Mood problems, including depression and bipolar disorder, are no laughing matter. More than 20 million American adults have a mood disorder and 40 million an anxiety disorder. And these numbers don’t include the average worrywart or person who suffers an occasional bout of the blues.
For depression alone, the annual cost for treatment and lost wages may be as high as $52 billion.
With these statistics, it’s no wonder that many people are searching for mood supplements or other mood-enhancing alternatives to drugs.
The Need for Mood Enhancers
“For so many people, antidepressant medication either stops working or has too many side effects,” says Henry Emmons, MD, a psychiatrist with the Center for Spirituality and Healing at the University of Minnesota. Emmons, author of The Chemistry of Joy: A Three-Step Program for Overcoming Depression through Western Science and Eastern Wisdom, prescribes medications for his patients, but he also highly recommends exercise and good nutrition as physical treatments for depression, combined with a few targeted mood supplements.
Which leads to the question: what vitamins, herbs, supplements, and lifestyle changes are the best mood enhancers?
The experts we talked to didn’t reach complete consensus; more research is clearly needed for the plentiful options available. But here is a brief overview of some of the more common complementary approaches used to treat mood problems.
Of course, if you suffer from severe mood problems see a doctor — before you reach for mood enhancers or supplements.
Mood Supplements with Potential
One of the most touted herbs used for enhancing mood is St. John’s wort, a yellow-flowered plant containing many chemical compounds that may have medicinal effects.
“Even though the evidence is mixed, it’s better for St. John’s wort than for other herbs,” says Adriane Fugh-Berman, MD, associate professor, Complementary and Alternative Medicine Master’s Program, Department of Physiology and Biophysics at Georgetown University School of Medicine. Fugh-Berman says that trials in the U.S. have been oddly less positive than in Germany, where it is widely prescribed.
SAMe (S-Adenosyl-L-Methionine), derived from an amino acid and also available from protein food sources, is another widely studied mood-enhancing substance that’s commonly used in Europe, Fugh-Berman tells WebMD.
Though the data is less solid, other potential mood enhancers include:
Valerian: an herbal remedy created from dried roots, often taken as a sleep aid and sometimes used for anxiety.Lavender: aromatherapy, essential oils, and teas use lavender to enhance relaxation and possibly help relieve anxiety and depression.Omega-3 fatty acids: found in cold-water fish and certain vegetable oils, and available as a supplement, omega-3 fatty acids are sometimes used to help depression and other psychological problems. Emmons recommends a dose of 2,000 to 4,000 milligrams or more when taken for mood problems.B vitamins: essential for cell metabolism and central nervous system maintenance. Emmons recommends a good B-complex or multivitamin to ensure plenty of B vitamins, which can help stabilize nerve cell membranes.Vitamin D: although not enough evidence exists to make any claims about the effectiveness of vitamin D as a mood enhancer, at least one study reported benefits from vitamin D in treating seasonal affective disorder, a form of depression that occurs during the winter months.
St. John’s Wort
Around for centuries, St. John’s wort is commonly used today for sleep disorders, anxiety, and mild to moderate depression. However, an analysis of 37 clinical trials found that St. John’s wort may have minimal to no benefit for those with more severe forms of depression.
Although more research is needed, St. John’s wort may also have the potential to reduce symptoms of anxiety, premenstrual syndrome (PMS), or perimenopausal mood changes.
Available as capsules, tablets, liquid extracts, and teas, a typical dose of St. John’s wort ranges from 900 to 1,200 milligrams a day, and it should be taken for at least one to three months, just as with pharmaceutical anti-depressants, to see the best effect.
St. John’s wort does have the potential for serious interactions with a wide variety of prescription drugs, including birth control pills, antidepressants, HIV medications, and blood thinners. It can also interact with other herbs or supplements. Mainly, it may lower the effectiveness of certain medications, Fugh-Berman tells WebMD. St. John’s wort may also lead to an increase in side effects when taken with pharmaceutical antidepressants.
Consult a doctor or pharmacist about interactions before using St. John’s wort. Although uncommon, side effects of St. John’s wort may include:
Gastrointestinal upsetSkin reactions, especially when exposed to sunFatigueAnxietySexual dysfunctionDizzinessHeadacheDry mouth
SAMe(S-Adenosyl-L-Methionine)
SAMe has been studied a lot for depression. Although current trials are not conclusive, an analysis of 28 studies showed that SAMe produced statistically significant improvement in the symptoms of depression when compared to a placebo. Some studies have shown that improvements were comparable to conventional antidepressants, such as the class of medications called tricyclic antidepressants.
