There's growing evidence that caviar, exercise, SAM-e, even meditation can help ease mood disorders. Sounds like more fun than antidepressants -- but psychiatrists don't take it lightly.
In fact, some are concerned. People who rely on alternatives too much -- who don't get treatment that is proven to be effective -- can slip into a more serious clinical depression or anxiety disorder before they realize it.
Post-traumatic stress disorder, or PTSD, can occur in anyone who experiences or witnesses a life-threatening event that causes feelings of intense fear and/or helplessness. These events include but are not limited to military combat, acts of terrorism, natural disasters, automobile accidents, and personal attacks such as rape. Because personal attacks, such as rape and sexual abuse, happen to females more often, women are twice as likely as men to develop PTSD in their lifetime.
"There's highly suggestive evidence that some alternatives, especially SAM-e and omega-3 fatty acids, can help, but it's not conclusive," says Andrew F. Leuchter, MD, vice-chair of psychiatry at the UCLA Neuropsychiatric Institute.
"When someone needs treatment, we have to look at what really works," he tells WebMD. "The real danger is that somebody with serious illness could forgo getting an effective treatment for months, even years."
Why are people turning to alternatives? For some, it's the side effects from antidepressants. Others simply don't want to take antidepressants -- they prefer a more "natural" approach. Still others don't think their antidepressants have worked well enough in treating their clinical depression or anxiety disorders.
Ronald Glick, MD, medical director of the Center for Complementary Medicine at the University of Pittsburgh Medical Center-Shadyside, has seen plenty of patients searching for alternatives for their mood disorders.
"Medications and psychotherapy are still the mainstays when it comes to treating depression and anxiety," says Glick, who is also professor of psychiatry at the University of Pittsburgh School of Medicine. "But alternative therapies can help. It depends on what you expect from them."
The Top Contenders
St. John's Wort
This may be the most-studied herb -- with more than 30 studies so far -- and some show it to be effective for treatment of mild forms of depression, says Glick. In fact, the University of Pittsburgh is participating in a study of the herb. "It looks quite promising," he says.
Despite the promise, the story of St. John's wort illustrates some important points, says Leuchter.
"There is data suggesting an effect -- a number of studies in Europe showed that it worked for major clinical depression," he tells WebMD. "But when double-blind, placebo-controlled 'gold-standard' studies were done, we found that it was not effective for major depression. That shows the peril of looking at small studies that are not well controlled to establish that something works."
Also, the FDA has issued a warning on St. John's wort, saying it dangerously interferes with a long list of prescription drugs. Too many people don't recognize that herbs affect the body physiologically just like prescription drugs do, Leuchter says.
Herbals can cause side effects, such as dizziness, headaches, stomach upset, or can dangerously affect how the body metabolizes other drugs, he says.
It's short for S-adenosylmethionine, a molecule that naturally occurs in the cells of plants and animals -- and it's not an herb. As we age, our bodies produce less SAM-e, so replacing it with a supplement can theoretically treat clinical depression.