Are There Useful Self-Help Treatments for Depression? A Review of the Evidence
Depression is a mental illness that is common and can affect anyone. Depressed people experience a low mood or disinterest in life, as well as trouble sleeping and concentrating, overwhelming fatigue, and feeling suicidal and worthless. Recommended treatments for depression include antidepressants and psychotherapy. The most common type of antidepressants are selective serotonin reuptake inhibitors, which work well for moderate to severe depression. Different types of psychotherapy include cognitive behavior therapy, problem solving therapy, and interpersonal therapy. However, many people self-treat their depression with techniques that often do not involve a professional. Self-help treatments are often preferred as an initial option when symptoms are still mild.
There are many self-help treatments that have been suggested as helpful for depression. These include different herbal remedies, dietary supplements, changes to diet and lifestyle, psychological techniques, and physical or sensory techniques. Yet are they likely to work for you, or are they a waste of effort, time and money? Scientific research can provide guidance about what treatments are likely to be helpful, and which should be left on the shelf. It's possible that treatments that have personal testimonials may work for you even if they have not been researched thoroughly. However, you can be much more confident that treatments will work for you if they have shown effectiveness for a group of people in a scientific study. Scientific studies can show that treatments are effective regardless of whether people normally improve with time, or expect to improve. This article will give an overview of what self-help treatments are effective for depression as shown by scientific research. Only evidence from high quality studies (randomized controlled trials) will be examined.
Bibliotherapy is another name for self-help books. The helpful ones use cognitive behavior therapy to change thinking and behavior patterns. Several studies suggest it is helpful for depression. However, it may require a lot of motivation to persistent with the treatment to see benefits.
Computerized cognitive behavior therapy
This is similar to bibliotherapy but uses the internet or a computer program instead of a book. Several studies suggest it is helpful for depression. However, it may require a lot of motivation to persistent with the treatment to see benefits.
Thinking about or visualizing pleasant or neutral thoughts (eg the shape of the African continent) may help improve depressed mood temporarily. Studies show that it is better than sitting quietly. It may help if you often think about why you are depressed and the negative outcomes from depression.
There is good evidence that exercise is helpful for depression. It is not clear whether aerobic exercise (eg running) is better than anaerobic exercise (eg weights). The amount needed to be beneficial is also unclear.
Light therapy uses a device to expose the eyes to very bright light for a period of time each day. The evidence is strong for winter depression (or seasonal affective disorder). It may also have a small benefit for non-winter depression.
Systematically doing more of the activities you usually enjoy is likely to be helpful. Studies with supervision by professionals show it helpful for depression. However, it may be less helpful when done on your own.
Progressive muscle relaxation is learning to relax by tensing and relaxing specific muscle group. It can be self-taught from books or audio instructions. Several studies show it is helpful for depression, though less helpful than psychotherapy.
S-Adenosylmethionine is a compound that is made in the body and is available as a supplement. It is involved in many biochemical reactions. It also helps make serotonin, a brain chemical targeted by antidepressants. Studies generally show it is helpful for depression. However, the dosage required is unclear.
Sleep deprivation is staying awake for the whole night or restricting sleep to part of the night. Studies show that many people find it temporarily improvements depression. However, the effect disappears once sleep is resumed.
St John's wort
St John's wort is a traditional herbal remedy for depression. It is available as a supplement. Studies consistently show that it is better than a placebo for mild depression. Be aware that herbal supplements are not usually well regulated, and that brands may differ in their effectiveness. It also concerns with some medications, so check with your doctor before using.
These treatments show promising evidence, but more studies are needed to be sure.
Autogenic training is the regular practice of simple mental exercises in body awareness for relaxation. One study shown encouraging results.
Borage is a herb traditionally used in Iranian medicine. Its flowers can be used in herbal teas. One study found it was better than placebo for depression, but more studies are needed to be sure.
Carnitine is a nutrient produced by the body and is available as a supplement. Carnitine has been tested in 3 studies for a mild form of depression called dysthymia. Promising results were shown for older adults.
Massage by trained therapists has promising evidence for depression.
Negative Air ionization
A negative air ionizer is a device that uses high voltage to electrically charge air particles. One study showed it helpful for winter depression (seasonal affective disorder).
Saffron is a spice made from the Crocus sativus flower. It is used in Persian traditional medicine. Several studies show that saffron is a promising treatment for depression.
Yoga exercises the mind and body through physical postures, breathing techniques and meditation. Initial evidence suggests it may be helpful for depression.
There are many other self-help treatments, but these were not reviewed because they have not been studied in good quality studies.
Content adapted from Morgan AJ, Jorm AF: Self-help interventions for depressive disorders and depressive symptoms: A systematic review. Annals of General Psychiatry 2008, 7:13.