Everyone feels blue occasionally, but for the one in eight American women who are depressed, feelings of sadness and hopelessness persist for months or years.

Conventional treatment for depression includes medication, most often with a selective serotonin reuptake inhibitor (SSRI), such as fluoxetine (Prozac), or a selective serotonin/norepinephrine reuptake inhibitor (SSNRI), such as venlafaxine (Effexor). The mechanism is unclear, but these drugs may work by blocking reabsorption of the brain chemicals serotonin and/or norepinephrine, leaving more of these mood-lifting neurotransmitters in the brain.

Problem: Antidepressants’ side effects can include lowered libido, weight gain, headache, fatigue, anxiety, zombie-like moods and even suicidal tendencies.

New finding: An analysis of numerous clinical studies concluded that SSRIs were not significantly more effective than a placebo against mild-to-moderate depression. Other studies are more favorable for anti­depressants, and medication is a vital part of treatment for some patients — but given the concerns about anti­depressants, many experts believe that these drugs are overprescribed.

Better: A natural approach that treats depression with minimal side effects. How it works…


Research demonstrates the mood-elevating effects of regular exercise, proper diet, sufficient sleep and moderate sunshine — yet depression can erode motivation to pursue healthful habits.

What helps: Certain dietary supplements are natural mood enhancers, combating depression by correcting biochemical imbalances and increasing motivation to make healthful lifestyle changes.

Important: Before using supplements, check with a doctor knowledgeable about natural medicine, especially if you take medication, have a medical condition or are pregnant or breast-feeding. Best…

  • If you are not depressed, take the nutrients listed below under “Mood Boosters for Everyone” to maintain healthful neurotransmitter levels.
  • If you are depressed but are not taking an antidepressant, try natural remedies before considering drugs.
  • If you take an antidepressant but see no improvement in mood and/or suffer from side effects, ask your doctor about weaning off the drug and starting natural therapies. Do not discontinue drugs on your own!
  • If an antidepressant is helping you and side effects are minimal, continue your medication and ask your doctor about also taking supplements.

Supplements below are available in health-food stores and online.

Guideline: Begin at the low end of each recommended dosage range. If symptoms do not improve within a week, gradually increase the dosage.


The following supplements are appropriate for most adults. Take all of them indefinitely to prevent or treat depression. They are safe to take while on antidepressants.

  • Omega-3 fatty acids. These are essential for production of neurotransmitters that affect mood and thinking. Most effective are eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), found in fish oil. Take 1,000 milligrams (mg) to 2,000 mg of combined EPA/DHA daily.

Caution: Fish oil may increase bleeding risk in people taking a blood thinner, such as warfarin (Coumadin).

  • B vitamins and magnesium. The B vitamins help carry oxygen to the brain and produce neurotransmitters. They work best together and are absorbed best when taken with magnesium. Take a daily multivitamin or a vitamin-B complex that includes the following — 25 mg each of vitamins B-1 and B-2… 20 mg each of vitamins B-3 and B-6… 50 mg each of B-5 and magnesium… and 100 micrograms (mcg) each of B-12 and folic acid.

Caution: Avoid supplements of B-3 if you have diabetes, gout or liver problems… avoid B-6 if you take L-dopa for Parkinson’s disease.

  • Vitamins C, D and E. These aid neurotransmitter production and/or protect brain cells. Take a daily multivitamin that includes 500 mg to 1,000 mg of vitamin C… 2,000 international units (IU) of vitamin D… and 400 IU of vitamin E.


If you still are depressed after taking the nutrients above for seven to 10 days, also take either of the following supplements. If symptoms do not improve within two weeks, switch to the other supplement. If you still see no improvement, take both.

Important: Though many patients are successfully treated with a combination of these supplements and antidepressants, this requires close medical supervision. Theoretically, the combination could lead to the rare but potentially fatal serotonin syndrome, caused by excess serotonin. Symptoms include headache, increased body temperature, fast heart rate, blood pressure changes, hallucinations and/or kidney damage.

Once you find an effective regimen, continue for several months. Then reduce your dose by one-quarter for one week. If symptoms return, resume the former dose. Otherwise, continue reducing until you find an effective maintenance dose or can stop completely.

  • St. John’s wort. This herb raises serotonin and possibly the neurotransmitter dopamine, and may calm nerves. With breakfast, take 300 mg to 900 mg daily of a standardized extract of 0.3% hypericin (the active constituent).

Caution: Side effects may include digestive distress and a sun-sensitivity rash. St. John’s wort may interact with some drugs, including warfarin, the heart drug digoxin (Digitalis) and birth control pills.

  • 5-HTP (5-hydroxytryptophan) or L-tryptophan. These are forms of the amino acid tryptophan, which converts to serotonin. With fruit juice, take either 50 mg to 100 mg of 5-HTP or 500 mg to 1,000 mg of L-tryptophan once or twice daily.

Caution: Occasional side effects include nausea and agitation.


If your symptoms include low energy and sleepiness, add either of the following to your regimen for as long as necessary. They may be taken with an antidepressant under close medical supervision.

  • Tyrosine. This amino acid aids production of energizing adrenaline, dopamine and thyroid hormone. Take 500 mg to 1,000 mg before breakfast and in mid-afternoon.

Caution: Tyrosine may raise blood pressure — talk to your doctor. Do not use tyrosine if you have melanoma — it may worsen this cancer.

  • SAMe (s-adenosyl-methionine). This compound boosts neurotransmitters and energy. Take on an empty stomach no less than 20 minutes before or after eating or taking any other supplement.

Dosage: Take 200 mg to 400 mg once or twice daily.

Caution: It may cause irritability and insomnia. Do not take SAMe if you have bipolar disorder — it could trigger a manic phase.


If depression symptoms include anxiety and/or insomnia, try…

  • Valerian. This herb enhances activity of gamma-aminobutyric acid (GABA), a calming neurotransmitter. Take 150 mg to 300 mg one-half to one hour before bed. After one to two months, stop for a week. If insomnia returns, resume use. It is safe to take with an antidepressant.

Caution: Don’t take valerian while using sedatives, such as muscle relaxants, antihistamines or alcohol.