The history of ECT begins in the 1500s with the idea of treating mental illness with convulsions. Initially, convulsions were induced by orally taking camphor. The history of modern electroconvulsive therapy (ECT) dates back to 1938 when Italian psychiatrist Lucio Bini and neurologist Ugo Cerletti used electricity to induce a series of seizures to successfully treat a catatonic patient. In 1939, this ECT procedure was introduced to the United States.¹

Early History of ECT

While it was known seizures could treat psychiatric illness, there was no ECT procedure available that would prevent severe ECT side effects like:

• Bone fracture and breakage
• Joint dislocation
• Cognitive impairment

In spite of these risks, ECT was still used; however, as the only known alternatives were lobotomy and insulin shock treatment.

The ECT Procedure is Scientifically Researched

In the 1950s, the history of ECT continues with psychiatrist Max Fink. Dr. Fink was the first to scientifically study the efficacy and procedure of ECT. The 1950s also saw the introduction of succinylcholine, a muscle relaxant that was used in combination with a short-acting anesthetic during the ECT procedure to prevent injury and to prevent the patient from feeling the ECT procedure.

In the 1960s, randomized clinical trials showed the superior efficacy of ECT when compared to medication for the treatment of depression. The concern of ECT's uneven use and possible abuse grew in the 1960s and 1970s.

Modern History of ECT

In 1978, the American Psychiatric Association published the first Task Force Report on ECT designed to outline standard ECT procedures consistent with scientific evidence, and reduce abuse and misuse of the treatment (in earlier years, ECT was used by some to abuse and control mentally ill patients). This report was followed by versions in 1990 and 2001.

While ECT is considered to be the most controversial practice in psychiatry, the National Institute of Mental Health and the American Psychiatric Association endorse its use in specific therapeutic situations. Both organizations stress the critical role of informed consent in the ECT procedure.

ECT is considered to be the "gold standard" of depression treatment as it produces remission rates of 60% - 70% - far higher than any other known depression treatment. However, the relapse rate is also high, requiring the use of ongoing treatment like antidepressant medication. In a survey, the American Psychiatric Association found most patients would voluntarily get ECT again if they needed it.²

A greater understanding of the science behind ECT - waveform, seizure quality, and electrode placement - is now available and enables more effective ECT. These new ECT procedures and techniques have lessened the risk of ECT side effects, including cognitive dysfunction, although this risk cannot be eliminated completely. Today's ECT procedure has the same mortality rate of minor surgery, approximately 1 in 10,000 patients, or 1 in 80,000 treatments which may be lower than that of tricyclic antidepressants.

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This is Julaine's personal ECT experience. Julaine is a mother and suffered from severe depression and anxiety disorder.

I tell this story of my ECT experience, not out of a desire to call attention to myself, but because I want mental health consumers, family members, friends, and their professionals to know there IS hope and recovery for those who experience the painful and often terrifying experience of having a mental illness.

Julaine's ECT Experience Begins with Anxiety

It started out with a simple panic attack one night. As a young mother, I had struggled for three long years, combining full-time work and caring for my family. I awoke suddenly in the middle of the night, breathless, heart pounding - feeling like I was suffocating. Pacing the floor until the attack subsided, I returned to bed mystified. The panic attack returned the next day and the next, increasing in frequency and severity.

Severe nausea then invaded my body, landing me in a hospital emergency room. Physicians there admitted me twice during the following week, treating me with intravenous feedings and medication for anxiety. Searching for intestinal problems but finding none, doctors released me and I returned home with my husband. Retreating to my bed, I began to feel worse and worse.

Severe Panic Attacks and Depression Lead to Julaine's ECT Experience

My third admittance to a hospital proved fruitless again. I returned to bed, sluggish from medications that seemed only to induce sleep. My weight plummeted to a dangerous level, along with my spirits. I could no longer function –neither did I have a desire to. An ominous weight pushed down on me. Powerless to escape its clutches, I began to think about dying.

