Treating depression: alternative remedies

Everyone gets sad sometimes, but clinical depression is much more serious. When it comes to alternative remedies for depression, the evidence is conflicting. Here's the low-down.

• Lack of evidence: Despite enthusiasm for them, few herbs or other natural methods have proved to be effective for depression. This includes megavitamins, acupuncture and electro­sleep therapies. Popular herbs like valerian, ginseng, St. John’s wort and the supplement SAMe continue to be dogged by questions over purity, dosage, safety and lack of evidence (there are few well-designed studies).
• St. John's wort: Recent research has only increased concerns. A 2002 study published in the Journal of the American Medical Association found the oldest and most popular herbal anti­depressant—St. John’s wort—ineffective for 340 people who were moderately to severely depressed. Mild depression wasn't studied, however, and many herbalists were quick to point out that the herb was never meant to treat major depression. St. John’s wort has at least 10 compounds with pharmacological action, so talk with your doctor. Recent findings indicate it can alter the effectiveness of other drugs, including blood thinners, oral contraceptives, AIDS/HIV drugs and even other antidepressants.

• Seasonal affective disorder (SAD): It’s thought that diminishing levels of sunlight affect the body’s production of serotonin—a hormone that seems to promote a positive mood. So if your sadness, fatigue, sugar cravings or excessive sleepiness sets in each fall and continues through the winter, when the hours of sunlight dwindle, you may have seasonal affective disorder (SAD).
• Full-spectrum lightbox: If this happens, make a conscientious effort to go outside frequently. Take a daily walk. Researchers report that more intense treatment with bright light—via a full-spectrum lightbox that you use for 30 to 60 minutes on a regular basis—can fully ease symptoms in 50 percent of SAD sufferers.
• Light devices: Various other light devices can also be purchased. Battery-powered light visors, for example, are effective and convenient, because you can move around while you're getting your daily light dose. One cautionary note: indoor tanning lights don't work for SAD.
• Vitamin D: Investigators are also looking into supplementation with vitamin D, a nutrient produced by the body in re­sponse to sunlight, to improve mood and outlook.