If you experience depression, it is not your fault, and you deserve to get treatment. There are many ways to effectively treat depression, but keep in mind that it is a serious mental illness and should not be tackled on your own. “Depression is a widespread mental health condition with various levels of severity and is treatable with an array of strategies,” says Emily Steinberg, MD, board-certified psychiatrist and assistant professor of psychiatry at the Icahn School of Medicine at Mount Sinai. If you choose to begin taking a supplement to help treat your depression, it is important to remember that dietary supplements are typically considered adjunctive treatments for depression. This means they can help make other treatments more effective but are not effective treatments on their own. However, some supplements interact with medications in a potentially dangerous way, and supplements that work for some may worsen symptoms for others. Those are a few of the many reasons it is so important to work with a healthcare provider if you are considering trying a supplement to help alleviate your symptoms. When exploring different supplements for depression, we considered efficacy, risks, interactions with medications, and third-party certifications.
Are Depression Supplements Beneficial?
There are dozens of vitamin, mineral, antioxidant, and herbal supplements that are marketed to treat depression, with varying levels of data to support their use. While supplements on their own are not likely to completely treat depression, there are some that may offer benefits in conjunction with other treatments. “Success or failure with a supplement could depend on a wide range of factors, such as age, gender, race, concurrent conditions, other supplements and medications, and even more,” says Jennifer Hanes, MS, RDN, LD. Additionally, “when considering natural remedies for depression, it’s important to understand that natural remedies can take longer to take effect than prescription medication,” says Sharon Puello, MA, RD, CDN, CDCES. It’s vital to work closely with a healthcare provider, including someone who specializes in mental health, when considering supplements as part of your treatment plan. Those who may be more likely to benefit from supplements for depression include: People with nutrient deficiencies. In the cases of vitamin and mineral supplements, more is not necessarily better. However, “B12, folate, magnesium, and zinc deficiencies seem to worsen symptoms of depression and potentially reduce the effectiveness of the medications,” says Hanes. Correcting vitamin D deficiencies is essential for overall health, and it may also help with depression. It is therefore important to work with a healthcare provider to supplement if you have a deficiency in a specific nutrient. People taking certain antidepressant medications. SAMe, methylfolate, omega-3s, and vitamin D may also be particularly useful when combined with antidepressant medications. Additionally, “EPA has shown to quantifiably improve response to various antidepressant medications," says Hanes. However, there may be risks of interactions with certain medications, so please talk to a healthcare provider before adding in these supplements, especially if you are taking medications. People who don’t respond well to medications. “Those most likely to benefit from herbal supplements may include people who cannot tolerate or are resistant to more standard treatment for depression, including psychotropic medications and psychotherapy,” says Steinberg. People with mild symptoms. There is some evidence to support the use of certain supplements like St. John’s wort, especially among people with milder symptoms. However, it doesn’t come without side effects and interacts with many medications, so proceed with caution and discuss symptoms and treatment options with a healthcare provider.
Who May Not Benefit from Certain Depression Supplements
The best way to determine if one of the many depression supplements available is right for you is to work closely with a healthcare provider. “Since herbs and other supplements are not monitored by the FDA, you don’t always know if what you’re getting is safe, so everyone should be cautious,” says Steinberg. However, there are certain people who should avoid or be extra cautious about using some of the supplements—especially the herbal supplements. Everyone is different, and what works for one person may not work for another. “It’s important to know that herbal supplements can actually significantly worsen a patient’s depression,” says Gauri Khurana, MD, MPH, psychiatrist and clinical instructor at Yale University School of Medicine. Those who should be extra cautious about certain supplements include: People with moderate to severe depression. “Those with moderate to severe depression (rather than mild symptoms) should definitely seek out a mental health professional for more standardized approaches for treatment. While it may be a more cost-effective approach (for some), supplements should not be a stand-alone treatment for this group,” says Steinberg. People taking SSRIs (selective serotonin reuptake inhibitors) such as Prozac, Zoloft, Lexapro, or Celexa. Both St. John’s wort and 5-HTP are known to potentially cause something called serotonin syndrome when taken in combination with SSRIs. Both SSRIs and these supplements increase the amount of serotonin in the brain and can lead to an overload. This can result in mild symptoms like changes in blood pressure, tremors, nausea, and vomiting or more life-threatening symptoms including seizures, renal failure, and respiratory failure. People taking other medications. St. John’s wort interacts with several medications, including HIV drugs, some cancer medications, blood thinners, oral contraceptives, pain medications, and more. Similarly, SAMe (short for S-adenosylmethionine) can worsen manic symptoms of those with bipolar disease and interact with other medications including those to treat Parkinson’s disease. Pregnant or breastfeeding people. In