One night, I awoke feeling as if someone were injecting me with toxic adrenaline. Sobbing and frantically pacing the floor, I began to think I had lost my mind. My frightened husband once again rushed me to a hospital, this time to a university medical center. There, a diagnosis was finally made. I had severe depression and anxiety disorder.

Admitted to a psychiatric in-patient center, I was heavily sedated. Weeks inched by as I endured various antidepressant medication trials and experienced ECT treatments. Many times, I felt I could not go on. The battle seemed interminable. Finally, following various treatment methods and two hospitalizations in six months, I was able to resume a normal life again.

The Results of Juliane's ECT Experience

For the next few years, I was successful in battling various minor episodes of recurrent depression. It was during this time, I discovered a wonderful support group for depressives and manic depressives (DBSA/San Antonio, Texas), where my family resided. Not only did I find friends and support, but received life-giving education and coping skills concerning clinical depression.

Upon relocating to Florida soon afterward, my participation in the San Antonio DBSA Chapter aided me in establishing DBSA Mid-Orlando in 1992. When I experienced a major depressive setback soon after, a DBSA support group friend and member stayed with me day-after-day, taking care of my physical and mental needs while my husband went to work.

For months, I fought a downhill battle of medication trials and treatments, only becoming increasingly ill. My family grew exhausted from the tremendous strain I was putting on them. Time-after-time, I came close to losing my struggle with depression. Only the perseverance of my doctor, loved ones, friends, and countless prayers in my behalf, kept me fighting to overcome this illness that seemed to want to devour me.

After three years of constant battling, I finally responded to a successful medication combination. It was as if I had risen from the dead! Because of the excellent training and support provided by DBSA on a local, state and national level, I was able to resume active DBSA leadership and help train others to in the same pursuit.

Since Juliane's Recovery

I have been privileged not only to work as an Orange County, Florida guardian advocate for psychiatric inpatients but to be a team member of the first official Guardian Advocacy pilot program in the state of Florida. My great desire to help educate and support others dealing with mental illness has expanded even further.

I have also aided in National Depression Day Screenings and participated in the following as an organizer and speaker: Orlando and Daytona, Florida's Mental Illness Awareness Week and Mental Health Association of Central Florida's Statewide Conference for Mental Health Consumers and their families. I was also privileged to be a Board Member and active volunteer for NAMI of Greater Orlando during the last 3 years I lived in Orlando, Florida.

The highlight of my victory, however, occurred just recently when I entered graduate school to become a licensed mental health counselor. Today, as a Master's student at Denver Seminary, I see clients in my counseling practicum program. I look forward to the day I can further serve others as a consumer-oriented professional in the community, churches and mental health support organizations.

Winning the 1998 Beth Johnson Scholarship from the Mental Health Association of Central Florida helped confirm my belief that mental health consumers can join the ranks of professionals, positively impacting not only clients and family members, but coworkers, as well.

The recovery and victories I have attained are largely due to the support, education and skills I received from being a DBSA member and leader.

Today, I can reach out to others in a more effective way. Truly, I have "walked the walk!"

Julaine

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This is Sasha's personal ECT story. Sasha is a married school teacher, suffering from severe depression. (You can learn more about elecontroconvulsive therapy by watching these ECT videos.)

My ECT story starts like this. I'm a 30-year-old female and I am a recent survivor of depression and ECT. I still truly can't believe this nightmare happened to me.

Everything was going great in my life. I had finally met the man of my dreams and we got married. We just bought a new house and I began a new job. I was so happy. I finally had everything I dreamed about.

Sasha's ECT Story Begins with Depression

All of a sudden, I began feeling very stressed out at work and slowly I became depressed. A doctor prescribed Paxil and I decided to try it. Everything just got worse from here. I feel like the Paxil just made it worse because I suddenly became so anxious I had to take some time off from work. When I returned after a 4-week absence, I was so depressed and anxious I could not function.

