Natural remedies for anxiety and depression
It is estimated that 20% of US adults will be diagnosed with depression, and over 30% with an anxiety disorder, at some point in their lives.1,2
The exact changes in the brain that cause depression, anxiety, and other mood disorders are still not completely clear. Low levels of certain neurotransmitters, such as serotonin or norepinephrine, was originally thought to be the major factor in causing depression. However, raising neurotransmitter levels, such as with selective serotonin reuptake inhibitors (SSRIs), doesn’t improve symptoms for everyone with depression. About 30-40% of patients don’t respond to antidepressant therapy.
Although serotonin is important for mood regulation, low levels of serotonin aren’t the whole story.3-5 Other possible contributing factors include genetics, trauma, stress, nutritional deficiencies, dysregulated circadian rhythms, oxidative stress, inflammation, and alterations in the gut microbiome.
Sources:
Epidemiology of Adult DSM-5 Major Depressive Disorder and Its Specifiers in the United States
Epidemiology of anxiety disorders in the 21st century
Neural basis of major depressive disorder: Beyond monoamine hypothesis
I consider antidepressants and anti-anxiety medications to be the last step in managing these conditions, and should only be used if dietary changes, counseling, supplementation, and other treatments have failed to improve symptoms. Both types of drugs have serious risks and drawbacks that you should consider before you resort to medications.
>> You can find my detailed step-by-step protocol for depression and anxiety in my free webinar Natural Remedies for Depression & Anxiety.
Depression is a potentially life-threatening disease. If you are currently on medications, do not stop taking them without help from your physician. If you are suffering from depression or anxiety symptoms, I urge you to work with your physician to discuss and implement the natural, drug-free methods I outline in the webinar. Note: The webinar and this blog post are not a substitute for professional help; they are meant to provide information on options you can explore with your chosen healthcare professional.
A brain-healthy diet and supplemental nutrients
For a healthy mood state, the research supports following a diet rich in vegetables and other fiber- and phytochemical-rich plant foods, and avoiding high-glycemic processed foods, fast food, and other junk foods.6-12
Carotenoids, flavonoids, and other phytochemicals support the health of neurons and protect the brain against oxidative stress and inflammation, which are contributors to anxiety and depression.7,13-17 Also, vitamins and minerals are important for the proper workings of the brain and production of neurotransmitters.18-24
Related: Short-term dietary intervention improves depression symptoms
Sources:
Diet quality and depression risk: A systematic review and dose-response meta-analysis of prospective studies
A brief diet intervention can reduce symptoms of depression in young adults - A randomised controlled trial
Fast-food and commercial baked goods consumption and the risk of depression
Depressive symptoms are independently correlated with lipid peroxidation in a female population: comparison with vitamins and carotenoids
The role of dietary polyphenols on adult hippocampal neurogenesis: molecular mechanisms and behavioural effects on depression and anxiety
Natural products, micronutrients, and nutraceuticals for the treatment of depression: A short review
Antidepressant Flavonoids and Their Relationship with Oxidative Stress
A diet rich in whole plant foods is health-promoting overall, but is low in a few key nutrients important for mood regulation: vitamin B12, zinc, and the omega-3 fatty acids DHA and EPA.18,24-28 It’s important to supplement with these nutrients.
Related: Why take a multivitamin?
