A Note On Supplements
Before trying any new supplements for depression, its important to ask a trusted healthcare professional about potential medication interactions or safety concerns.
While supplements may be helpful in managing depression, they are not a cure for the condition. Therefore, when selecting supplements, be wary of products that claim to treat or cure depression.
There are a ton of dietary supplements on the market, but not all of them are safe and effective.
For this article, we chose supplements based on the following criteria:
- Evidence-based: The supplements on this list have research supporting their use in depression.
- Testing: We chose brands whose products are tested regularly throughout the manufacturing process, ideally by a third-party organization.
- Ingredients: We selected products from brands that prioritize the use of high quality ingredients and easily absorbed forms of vitamins and minerals. The brands below also avoid or limit the use of artificial flavors, fillers, and preservatives.
- Price: While the supplements included vary in price, they provide a good value.
- Vetting: All brands and products listed below have been vetted and approved by our team of experts, who evaluate companies based on medical credibility and business practices.
Where To Find Folic Acid
Benefits of folic acid are easily available in its natural form in a number of foods, including:
In addition, many grain products have been enhanced with folic acid, especially breads and cereals. So you can reap the benefits of folic acid, without even noticing it.
And in addition to watching your diet, taking a folic acid supplement is a fantastic way to ensure you are providing your body with an adequate supply.
Some drugs notably various barbiturates, anticonvulsants, and birth control pills can interact with folic acid, so if you are taking any of these, make sure to consult your prescriber before adding a folic acid supplement to your daily regime.
Standard daily doses of folic acid vary, but typically fall between 250 -1,000 mcg per day. The recommended amount, unless a medical professional has advised otherwise, is 400 mcg per day. At this dose, most adults experience no side effects whatsoever.
Folic acid supplements typically come in tablet form, and can be found in most natural food and drug stores.
What Vitamins Are Good For Anxiety
If you experience chronic anxiety or acute bouts of nervousness , considering vitamins for anxiety and stress, in addition to other treatment options, is a good decision. Be sure to discuss this with your doctor before starting supplements, especially if youre taking other medications.
If you were wondering how to treat anxiety with vitamins, some of the best vitamins for anxiety include both water-soluble vitamins that dissolve quickly in the body, as well as fat-soluble vitamins that circulate through the bloodstream and are stored by the body when not in use.
Vitamins alone wont cure your anxiety, but they may help bolster your health and mood overall. A review of 24 studies suggests that herbal and vitamin supplementation can be a beneficial and effective therapy for treating anxiety. Especially when taken in addition to other forms of treatment, like therapy for anxiety, medication, and self-help techniques, vitamins might be an integral component of your overall treatment plan for dealing with anxiety. Read on to learn more.
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Folic Acid Ageing Depression And Dementia
It is becoming clear that folic acid affects mood and cognitive function, especially in older people. Edward Reynolds draws together the evidence
Folic acid is important for functioning of the nervous system at all ages.14 In the fetus the relation between maternal folate status and the risk of neural tube defects is well established: clinical trials have shown that periconceptual preventive treatment with 400 g or higher of folic acid significantly reduces the risks of such defects.4
In neonates, infants, children, and adolescents, inborn errors of folate transport and metabolism are associated with a variety of overlapping syndromes which are influenced by age of clinical presentation. These include developmental delay, cognitive deterioration, motor and gait abnormalities, behavioural or psychiatric symptoms, seizures, signs of demyelination or failure of myelination, and vascular changes seen on magnetic resonance imaging or postmortem examination.4 Less commonly, subacute combined degeneration and peripheral neuropathy may also occur.
In this paper I review the evidence relating folate deficiency to depression and dementia, especially in the ageing nervous system.
Recommended Dietary Intake Of Folate
The official recommended dietary intake of folate for adults is 400 mcg. Pregnant and lactating women require 600 mcg and 500 mcg, respectively. Its worth noting these RDIs were established many, many years ago and studies have shown there may be many reasons why taking more for certain conditions might be beneficial.
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Which Supplements Are Best For Depression
Numerous studies have evaluated the role of supplements in treating depression. Nonetheless, not all studies are of equal quality and its important to consider findings from rigorous studies published in high quality journals. A Harvard affiliated analysis published in the American Journal of Psychiatry completed a comprehensive evaluation of existing studies , offering a condensed and reliable way to review what works. They analyzed existing study results across 16 different depression-related supplements to determine which ones had sufficient evidence to suggest they help reduce symptoms of depression when taken with antidepressant medication.
Here are the depression supplements they found to be successful:
Fish oil is high in omega-3 fatty acids, which are key to certain brain functions and may help reduce inflammation associated with depression. There are two types of omega-3s in fish oil: EPA and DHA. Researchers found that EPA is the one that helps the most when it comes to depression.
