Complementary Medicine
By Dr James Hawkins

Which therapies to include?
Which therapies work?
Supplements
Other therapies

Which therapies to include?

There is not a lot of research into the effectiveness of complementary medicine for Depression. There is also some disagreement on what therapies to include and what to leave out.  Therapies to consider include herbs, dietary supplements,  meditation and relaxation, hypnotherapy, acupuncture, homoeopathy, Bach flower remedies, massage, aromatherapy, reflexology and kinesiology.  There are also many other potential candidates.  Occasionally light therapy, sleep manipulations, and exercise are seen as complementary therapies.

Which therapies work ?

Current research has had mixed results for St John’s wort, some dietary supplements (examples include SAMe, folic acid, omega-3 fatty acids, vitamin B6, and chromium) and a form of meditation called mindfulness-based cognitive therapy.  Acupuncture, hypnotherapy and relaxation therapy have some modest research base too.  Most other forms of complementary therapy are not currently supported by good research evidence as treatments for Depression.  Light therapy, sleep restriction, and exercise do have research showing they can be helpful for Depression but they are not included in this section of the website on complementary medicine.  

Supplements

In general, complementary therapies for Depression are best considered as methods that might be added to standard treatments like antidepressants and psychotherapy. Alternatives to antidepressants such as SAMe and St John’s wort are worth considering under special circumstances.  For more details click on the articles ‘st john’s wort, background research’ and  ‘complementary therapies for Depression, background research’ .  People affected by Depression would do well to consider taking a general multi-vitamin and multi-mineral supplement to complement the main forms of treatment they are using.  This supplement should, amongst other ingredients, contain vitamins B6 and B12, at least 400 micrograms of folic acid, and – in the UK – at least 200 micrograms of selenium.  This in no way means that one should not also be eating a healthy diet (see the article on food and mood).

Other Therapies

Mindfulness-based cognitive therapy (MBCT) looks as though it may be helpful in reducing depressive relapse, particularly for those who are currently well but have previously suffered at least three episodes of Depression.  Visit the UK website to find out more –  mbct.co.uk .  There is a bit of evidence suggesting that relaxation skills training may be helpful, as too may hypnotherapy especially when it is used to deliver a well-validated treatment like cognitive therapy. 

Acupuncture is also an option that can be considered, but the research back-up is very limited and currently seems best for women affected by Depression during pregnancy.  Other forms of complementary medicine have little evidence base to recommend them at present.  Clearly there will be people who will find some of their symptoms benefit from other forms of complementary therapy, but in general there is currently little reason to try other complementary treatments for Depression.  Click on ‘complementary therapies for Depression, background research’ for a more technical discussion of these issues.  

Dr James Hawkins, DAS Clinical Advisory Group Member, April 2006. www.goodmedicine.org.uk and www.stressedtozest.com