4 of the best natural supplements and herbs for depression

Omega-3 fatty acids are one of the best natural supplements for depression.Cathy Scola/Getty Images
  • The most effective natural supplements and herbs for depression include Omega-3 fatty acids, SAM-e, Folate, and St. John's wort.
  • There is some evidence to suggest that these natural remedies can help lift mood and relieve depressive symptoms, though they may not work for everyone.
  • It's important to talk with your doctor before using these herbs and supplements, and check in with them regularly when treating depressive symptoms.
  • This article was medically reviewed by Zlatin Ivanov, MD, who is certified in psychiatry and addiction psychiatry by the American Board of Psychiatry and Neurology at Psychiatrist NYC.
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The best treatment for depression can vary depending on a person's medical history and their severity of symptoms. For some people, particularly those with mild depression, certain herbs and supplements can either complement or take the place of traditional treatment methods, like antidepressant medication and therapy.

But alternative treatment options are not the best fit for everyone with depression. Here's what you need to know about the herbs and supplements that may improve mood, possible side effects of these remedies, and when and how to use them.

Talk with your doctor first

If you think you may have depression, you should first consult with a mental health professional, like a psychiatrist, or reach out to your primary care provider. A doctor can evaluate your symptoms and discuss treatment options, ranging from supplements that may help manage your mood to lifestyle changes or medication.
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In some cases, supplements can interfere with other medications, or even worsen symptoms in some people, so you should always consult with a doctor, and never attempt to treat your depression entirely on your own.

In most cases, alternative treatment options like herbs and supplements are best suited for those with mild depressive symptoms, characterized by short periods of low moods. While they may be enough to help someone with mild depression manage their mood, these options may not be effective for those with more severe depressive symptoms.

"The challenge is figuring out what works for you and when, if necessary, to switch to the more traditional treatments because the symptoms are interfering with your life," says Kevin Gilliland, Psy. D, a licensed clinical psychologist and executive director of Innovation360, an outpatient counseling service that serves people with mental health and substance abuse issues.
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It's also important to keep in mind that the supplement industry in the US is largely unregulated, says Michael Ingram, MD, owner of Michael T. Ingram Psychiatry, whereas medications go through an extensive review process by the Food and Drug Administration (FDA).

While supplements are not regulated by the FDA, third-party laboratories, like Consumer Lab, do test supplements for potency and accuracy, so you can check to see if a supplement has been tested before you buy one. Research around these natural remedies for depression is still emerging, and more studies are needed to draw definitive conclusions about their benefits, but some herbs and supplements appear to help with managing mood. Here are four of the most well-studied options:
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1. Omega-3 fatty acids

Omega-3 fatty acids are part of the building blocks for lipids or fats in our bodies, and are essential components in the membranes of our cells. Some studies have suggested that omega-3 fatty acids may relieve depressive symptoms in both children and adults.

A 2008 Cochrane review of five trials of omega-3 fatty acids as an add-on treatment for bipolar disorder found that these supplements are unlikely to relieve manic symptoms affiliated with bipolar disorder, but might help improve depressive symptoms.

A 2014 meta-analysis published in the Public Library of Science found supplemental omega-3 fatty acids to be effective at relieving symptoms in patients with mild depression, but more research is needed, Ingram says.
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"To date, there is growing support but still insufficient evidence for omega-3 monotherapy in patients suffering from depression, especially those suffering with more severe depression," Ingram says.

The risks associated with omega-3 fatty acid supplements are relatively low, Ingram says, and while he does not recommend these supplements as a first line of treatment for depression, some people with minor symptoms may benefit from the following:

  • Taking one gram of an omega-3 supplement capsule each day
  • Eating more fatty fish, such as salmon (a food rich in omega-3 fatty acids)
To learn more common foods that contain omega-3 fatty acids, read about the foods that battle depression.
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2. SAM-e

S-adenosyl-L-methionine, or SaM-e, is a compound made naturally in the body and also manufactured as dietary supplements. Several research studies have found the supplement to be promising in treating depressive symptoms.

For example, a 2010 study published in the American Journal of Psychiatry examined 73 patients with depression, who were still experiencing symptoms even when taking an antidepressant. Participants were separated into two groups: one received 800mg of a SAM-e oral supplement twice a day for six weeks, in addition to antidepressants, and the other group received a placebo. The group who took the SAM-e supplements scored higher on a depression rating scale (meaning they reported fewer symptoms) than the placebo group.

The antidepressant mechanism of SAM-e is still unclear, but some researchers believe it works by silencing certain genes that are involved with the breakdown of serotonin and dopamine, the "feel good" hormones that help regulate mood.
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Supplement capsules of SAM-e range from 800mg to 1600mg a day, and may be an appropriate treatment method for patients who have not responded well to traditional antidepressant medications, Ingram says.

Side effects from SAM-e are uncommon, but the supplement may cause nausea and constipation for some people.

3. Folate

Folate is a B vitamin that is vital for neurological functioning, and is thought to break down homocysteine, an amino acid, which helps generate SAM-e. Folate is naturally present in many foods, including dark green leafy vegetables, dairy products, eggs and grains.
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Several studies show a link between folate deficiency and depression. A 2005 study in the Journal of Psychopharmacology suggested that folic acid — the manufactured form of folate sold as supplements — might be effective in reducing depressive symptoms, but more research is needed to determine its overall effectiveness, as well as what dosage is best for managing depression, Ingram says.

Overall, doses between 7.5mg to 15mg daily are considered safe for most patients, Ingram says. But folate supplements may also mask B12 deficiency, so it's important to talk with your doctor, and check your B12 levels, before taking a folate supplement.

4. St. John's wort

St. John's wort is an herb with yellow flowers that has been used for centuries to help with mental health problems, and is routinely prescribed for depression in Europe, according to the National Institutes of Health.
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Some controlled studies of patients with mild to moderate cases of depression have demonstrated improvements similar to antidepressants when taking St. John's wort, however, the data is limited by low sample size and inconsistent diagnostic criteria, Ingram says.

Plus, the research is mixed. A 2002 study published in the Journal of the American Medical Association found St. John's wort to be no more effective than placebo for moderate to severe depression and a 2011 study published in the Journal of Psychiatric Research found the supplement wasn't effective in mild to moderate cases of depression.

St. John's wort can also interact poorly with many medications, such as traditional antidepressants, birth control pills, and the blood-thinning medication warfarin. Combining some antidepressants with St. John's wort can also significantly increase the risk of serotonin toxicity, or serotonin syndrome, a potentially life threatening condition, Ingram says.
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Still, the supplement taken as a capsule remains a popular depression treatment option in Europe. The average dose ranges from 300mg to 900mg a day, Ingram says, and side effects can include abdominal discomfort, dizziness, and sensitivity to sunlight.

The bottom line

There are many different treatment options available for people with depression, and supplements may be part of an overall plan that could help those with mild depression, but they should always be used under the direction of a doctor.

"It's important to be mindful that for some people, untreated depression can worsen and have severe consequences, so individuals need to be mindful and watchful of whether or not alternative approaches are helping to relieve symptoms," Gilliland says.
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For more information, learn about how to deal with depression and lift your mood.

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