Depression: alternatives to drug treatment

If you suspect you could be depressed, talk to your GP. Prompt diagnosis and treatment can stop it becoming worse.

If you have mild depression, and your GP thinks that you’re likely to get better without treatment, they may ask to come back in a couple of weeks’ time, to see how you’re feeling. It’s worth asking for advice if there’s anything that’s causing particular problems – indigestion, for instance, or insomnia. You won’t normally be prescribed antidepressants if you have mild depression, although may be given them if you’ve had more serious depression in the past or if you’ve been depressed for a long time.

Is 'natural' actually better?

We all tend to assume that ‘natural’ is inherently better and so, when it comes to treatments for depression, it’s also easy to assume that home remedies and natural treatments are at best safe and effective, at worst safe and ineffective. This isn’t the case, however. Some natural remedies and treatments can be harmful.

Find out the science behind some of the most commonly proposed home remedies before you consider trying them.

Please note: anti-depressants can be life-saving and if your GP has recommended you take them, we do not suggest you ignore that advice. Whenever considering new treatments or supplements to treat your depression it is essential to talk to your GP, especially if you are taking medication. Any changes could affect your medication’s effectiveness.

How to spot symptoms of depression

Talking therapies

There are a variety of talking therapies available, but you may have to wait some time for them. The average wait, according to the charity SANE, is around 18 months. The Government is investing millions of pounds in psychological therapies, and aims to eventually cut waiting time to two weeks, but in the meantime, you should ask your GP about the local situation. Some GPs’ surgeries have counsellors attached to their practices, which may mean a shorter wait for treatment.

If you can pay for private treatment, your GP may be able to put you in touch with a private therapist. Be sure though, that you choose one who is registered or accredited.

Different approaches

• Cognitive Behavioural Therapy (CBT): focuses on teaching you to challenge negative thought patterns.
• Psychodynamic Therapy: helps you to look at difficulties in your past and deal with feelings of guilt, aggression and inadequacy.
• Counselling: allows you to talk about your life, and the areas that may be influencing your feelings of depression.
• Interpersonal Therapy (IPT): looks at your relationships with others and helps you improve how you see yourself.

Talking therapies and antidepressants may work better if you have both at the same time.

Exercise

Taking a brisk walk may sound old-fashioned, but studies have shown that regular exercise can help you feel better, and sometimes prevent depression developing in the first place.

Exercise triggers the release of your body’s feel-good chemicals, endorphins, serotonin and dopamine which may help ease your symptoms. Taking exercise such as walking, running or swimming also gives you targets to aim for, and gets you up and out and meeting people.

Thirty minutes’ moderate exercise, five or more days a week, should be the minimum that we all aim for. You can do this on your own, with a friend, or join a club. Your GP may also be able to refer you for ‘Exercise on Prescription’. There are around 1,300 of these schemes in the UK. Ask your GP if there’s one near you.

Get outside for even a very short walk in a local park or even down a tree-lined street, and you will feel a difference. There are other benefits to exericse too, which may have a knock-on effect on your depression: lower blood pressure, protecting against heart disease and boosting self-esteem.

Some small studies have also shown that being in ‘green spaces’ ie with trees and/or grass, flowers or plants, has a positive effect on patients, improving depression symptoms.

While these studies have generally been too small from which to draw concrete conclusions, this is one situation where you can let your body tell you what works and what doesn’t: try it and see. Going for a walk in the park doesn’t have any known negative side effects.

Is your physical health linked to depression?

Improve your diet

A balanced diet, with at least five portions of fruit and vegetables every day, plenty of fibre, some protein and small amounts of fat and salt, should help keep your health on track. But if you don’t feel physically well, you’re less likely to feel emotionally well and positive. And if you’re lacking certain nutrients it can have an impact on your mental health. Protein, for instance, contains the amino acid tryptophan, which affects your mood.

Like exercise, certain nutrients help maintain healthy serotonin levels.

Omega-3s, for example, found in salmon, tuna, mackerel, have been linked with improved depression symptoms in some people. It’s known that omega-3 is essential for healthy brain function and it’s thought that if a person’s depression is related to low blood levels of certain brain chemicals (EPA and DHA), then fish oil supplementation may help.

Folic acid is essential for your body to create serotonin and other neurotransmitters, so taking a supplement, especially if your diet lacks good sources of folate (dark green vegetables, liver, and nuts, for example), could help. If, however, you have a healthy balanced diet, taking a supplement is unlikely to make a big difference to your depression.

Caffeine appears to reduce serotonin levels, so if you can cut it out or cut down, do so.

Stay hydrated

It’s also important to watch what you drink. Keeping your non-alcoholic fluids up is important, as dehydration can affect you mentally, making you confused and irritable. Keeping to a moderate alcohol intake is also important as alcohol is a depressant.

Need to talk to a GP from the comfort of your own home? Saga Health Insurance customers can talk to a qualified, practising UK GP 24 hours a day by phone. Find out more about our GP service.

Meditation, mindfulness and yoga

Numerous studies support the benefits on depression of these techniques.

Yoga, for example, has been found to lower stress hormones such as cortisol and corticotropin, and also helps moderate anxiety and depression. And a study published in The Lancet, found that people with depression who had 8 group sessions of more than two hours of mindfulness training and cognitive behavior exercises over a period of a year, had the same risk of relapsing into depression as those who took anti-depressants.  

Can your favourite hobby help promote mindfulness?

St John’s Wort

St John’s Wort is a herbal remedy that is known to help ease the symptoms of mild to moderate depression. It’s available over the counter, but GPs aren’t allowed to prescribe it. While it can be helpful, take it with caution, as it can react with other medicines. If you are on other medication, talk to your GP or pharmacist before taking St John’s Wort. You shouldn’t take St John's Wort if you’re already taking SSRI or MAOI antidepressants. Be aware that taking St Johns Wort is known to have adverse effects on certain medications such as blood-thinners, HIV meds and others. For this reason check with your GP before taking it.

St John’s Wort is widely available, but it can come in varying strengths and preparations depending on the brand, so read the label carefully. It can take up to four weeks to have any effect.

Learn more about St John's Wort

Goal-setting and developing a routine

These types of psychological ‘tricks’ can be effective at helping relieve the feeling of being out of control and getting nowhere.

“Depression can be likened to the feeling of wading through thick mud,” says psychotherapist David Waters, who is also on the faculty at The School of Life.

“Your days feel heavy, without purpose and as though you’re not making much progress. By setting yourself small goals – today I will do the washing up, for example – and developing a routine so that the day has structure, you feel more in control. This will help.”

Anti-depressants can be life-saving and if your GP has recommended you take them, we do not suggest you ignore that advice. Whenever considering new treatments or supplements to treat your depression it is essential to talk to your GP, especially if you are taking medication. Any changes could affect your medication’s effectiveness.

Want to talk to a GP today? With Saga Health Insurance, you have unlimited access to a qualified GP 24 hours a day, 365 days a year. Find out more about our GP phone service.