My supervisors noticed this. I was a teacher, and they constantly watched me. I was truly hanging on by a thread. I could not concentrate or focus on what I was doing. I started having suicidal thoughts and I just could not function anymore. My supervisors asked me to leave. I loved teaching so much but I just could not function anymore.

I went on disability, ashamed and more depressed. I went to many therapists and tried many antidepressant medications, with no help. I was sure that my new husband was going to leave me. Who would want to deal with this in their first months of marriage? We didn't even have time to enjoy being married. I was a zombie most of the time. I was truly not there.

Sasha's ECT Story Continues in the Hospital

Finally, I checked into a hospital for a week. I constantly thought about dying. I couldn't get it out of my head. My life was over. After a week at the hospital, I checked out but had no improvement. I was put on many different medications, but I just got worse and worse.

One morning, I put a knife to my chest and ran to tell my husband what I did. He took me to another hospital and this time I stayed for almost 2-months. I was put on suicide watch at first and then I was closely watched as I attended group therapy. Nothing was helping.

Finally, after about 10 more different medications, the doctors suggested ECT (electroconvulsive therapy). At this point, it was all that was left. I could not even get through 5 minutes of the day without thinking about dying. We did the ECT and I can truly say that it saved my life.

Sasha's ECT Story – ECT Results

After the first ECT treatment, I already felt a difference. My ECT story was only six treatments long (March-April 2000) and I am back to the same person I used to be. I went back to work and I am functioning and performing great. I feel so good and blessed. I feel like I owe my life to ECT. It's been about four months since the treatments and I just pray that it doesn't come back. My story of ECT is really a miracle for me. ECT truly saved my life.

Ed. note: Not all patients have positive ECT experiences. Here's information on ECT problems. Other personal ECT stories are here.

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Personal ECT stories are hard to come by. Electroconvulsive therapy (ECT), once known as shock therapy, has a checkered past. Because people associate ECT with abuse and inhumane treatment of patients, many people are unwilling to talk about their personal ECT stories. However, most people who have had the treatment have stories of ECT that are positive and lead to their recovery and going on to regain their lives.

Personal ECT stories are critical to share because they talk about ECT, not from the perspective of a doctor but from that of a patient. Patients can express and address the same fears and concerns as the reader. In a first-hand ECT story, the patient can outline how it feels to get ECT, and not just the clinical procedure. These ECT stories – good or bad – give real faces and meaning to a treatment that most have only seen inaccurately portrayed in movies.

Real ECT stories work to reduce the stigma associated with the treatment. They provide hope to others that may be considering this treatment. Read these ECT stories.

• Personal ECT Story: ECT Saved My Life
• My ECT Experience
• Electroshock Therapy: Harmed By Electric Shock Treatment

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The effects of ECT (electroconvulsive therapy) are not fully understood, nor is the way in which ECT is able to treat mental illness. It is known the effects of ECT are seen in multiple parts of the central nervous system such as the:

• Hormones
• Neuropeptides
• Neurotrophic factors
• Neurotransmitters

The effects in ECT have been seen in nearly every neurotransmitter system in the brain and this is also what antidepressants target, leading to the belief that part of the therapeutic effect of ECT is through changes to neurotransmitters.

ECT also has been shown to increase a protein known as a brain-derived neurotrophic factor (BDNF),¹ an effect also seen in antidepressants. This protein increase is thought to cause the formation of both synapses and neurons in the brain. This effect of ECT is more robust than in antidepressant treatment and is thought to be responsible for the increase in volume in parts of the brain.²

ECT Side Effects

The primary ECT side effects are cognitive in nature, including possible memory loss. ECT side effects include:³

• Brief disorientation and confusion immediately after treatment
• Headache
• Nausea
• Muscle pain and stiffness
• Memory loss, particularly of the recent events before the ECT treatment
• Possible impact on information processing speed, particularly in the elderly

There is great debate over severity and duration of cognitive side effects, with some claiming permanent cognitive changes. (read ECT stories and Electroshock Therapy: Harmed By Electric Shock Treatment)

Some ECT memory loss diminishes with time while some may be permanent. It is thought impersonal memory (memory of outside events) is more subject to ECT memory loss than autobiographical memory (memory about the self).⁴ ECT memory loss and other cognitive ECT side effects are often related to the type of ECT treatment and the number of treatments received.

