Natural Treatments for Depression

Syd Baumel, our guest and author of Dealing With Depression Naturally, joined us to discuss natural remedies for treating depression, stress, and PMS, from vitamins and herbs (such as St. John's Wort, Gingko, and more) to maintaining a healthy diet, and exercise.

To find out more about natural treatments for depression, read the transcript below.

David Roberts is the HealthyPlace.com moderator.

The people in blue are audience members.

David: Good Evening. I'm David Roberts. I'm the moderator for tonight's conference. I want to welcome everyone to HealthyPlace.com.

(note: see What is Depression?)

Our topic tonight is "Dealing With Depression Naturally." Our guest is Syd Baumel, author of a book by the same name. Mr. Baumel wrote Dealing With Depression Naturally after researching and using alternative therapies to treat his own depression. It covers many alternatives to treating depression, most of which employ readily obtainable vitamins and herbs, or feature cognitive therapy or exercise programs.

Mr. Baumel maintains that there are natural antidepressant therapies which can restore emotional health, from vitamins and dietary adjustments to visualization exercises and sleep therapy. Good evening, Syd, and welcome to HealthyPlace.com. To start with maybe you can tell us a bit about yourself and your history of depression?

Syd Baumel: Well, the depression bug first bit me in my teens about 30 years ago. It hit me like a ton of bricks. It took until my mid-twenties for me to find some lasting solutions - first drugs, then natural treatments, which I continue to use as needed to this day.

David: What lead you to start exploring natural remedies for depression?

Syd Baumel: I'm just one of those people who is drawn to natural approaches to solving problems. Ironically, the effectiveness of drugs helped me try harder to find natural chemical help.

David: What do you mean by that?

Syd Baumel: In my case, an amino acid called phenylalanine, which is a precursor to a few mood regulating neurochemicals, made the most dramatic and lasting difference.

David: If the pharmaceutical medications were effective, why would you turn to natural treatments?

Syd Baumel: They had very obvious and varyingly unpleasant side effects. Also, there was and always is the concern that a "xenobiotic" (foreign to the body) chemical could do harm if used chronically.

David: There is one thing I'd like you to clarify for everyone here. When you talk about "natural treatments," what exactly are you referring to?

Syd Baumel: It's a very wide spectrum that excludes artificial/human-made drugs and includes such things as diet, exercise, meditation, psychotherapy, herbs, and preventative/therapeutic lifestyle changes, such as identifying and avoiding depressing toxic chemicals.

I better clarify that I'm not against "unnatural; antidepressants" in addition to the natural approaches.

David: Yes, in fact, I believe you mention that some of the natural treatments can be used in addition to taking pharmaceutical antidepressants.

Syd Baumel: And only a few of them - notably the natural chemical ones, including herbs - need to be taken with much caution when combining with drugs.

David: Before we get into the herbs and other substances, I'd like you to talk about how diet and exercise can impact a person's level of depression.

Syd Baumel: Exercise is the easiest one to answer because there has been such a huge amount of research. Basically, it says that being physically active and being depressed are very largely mutually incompatible.

David: And so how much exercise is recommended?

Syd Baumel: Early research suggested that a typical aerobic conditioning regime - around 20 or 30 minutes of fairly intense aerobic exercise three times a week - would usually be very helpful. In the last decade or so, just as more moderate physical activity has been linked to better health in general, evidence that it too can be anti-depressive has begun to appear.

There also has been a parallel thread of research suggesting that non-aerobic exercise - especially of the weight-training type, but also perhaps things like yoga and tai chi - can work too.

David: And what about diet and depression?

Syd Baumel: There the research is mostly indirect. For example, study after study has found that depressed people tend to be deficient - mildly or severely - in nutrients known to be key to good mental health. Some research has gone further, suggesting that some of these vitamins and minerals can be therapeutic for depression.

David: Can you give us a short list of nutrients that would be helpful to reducing depression?

Syd Baumel: The important thing is to cover all bases by taking a well-rounded, moderate/high dosage multivitamin and mineral supplement. Then one can focus on higher doses of nutrients with a high profile as antidepressants, at least for some people. The B vitamin folic acid is probably at the top of the list right now, based on current evidence. Other contenders include vitamins B1, B6, and B12, vitamin C, and the mineral selenium.

It's hard to generalize, because a combination of testing people for specific deficiencies and using nutrients as if they were drugs - in high or mega doses - is the "art" and science that's involved here.

David: Mr. Baumel is coming to us from Winnipeg, Manitoba, Canada. He dealt with depression for a long time and actually started researching, then using, natural remedies to treat his own depression.

Gor more information visit Mr. Baumel's website.

We have a lot of audience questions. I want to get to a few, then get into a discussion of some of the herbs that might be helpful in treating depression. Here's the first question:

donotknow: What foods should we avoid?

Syd Baumel: There are two general answers to that question. The first one has to do with what kinds of food everyone would be best off avoiding, the second has to do with individual sensitivities, intolerances, or allergies that can cause some people - some research and much anecdotal evidence suggest - to be more susceptible to depression.