The omega-3 fatty acids DHA and EPA are important for regulating inflammation, supporting the structure of brain cell membranes, maintaining the connectivity between neurons, and play a role in neurotransmitter synthesis and neurotransmission.29-32 Supplementation has improved symptoms of anxiety and depression, with EPA more effective than DHA in depression.33,34
Related: How omega-3 fatty acids support brain health
Sources:
B Vitamins and the Brain: Mechanisms, Dose and Efficacy-A Review
Zinc in depression: a meta-analysis
Omega-3 fatty acids and depression: scientific evidence and biological mechanisms
Association of Use of Omega-3 Polyunsaturated Fatty Acids With Changes in Severity of Anxiety Symptoms: A Systematic Review and Meta-analysis
Meta-analysis and meta-regression of omega-3 polyunsaturated fatty acid supplementation for major depressive disorder
Additional supplements: amino acids and plant extracts
Several amino acids are either precursors to neurotransmitters or are otherwise involved in neurotransmitter synthesis. Amino acid supplements that are likely helpful for mood disorders include 5-hydroxytryptophan (5-HTP), L-tryptophan, S-adenosylmethionine (SAMe), gamma-aminobutyric acid (GABA), L-theanine, and creatine.35-44 Phosphatidylserine, a major phospholipid in brain cell membranes, may blunt the body’s response to stress.45,46
Sources:
Tryptophan and 5-hydroxytryptophan for depression
S-adenosyl methionine (SAMe) for depression in adults
Effects of Oral Gamma-Aminobutyric Acid (GABA) Administration on Stress and Sleep in Humans: A Systematic Review
L-Theanine reduces psychological and physiological stress responses
Creatine for the Treatment of Depression
A soy-based phosphatidylserine/ phosphatidic acid complex (PAS) normalizes the stress reactivity of hypothalamus-pituitary-adrenal-axis in chronically stressed male subjects: a randomized, placebo-controlled study
Among plant extracts, saffron in particular was found in several studies to be either similarly effective to an antidepressant, or superior to placebo in depression.47-50 Additional plant extracts that may help manage depression, anxiety symptoms, and/or stress include ashwagandha, lemon balm, passionflower, chamomile, and valerian.51-60
Counseling, light therapy, exercise, and other non-dietary methods
Essentials
Exercise provides natural mood-elevating and stress-relieving effects and is an important component of treatment for mood disorders.61-65
Circadian rhythms are a major factor in mood regulation, and circadian disruption is thought to contribute to depressive symptoms.66 Morning light therapy is an effective treatment for depression and a first-line treatment for seasonal depression.67-71
Counseling is an important component of care for anxiety and depressive disorders.72,73
Sources:
Efficacy of exercise combined with standard treatment for depression compared to standard treatment alone: A systematic review and meta-analysis of randomized controlled trials
Light therapy in non-seasonal depression: An update meta-analysis
Cognitive behavioral therapy for primary care depression and anxiety: a secondary meta-analytic review using robust variance estimation in meta-regression
Additional methods
Eye movement desensitization and reprocessing (EMDR), a method used to help patients reprocess memories of traumatic events using eye movements guided by a therapist, may also provide benefits for depression symptoms.74,75
Another option to consider trying is neurofeedback, a system of learning how to self-regulate brain activity, guided by electroencephalography (EEG) or functional magnetic resonance imaging (fMRI).76,77
Infusions of nicotinamide adenine dinucleotide (NAD+), a form of niacin thought to have anti-aging properties, are also potentially helpful.78
Sources:
Eye movement desensitization and reprocessing for depression: a systematic review and meta-analysis
The Current Evidence Levels for Biofeedback and Neurofeedback Interventions in Treating Depression: A Narrative Review
NAD+ Metabolism in Aging and Cancer
Medical treatments
If the dietary, supplement, and behavioral methods above have not improved symptoms, there are medical treatments that are worthwhile to try before starting an SSRI or other antidepressant medication.
Transcranial magnetic stimulation (TMS) is an FDA-approved, non-drug treatment for depression. TMS and a newer, individualized version of TMS called magnetic e-resonance therapy (MeRT) are helpful options to consider.79.80
Watch: Natural Remedies for Depression & Anxiety
Sources:
Functional Magnetic Resonance Imaging-Guided Personalization of Transcranial Magnetic Stimulation Treatment for Depression
Repetitive Transcranial Magnetic Stimulation for the Treatment of Resistant Depression: A Scoping Review
These methods can be layered: Start with diet, light therapy, omega-3 supplementation, and counseling, and then add the other methods as needed. The appropriate use of antidepressants is as a last resort, if all of the safer options have not provided relief from symptoms. I encourage you to watch my free webinar on treating depression and anxiety to learn the details on these treatments.