Depression is a relatively common medical condition. Common symptoms often include impaired sleep, energy, appetite and concentration. Other symptoms may include crying spells, decreased self-esteem, bodily complaints such as headaches, feelings of hopelessness and helplessness, indecisiveness, decreased sex drive, feelings of guilt and diminished ability to experience pleasure. About two-thirds of those with depression also complain of anxiety. Fortunately, the condition is often very treatable with the combination of medication and therapy.

Many people have become interested in natural, complementary and holistic approaches to treating depression. Below are a number of different nutritional supplements that may be helpful in the treatment of either depression or some of the individual symptoms of depression.

Gingko Biloba is an herbal product that increases blood and oxygen flow to the brain and, in doing so, may help elevate mood, and improve concentration and the ability to process information. Those with depression may have a decreased blood flow to the frontal parts of the brain, which may adversely affect the brain’s ability to produce important neurotransmitters. Gingko has been recommended by some to help improve cognitive functioning in those with Alzheimer’s disease and other dementias. In addition, Gingko has anti-oxidant properties and may decrease cortisol, a stress hormone that is often elevated in those with depression. CAUTION: Gingko should not be taken if one is on either blood-thinners or SRI antidepressants, as it may increase the chance of bleeding.

Tyrosine is an amino acid that the brain can use to make the neuro-transmitters dopamine and norepinephrine. Dopamine is considered a “pleasure chemical,” and low levels of dopamine could make it difficult to experience pleasure. Low levels of dopamine in certain parts of the brain are thought to cause attention-deficit or ADHD. Tyrosine, especially if taken on an empty stomach in a dose between 1,000-3,000 mg., may help one think more clearly and lift one’s mood.

Phenylalanine (DLPA), another amino acid, helps prevent the breakdown of endorphins and increases norepinephrine. It may thus help improve mood and decrease fatigue. It also helps our bodies to make tyrosine.

Dimethylaminoethanol (DMAE) increases brain levels ofacetylcholine; a brain chemical needed for memory and that is low in those with Alzheimer’s. DMAE may improve concentration, elevate mood and increase energy.

B-Complex Vitamins include folic acid, thiamin, riboflavin, niacin, B-6 (pyridoxine), B-12 (cobalamin) and others. A deficiency in certain B vitamins may be the result of a poor diet, vegetarianism, smoking, stress and excessive caffeine use, and result in or contribute to the symptoms of depression, anxiety, anemia, premenstrual syndrome and irritability.

St. John’s Wort is a well studied herb that has been shown to help in about half of those with a milder type of depression. It is thought to help increase brain levels of serotonin. It is generally safe and well tolerated when takenalone but should never be taken in combination with a prescriptive antidepressant. To be effective, it needs to be taken in doses of 900-1,200 mg. per day in 2-3 divided doses and requires several weeks to determine its effectiveness. In general, I have not been overly impressed with the compound.

Dehydroepiandrosterone (DHEA) is used by the body to make many other hormones including testosterone. It may help increase energy, sex drive and muscle mass while decreasing body fat levels. It has been suggested in some studies to also have a mood elevating effect, however, this compound may have unwanted side effects such as acne, increased facial hair growth and, in rare cases, mania.

S-adenosylmethionine (SAM-e) has been getting a lot of attention lately. It is a metabolite of the amino acid methionine and has been used for some time in Europe to help treat depression and arthritis. It may be helpful, but it is quite expensive to take at the recommended dosage. A more cost acceptable alternative may be to take methionine with B-complex vitamins to assist your body in making its own SAM-e, which may be lower in individuals with depression.

Essential fatty acids (EFA’s), such as omega 3 and 6 fatty acids, may also be at lower than optimal levels in those with depression, and supplementing your diet with EFA’s has elicited a positive effect in some. It also may reduce risk of coronary heart disease and strokes as well as make your skin and hair look nice. Due to its many health benefits, I recommend that everyone supplement their diet with EFA’s regardless of whether or not a person is depressed.

Melatonin is another hormonal product that many people have found helpful for sleep. Melatonin is made by the pineal gland in the brain. As one ages, the brain’s ability to make this hormone decreases, which may in part account for why many elderly individuals have sleep difficulties. Melatonin is generally taken 1-2 hours before bedtime on an as needed basis. Due to its anti-oxidant effect, this substance may also reduce the risk of certain cancers. Some feel that it also has anti-aging properties.

Kava-Kava is an herb that may have a calming effect and, therefore, be helpful for those with anxiety. It may also reduce muscle tension. Some have suggested that Kava may also help those with inhibited sexual desire. It is not supposed to cause drowsiness or inhibited motor function, but buyers beware.

(The above is to be used for education information and is not a claim or cure for disease.)

* Before using any herbal supplement, please check with your physician.

Nutritional Approaches to Treating Depression by Gary Casaccio, M.D. Dr. Gary Casaccio is general adult psychiatrist with special interests in depression, anxiety, seasonal affective disorders and nutrition.