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Depression is a mental illness. People with it have feelings of sadness and lack of interest in activities. It is a lasting low mood that gets in the way of everyday life. Depression can cause a wide range of symptoms that are physical and emotional. It can last for weeks, months, or years.

Medicine and therapy can help to manage depression. Natural therapies may help to ease symptoms when used with standard care.

Natural Therapies

Therapies that are likely to be effective are:

Likely Effective

  • Mindfulness-based therapies focus on paying attention to thoughts and feelings in the present without judging them K1-K5
  • Music therapy J1-J5

Herbs and supplements that are likely to be effective are:

May Be Effective

Therapies that may be effective are:

  • Acupuncture inserts thin needles into points of the body to promote health A1
  • Massage therapy is the use of touch to ease health problems I1, I2
  • Yoga is the use of breath control, meditation, and poses L1

Herbs and supplements that may be effective are:

  • 5-HTP is a chemical made by the body Y1, Y2
  • B vitamins help the body make energy from foods G1
  • Black cohosh is a plant in the buttercup family R1
  • Chamomile is an herb S1
  • Chasteberry is the fruit of the chaste tree T1
  • Echium is a flowering plant W1
  • Folate is a B-vitamin present in foods B1-B4
  • Galphimia is an herb Q1
  • Kava is a tropical evergreen shrub O1
  • Lavender is a flowering plant in the mint family U1, U2
  • Passionflower is a climbing vine P1, P2
  • Rhodiola rosea is a flowering plant X1
  • S-Adenosylmethionine (SAMe) is a chemical found naturally in the body. (Note: SAMe should not be taken by people who have bipolar disorder as it may worsen symptoms. It may also interact with drugs and supplements that increase serotonin.) D1-D3
  • St. John's Wort is a supplement made from a plant. (Note: St. John’s wort is not regulated in the United States. Major organizations advise against routine use because it may cause serious reactions.) C1-C5

Not Enough Data to Assess

Diet and nutritional supplements for perinatal depression. V1

Editorial process and description of evidence categories can be found at EBSCO NAT Editorial Process.

Editorial process and description of evidence categories can be found at EBSCO NAT Editorial Process.

Herbs and Supplements to Be Used With Caution

Talk with your doctor about all herbs or supplements that you are taking. Some may cause problems with your treatment plan or other health problems, such as:

  • Omega-3 fatty acids may cause problems for people who take blood thinners and those with diabetes.
  • SAMe should not be taken by people who have bipolar disorder. It may also interact with drugs and supplements that increase serotonin.
  • St. John’s wort can cause death when combined with some antidepressants. It may also weaken effects of some medicine, such as antidepressants and birth control pills.

References

Acupuncture

REFA1 Smith CA, Armour M, et al. Acupuncture for depression. Cochrane Database Syst Rev. 2018 Mar 4;3:CD004046.

Folate

REFB1 Taylor MJ, Carney S, et al. Folate for depressive disorders. Cochrane Database Syst Rev. 2003;(2).

REFB2 Venkatasubramanian R, Kumar CN, et al. A randomized double-blind comparison of fluoxetine augmentation by high and low dosage folic acid in patients with depressive episodes. J Affect Disord. 2013 Sep 5;150(2):644-648.

REFB3 Bedson E, Bell D, et al. Folate augmentation of treatment—evaluation for depression (FolATED): randomized trial and economic evaluation. Health Technol Assess. 2014 Jul;18(48):vii-viii, 1-159.

REFB4 Sarris J, Murphy J, et al. Adjunctive Nutraceuticals for Depression: A Systematic Review and Meta-Analyses. Am J Psychiatry. 2016 Jun 1;173(6):575-87.

St. John’s Wort

REFC1 Linde K, Berner MM, et al. St John's wort for major depression. Cochrane Database Syst Rev. 2008;CD000448.

REFC2 Carpenter DJ. St. John’s wort and S-adenosyl methionine as “natural” alternatives to conventional antidepressants in the era of the suicidality boxed warning: what is the evidence for clinically relevant benefit? Altern Med Rev. 2011 Mar;16(1):17-39.

REFC3 Kasper S, Volz HP, et al. Continuation and long-term maintenance treatment with Hypericum extract WS 5570 after recovery from an acute episode of moderate depression—a double-blind, randomized, placebo controlled long-term trial. Eur Neuropsychopharmacol. 2008 Nov;18(11):803-813.

REFC4 Singer A, Schmidt M, et al. Duration of response after treatment of mild to moderate depression with Hypericum extract STW 3-VI, citalopram and placebo: a reanalysis of data from a controlled clinical trial. Phytomedicine. 2011;18(8-9):739-742.

