The endorphins from exercise work wonders against depression. Of course, getting the patient to "take their medicine" is non-trivial, but even a short walk can be helpful.

>> The endorphins from exercise work wonders against depression.

When I was a in fairly deep depression, the only thing which kept me sane was playing hockey and pushing my cardio to the max every time I stepped on the ice.

The rush of adrenaline and release of endorphins and making my brain engage in something other than why my life is so miserable did wonders for me.

A few years later, I was seeing a psychologist and told her about how hockey in essence saved my life. She posited the same thing. The release of endorphins and adrenaline actually help combat the depression and helped me, at least for periods of time, overcome the feelings of despair and isolation.

> The endorphins from exercise work wonders against depression.

There is very little benefit from exercise for people who have depression.

Children and adolescents: http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD004691...

Adults: http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD004366...

Exercise is better than a placebo, if the trial is low quality. Once you get better quality trials the benefit is less significant.

There's some evidence that exercise might build resilience against depression in people currently not depressed.

Paper: The antidepressive effects of exercise: a meta-analysis of randomized trials.

Link: http://www.ncbi.nlm.nih.gov/pubmed/19453207

From the abstract:

> ...the current meta-analysis examines the effects of exercise on depressive symptoms in 58 randomized trials (n = 2982). An overall effect size of -0.80 indicates participants in the exercise treatment had significantly lower depression scores than those receiving the control treatment. This frac34; SD advantage represents level 1, Grade A evidence for the effects of exercise upon depression.

These are all rather small trials which would require a fairly large effect to be noticeable. 1191 total from 16 studies of children and 2336 from 39 studies for adults.

Note: A single stuidy of 200 people is generally better than 10 studies of 50 people because you can't combine raw data from different studies. And treatments for mental issues are generally only useful for sub populations.

You absolutely can combine results from different studies, look up meta-analysis.

http://xkcd.com/1447/ However, don't overdo it!

1. Traveling 2. Sunlight 3. Walking 4. Meeting new people (travel, couchsurfing meetings, classes)

Taking an herbal drug can be very helpful psychologically even if it is not proven medically effective (the placebo effect). Just do some research because natural drugs can have harmful side effects too.

Saint John's Wort in conjunction with therapy is one that comes to mind. All antidepressants should be combined with active, regular therapy. Often the cause of depression is not chemical imbalance, but an actual issue in the person's life.

St John's wort can have serious drug interaction consequences, so talk to a pharmacist if you're already taking any other meds.

St John's wort is not sold as a medicine so the products you can buy are subject to much lower levels of quality control. St Johns Wort varies in quality across different brands.

Here's a big problem - in the US St Johns Wort isn't regulated like a drug, it is regulated as a supplement. Which in practice means when you buy a bottle of St Johns Wort it can contain almost anything and may or may not contain any actual St Johns Wort.

Plus St Johns Wort interacts with practically everything.

Sources: http://www.nytimes.com/2010/05/26/health/policy/26herbal.htm...

>16 of the 40 supplements tested contained pesticide residues that appeared to exceed legal limits, the investigators found. In some cases, the government has not set allowable levels of these pesticides because of a paucity of scientific research.

http://www.nytimes.com/2013/11/05/science/herbal-supplements...

>DNA tests show that many pills labeled as healing herbs are little more than powdered rice and weeds.

>Two bottles labeled as St. John’s wort, which studies have shown may treat mild depression, contained none of the medicinal herb. Instead, the pills in one bottle were made of nothing but rice, and another bottle contained only Alexandrian senna, an Egyptian yellow shrub that is a powerful laxative.

http://well.blogs.nytimes.com/2014/10/21/dangerous-dietary-s...

>out of more than two dozen supplements that were pulled from shelves after they were found to contain anabolic steroids or powerful prescription drugs, roughly two-thirds were back on the market a year later with the same illicit ingredients

> Often the cause of depression is not chemical imbalance, but an actual issue in the person's life.

Not trying to be contrary, but do you have a source?

I met a Swedish nurse who worked in a ward where they treated young people who'd had mental breakdowns. She said the most common cause was a tough life situation. In the short term they would prescribe drugs, but ultimately their treatment was focused on changing that persons life to remove the negativity which spurned the breakdown. Whether it be encouraging them to get a new job or move out of their current living/ relationship situation.

OTOH, plenty of people go through tough life situations without suffering mental breakdowns.

I think it's more complicated than a simple either-or proposition.

I would be more happy to accept the idea that depression was usually a result of a chemical imbalance in your brain if this was able to be reliably diagnosed by measuring the balance of chemicals in your brain, rather than the current method of divining the supposed chemical imbalance by filling in a short questionnaire.

Warning: Saint John's Wort can cause cataracts if used for a long time.

That is highly disputed - there is only one study suggesting a correlation (not causation).

The causation is simple - hypericin becomes toxic when activated by light. While that doesn't mean that it definitely causes cataracts, given available data I think it's more likely that it does.

http://www.ncbi.nlm.nih.gov/pubmed/16814590 http://www.ncbi.nlm.nih.gov/pubmed/19739671

S-ame (s-adenosylmethionine) is probably the most effective natural anti-depressant. I know it's widely used in Germany. There's extensive research on PubMed regarding it's effectiveness--if it weren't naturally occurring and therefore not subject to patent, it would likely be a blockbuster drug given that it outperforms most prescription drugs.

From my own personal experience, it reduces my anxiety within hours of taking it. And relieves depression in about a week. In the US, you can buy it off the shelf at any CVS/Walgreens. But it's certainly not cheap.

How is that "natural" ? Is it harvested from natural producers of the substance?

http://en.wikipedia.org/wiki/S-Adenosyl_methionine#Therapeut...

It's natural in the sense that the healthy human body produces s-ame on it own, and if your body ever stopped producing s-ame, you'd probably die since (quoting Wikipedia) "more than 40 metabolic reactions involve the transfer of a methyl group from SAM to various substrates, such as nucleic acids, proteins, lipids and secondary metabolites."

Oh wow, that's a fascinating drug. A shame it seems it's not allowed here in Australia?

I hear B and D vitamins help. I also hear that doctors aren't really sure if vitamin supplements even work, so eat leafy greens and beans and get some sun.

Vitamin D supplements are very well attested to work, but it's true that some other kind of supplements either don't matter or aren't really bioavailable to humans. Those chewy multivitamins and plant-based omega-3 sources don't seem to really help anything, for instance.

By the way, omega-3 from fish oil has strong evidence of an effect on major depression[1], but not the everyday kind. And that doesn't mean take it just in case, it could be bad for you!

[1] http://examine.com/supplements/Fish+Oil/

The most common is Hypericum Perforatum (St. John's Wort). It's an (considerably strong) SSRI inhibitor and potent CYP450 inducer. Better not take it if you're regularly taking any other kind of drug. If you do ask your pharmacist/doctor, if you're already into any kind of anti-depressants also it's better to avoid it, excessive SSRI activity could lead to serotonin-syndrome.

I find meditation and strong exercise help quite a bit. I also took classes with a Tibetan Buddhist monk. He had pretty good insights into how the mind works. Not sure if that can be generalized though.

Check out the book Perfect Health Diet, a nutrition book written by an ex-Astrophysicist (Harvard, MIT, ... ) . Plural of anecdote etc., but I am a very satisfied customer.

Why do you want natural drugs only?

If you want natural, I would try tobacco (it can be snuff, no need to smoke, although smoking works faster). For synthesized, try moclobemide.

How would you describe your symptoms?