ECT side effects are generally considered reasonable risks given the severity of the illness being treated by ECT.

Electroconvulsive therapy, once known as shock therapy, uses electricity to stimulate parts of the brain in the treatment of mental, and other, illness. While some find this to be controversial, approximately 100,000 patients receive electroconvulsive therapy (ECT) in the United States every year. In a meta-analysis of study data, ECT outperformed placebo, sham treatment, and antidepressants in the treatment of depression.⁵

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ECT therapy (electroconvulsive therapy), once known as shock therapy, is a neurostimulation therapy that uses electricity to stimulate parts of the brain. ECT therapy is most commonly used in patients with severe mental illnesses that do not respond to other treatments such as antidepressants or other psychiatric medications. ECT treatment for depression is the most common use.

Because of the history of ECT and its violent and abusive depiction in movies, ECT therapy is often viewed as controversial or harmful. However, ECT treatments seen in movies and on television are not accurate portrayals of modern ECT.

Electricity-induced seizures have been used as a treatment for mental illness since the late 1930s. However, when ECT therapy was introduced, no anesthetic, muscle relaxants or paralytics were available, so seizures were painful and often injured the patient. Today's ECT therapy does not involve therapeutic convulsions and is considered both safe and effective.

ECT Therapy for Depression

ECT treatment for depression is considered in cases where:¹

• Depression symptoms are severe
• Symptoms include psychosis
• The patient has a high degree of functional impairment
• The patient is catatonic
• The patient is a danger to themselves or others
• An immediate treatment effect is required

ECT therapy is often chosen because the patient hasn't responded, or cannot tolerate, other treatments such as medication. Patients with co-occurring borderline personality disorder do not respond as well to ECT treatment.

Confounding Factors in ECT Therapy Safety

ECT therapy is considered safe and there are no definite contraindications for ECT treatment. It is known that some conditions may place people at additional risk; however, much of this is due to the risks seen in any procedure done under general anesthesia. Co-occurring conditions that may increase the risks involved with ECT treatments include:

• Neurological conditions like brain lesions or a very recent stroke
• Cardiac conditions like unstable angina, congestive heart failure, uncontrolled high blood pressure or a recent myocardial infarction
• Disorders with autonomic or anesthetic sensitivity
• Brain injury
• Metabolic disorders

Most medication can be used safely during ECT treatment and some psychiatric medication may increase ECT efficacy. Benzodiazepine and lithium doses may be reduced during the treatment period.

ECT Treatment Safety

The most common safety concern during ECT treatment for depression or other mental illnesses is cognitive dysfunction. The immediate effects of ECT treatment include confusion and memory loss; however, these are temporary.

Other loss of pre- and post-treatment memory is sometimes seen. Longer-term memory loss often occurs for events immediately preceding the ECT treatment. Information processing speed may also be affected by ECT therapy but this effect tends to reverse with time. (read: ECT Stories: Personal Stories of ECT for conflicting stories about long-term memory loss.) Cognitive deficits are generally related to:

• The number of ECT treatments
• Type of ECT therapy
• Electrical stimulus dose
• Time between treatments

Physical side effects of ECT therapy include headache, muscle soreness or stiffness and nausea.

The risk of death reported for ECT treatment is significantly smaller than for the spontaneous death rate of the general population. ECT therapy is about ten times safer than childbirth.²

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Electroconvulsive therapy, once known as shock therapy, is a safe and effective treatment for depression and other mental illnesses. Electroconvulsive therapy (ECT) is most often used in cases of severe, intractable, hard to treat (treatment-resistant) depression. Generally, ECT is a short-term treatment where the patient receives 6-12 treatments over the course of 2-4 weeks.