general, herbal supplements are not well studied among pregnant and breastfeeding people. While vitamins and minerals are generally safe (and recommended) during pregnancy, it’s always best to consult with a healthcare provider to ensure the levels you are taking are safe for you. These are the best supplements for depression, according to a dietitian. Unlike some fish oil supplements, its aftertaste is minimal, but if you do experience any fish burps, putting them in the refrigerator or freezer might help. Unfortunately, high-quality supplements can come with a hefty price tag. But one bottle does contain four months’ worth of supplements, so you only have to remember to replenish it three times a year. Because it’s made from fish oil, it may not be safe for someone with a fish allergy, and it is not vegetarian or vegan. Price at time of publication: $74 for 120 count ($0.62 per serving) That said, the research on vitamin D supplements and depression is inconsistent. While there appears to be a connection between low vitamin D and depression risk, it’s not clear if supplements will actually offer many benefits. This could mean that either supplements are not helpful or that there is another reason for the link, such as less exposure to sunlight. However, if you are vitamin D deficient, it’s important for overall health to replete with supplementation—and it may offer some mild mood benefits. Price at time of publication: $24 for 250 count ($0.10 per serving) When choosing a St. John’s wort supplement, it’s important to consider dose and form. Most research has looked at the safety and efficacy of two different extracts—hyperforin and hypericin—not the whole herb. The research suggests a dose of 1-3 percent hyperforin taken at 300 mg three times per day and 0.3 percent hypericin at 300 mg three times per day may be beneficial. You also want to choose a product that includes all parts of the plant—flower, stem, and leaves. Some newer studies have looked at the whole herb (rather than extracts) and show some efficacy as well. In the case of the whole herb, look for a dose with 01.-0.15 percent hypericin, taken two to four times per day. However, it’s important to know that the whole herb is more likely to be contaminated with cadmium (a carcinogen and kidney toxin) and lead. We like Nature’s Way Perika since it’s not only approved by ConsumerLab but contains a research-backed dose of 3 percent hyperforin. Of note, when ConsumerLab tested this product, the actual amount of hyperforin was lower than on the label but still within the recommended 1 to 3 percent saturation. For comparison, nearly all of the St. John’s wort supplements tested by ConsumerLab came back at lower amounts than on the label. Price at time of publication: $48 for 180 count ($0.32 per serving) “If St. John’s wort is taken with an SSRI, you could experience serotonin syndrome. Both St. John’s wort and SSRIs increase serotonin in the brain, which can overload the system and cause symptoms such as muscle spasms, heavy sweating, agitation, fever, diarrhea, tremors, confusion, and even hallucinations. If this goes untreated, it can be deadly,” says Khurana. St. John’s wort is also not recommended if you have severe depression or bipolar disorder, are pregnant, looking to become pregnant, or breastfeeding. It also poses risks for those with ADHD, schizophrenia, and Alzheimer’s disease. Possible side effects include stomach discomfort, hives, decreased energy, headache, restlessness, dizziness or confusion, and increased sensitivity to sunlight. Because of all of these risk factors, it is essential to talk to a healthcare provider before starting St. John’s wort. Of note, B-vitamin supplementation hasn’t been shown to treat depression, especially among people who are not deficient. Also, it is possible for most people to meet their B-vitamin needs through diet unless you are vegan, in which case a B12 supplement may be helpful. While it’s rare to have negative effects from consuming too many B vitamins, check in with a healthcare provider to make sure you aren’t consuming more than the Tolerable Upper Intake levels. Price at time of publication: $21 for 60 count ($0.35 per serving) The benefits are more pronounced for people who don’t consume enough folate in their diet. In addition, there are some people who have a gene mutation that reduces their ability to convert folic acid to methylfolate, in which case it is important to take methylfolate directly. We like the Thorne 5-MTHF 15mg since it provides the active form of folate in the dose supported by research. While this supplement is not verified by one of our top third-party testing companies, Thorne is known for their high-quality ingredients, and they regularly screen for contaminants. Since this supplement is only effective alongside other depression treatments, it is important to consult with a healthcare provider and make sure it fits into your treatment plan before you start taking it. Price at time of publication: $62 for 30 count ($2.07 per serving) Studies have shown benefits to SAMe with doses ranging from 200 to 1,600 mg daily (in divided doses), so it’s important to work with a healthcare provider that specializes in mental health and supplements to determine the best dose for you. A top pick by ConsumerLab, Nature’s Trove SAMe contains a moderate dose of 400mg, which may lead to fewer side effects and be a good place to start, especially for people with mild to moderate depression. It’s free of the top eight allergens, is gluten-free, and contains no artificial colors or flavors. It’s certified kosher and non-GMO, and is a budget-friendly choice. Price at time of publication: $40 for 90 count ($0.44 per serving) SAMe is also converted to homocysteine in the body, which, in excess amounts, is associated with increased risk of cardiovascular disease (CVD). However, more research is needed to understand the connection between SAMe supplements and CVD risk. Consuming adequate B-vitamins in your diet may help your body get rid of excess homocysteine.
