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Treatment Approach

People with depression have a number of options for treatment, but a combination of psychotherapy and antidepressant medications is the regimen of choice, particularly for people with major depression. Cognitive-behavioral therapy appears to be the most effective type of psychotherapy, particularly for adolescents and people with atypical or postpartum depression. As many as 90% of people with depression improve from a combination of psychotherapy and antidepressants; however, adverse side effects from certain medications make it difficult for many to take their medications. Some complementary and alternative therapies may be helpful in reducing the side effects from such medications; other complementary and alternative therapies may actually diminish the symptoms of depression. The following, in the order indicated, may be considered under the guidance of an appropriately trained specialist such as a psychiatrist or psychologist:

• Physical activity
• Folate supplements
• St. John's wort (Hypericum perforatum)
• Essential fatty acids
• Acupuncture

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Lifestyle

Exercise

Studies have consistently shown that regular exercise (either aerobic or strength/flexibility training) significantly reduces depressive symptoms in people with mild to moderate depression and improves the mood of people with major depression. Some even suggest that exercise may be as effective as psychotherapy for people with mild to moderate depression, although additional research is needed to confirm this encouraging finding. In the meantime, exercise can be used safely in conjunction with medication for those with depression.

Diet

Studies suggest that people with depression who eat a healthy diet that includes fatty fish (such as salmon, mackerel, herring, and sardines) two to three times per week may significantly reduce their feelings of depression and anxiety. Fatty fish contain omega-3 polyunsaturated fatty acids (PUFAs), and many individuals with depression are deficient in this substance. Some studies suggest that dietary supplementation with docosahexaenoic acid (DHA), one type of PUFA, may help prevent depression.

Diets rich in fruits and vegetables, particularly leafy green vegetables, are also recommended for people with depression. For those who have difficulty maintaining a balanced diet, supplementation with a multivitamin may also be recommended.

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Reviewed: 03/2006