St. John’s wort “promotes a positive mood.” Valerian root reduces “anxiety and stress.” Lavender oil is “soothing for the body and mind.”
If you’re one of the tens of millions of people in the United States who suffer from depression or anxiety, it’s easy to become captivated by the promise of mood-enhancing supplements. Take these pills daily, their marketing suggests, and soon you’ll be hopping happily through green, sun-drenched fields with no prescription required.
But while experts say some mood-boosting supplements are better studied than others, the broader evidence for their effectiveness is shaky at best. “I’m not saying there’s evidence these things aren’t useful,” said Dr. Gerard Sanacora, Professor of Psychiatry at the Yale School of Medicine and Director of the Yale Depression Research Program. Rather, it is that “the quality of the evidence is not of a level that we can really have much confidence in.”
And compared to other treatments like traditional medications or psychotherapy, experts say, dietary supplements fall behind. Here’s what we know about some of the most common supplements marketed for mental health.
Supplements for Depression
St. John’s wort, omega-3 fatty acids, L-methylfolate, S-adenosylmethionine (SAMe), and N-acetylcysteine (NAC) are among the most commonly used dietary supplements to treat depression symptoms. But some have more research behind them than others.
Johannis herbs. This flowering plant is among the best-studied supplements for treating depression, but not all studies suggest benefits.
“A lot of work has actually been done on St. John’s wort over the years,” said Dr. Sanacora. “But it’s still not the high-quality evidence you would see for a Food and Drug Administration-approved drug.”
For example, a 2016 review of 35 studies involving about 7,000 people found that St. John’s wort helps people with mild to moderate depression better than a placebo; A 2008 review had similar results. However, two carefully conducted studies published in 2001 and 2002 found no evidence of benefit.
Omega-3 fatty acids. Supplements for these essential fats have some – albeit limited – evidence to help with mild to moderate depression. “So far, the data suggests that the treatment may have small to modest benefits, but this is far from a definitive finding,” said Dr. Sanacora, adding, “I would not describe the evidence for these studies as being of high quality.”
For example, a 2015 analysis of more than two dozen studies concluded that even if omega-3 supplements help with depression, the benefits may not be large enough to be significant.
dr Dan Iosifescu, associate professor of psychiatry at New York University Grossman School of Medicine, agreed. “It’s very mixed data and some studies don’t really see that much of a benefit,” he said. “The dates are somewhat controversial.”
L-methylfolate. This metabolically active form of folate, an essential B vitamin, has some evidence to support its use in depression, said Dr. Sanacora, but the overall data is conflicting and falls short of the quality of evidence supporting FDA-approved drugs. And it may only be helpful for certain people, particularly those who have trouble properly metabolizing or using folic acid in the body, he said.
dr Sanacora also pointed out that the existing evidence was mostly for taking L-methylfolate in combination with standard antidepressants and not for taking supplements alone. Therefore, people should not expect to take the supplement alone for treatment.
Everything else. Evidence for the benefit of other dietary supplements in treating depression is fading fast, said Dr. Sanacora. He and the other experts said there have been studies of SAMe and NAC supplements, but “there really isn’t any strong data to support their use,” said Dr. Sanacora. “And even for the best, the data is questionable.”
supplements for anxiety
The main anti-anxiety supplements — including lavender, kava, and valerian root — have even less evidence than those for depression, and they lack strong, high-quality research, at least as far as the experts knew. “That doesn’t mean they aren’t effective,” said Dr. Sanacora. “There just hasn’t been the rigorous research that’s normally done for drugs that are pending for FDA indications.” dr Iosifescu said he thinks kava has moderate benefits; However, he cautioned that kava could carry a rare but serious risk of liver toxicity.
Is there any harm in trying them?
Some may think that taking a supplement for their depression or anxiety couldn’t hurt, so why not give it a try? However, the experts warned that there could be potential risks and downsides. Dietary supplements can be expensive and cause side effects or unwanted drug interactions. And dietary supplements aren’t as tightly regulated as FDA-approved and over-the-counter drugs, and they don’t have to be proven safe and effective before they can be sold. “There isn’t nearly as much oversight as there is with traditional medicines, which require consistent manufacture of the pills with a consistent dosage,” said Dr. Paul Nestadt, Co-Director of the Johns Hopkins Anxiety Disorders Clinic and Assistant Professor of Psychiatry and Behavioral Sciences at Johns Hopkins Medicine.
Megan Olsen, general counsel of the Council for Responsible Nutrition, a trade association for the dietary supplement industry, wrote in a statement to The New York Times that dietary supplement companies are permitted to make health-related claims about their product’s “effect on the structure or function of the body ‘ and that these claims must be backed up by evidence. dr But Pieter Cohen, associate professor of medicine at Harvard Medical School, said dietary supplement companies are rarely held accountable for specific health claims made in connection with their products. As long as the manufacturer doesn’t claim that their product treats or cures a specific disease, “they can say what they want,” he said.
Another potential risk from dietary supplements is paradoxical: they could aggravate a mental health condition. dr Nestadt said there is some evidence, for example, that St. John’s wort may trigger a manic episode in people with bipolar disorder.
Perhaps one of the biggest dangers is people taking a dietary supplement instead of seeking a proven treatment for their anxiety or depression. “I’m not so concerned that anyone will try lavender or chamomile,” said Dr. Sanacora. “I’m much more concerned about the risks associated with delaying effective treatment.”
If your depression or anxiety is severe, experts say supplements are unlikely to help, and you should see a trained professional instead. In fact, experts recommend that you consult a doctor before starting any supplement, regardless of what it is intended to treat.
Which treatments are actually proven to work?
Traditional medications and psychotherapy, including antidepressants and cognitive behavioral therapy, have the highest quality evidence of benefit for anxiety and depression, the experts said. They also mentioned treatments like transcranial magnetic stimulation, a non-invasive technique that uses magnetic pulses to stimulate a specific area of the brain; The FDA has approved this treatment for depression and obsessive-compulsive disorder.
Exercise can also be beneficial, the experts said. Although there isn’t as much high-quality evidence as the other approaches, Dr. Sanacora that there is still very good data on its effectiveness in mild to moderate anxiety and depression. And he added that unlike supplements, exercise is free. “There’s always a balance between what’s practical and sustainable and what the evidence is.”
If you have suicidal thoughts, call the National Suicide Prevention Lifeline at 1-800-273-8255 (TALK). Here’s what you can do if you’re having trouble finding help during the pandemic.
Annie Sneed is a science writer and has written for Scientific American, Wired, Public Radio International and Fast Company.