REFC5 Sarris J. Herbal medicines in the treatment of psychiatric disorders: 10-year updated review. Phytother Res. 2018 Jul;32(7):1147-1162.

S-adenosyl methionine (SAMe)

REFD1 Papakostas GI, Mischoulon D, et al. S-adenosyl methionine (SAMe) augmentation of serotonin reuptake inhibitors for antidepressant nonresponders with major depressive disorder: a double-blind, randomized clinical trial. Am J Psychiatry. 2010 Aug;167(8):942-948.

REFD2 Carpenter DJ. St. John’s wort and S-adenosyl methionine as “natural” alternatives to conventional antidepressants in the era of the suicidality boxed warning: what is the evidence for clinically relevant benefit? Altern Med Rev. 2011 Mar;16(1):17-39.

REFD3 Sarris J, Murphy J, et al. Adjunctive nutraceuticals for depression: a systematic review and meta-analyses. Am J Psychiatry. 2016 Jun 1;173(6):575-587.

Vitamin D

REFE1 Li G, Mbuagbaw L, et al. Efficacy of vitamin D supplementation in depression in adults: a systematic review. J Clin Endocrinol Metab. 2014 Mar;99(3):757-767.

REFE2 Sarris J, Murphy J, et al. Adjunctive Nutraceuticals for Depression: A Systematic Review and Meta-Analyses. Am J Psychiatry. 2016 Jun 1;173(6):575-87.

Chinese Herbal Medicine

REFF1 Yeung WF, Chung KF, et al. A systematic review on the efficacy, safety, and types of Chinese herbal medicine for depression. J Psychiatr Res. 2014 Oct;57:165-175.

B Vitamins

REFG1 Almeida OP, Ford AH. B vitamins to enhance treatment response to antidepressants in middle-aged and older adults: results from the B-VITAGE randomized, double-blind, placebo-controlled trial. Br J Psychiatry. 2014 Dec;205(6):450-457.

Omega3 Fatty Acids

REFH1 Appleton KM, Sallis HM, et al. Omega-3 fatty acids for depression in adults. Cochrane Database Syst Rev. 2015 Nov 5(11). Sarris J, Murphy J, et al. Adjunctive Nutraceuticals for Depression: A Systematic Review and Meta-Analyses. Am J Psychiatry. 2016 Jun 1;173(6):575-87.

Massage Therapy

REFI1 Coelho HF, Boddy K, et al. Massage therapy for the treatment of depression: a systematic review. Int J Clin Pract. 2008;62:325-333.

REFI2 Hou WH, Chiang PT, et al. Treatment effects of massage therapy in depressed people: a meta-analysis. J Clin Psychiatry. 2010 Jul;71(7):894-901.

Music Therapy

REFJ1 Gold C, Solli HP, et al. Dose-response relationship in music therapy for people with serious mental disorders: systematic review and meta-analysis. Clin Psychol Rev. 2009 Apr;29(3):193-207.

REFJ2 Erkkila J, Punkanen M, et al. Individual music therapy for depression: randomised controlled trial. Br J Psychiatry. 2011 Aug;199(2):132-139.

REFJ3 Chan MF, Wong ZY, et al. The effectiveness of music listening in reducing depressive symptoms in adults: a systematic review. Complement Ther Med. 2011 Dec;19(6):332-348.

REFJ4 Chan MF, Wong ZY, et al. Effects of music on depression in older people: a randomised controlled trial. J Clin Nurs. 2012 Mar;21(5-6):776-783.

REFJ5 Aalbers S, Fusar-Poli L, et al. Music therapy for depression. Cochrane Database Syst Rev. 2017 Nov 16;11:CD004517.

Mindfulness

REFK1 Britton WB, Haynes PL, et al. Polysomnographic and subjective profiles of sleep continuity before and after mindfulness-based cognitive therapy in partially remitted depression. Psychosom Med. 2010 Jul;72(6):529-548.

REFK2 Klainin-Yobas P, Cho MA, et al. Efficacy of mindfulness-based interventions on depressive symptoms among people with mental disorders: a meta-analysis. Int J Nurs Stud. 2012 Jan;49(1`):109-121.

REFK3 Strauss C, Cavanagh K, et al. Mindfulness-based interventions for people diagnosed with a current episode of an anxiety or depressive disorder: a meta-analysis of randomized controlled trials. PLoS One. 2014 Apr 24;9(4):e96110.

REFK4 Sundguist J, Lilja A, et al. Mindfulness group therapy in primary care patients with depression, anxiety and stress and adjustment disorders: randomised controlled trial. Br J Psychiatry. 2015 Feb206(2):128-135.