However, in some cases, continuation ECT or maintenance ECT is used. These two therapies continue ECT beyond the initial 6-12 sessions used in acute treatment. This initial acute treatment is known as an "index series" or a "course" of ECT.

Continuation ECT

Relapse after a positive response to ECT is common. Most frequently, prevention of relapse is accomplished through the use of medication but continuation ECT has also been shown effective for the prevention of illness relapse.

Continuation ECT is electroconvulsive therapy continued for approximately the six months following the initial index series.¹ Continuation ECT involves a treatment once every 1-6 weeks.² Continuation ECT is typically used for patients who have initially positively responded to ECT and can give informed consent for its further use. Often those who do not respond to medication choose continuation ECT.

Maintenance ECT

Maintenance ECT consists of ECT treatments given infrequently over a long period of time after the index series and continuation ECT. The goal of maintenance ECT is to prevent the reoccurrence of the mental illness.

Maintenance ECT may be given for months or even years with approximately one ECT treatment every three weeks.³ Maintenance ECT has been shown safe and effective in preventing illness reoccurrence. When maintenance ECT is combined with psychiatric medication treatment, it appears to be more effective than either medication or maintenance ECT alone.⁴

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"Shock therapy" was so-called, as an electric shock is used to induce a controlled seizure intended as a treatment, primarily for mood disorders, although other conditions may be treated as well. Shock therapy is now known as electroconvulsive therapy or ECT.

The brain is still not well understood, nor is the reason for the treatment effects ECT (shock) therapy has on some individuals. It is known that ECT affects hormones, neuropeptides, neurotrophic factors, and neurotransmitters in the brain. All of this may come together to explain how ECT works in treatment.

Shock therapy was overused and misused in the past and since has come to have a mixed reputation (read about the history of ECT procedure). Great care is now taken to ensure ECT treatment is warranted, and signed consent must typically be given before its use.

How to Prepare for a Shock Treatment

A full physical is generally needed before shock therapy. Because general anesthesia will be administered, one should not eat or drink 8-12 hours before the shock treatment. This helps to prevent any vomiting during the procedure. Other exams like an electrocardiogram (ECG) may also be given before ECT to ensure the procedure is safe and appropriate.

How Shock Therapy is Performed

Shock therapy is performed in a hospital, sometimes in an area specifically set aside for this treatment. An intravenous (IV) is inserted to provide anesthetic medication. Vital signs are taken initially and continuously throughout the shock therapy treatment.

An anesthesiologist administers anesthesia and after you are asleep, places a tube in your throat to help you breathe. A paralyzing agent called succinylcholine is then administered to prevent the seizure from spreading to your body. The electrodes are then applied to your head with conducting jelly and a brief shock (less than 2 seconds) is administered.

How Shock Therapy Feels

When you awake from the anesthesia, you may be confused and tired. You will likely experience short-term memory loss around the time of the procedure. With multiple treatments, this may increase. Adverse cognitive effects tend to be the most concerning factors around ECT and tend to affect the frequency and duration of treatments and whether ECT is offered at all. Your vital signs will be monitored closely after the shock treatment to ensure proper recovery. You may feel head, muscle or back pain. Such discomfort tends to be relieved by mild medications. If any post-treatment effect is concerning you, you should talk to the treating physician immediately.

Why Shock Therapy is Performed

It is most common to see shock therapy used in severe cases of depression. Shock therapy is also performed to improve the condition of the following disorders:¹

• Acute mania
• Catatonia
• Occasionally, types of schizophrenia or other psychotic disorders

Electroconvulsive therapy has also shown effectiveness in treating other disorders such as neuroleptic malignant syndrome (a rare, severe, adverse reaction to antipsychotic medication).

Shock treatment for depression and other disorders is indicated when the patient needs rapid improvement because the patient is:

• Suicidal
• Self-injurious
• Refusing to eat or drink
• Refusing to take medication as prescribed
• A danger to themselves
• Psychotic
• Pregnant or otherwise can't take standard medications

Some patients need maintenance ECT. Find out why.

