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Among the most heavily prescribed medications are those for mental health issues ranging from general anxiety and depression to full blown psychosis. Indeed, it is very easy for prescribing doctors as myself, to reach into our white coat, pull our prescription pad, and write a prescription—much easier than actually exploring what might be going on in a person’s life now or in the past. It is also much easier to obtain information from drug reps who come right to our door and regurgitate studies from medical journals, than it is to learn about possible alternatives. Indeed, sometimes prescription medication is needed. However, in many cases one can get much help with a supportive doctor’s ear and over-the-counter supplements, which, contrary to what your doctor will likely tell you or know, are backed by many clinical studies.
Here are a 12 of my go-to supplements for various mental health issues. I am not your doctor, so you should clear anything you take with your personal physician.
1. L-methylfolate up to 15mg/day for depression.
Literature suggests that depression is linked with folate deficiency and that patients with insufficient folate are less likely to respond to treatment and more likely to experience a relapse. Folate supplementation does help some patients. Folic acid in and of itself does not alleviate depression. Our brain must convert folic acid into L-methylfolate before it can manufacture enough serotonin, norepinephrine, and dopamine to alleviate depression. However, certain individuals lack the ability to convert folic acid to l-methylfolate, rendering folic acid supplements ineffective for this group of patients.
2. S-adenosyl-L-methionine (SAMe) for depression.
SAMe is a substance made naturally in the body. May boost production of chemical messengers in the brain involved in regulation of mood. Adults may benefit from 400 to 1,600 mg per day, although some people will need to take 3,000 mg per day to alleviate symptoms. Taking SAMe seems to reduce symptoms of depression. Several studies have shown that SAMe can be beneficial and might be as effective as some prescription medications used for depression (tricyclic antidepressants). Some research also shows that taking SAMe might be helpful for people who do not have a good response to a prescription antidepressant. However, as with all supplements, SAMe should not be taken in combination with a prescription antidepressant without the monitoring of a health professional.
3. Omega-3 fatty acids - DHA and/or EPA (DHA may be more effective) for depression, memory and ADHD. DHA 500mg – 1000mg/day
Taking fish oil with conventional treatments for bipolar disorder seems to improve symptoms of depression and increase the length of time between episodes of depression. However, fish oil does not seem to improve manic symptoms in people with bipolar disorder. Taking a fish oil supplement might help prevent full psychotic illness from developing in people with mild symptoms. This has only been tested in teenagers and adults up to age 25. Attention deficit-hyperactivity disorder (ADHD) in children. Early research shows that taking fish oil improves attention, mental function, and behavior in children 8-13 years-old with ADHD.
4. St. John’s wort (Extract of the plant hypericum perforatum) 900mg – 1800mg/day in divided doses for depression.
For mild to moderate depression. Taking St. John’s wort extracts improves mood, and decreases anxiety and insomnia related to depression. It seems to be about as effective in treating depression as many prescription drugs. In fact, clinical guidelines from the American College of Physicians-American Society of Internal Medicine suggest that St. John’s wort can be considered an option along with antidepressant medications for short-term treatment of mild depression. However, since St. John’s wort does not appear to be more effective or significantly better tolerated than antidepressant medications, and since St. John’s wort causes many drug interactions, the guidelines suggest it might not be an appropriate choice for many people, particularly those who take other medications. St. John’s wort might not be as effective for more severe cases of depression.
5. 5-HTP (Precursor to serotonin) for depression. 100mg – 300mg three times a day
Research shows that taking 5-HTP by mouth might improve symptoms of depression. Several trials have found that doses of 50-3000 mg daily for 2-4 weeks can improve symptoms of depression. Some early research also shows that 5-HTP might be as beneficial as conventional antidepressant therapy.
6. Valerian root (An herb derived from the pink flower, valeriana officinalis) for insomnia, anxiety, or depression. 400mg – 650mg/day
Some research suggests that valerian does not relieve insomnia as fast as “sleeping pills.” Continuous use for several days, even up to four weeks, may be needed before an effect is noticeable. Valerian seems to improve the sleep quality of people who are withdrawing from the use of sleeping pills.
For Anxiety. There is contradictory evidence about the effectiveness of valerian for anxiety. Some people have reported that it seems to reduce stress in social situations. Yet, other studies have shown no effect.
For Depression. Some early research suggests that taking valerian plus St. John’s wort improves symptoms of depression. Taking higher doses of valerian with St. John’s wort improves depression symptoms faster than low doses.
7. L-theanine (Component of green tea) for stress, anxiety & sleep problems. 200mg/day
L-theanine may help relieve stress by inducing a relaxing effect without drowsiness and may also possess immunologic attributes. Theanine may also have effects on the cardiovascular system and play a preventative role in cancer; however, limited clinical information is available to support these claims. The fact that it can have a calming effect can help with people who have sleep problems due to anxiety.