Probiotics
There is a well-established connection between the gut and the brain, and research has suggested a relationship between your gut microbiota (the colony of bacteria found in the gut) and depression. People with known digestive disorders may benefit from a probiotic and experience some mood benefits as well. However, more research is needed to understand the best dose and the specific types of probiotics. In addition, research has shown no real benefit to otherwise healthy people. It’s always helpful to talk with a healthcare provider, especially one that specializes in digestive health, to determine if a probiotic supplement might help you.
5-Hydroxytryptophan (5-HTP)
“The 5-hydroxytryptophan supplements, also known as 5-HTP, may increase serotonin levels and positively affect mood,” says Khurana. Our bodies naturally make 5-HTP from L-tryptophan (an amino acid found in some protein-rich foods), which they then convert into both serotonin and melatonin. This is why this supplement is marketed for both depression and sleep. However, there is very little research testing this supplement, so it’s unclear how helpful it actually is—and at what dose. 5-HTP supplements also come with serious side effects, including serotonin syndrome if taken with SSRIs. “Some people taking 5-HTP have experienced mania or suicidal thoughts as well,” says Puello.
Turmeric
It’s believed that curcumin may benefit people with depression by reducing inflammation. However, there’s limited research to test the benefits, and the current quality of evidence is low. Participants in most of the studies looking at turmeric or curcumin (the active compound in turmeric) were also taking antidepressants.
How We Select Supplements
Our team works hard to be transparent about why we recommend certain supplements; you can read more about our dietary supplement methodology here. We support supplements that are evidence-based and rooted in science. We value certain product attributes that we find to be associated with the highest-quality products. We prioritize products that are third-party tested and certified by one of three independent, third-party certifiers: USP, NSF, or ConsumerLab. It’s important to note that the FDA does not review dietary supplements for safety and effectiveness before they go to market. Our team of experts has created a detailed, science-backed methodology to choose the supplements we recommend.
What to Look for in Supplements for Depression
Third-Party Testing
Supplements that are third-party tested are sent to a lab where they are tested to ensure they contain what they say they contain and are not contaminated with specific high-risk, common contaminants. However, it’s important to note:
Form
Each supplement reviewed in this article comes in different forms. Please review our top picks to learn about the best form of each supplement.
Ingredients & Potential Interactions
It is essential to carefully read the ingredient list and nutrition facts panel of a supplement to know which ingredients and how much of each ingredient is included relative to the recommended daily value of that ingredient. Please bring the supplement label to a healthcare provider to review the different ingredients contained in the supplement and any potential interactions between these ingredients and other supplements and medications you are taking. Many supplements (including St. John’s wort, SAMe, and 5-HTP) marketed to treat depression can interact or lead to dangerous side effects when taken with antidepressants or other medications meant to treat mental illness. They may also interact with other medications and supplements. Therefore, it’s vital that you discuss all supplements with a healthcare provider.
Depression Supplement Dosage
There is no standard dose for supplements to treat depression. In the case of vitamins, the recommended amount will vary by vitamin, and most manufacturers will use daily values, dietary reference intakes (DRIs), and adequate intakes (AIs) to determine dosage. Some manufacturers add more than the recommended amount of certain vitamins and minerals—as is the case with many B vitamins—since emerging research suggests there may be benefits to higher doses. In addition, the amount your body absorbs varies by vitamin, so doses higher than the recommended amount may be indicated. When it comes to herbal and other supplements, there is also no standard dose, but most manufacturers will look to the research to determine an appropriate amount to include. The recommended dose may vary by symptoms and your individual health.
How Much Is Too Much?
Your body filters out excess water-soluble vitamins (like B-vitamins), so it’s difficult to overconsume these. However, fat-soluble vitamins like vitamin D are stored in fat tissues and can be dangerous in excess. While there is no upper limit (UL) established for omega-3s, high doses may interact with some anticoagulant medications. You can ensure you aren’t exceeding the upper limits of any vitamin or mineral by running your supplements by a healthcare provider. When it comes to other types of supplements like herbs and other compounds, safe amounts will vary and may depend on your health status and other supplements and medications you are taking. It’s always best to discuss the dosing of any supplements with a healthcare provider first. “The treatment that the patient is willing to take is the best treatment. Some individuals really shy away from conventional medicine. In that case, working closely with a professional who can critically evaluate your bloodwork, lifestyle, and diet to identify potential areas of deficiency is key to determining a potentially beneficial supplement regimen,” says Puello. That said, for many people, supplements may not be enough. “There are serious consequences to not treating depression in an effective way, which may or may not include medications, but should generally include lifestyle changes and therapy, not just taking a supplement,” says Hanes.
