If you are suffering from depression, but would prefer to try something natural before going the traditional pharmaceutical route, here are some remedies that have stood up to rigorous testing.

1. Cognitive behavioral therapy (CBT)

Cognitive Behavioral Therapy seeks to help people change how they think about things. Unlike more traditional forms of therapy, it focuses on “here and now” problems and difficulties. Numerous clinical studies throughout the world have consistently demonstrated that cognitive behavioral therapy is as effective as antidepressant medication. Within 20 sessions of individual therapy, approximately 75 percent of patients experience a significant decrease in their symptoms.

2. St John’s wort

St John’s wort (Hypericum perforatum) is commonly used for the treatment of depression. It is available in tablets, capsules and liquid form from supermarkets and health food shops. Research suggests that it exerts its antidepressant action by inhibiting the reuptake of the neurotransmitters serotonin, norepinephrine, and dopamine. Numerous double-blind, placebo-controlled studies have examined the effectiveness of St. John’s wort for the treatment of mild to moderate major depression, and most have found the herb more effective than a placebo. It can be at least as effective as paroxetine (Paxil) in the treatment of moderate to severe depression in the short term.

3. S-Adenosylmethionine (SAMe)

SAMe is an amino acid derivative that occurs naturally in all cells. It plays a role in many biological reactions by transferring its methyl group to DNA, proteins, phospholipids and biogenic amines. Several scientific studies indicate that SAMe may be useful in the treatment of depression.

4. Light Therapy

For years, light therapy has been used to treat seasonal affective disorder, a type of depression caused by short winter days and extended darkness. A lack of exposure to sunlight is responsible for the secretion of the hormone melatonin, which can trigger a dispirited mood and a lethargic condition. Light therapy helps to regulate the body’s internal clock in the same way that sunlight does. Light therapy is an effective treatment for seasonal affective disorder, and it may reduce the symptoms of non-seasonal depression as well.

5. Exercise

Researchers have found that regular exercise, and the increase in physical fitness that results, alters serotonin levels in the brain and leads to improved mood and feelings of wellbeing. Study after study has shown that exercise promotes mental health and reduces symptoms of depression. The antidepressant effect of regular physical exercise is comparable to potent antidepressants like Sertraline.

6. 5-Hydroxytryptophan (5-HTP)

5-Hydroxytryptophan (5-HTP) and tryptophan are also natural alternatives to traditional antidepressants. When your body sets about manufacturing serotonin, it first makes 5-HTP. Taking 5-HTP as a supplement may raise serotonin levels. The evidence suggests 5-HTP and tryptophan are better than a placebo at alleviating depression.

7. Massage

One of the best-known benefits of massage therapy is its ability to enhance feelings of well-being. Massage produces chemical changes in the brain that result in a feeling of relaxation and calm. It also reduces levels of stress hormones. Massage therapy lowers levels of stress hormone cortisol by an average of 30 percent. Massage also increases serotonin and dopamine, neurotransmitters that help reduce depression.

8. Acupuncture

Acupuncture is a traditional Chinese treatment in which needles are inserted at specific points in the body. Research suggests that acupuncture can decrease or eliminate the symptoms of depression. A review of 8 controlled trials supported the theory that acupuncture can significantly reduce the severity of depression.

9. Yoga & Meditation

Yoga is an ancient system of relaxation, exercise, and healing with origins in Indian philosophy. Practicing yoga can alter your brain chemistry. Some yoga positions are effective in stimulating the release of endorphins and reducing the level of stress hormone cortisol. Several human studies support the use of yoga for depression, and yoga postures have been specifically shown to increase levels of the neurotransmitter GABA, which may alleviate depression.

10. B Vitamins

B vitamins play a role in the production of certain neurotransmitters, which are important in regulating mood and other brain functions. Folic acid deficiency has been noted among people with depression. Vitamin B6, or pyridoxine, is the cofactor for enzymes that convert L-tryptophan to serotonin, so vitamin B6 deficiency might result in depression. And there is some evidence that people with depression respond better to treatment if they have higher levels of vitamin B12.

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