10 Best Supplement Options For Depression And Anxiety, From A Holistic Psychiatrist
In my years as a holistic psychiatrist, I've seen patients benefit from comprehensive, effortful lifestyle changes, like shifting toward a real food diet, getting a full night of sleep, moving your body, engaging with your IRL community, limiting your social media use, connecting with nature, drinking water, and getting exposure to sunlight.
Of course, there's nothing wrong with choosing to take medication for anxiety and depression. But if you're eager to take a more holistic approach to managing your depression, and you want to use diet and lifestyle rather than pharmaceuticals, there are a number supplements I'd recommend. Just make sure to always consult your doctor before making any changes to your treatment or medications.
Curcumin, which is the active compound in turmeric (the spice that gives curry its characteristic golden color), is a powerful anti-inflammatory. Given that inflammation is thought to be at the root of so many modern cases of depression, this natural treatment may improve your mood while helping your body get healthier.
The best way to get the benefit of turmeric is to cook with it. Make a curry, and be sure to combine turmeric with black pepper, since it increases the absorption rate, or prep a turmeric paste and use that to make golden milk.
If you don't think you'll be able to consume it consistently, then consider curcumin in pill form. Curcumin is safe and effective, and you might see side benefits like improved joint pain or less digestive discomfort.
While Rhodiola is very effective, it's not safe for everyone. I don't recommend Rhodiola for my patients on the bipolar spectrum, and it's not recommended during pregnancy or lactation.
It may also cause dry mouth and dizziness, according to the National Center For Complementary And Integrative Health (NCCIH). Rhodiola can also have interactions with certain medications like ACE inhibitors and some diabetes medications, so it's important to clear this one with your doctor.
SAM-e is not safe in all scenarios, but when it's indicated, it can be a huge help. Some people with depression have what's called a methylation defect at the root of their depression. SAM-e may help compensate for this defect and can have a tremendous impact on mood. There is some research on this supplement's ability to help with depression, but they've mainly been small studies, without any conclusive evidence, according to Mayo Clinic.
If you give it a try, I recommend starting at a dose of 400 milligrams daily and increasing by 400 milligrams every week. A good final dose is 1,200 to 2,400 milligrams daily. It's best to take it on an empty stomach along with a B complex. It's not safe for folks on the bipolar spectrum, and it can't be taken in conjunction with some psychiatric medications, such as MAO-I's. It's definitely best to clear this one with your doctor before initiating.
Probiotics may be a very helpful natural supplement to treat depression. In my practice, I've found that a compromised gut flora is often at the root of gut inflammation, systemic inflammation, and compromised neurotransmitter production, all of which may contribute to depression.
One way to support your gut is by consuming fermented foods (e.g., sauerkraut, sauerkraut juice, beet kvass, kimchi, miso paste, natto) along with starchy vegetables (e.g., sweet potatoes, plantains). The second way to repopulate your gut is by taking the right probiotic.
5. Cod Liver Oil
There's decent evidence that omega-3 fatty acids (aka fish oil) can support brain health and improve mood. And sadly, many people are walking around with omega-3 deficiency. Signs of deficiency include things like brittle nails, dry hair or hair loss, slow wound healing, excessive thirst, and even those red bumps on the backs of your upper arms. Another good sign of omega-3 deficiency is if your diet consists of processed foods, fried foods, and other foods that are lacking in essential nutrients.
If you do take cod liver oil, it's worth monitoring vitamin D levels, since cod liver oil contains vitamins A, D, E, and K in addition to the omega-3 fatty acids.
6. Vitamin D
When I do blood work, I find that nearly all of my patients are vitamin D deficient. Vitamin D deficiency contributes to a host of hormonal and inflammatory imbalances in the body, thereby potentially contributing to depression.
I'm generally a naturalist, and I prefer my patients get their vitamin D the old-fashioned way, from sun exposure. But in many parts of the country during the winter, sun exposure is on backorder. In those cases, I recommend a good vitamin D3 with K2 supplement. The NIH recommends1 200 to 600 IUs of vitamin D a day to prevent rickets. But for optimal health, I recommend taking around 2,000 to 5,000 IU daily. If you have a deficiency, speak to your doctor before taking any higher levels of vitamin D.
7. B Vitamins (methylated folate and methylated B12)
As I mentioned when we were discussing SAM-e, some people have a methylation defect that may contribute to depression. You can find out if you have this by having your MTHFR gene tested. If you have a methylation defect, a good-quality B complex containing methylated B vitamins such as 5-MTHF and methylcobalamin is helpful for proper neurotransmitter function and good mood.
For some people, it's even necessary to get B12 as a monthly shot. Ask your doctor to test your B12 levels, and consider getting intramuscular B12 shots if you're very low.
8. Hemp Oil
Let me add my voice to the chorus singing the praises of hemp oil. The hemp plant's anti-inflammatory and relaxing properties can be immensely helpful for depression. I instruct my patients to find a good-quality liquid tincture of hemp oil and start with a dose of around 15 milligrams, increasing from there until they experience the benefit. It can take a few weeks of regular use to experience the full benefit.
Research suggests that hemp oil is very safe, but some studies have noted it can cause sleepiness2, decreased appetite, diarrhea, and fatigue—so it's worth observing your body to make sure you're tolerating it well.
9. St. John's Wort
I'd be remiss if I didn't bring up St. John's wort (SJW) in a conversation about natural treatment for depression—it's often considered the original supplement for depression. While the research is mixed on its efficacy, according to the NCCIH, integrative practitioners have been using the natural remedy for many years. And some studies indicate it may be helpful in treating mild to moderate depression, reports Mayo Clinic.
That said, it can have dangerous interactions with other medications, so it's important to speak to your doctor before giving it a try. I'll typically have someone start at 450 milligrams twice a day for a month, then increase to 900 milligrams twice a day. With such a potent supplement, I would recommend working with an integrative practitioner to make sure you're using SJW safely.
Like Rhodiola, ashwagandha is an adaptogenic herb that has long been used in ayurvedic tradition, said to help support the body's ability to cope with stress.
In fact, one study published in the Indian Journal of Psychological Medicine, participants who took ashwagandha for 60 days lowered their cortisol levels by almost 30 percent3.
I recommend taking 225 to 500 milligrams twice a day for three to six months and then giving your body a break from it. It may help soothe depression and anxiety, and it even help you feel less overwhelmed by the stressors of life.
A supplement will never be the silver bullet that addresses these fundamental causes of depression, but there are several supplements that are safe, well-tolerated, and helpful in the process of healing depression. If you do want to try a natural supplement for depression or anxiety, be sure to speak with your doctor first, to figure out the best way it can fit into your course of treatment.
Ellen Vora, M.D. is a board-certified psychiatrist, acupuncturist, and yoga teacher, and she is the author of the No. 1 bestselling book The Anatomy of Anxiety. She takes a functional medicine approach to mental health—considering the whole person and addressing imbalance at the root. Vora received her B.A. from Yale University and her M.D. from Columbia University.