIs and the older tricyclic antidepressants, but the taint of the L-tryptophan contamination has cast a cloud over 5-HTP. While fewer side effects than prescription medications are reported for 5-HTP, some very serious drug interactions are possible. As with SAMe, be sure to inform all medical providers if you use this supplement, and do not take 5-HTP if you are currently taking antidepressants.

The Best Supplement?

As with all medications, different supplements work differently for every individual, and “one size fits all” is not accurate in most situations! However, there is one recommendation that stands out as almost universally acknowledged as safe and effective, and that’s exercise. Daily moderate exercise, such as walking, is considered the best “medicine” that isn’t medicine available. So before you spend money on supplements, try lacing up a good pair of walking shoes and stretching your legs. You may find an improved mood is not the only positive result!

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