From the Guidelines
Exercise, particularly aerobic activity like walking, running, or swimming for 30 minutes 3-5 times weekly, is the most effective complementary treatment for depression. This is based on the evidence from studies such as 1, which compared the benefits and harms of antidepressant, psychological, complementary, and exercise treatments for major depression. Other effective complementary treatments include St. John's Wort (300-600mg three times daily, standardized to 0.3% hypericin), mindfulness meditation practiced for 20-30 minutes daily, and omega-3 fatty acids (1-2 grams daily, with higher EPA than DHA content) 1. Cognitive Behavioral Therapy (CBT) is also highly effective when combined with other treatments 1. These approaches work by addressing various aspects of depression, such as increasing endorphins and neurotransmitters like serotonin, affecting neurotransmitter activity, changing thought patterns, and reducing inflammation linked to depression. For severe depression, these should complement rather than replace conventional treatment.
Some key points to consider when using these complementary treatments include:
- St. John's Wort can interact with many medications, including birth control pills, blood thinners, and other antidepressants 1.
- Mindfulness meditation can help reduce depressive symptoms by increasing awareness of thought patterns and reducing rumination 1.
- Omega-3 fatty acids may improve mood by reducing inflammation and supporting brain function 1.
- CBT is highly effective when combined with other treatments, and can help address various aspects of depression 1.
Overall, the evidence suggests that a combination of these complementary treatments, along with conventional treatment, can be an effective way to manage depression and improve quality of life.
From the Research
Most Effective Integrative or Complementary Treatment for Depression
The most effective integrative or complementary treatment for depression is Mindfulness-Based Cognitive Therapy (MBCT).
- MBCT has been shown to be efficacious in preventing relapse in patients with recurrent depression, with a reduced risk of depressive relapse within a 60-week follow-up period compared to those who did not receive MBCT 2.
- Studies have also found that MBCT is as effective as maintenance antidepressant pharmacotherapy in preventing relapse, with a relative reduction of risk on the order of 30-40% 3.
- MBCT has been found to be superior to non-specific controls in reducing current depressive symptoms, although it did not differ from other active therapies 4.
- The mechanisms of action of MBCT include mindfulness, repetitive negative thinking, self-compassion and affect, and cognitive reactivity, which have emerged as important mechanisms of change 5.
- MBCT has been recommended as a treatment to prevent recurrence of depressive disorders, and mindfulness may also contribute to improving the patient's symptoms as well as improving the therapeutic relationship with the therapist 6.
Key Findings
- MBCT is an effective treatment for preventing relapse in patients with recurrent depression.
- MBCT is as effective as maintenance antidepressant pharmacotherapy in preventing relapse.
- MBCT is superior to non-specific controls in reducing current depressive symptoms.
- The mechanisms of action of MBCT include mindfulness, repetitive negative thinking, self-compassion and affect, and cognitive reactivity.
- MBCT has been recommended as a treatment to prevent recurrence of depressive disorders.
Treatment Implications
- MBCT can be used as a prophylactic intervention or for residual depressive symptoms.
- MBCT can be extended to novel populations, such as acutely depressed patients or those diagnosed with health anxiety.
- Online MBCT platforms can increase accessibility and availability of the treatment.
- Further research is needed to address dose-effect relationships between mindfulness practice and clinical benefits, as well as establishing the rates of uptake for online MBCT.