Risks Associated with Shock Therapy (ECT)

The complications associated with ECT / shock therapy are often related to electrode placement with bilateral placement (an electrode by each temple) typically showing greater unwanted cognitive effects than unilateral placement (one electrode at the temple and the other on the forehead). Risks of shock therapy include slow heart beat (bradycardia) and rapid heartbeat (tachycardia), as well as memory loss, confusion and other cognitive effects. Persons at high risk include those with recent heart attack, uncontrolled blood pressure, brain tumors and previous spinal injuries.

Read more comprehensive information about: ECT side effects.

Normal Results After Shock Treatment

Shock treatment for depression often produces a dramatic improvement in symptoms, especially in elderly individuals, sometimes during the first week of treatment. While it is estimated many of these patients will experience a future return of depression symptoms, the prognosis for each episode of depression is good. Mania also often responds well to shock treatment. The picture is not as bright for schizophrenia, which is more difficult to treat and is characterized by frequent relapses.

A small number of patients are placed on maintenance shock therapy. This means they return to the hospital every 1-2 months, as needed, for an additional treatment. These individuals choose shock therapy because it can keep their illness under control and help them lead a normal and productive life.

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You may be surprised to learn electroconvulsive therapy (ECT) is still being practiced in most, if not all, psychiatric units in general hospitals and mental institutions. ECT is the procedure of stimulating the brain through the use of an electrical current applied directly to the skull.

What is the History of ECT?

The original use of electricity as a cure for "insanity" dates back to the beginning of the 16th century when electric fish were used to treat headaches. Electroconvulsive therapy originates from 1930's research into the effects of camphor-induced seizures in people with schizophrenia. In 1938, two Italian researchers, Ugo Cerletti and Lucio Bini, were the first to use an electric current to induce a seizure in a delusional, hallucinating, schizophrenic man. The man fully recovered after 11 treatments which led to a rapid spread of the use of ECT as a way to induce therapeutic convulsions in the mentally ill. (more about the history of ECT)

Public Perception of ECT

When we think of ECT, some recall the terrifying image of Jack Nicholson in "One Flew Over the Cuckoo's Nest." While this depiction suggests ECT is used to control patients, this is not an accurate portrayal of the present day ECT.

Many years ago when psychiatry was less advanced, ECT was used for a much wider range of mental illnesses and sometimes, unfortunately, it was used to control troublesome patients. Patients who went through ECT might also have suffered broken bones before the advent of modern anesthesia and muscle paralytics.

What is Modern ECT Like?

Today, the American Psychiatric Association has very specific guidelines for the administration of ECT. Electroconvulsive therapy is to be used only to treat severe, debilitating mental disorders and not to control behavior. In most states, written and informed consent is required. The doctor must explain in detail to the patient, and / or family, the reasons why ECT is being considered along with the potential electroconvulsive therapy side effects.

Electroconvulsive therapy is generally used in severely depressed patients for whom psychotherapy and depression medication have proven ineffective. As ECT has much quicker antidepressant effects than medication, it may also be considered when there is an imminent risk of suicide. Electroconvulsive therapy is often performed on an inpatient basis, although maintenance ECT may be performed once a week or so as an outpatient. You can watch these ECT videos for a better perspective on modern-day ECT.

How is ECT Performed?

The patient is required to fast for 8-12 hours prior to a treatment of ECT. Involved in the administration of ECT are usually a psychiatrist, anesthesiologist and other supportive medical personnel. The patient is anesthetized with an intravenous injection and then injected with a drug that causes paralysis, to prevent the jerking motions of a seizure. The heart rate and other vital signs are monitored throughout the ECT treatment. (details on how shock treatment for depression works)

Bilateral ECT vs. Unilateral ECT

In bilateral ECT, electrodes are placed above each temple. For unilateral ECT, one electrode is placed above the temple of one side of the brain and the other in the middle of the forehead. An electrical current is then passed through the brain, inducing a grand mal seizure. Evidence of the seizure may show in twitching toes, an increased heart rate, clenched fists or a chest heave. Because current passes through more of the brain during bilateral ECT, it is more likely to cause cognitive side effects such as short-term memory loss than unilateral ECT.