REFK5 Biegel GM, Brown KW, et al. Mindfulness-based stress reduction for the treatment of adolescent psychiatric outpatients: a randomized clinical trial. J Consult Clin Psychol. 2009 Oct;77(5):855-866.

Yoga

REFL1 Cramer H, Lauche R, et al. Yoga for depression: a systematic review and meta-analysis. Depress Anxiety. 2013 Nov;30(11):1068-1083.

Zinc

REFM1 Li Z, Li B, et al. Dietary zinc and iron intake and risk of depression: A meta-analysis. Psychiatry Res. 2017 May;251:41-47.

REFM2 Salari S, Khomand P, et al. Zinc sulphate: A reasonable choice for depression management in patients with multiple sclerosis: A randomized, double-blind, placebo-controlled clinical trial. Pharmacol Rep. 2015 Jun;67(3):606-609.

REFM3 Ranjbar E, Shams J, et al. Effects of zinc supplementation on efficacy of antidepressant therapy, inflammatory cytokines, and brain-derived neurotrophic factor in patients with major depression. Nutr Neurosci. 2014 Feb;17(2):65-71.

REFM4 Lai J, Moxey A, et al. The efficacy of zinc supplementation in depression: systematic review of randomised controlled trials. J Affect Disord. 2012 Jan;136(1-2):e31-e39.

REFM5 Sarris J, Murphy J, et al. Adjunctive Nutraceuticals for Depression: A Systematic Review and Meta-Analyses. Am J Psychiatry. 2016 Jun 1;173(6):575-587.

REFM6 Sparling TM, Henschke N, et al. The role of diet and nutritional supplementation in perinatal depression: a systematic review. Matern Child Nutr. 2017 Jan;13(1).

Curcumin

REFN1 Lopresti AL, Drummond PD. Efficacy of curcumin, and a saffron/curcumin combination for the treatment of major depression: A randomised, double-blind, placebo-controlled study. J Affect Disord. 2017 Jan 1;207:188-196.

REFN2 Al-Karawi D, Al Mamoori DA, et al. The Role of Curcumin Administration in Patients with Major Depressive Disorder: Mini Meta-Analysis of Clinical Trials. Phytother Res. 2016 Feb;30(2):175-183.

REFN3 Lopresti AL, Maes M, et al. Curcumin for the treatment of major depression: a randomised, double-blind, placebo controlled study. J Affect Disord. 2014;167:368-375.

REFN4 Sanmukhani J, Satodia V, et al. Efficacy and safety of curcumin in major depressive disorder: a randomized controlled trial. Phytother Res. 2014 Apr;28(4):579-585.

REFN5 Sarris J. Herbal medicines in the treatment of psychiatric disorders: 10-year updated review. Phytother Res. 2018 Jul;32(7):1147-1162.

Kava

REFO1 Sarris J. Herbal medicines in the treatment of psychiatric disorders: 10-year updated review. Phytother Res. 2018 Jul;32(7):1147-1162.

Passionflower

REFP1 Sarris J. Herbal medicines in the treatment of psychiatric disorders: 10-year updated review. Phytother Res. 2018 Jul;32(7):1147-1162.

REFP2 Yeung KS, Hernandez M, et al. Herbal medicine for depression and anxiety: A systematic review with assessment of potential psycho-oncologic relevance. Phytother Res. 2018 May;32(5):865-891.

Galphimia

REFQ1 Sarris J. Herbal medicines in the treatment of psychiatric disorders: 10-year updated review. Phytother Res. 2018 Jul;32(7):1147-1162.

Black Cohosh

REFR1 Yeung KS, Hernandez M, et al. Herbal medicine for depression and anxiety: A systematic review with assessment of potential psycho-oncologic relevance. Phytother Res. 2018 May;32(5):865-891.

Chamomile

REFS1 Yeung KS, Hernandez M, et al. Herbal medicine for depression and anxiety: A systematic review with assessment of potential psycho-oncologic relevance. Phytother Res. 2018 May;32(5):865-891.

Chasteberry

REFT1 Yeung KS, Hernandez M, et al. Herbal medicine for depression and anxiety: A systematic review with assessment of potential psycho-oncologic relevance. Phytother Res. 2018 May;32(5):865-891.

Lavender

REFU1 Yeung KS, Hernandez M, et al. Herbal medicine for depression and anxiety: A systematic review with assessment of potential psycho-oncologic relevance. Phytother Res. 2018 May;32(5):865-891.

REFU2 Dwyer AV, Whitten DL, et al. Herbal medicines, other than St. John's Wort, in the treatment of depression: a systematic review. Altern Med Rev. 2011 Mar;16(1):40-49.

Diet and Nutritional Supplements

REFV1 Sparling TM, Henschke N, et al. The role of diet and nutritional supplementation in perinatal depression: a systematic review. Matern Child Nutr. 2017 Jan;13(1).