Regarding the first consideration: In general, as far as the evidence has been able to show us so far, the same kind of diets that help prevent cancer, heart disease, etc. also are good for the brain and the mind and one's mood. This means avoiding things like a diet over-endowed with processed grains, sugar, and an evolutionarily unnatural balance of fatty acids.

On the latter point, what I mean is: avoid too much saturated and hydrogenated fat, and also attempt to concentrate on fats and oils that are unrefined and that have a higher balance of omega-3 fatty acids to omega-6 fatty acids than modern diets typically have.

Omega 3s abound in the fat of wild animals - especially cold-water fish - and in vegetable crops from temperate or northern climates, especially dark leafy greens, beans, and (above all) flax and hemp.

David: Here's an interesting comment from one audience member, which has to do more with the stigma of having depression or mental illness:

WildWindTeesha: There is a stigma attached to taking prescribed anti-depressants. In my case, I have found it almost shameful to admit that I am taking anti-depressants, but if I were to tell my family and friends I am on NATURAL remedies, well, that means that their relative or friend (me) is not so MAD after all.

Syd Baumel: That's interesting. In some circles, I think being on Prozac et al is almost considered normal. It is nice, though, to see that using natural treatments has become kind of "cool," where years ago it was rather... dorky .

David: Before we get into the herbs, do you see herbal remedies as being as effective as pharmaceutical antidepressants? And secondly, I'm wondering if natural treatments work as well for clinical depression (brain chemical depression) as non-clinical depression?

Syd Baumel: The evidence - research and anecdote both - suggest that natural antidepressants (NAs) can be as effective or more effective than drugs for some people and that some NAs are generally about as effective as any drug for mild, moderate, or even severe major depression. I'm thinking of St John's Wort (SJW), for example.

David: So what herbs have you found to be the most effective in treating depression and in what dosages?

Syd Baumel: St Johns Wort (SJW) is, so far, the star here. The most commonly used and recommended dosage is 300 mg of a standardized extract (0.3% hypericin) three times a day. But if you actually look at the studies and what people say, you find that people can apparently respond to as little as 300 mg and as much as 2700 mg a day.

I believe, if memory serves, it was 2700 mg that was used in a recent study which found SJW about equal to imipramine (the gold standard tricyclic) for severe major depression, but with far fewer side effects. The current NIMH-sponsored trial is supposedly allowing research psychiatrists to administer up to 2700 mg also.

Other herbs that show varying degrees of effectiveness or promise include Ginkgo biloba (at least as an adjunct to drugs) and several herbs for "women's problems" (traditionally) that appear to work for PMS and/or perimenopausal depression, e.g. Vitex agnus-castus and black cohosh.

David: Here's an audience question on St. John's Wort:

MsPisces:I've read that St John's Wort only helps mild depression... Is this true? Will it help with clinical depression?

Syd Baumel: The "rap" on SJW that it only helps for mild depression is based on the fact that most clinical trials have used only patients with mild to moderate depression (major or dysthymic are undefined). But at least one or two have successfully used it for severe major depressive disorder. By "successfully" I mean that the response rate was significantly better than a placebo and/or not significantly different from an adequate dosage of an effective antidepressant drug.

It's really hard to say just how effective SJW might truly be for severe depression. The large NIMH study should help answer that question. For now, it's very much a trial and error, your mileage may vary thing. But then that's true of any antidepressant drug when it comes down to the individual.

donotknow:What about the side effects of St. Johns Wort?

Syd Baumel: The more SJW has been used, the more people have reported side effects. The studies, overall, suggest SJW has a net side effect rate that's little different than a placebo, but some studies suggest worse. And there's always the concern that - as probably happens with drugs in some studies - the researchers are biased against reporting the full extent of SJW's adverse effects.

All in all, I think St Johns Wort has a much lower side effect profile than the average drug (probably any drug) and that most people don't notice any side effects, but there is good reason to use SJW and other supplements knowledgeably and cautiously. Most books and websites that write about SJW et al. in any depth are very forthcoming about known side effects, drug interactions, precautions, etc.

Gattaca:Would you recommend combining St. John's Wort with gingko? I have read the increased blood flow is beneficial in itself from the gingko and also helps deliver the SJW more effectively. I have seen combined tablets at 300mg SJW with 60mg gingko, 3 times a day. What range of doses would you recommend for the gingko?

Syd Baumel: Not being a clinician, I hesitate to recommend, but the dosage you cite is right in the pocket as far as average therapeutic dosages for the two herbs are concerned. Also, because at least one placebo-controlled study has found that Ginkgo can augment antidepressant drugs it stands to reason that it might do the same for herbs like SJW which appear to work via identical or very similar mechanisms. In general, combos are both potentially riskier and potentially more likely to help.