8. Lemon balm (Melissa officinalis) for stress, anxiety & sleep problems. 600mg/day
For Anxiety. Some research shows that taking lemon balm reduces symptoms in people with anxiety disorders. A product containing lemon balm plus 12 other ingredients has also been shown to reduce symptoms of anxiety such as nervousness or edginess.
For Insomnia. Taking a lemon balm by itself or along with other ingredients might improve the length and quality of sleep in healthy people and in those with insomnia or sleeping disorders.
For Stress. Some research suggests that taking one 600 mg dose of lemon balm increases calmness and awareness in adults during a stress test. Other research suggests that larger lemon balm doses reduce anxious behavior in children, but not lower doses. Another study suggests that taking a combination product containing valerian and lemon balm might lower anxiety when taken at a lower dose, but might increase anxiety when taken at a higher dose. Other research found that taking a lemon balm product for 4 weeks lowered agitation and edginess in people with anxiety caused by stress.
9. Passionflower (Passiflora incarnate), for anxiety. 90mg/day or 10 – 45 drops of elixer
For Anxiety. There is some evidence that passionflower can reduce symptoms of anxiety, sometimes as effectively as some prescription medications.
Relieving symptoms related to narcotic drug withdrawal, when used in combination with a medication called clonidine. This combination seems to be effective in reducing symptoms such as anxiety, irritability, sleep problems (insomnia), and agitation.
Relieving symptoms of a psychiatric disorder known as “adjustment disorder with anxious mood” when used in a multi-ingredient product (Euphytose, EUP). Other herbs in the product are crataegus, ballota, and valerian, which have mild sedative effects, and cola and paullinia, which have stimulant effects. It’s not clear, though, which ingredient or ingredients in the mix are responsible for decreasing anxiety.
10. Lavender (Essential oil) for anxiety and sleep problems. Inhale 2 to 4 drops in 2 to 3 cups of boiling water.
For Anxiety. Some research shows that taking lavender oil by mouth for 6-10 weeks improves anxiety and sleep and prevents anxiety recurrence in people with mild-to-severe anxiety.
11. GABA (gamma-Aminobutyric acid) May inhibit production of chemical messengers in the brain involved in regulation of mood. For anxiety, sleep problems, (and lowering blood pressure). 100mg – 250mg three times a day
GABA’s role as an inhibitory neurotransmitter is paramount. A study of over 1200 students in China looked at the association of problem behavior with neurotransmitter deficiency in adolescents. Upon completion of two analytical questionnaires it was concluded that deficiencies in neurotransmitters such as GABA may cause behavior and mental issues, including those of anxiety and depression
Another benefit of GABA’s ability to promote relaxation is that it may be helpful in inducing sleep.
Supplementing with GABA has been shown to help reduce blood pressure in adults with mild hypertension. An eight-week trial was conducted on 50 men and women with systolic blood pressure between 130 and 180mmHg. The results of this study showed a significant reduction in blood pressure with daily supplementation of 80 mg of GABA, as compared to the placebo group (Matsubara F, et al., Japanese. (Pharmacology & Therapeutics, 2002).
12. Melatonin (hormone that regulates natural sleep/wake cycles) for sleep problems .25mg – 10mg/night
Taking melatonin by mouth helps improve sleep disorders in blind children and adults.
Taking melatonin by mouth appears to reduce the length of time needed to fall asleep in young adults and children who have trouble falling asleep. However, within one year of stopping treatment, this sleeping problem seems to return.
Melatonin also appears to shorten the time it takes for to children with developmental disabilities to fall asleep. In addition, melatonin appears to improve sleep quality in people with reduced rapid-eye movement (REM) sleep. Also, melatonin appears to reduce the time it takes to fall asleep and the number of sleep interruptions in elderly people with sleep-wake cycle disturbances and dementia.
It is also possibly effective for withdrawal from drugs called benzodiazepines (Valium, Xanax, etc…) Taking the controlled-release form of melatonin by mouth seems to help older people with insomnia related to withdrawal from these drugs.
For primary insomnia (insomnia that is not attributable to a medical or environmental cause), melatonin seems to be able to shorten the amount of time it takes to fall asleep. Some people say melatonin makes them sleep better. There is some evidence that melatonin is more likely to help older people than younger people or children. This may be because older people have less melatonin in their bodies to start with.
Most research shows that melatonin can improve certain symptoms of jet lag such as alertness and movement coordination. Melatonin also seems to slightly improve other jet lag symptoms such as daytime sleepiness and tiredness.
Melatonin used under the tongue seems to be effective in reducing anxiety before surgery.