Certain people have a genetic makeup that actually impairs their use of folic acid in cellular processes, which may be associated with depression. Supplementing with L-methylfolate can help bridge this gap and keep the cellular processes moving. In fact, there is already an FDA-approved form of L-methylfolate that doctors prescribe to individuals who dont initially respond to antidepressant treatment.
Does Folic Acid Affect Mood
The purpose of this study was to determine whether a daily dose of folic acid can prevent new episodes of depression in adolescents and young adults. Participants were aged 14 to 24 years. To determine if folic acid may improve mood, participants were given either placebo or 20 mg/d of the nutrient. Although these results have not been confirmed, they suggest that folic acid may be effective in reducing symptoms of depression.
Folic acid is believed to regulate mood and cognition, and has been shown to increase the effect of antidepressants. It is a water-soluble B-Vitamin that is critical for DNA synthesis, gene expression, amino acid synthesis, and neurotransmitter synthesis. It is also a component of the neurotransmitter cycle, helping to produce serotonin and norepinephrine. It is important for the production of red blood cells, as well as in the regulation of mood.
A recent study found that high blood folate intake can speed up age-related mental decline in people with low levels of vitamin B12. However, further research is needed to determine if folic acid intake can increase the risk of dementia in older people. Furthermore, women do not get their required folate levels from food sources, so they are often encouraged to take folic acid supplements. However, too much folic acid intake during pregnancy may lead to insulin resistance and slow down the brain development of children.
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Folate Deficiency And Depression
A significant number of scientific studies suggest that depression is associated with folate deficiency. In addition, folate deficiency in depressed patients can also reduce the effectiveness of antidepressant drugs.
The importance of folate in depression can be traced to the role of the vitamin in transmethylation reactions. A transmethylation reaction involves the transfer of a methyl group from one compound to another. Such methyl transfers are necessary for the formation of certain neurotransmitters.
The relationship between folate and depression is also supported by observations that a common genetic variant of an enzyme that reduces a persons ability to convert folic acid to L-methyl folate , is more common in patients with depression.
This means that the genetic anomaly would affect transmethylation reactions and, by extension, neurotransmitter syntheses.
Furthermore, because low levels of folate disrupt transmethylation reactions, it can lead to the accumulation of homocysteine along with the disruption of neurotransmitters, phospholipids, myelin, and receptors.
Homocysteine is a toxic intermediate of amino acid syntheses and it is an amino acid not used in making proteins. It is formed from methionine and converted to its homolog, cysteine. Both the conversion and recycling of homocysteine back to methionine require B vitamins such as folic acid.
In the brain, homocysteine is responsible for kinds of neurological damage that can cause depression.
When Antidepressants Dont Work
Folate deficiencies are especially frequent in patients who dont respond to conventional antidepressants. Some studies also indicate that folic acid may be a very helpful add-on to other prescription antidepressants.
In one study, folic acid was compared with a placebo pill as a combination with a Prozac treatment approach.
Patients who received folic acid improved more those who received the placebo. This improvement was especially marked in woman. Nearly 95% of female patients who received folic acid responded to the combo treatment, compared to 60% of woman given the placebo.
Another study conducted with elderly depressed patients found that another type of folate was essentially just as effective as a mainstream antidepressant medication.
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Can Folic Acid Help With Anxiety
If you have a chronic case of anxiety, taking a vitamin supplement could be beneficial. Although you shouldnt take them on a daily basis, they can help your body combat anxiety and boost your overall health. A simple blood test can help your doctor determine whether youre deficient in vitamins or minerals, which may have a negative effect on your symptoms. In some cases, vitamin supplementation can even help prevent anxiety attacks.
While no scientific study has been conducted directly comparing the effect of B vitamins and folic acid on anxiety, it is clear that the vitamin plays a role in the body. B vitamins are important in the metabolism of serotonin, which is a neurotransmitter important for mood regulation. Vitamin B12 supports nerve health, which is crucial for the brains normal functioning. Its essential to get enough of the B vitamins in your diet, and vitamin B12 can help you combat the physical symptoms of anxiety, as well.
In addition to leafy green vegetables, folic acid is also found in eggs and legumes. For added benefit, fortified grain products are a good choice, although be aware that these are highly processed. Gluten may be a trigger for anxiety and depression, so limiting your intake of these products could make it easier to combat the condition. However, this shouldnt be a permanent solution. Folic acid can help with anxiety, if taken in the proper amounts, and in combination with vitamin B12, a diet rich in folic acid will improve the symptoms.
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Natural Sources Of Folate
You can get folate from the food you normally eat, including leafy vegetables , okra, asparagus, fruits beans, yeast, mushrooms, meat , orange juice, and tomato juice.
The amount of folate that will be available for absorption after its ingestion depends on many factors, such as the intestinal environment, genetics, lifestyle, the presence of diseases, and other conditions. Folic acid is actually more problematic for the body than the natural folate.