David: Here are a few audience comments on what's been said, so far, tonight, then we'll continue with the questions:

ronnie@tnni.net: I have been bipolar all my life. I found out 13 years ago I was manic depressive and have been on medicines for 13 years. I also do fitness 4 times a week. It has helped me in so many ways. I'm not 100 percent but I can deal with a lot more in my life.

WildWindTeesha: Who feels like doing aerobics when they are depressed!?

finngirl: Cardiovascular exercise 3 times a week increases endorphins and natural chemicals.

bladedemon: I'm willing to try anything right now. Nothing works as far as a meds.

finngirl: Natural is closer to not having any depression - if you can take an over the counter herb you're not all that depressed. It is just what the people perceive of their own reality.

Syd Baumel: I love the comment about not feeling like doing aerobics when you're depressed. How true, but it's true of many things that go together with depression in either a vicious cycle or a healing cycle. That is: depression disturbs your sleep, makes you lazy, makes you withdraw from people and from activities, makes you less assertive, makes you get sloppy about eating well, makes you question your spiritual values and beliefs, and on and on and on. Yet, if you can - with a little help from your friends, a "professional," or your own bootstraps - go against the grain on these depressive tugs, there is so much evidence that you can reverse the tide.

Of course, the milder the depression, the easier it is to perform this reversal, but even in hospitalized depressives with severe depression, exercise on the side (for example) has been found to significantly improve their response to standard therapies.

David: Here's an audience member's comment which addresses just that point, Syd:

ddoubelD: I decided recently that I am going to do everything I can think of to take care of my physical, mental, and emotional health, and just that decision has made me feel better cause I am taking charge.

Syd Baumel: Talk about hitting a nail right on the head. Feeling out of control - helpless, hopeless - is one of the defining hallmarks of depression. But again, if you can do anything that makes you feel even just a little bit in control again, you will almost certainly feel that much better.

David: Here's the next audience question:

finngirl: How do the natural approaches affect levels of serotonin?

Syd Baumel: Many if not most natural approaches have been shown to have a positive effect on brain levels of serotonin. This is true not only of chemical approaches like tryptiophan and 5-hydroxytryptophan (5-HTP), which the brain make serotonin FROM, but also of other chemical approaches that facilitate either serotonin's synthesis or that, like most antidepressant drugs, increase its potency in the brain (e.g. SJW, Ginkgo). The interesting thing is that several lifestyle or non-chemical antidepressants (e.g. exercise, acupuncture) have also been shown to increase brain serotonin.

There are a few books that deal with natural serotonin boosters, including my own (Serotonin) and a good one by psychiatrist Michael Norden, entitled Beyond Prozac.

David: Here's the link to the HealthyPlace.com Depression Community. You can click on this link and sign up for the mail list at the top of the page so you can keep up with events like this.

Here's the next question:

Kellijohn: Can you give maximum dosage on the PMS herbs? How quickly can persons see results?

Syd Baumel: I've just rather frantically checked my book, but to no avail as far as Vitex is concerned. Black cohosh, which may also alleviate PMS, is usually taken at a dose of 40 to 200 mg per day. Vitamin B6 - an old standby - usually seems to work in the 50-200 mg range, if memory serves. I'm honestly, offhand, not sure of how long it tends to take to see a response, but these things tend to take weeks rather than days.

David: Several of our audience members want to know what natural treatments you take and what effect have they had on your depression and well-being?

Syd Baumel: I've had the most bang for buck from L-phenylalanine - a low dose of (usually) 400 or 500 mg every morning on a "protein-free stomach" for optimal absorption by the brain. I've also - much more recently - noticed a kind of "stress guard" effect from a modest dosage of St Johns Wort. This is on top of a nutritious, low junk-food vegetarian (vegan, since last summer) diet and a few other odds and ends. The effect has been that - for the last twenty or so years - when I get down, it's a) not nearly as frequent as before, b) typically very mild, and c) also very short-lived. If I had to quantify it, I'd estimate that my degree of suffering and impairment from depression has been about 15% of what it was prior to my breakthrough with phenylalanine.

David: What do you mean by "stress guard" effect?

Syd Baumel: About the stress guard effect: What I mean is that I noticed, after I first began using a properly standardized St Johns Wort product, that I wasn't getting as perturbed, bothered, disturbed etc. as I expected I would be by the great amount of stress in my life at the time.

David: Thank you, Syd, for being our guest tonight and for sharing this information with us. And to those in the audience, thank you for coming and participating. I hope you found it helpful. Also, if you found our site beneficial, I hope you'll pass our URL around to your friends, mail list buddies, and others. http://www.healthyplace.com

David: Thank you again Syd for being our guest tonight.

Syd Baumel: It was my pleasure and privilege to be your guest. Thanks to everyone who came to listen and participate.

David: Good night everyone and I hope you have a pleasant weekend.

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Disclaimer: We are not recommending or endorsing any of the suggestions of our guest. In fact, we strongly encourage you to talk over any therapies, remedies or suggestions with your doctor BEFORE you implement them or make any changes in your treatment.