Clinically effective ECT seizures generally last from about 30 seconds to just over a minute. The patient's body does not convulse and the patient feels no pain. During the ECT therapy seizure, there are a series of changes in brain waves on an electroencephalogram (EEG) and when the EEG levels off, this is an indication that the seizure is over. As the patient wakes, they may experience electroconvulsive therapy side effects including:

• Headache
• Nausea
• Temporary confusion
• Muscle stiffness and pain

Safety and Efficacy of Electroconvulsive Therapy

Memory impact is one of the possible side effects of ECT, but opinions vary as to its severity. Many patients report loss of memory for events that occurred in the days, weeks or months surrounding the ECT. Many of these memories return, although not always. Some patients have also reported their short-term memory continues to be affected by ECT for months, although some say this may be the type of amnesia that is sometimes associated with severe depression. (read: ECT for Depression: Is ECT Treatment Safe)

In the first few decades of ECT's use, death occurred in 1 in 1,000 patients. Current studies report a very low mortality rate of 2.9 deaths per 10,000 patients or, in another study, 4.5 deaths per 100,000 ECT treatments. Most of this risk is due to the anesthetic and is no greater than the use of anesthetic for any minor surgical procedure.

Electroconvulsive therapy has been proven an effective treatment of severe depression. Surprisingly, experts are still uncertain as to how ECT works. It is thought ECT acts by temporarily altering some of the brain's electrochemical processes and helping to create new neurons.

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Some prefer to try natural depression treatments, particularly in the case of mild to moderate depression, even though antidepressants have been shown safe and effective in treating depression. Some natural depression treatments (aka alternative depression treatments) can be combined with prescribed medical treatments.

It's important to consult a doctor before trying an alternative depression treatment to make sure it is right for you, as these treatments can have unintended side effects just like prescription medication. Supplements and herbal remedies for depression can also interact with over-the-counter and prescription medications.

Herbal Remedies for Depression

A number of natural remedies for depression are in the form of herbs and supplements. The most well-known herbal depression remedy is St. John's wort. This herbal extract has been used as a depression treatment in Europe. While this herb is known as a natural depression treatment, a study by the National Institute of Mental Health (NIMH) showed St. John's wort was no better than a placebo in treating depression of moderate severity.¹ Another study is looking into whether St. John's wort is an effective natural antidepressant for treating minor depression.

It's important to note that St. John's wort interacts with many critical medications including those used to treat the human immunodeficiency virus (HIV). The Food and Drug Administration (FDA) released a public advisory in 2000 stating St. John's wort appears to affect an important metabolic pathway and can reduce the effectiveness of drugs such as oral contraceptives and those used to treat illnesses like:²

• Heart disease
• Depression
• Seizures
• Certain cancers
• Rejection of organ transplants

Another natural remedy for depression is SAMe, short for S-adenosylmethionine. SAMe is a synthetic form of a chemical found in the body and is considered a dietary supplement. In Europe, SAMe is used as a prescription treatment for depression although it is not government approved in North America.³

Omega-3 fatty acids are sometimes considered to be a natural depression treatment. Omega-3 fatty acids are available in supplements but are better absorbed through the diet. Foods high in omega-3s include coldwater fish, flaxseed and walnuts.

Alternative depression treatments are available without a prescription. However, natural depression treatments are not approved for the treatment of depression and are not regulated by the FDA so their reliability can be inconsistent.

Holistic Depression Treatments

People often use holistic depression treatments in addition to medical treatments. Holistic depression treatments often include mind-body treatments, believing the body and mind heal together as one. Examples of holistic depression treatments include:

• Yoga
• Meditation
• Acupuncture
• Guided imagery
• Massage therapy

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