Emmons suggests SAMe for those with a type of depression that produces low energy. He prescribes 400 to 800 milligrams daily, depending upon need or tolerance. The dose most often used for depression in clinical studies is 800 to 1,600 milligrams daily for up to 6 weeks.
Although SAMe usually causes few problems, you should use caution if you have diabetes, low blood sugar, or an anxiety or other type of psychiatric disorder. Gastrointestinal problems, headaches, fatigue, and skin rashes are the most common side effects.
Mood Enhancers That May Be Unsafe
Kava kava. A ceremonial beverage used commonly in the Pacific Islands, kava kava earned its claim to fame as an herb that’s very helpful for anxiety. Unfortunately, kava kava has largely fallen out of favor because concentrated forms for sale in the U.S. have been associated with a rare risk of significant liver problems.
According to the FDA, you should consult a doctor before using kava if you have liver disease or are taking drugs that affect the liver. Likewise, you should see your doctor if you experience any signs of liver illness after taking a kava supplement.
5-HTP. This is a precursor to a neurotransmitter called serotonin. Although some health care providers recommend it for mood problems, others are more cautious. “It is not clear whether 5-HTP is immune from the same problems L-tryptophan had,” Fugh-Berman tells WebMD, referring to an amino acid that was taken off the market in 1989 due to a dangerous contaminant. This concern has been largely disputed, and 5-HTP is generally considered safe, and effective for depression when taken at 150-300 milligrams daily.
As you evaluate other mood supplements, keep in mind that the FDA does not strictly regulate herbs and supplements; it treats them like foods rather than drugs. The makers of supplements don’t have to show their products are safe or effective before selling them on the market.
This makes it harder for you to assess their strength, purity, and safety. Fugh-Berman advises doing your own research on effectiveness and adverse effects, using reliable, unbiased sources, and by consulting groups that independently evaluate dietary supplements.
Lifestyle Changes for Enhancing Your Mood
“If you look at the research on exercise for depression, it’s equal to or better than medication for depression — probably the best outright alternative treatment for depression,” says Emmons, who often recommends mild, rhythmic activities such as walking, biking, or jogging. “It may not be enough for a lot of people, but it’s a good place to start.”
Reporting in a February 2008 issue of Cerebral Cortex, German researchers described PET scans and recently available chemicals they used to prove that running does, in fact, release mood-enhancing endorphins. The more released, the greater the effect.
How much exercise is enough to enhance mood? Three hours of moderate activity per week may do the trick, according to a study published in the January 2005 American Journal of Preventive Medicine.
Emmons also strongly recommends a variety of stress management techniques, such as learning meditation to self-regulate thoughts, called mindfulness.
“People with recurring depression tend to get triggered very quickly — almost like a track is laid down, a slippery slope,” he says. “It pays to put some real effort into learning to recognize this immediately and to learn ways to steady yourself.”
Even certain computer games can help create more positive thought patterns. Based on scientifically tested tools published in the journal of the American Psychological Association, MindHabits is one example. It helps players reduce stress and boost esteem by training the mind to refocus the way it perceives the world.
SOURCES:
Adriane Fugh-Berman, MD, associate professor, Complementary and Alternative Medicine Master’s Program, department of physiology and biophysics, Georgetown University School of Medicine.
Henry Emmons, MD, psychiatrist, Center for Spirituality and Healing, University of Minnesota.
The National Institute of Mental Health Web site: “The Numbers Count: Mental Disorders in America.”
Agency for Healthcare Research and Quality Web site: “S-Adenosyl-L-Methionine for Treatment of Depression, Osteoarthritis, and Liver Disease.”
National Center for Complementary and Alternative Medicine Web site: “Get the Facts: St. John’s Wort and Depression,” “Herbs at a Glance: Lavender.”
MedlinePlus Web site: “Lavender (Lavandula angustifolia Miller),” “St. John’s wort (Hypericum perforatum L.),” “Kava (Piper methysticum G. Forst).”
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NIH Office of Dietary Supplements Web site: “FDA Issues Consumer Advisory for Dietary Supplements Containing Kava.”
Boecker, H. et al. Cerebral Cortex, 2008; vol 18: pp 2523-2531.
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