Echium

REFW1 Dwyer AV, Whitten DL, et al. Herbal medicines, other than St. John's Wort, in the treatment of depression: a systematic review. Altern Med Rev. 2011 Mar;16(1):40-49.

Rhodiola

REFX1 Dwyer AV, Whitten DL, et al. Herbal medicines, other than St. John's Wort, in the treatment of depression: a systematic review. Altern Med Rev. 2011 Mar;16(1):40-49.

5-HTP

REFY1 Shaw K, Turner J, et al. Tryptophan and 5-hydroxytryptophan for depression. Cochrane Database Syst Rev. 2002;(1):CD003198.

REFY2 Jangid P, Malik P, et al. Comparative study of efficacy of l-5-hydroxytryptophan and fluoxetine in patients presenting with first depressive episode. Asian J Psychiatr. 2013 Feb;6(1):29-34.

Saffron

REFZ1 Lopresti AL, Drummond PD, et al. affron(®), a standardised extract from saffron (Crocus sativus L.) for the treatment of youth anxiety and depressive symptoms: A randomised, double-blind, placebo-controlled study. J Affect Disord. 2018 May;232:349-357.

REFZ2 Kashani L, Esalatmanesh S, et al. Efficacy of Crocus sativus (saffron) in treatment of major depressive disorder associated with post-menopausal hot flashes: a double-blind, randomized, placebo-controlled trial. Arch Gynecol Obstet. 2018 Mar;297(3):717-724.

REFZ3 Tabeshpour J, Sobhani F, et al. A double-blind, randomized, placebo-controlled trial of saffron stigma (Crocus sativus L.) in mothers suffering from mild-to-moderate postpartum depression. Phytomedicine. 2017 Dec 1;36:145-152.

REFZ4 Lopresti AL, Drummond PD. Efficacy of curcumin, and a saffron/curcumin combination for the treatment of major depression: A randomised, double-blind, placebo-controlled study. J Affect Disord. 2017 Jan 1;207:188-196.

REFZ5 Ghajar A, Neishabouri SM, et al. Crocus sativus L. versus Citalopram in the Treatment of Major Depressive Disorder with Anxious Distress: A Double-Blind, Controlled Clinical Trial. Pharmacopsychiatry. 2017 Jul;50(4):152-160.

REFZ6 Kashani L, Eslatmanesh S, et al. Comparison of Saffron versus Fluoxetine in Treatment of Mild to Moderate Postpartum Depression: A Double-Blind, Randomized Clinical Trial. Pharmacopsychiatry. 2017 Mar;50(2):64-68.

REFZ7 Mazidi M, Shemshian M, et al. A double-blind, randomized and placebo-controlled trial of Saffron (Crocus sativus L.) in the treatment of anxiety and depression. J Complement Integr Med. 2016 Jun 1;13(2):195-199.

REFZ8 Dwyer AV, Whitten DL, et al. Herbal medicines, other than St. John's Wort, in the treatment of depression: a systematic review. Altern Med Rev. 2011 Mar;16(1):40-49.

REFZ9 Hausenblas HA, Heekin K, et al. A systematic review of randomized controlled trials examining the effectiveness of saffron (Crocus sativus L.) on psychological and behavioral outcomes. J Integr Med. 2015 Jul;13(4):231-240.

REFZ10 Talaei A, Hassanpour Moghadam M, et al. Crocin, the main active saffron constituent, as an adjunctive treatment in major depressive disorder: a randomized, double-blind, placebo-controlled, pilot clinical trial. J Affect Disord. 2015 Mar 15;174:51-56.

REFZ11 Yeung KS, Hernandez M, et al. Herbal medicine for depression and anxiety: A systematic review with assessment of potential psycho-oncologic relevance. Phytother Res. 2018 May;32(5):865-891.

REFZ12 Shahmansouri N, Farokhnia M, et al. A randomized, double-blind, clinical trial comparing the efficacy and safety of Crocus Sativus L. with fluoxetine for improving mild to moderate depression in post percutaneous coronary intervention patients. J Affect Disord. 2014 Feb;155:216-222.

REFZ13 Sarris J. Herbal medicines in the treatment of psychiatric disorders: 10-year updated review. Phytother Res. 2018 Jul;32(7):1147-1162.

REFZ14 Tóth B, Hegyi P, et al. The Efficacy of Saffron in the Treatment of Mild to Moderate Depression: A Meta-analysis. Planta Med. 2019 Jan;85(1):24-31.

Revision Information

  • Reviewer: EBSCO NAT Review Board Eric Hurwitz, DC
  • Review Date: 02/2020
  • Update Date: 11/13/2020