The Danger Of Dissing Antidepressants
The team found there was no significant difference with regard to benefit across the treatment groups during the first trial. In the second trial, however, adjunctive l-methylfolate at 15 mg/day showed significantly greater efficacy compared with continued SSRI therapy plus placebo in terms of both the response rate and degree of change in depression symptom score, as well as on two secondary measures of symptom severity. L-methylfolate was well tolerated, with rates of adverse events no different from those reported with placebo.
The researchers concluded that adjunctive l-methylfolate at the higher dose of 15 mg/day may constitute an effective, safe, and well-tolerated treatment strategy for patients with major depressive disorder who have previously had either a partial response or no response to SSRIs.
Summary and Recommendations
Folate deficiency or malabsorption due to illness, taking certain medications, or other issues can increase the risk of developing major depressive disorder, as well as make it more difficult to treat. L-methylfolate supplementation may be beneficial for those who have major depressive disorder that has not responded adequately to treatment with antidepressant medications.
Finally, anyone experiencing depressive symptoms should be evaluated by a licensed mental health professional. Psychotherapy can be an invaluable part of a depression management approach whether or not someone has responded well to antidepressant medications.
References
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What Is Folic Acid
Folic acid is a type of B vitamin that is normally found in foods such as dried beans, peas, lentils, oranges, whole-wheat products, liver, asparagus, beets, broccoli, brussels sprouts, and spinach.
Folic acid helps your body produce and maintain new cells, and also helps prevent changes to DNA that may lead to cancer.
As a medication, folic acid is used to treat folic acid deficiency and certain types of anemia caused by folic acid deficiency.
Folic acid is sometimes used with other medications to treat pernicious anemia. Folic acid used alone will not treat pernicious anemia and other anemias not related to Vitamin B12 deficiency. Take all of your medications as directed.
Could A Folic Acid Prescription Help Prevent Suicide
FRIDAY, Sept. 30, 2022 More than 1 million Americans attempted suicide in 2020, and a new study is hinting at a potential way to reduce that risk: prescription folic acid.
The study, of more than 800,000 Americans in a health care database, found that when people were on prescription folic acid, their likelihood of being treated for self-harm or suicide attempt dropped by 44%.
Folic acid is a synthetic form of folate, or vitamin B9, that is used in supplements and added to some foods.
Experts stressed that the new findings do not prove that folic acid, itself, reduces suicide risk.
I would not rush out to the drugstore to get folic acid, said lead researcher Robert Gibbons, a professor at the University of Chicago. And I certainly wouldnt replace any medical evaluation, or ongoing care, with a supplement.
To prove that folic acid has a direct effect on suicidal behavior, Gibbons said, it will take a clinical trial where people are randomly assigned to take the vitamin or not.
But the study, published Sept. 28 in JAMA Psychiatry, does add to evidence tying vitamin B9 to mental health.
Past research has linked low folate levels in the blood to depression. And when evaluating patients for depression, some mental health professionals order blood tests to measure folate, as well as vitamins D and B12 .
I do that all the time, said Dr. Christine Crawford, a psychiatrist and associate medical director of the nonprofit National Alliance on Mental Illness.
More information
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Ascertainment Of Incident Depression
Incident depression was defined as physician/clinician-diagnosed depressionor presence of clinically significant depressive symptoms. Information usedto determine incident depression was obtained on the WACS 24-, 48- 72-, 84-,96- and 120-month study questionnaires as either self-reportedphysician/clinician-diagnosed depression or self-reported depressivesymptoms, based on the Mental Health Index .Reference Cuijpers, Smits, Donker, ten Have and de Graaf22 Among participants in our sample for this depression substudy, theWACS 24-month questionnaire was the baseline/pre-randomisation survey forthe B-vitamin/folate factorial arm. Thus, during follow-up, incidentdepression was classified as the first occurrence of self-reported: physician/clinician-diagnosed depression or clinically significant depressive symptoms.
Regarding the capture of physician/clinician-diagnosed depression,participants also had the ability to use write-in space to indicate adiagnosis, along with month/year of diagnosis, on any of the annualquestionnaires during the entire follow-up period however,physician/clinician depression diagnosis was only explicitly ascertained onthe questionnaire years specified above.
What Are The Treatment Options For Depression
Depression is caused by a chemical imbalance in the brain it is a treatable disorder. Depression is typically treated with antidepressants or other drugs, psychotherapy , or a combination of these approaches.
Antidepressants
- Selective serotonin reuptake inhibitors
- The most often prescribed antidepressants, SSRIs, raise serotonin levels in the brain, which are believed to help regulate body temperature, sleep, mood, appetite, and pain.
- The term “selective” refers to the fact that SSRIs only affect serotonin and not norepinephrine or dopamine. They reduce serotonin reabsorption into neurons, making more serotonin available for enhanced neuron communication.
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