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Aug 11, 2023

The 6 Best Supplements for Depression, According to a Dietitian

Experts weigh in on which supplements may help with some types of depression

Experts weigh in on which supplements may help with some types of depression

Sarah Anzolar, MS, RD is a private practice dietitian who works as a freelance writer, recipe developer, food photographer, and brand consultant. She has a BA in Business Administration and a MS in Nutrition Communications.

Melissa Nieves, LND, RD, is a registered dietitian working for a private practice.

Rich Scherr is a seasoned journalist who has covered technology, finance, sports, and lifestyle.

We independently evaluate all recommended products and services. If you click on links we provide, we may receive compensation. Learn more.

Verywell Health / Marcus Millan

According to the National Institutes of Health (NIH), in 2020 more than 21 million U.S. adults experienced a major depressive episode. COVID-19 has contributed to an increase in depression, and those with major stressors, including financial hardship, may be more likely to struggle with this mental illness.

If you experience depression, it is not your fault, and you deserve to get treatment. There are many ways to effectively treat depression, but keep in mind that it is a serious mental illness and should not be tackled on your own. "Depression is a widespread mental health condition with various levels of severity and is treatable with an array of strategies," says Emily Steinberg, MD, board-certified psychiatrist and assistant professor of psychiatry at the Icahn School of Medicine at Mount Sinai.If you choose to begin taking a supplement to help treat your depression, it is important to remember that dietary supplements are typically considered adjunctive treatments for depression. This means they can help make other treatments more effective but are not effective treatments on their own. However, some supplements interact with medications in a potentially dangerous way, and supplements that work for some may worsen symptoms for others. Those are a few of the many reasons it is so important to work with a healthcare provider if you are considering trying a supplement to help alleviate your symptoms.

When exploring different supplements for depression, we considered efficacy, risks, interactions with medications, and third-party certifications.

Our team of registered dietitians reviews and evaluates every single supplement we recommend according to our dietary supplement methodology. From there, a registered dietitian on our Medical Expert Board reviews each article for scientific accuracy.

Always speak with a healthcare professional before adding a supplement to your routine, to ensure that the supplement is appropriate for your individual needs and which dosage to take.

Amazon

ConsumerLab.com approved

Dose supported by research

Gluten-free and non-GMO

Expensive

Eicosapentaenoic acid (EPA) is a type of omega 3 fatty acid. Carlson Elite EPA Gems provide 1,000 mg of EPA, which is the dose that research shows may help with depression. While it is not likely to be effective on its own—or boost your mood if you are healthy—there is evidence to support taking EPA in conjunction with antidepressant medications. Carlson Elite EPA Gems were tested and approved as a top pick in a 2023 review of omega 3 supplements through ConsumerLab.com's voluntary certification program. This verifies that the product contains what it says it contains without potentially harmful contamination. In addition, it is International Fish Oil Standards (IFOS) certified for quality and purity as well as non-GMO certified.

Unlike some fish oil supplements, its aftertaste is minimal, but if you do experience any fish burps, putting them in the refrigerator or freezer might help.

Unfortunately, high-quality supplements can come with a hefty price tag like this supplement. But one bottle does contain four months' worth of supplements, so you only have to remember to replenish it three times a year. Because it's made from fish oil, it may not be safe for someone with a fish allergy, and it is not vegetarian or vegan.

Price at time of publication: $74 for 120 count ($0.62 per serving)

Key Specs

Form: Soft gel | Dose: 1,000mg (1g) | Active Ingredients: EPA | Servings Per Container: 120

Amazon

USP verified

Budget-friendly

Available in wide range of doses

Gluten-free

Not vegan

We are fans of Nature Made Vitamins since they are USP verified and tend to be budget-friendly. They have vitamin D supplements that range from 1,000 to 5,000 IU, which means that you can find an effective dose for you. Before supplementing with vitamin D, it's helpful to get your blood levels checked to see if you have a deficiency. A registered dietitian or a healthcare provider can help you determine the best dose for you.

It's important to keep in mind the research on vitamin D supplements and depression is inconsistent. While there appears to be a connection between low vitamin D and depression risk, it's not clear if supplements will actually offer many benefits. This could mean that either supplements are not helpful or that there is another reason for the link, such as less exposure to sunlight.

However, if you are vitamin D deficient, it's important for overall health to replete with supplementation—and it may offer some mild mood benefits.

Price at time of publication: $11 for 125 count ($0.09 per serving)

Key Specs

Form: Tablet | Dose: 1,000-5,000 IU | Active Ingredients: Vitamin D | Servings Per Container: 125

Amazon

ConsumerLab.com approved

Vegan

Gluten-free

May contain less than on label

Interacts with many medications

St. John's wort may help treat mild or moderate depression as effectively as selective serotonin reuptake inhibitors (SSRIs), which are among the most common medications used to treat depression. However, it is absolutely essential to talk to a healthcare provider before starting this supplement because it can be risky for many individuals.

When choosing a St. John's wort supplement, it's important to consider dose and form. Most research has looked at the safety and efficacy of two different extracts—hyperforin and hypericin—not the whole herb. The research suggests a dose of 1-3 percent hyperforin taken at 300 mg three times per day and 0.3 percent hypericin at 300 mg three times per day may be beneficial. You also want to choose a product that includes all parts of the plant—flower, stem, and leaves.

Some newer studies have looked at the whole herb (rather than extracts) and show some efficacy as well. In the case of the whole herb, look for a dose with 01.-0.15 percent hypericin, taken two to four times per day. However, it's important to know that the whole herb is more likely to be contaminated with cadmium (a carcinogen and kidney toxin) and lead.

We like Nature's Way Perika since it's not only third-party tested but contains a research-backed dose of 3 percent hyperforin. Of note, when ConsumerLab.com tested this product, the actual amount of hyperforin was lower than on the label but still within the recommended 1 to 3 percent saturation. For comparison, nearly all of the St. John's wort supplements tested by ConsumerLab.com came back at lower amounts than on the label.

Price at time of publication: $48 for 180 count ($0.32 per serving)

Key Specs

Form: Tablet | Dose: 300 mg | Active Ingredients: St. John's wort extract (stem, leaf, flower) 3% hyperforin | Servings Per Container: 60

St. John's wort may be helpful for some people, but other people may find it worsens their depression symptoms. It is also known to interact with many medications, including antidepressants, allergy medicines, birth control pills, cough medicine, immunosuppressants, HIV medicine, sedatives, and many more. It sometimes makes the medications less effective, sometimes strengthens the effects of the medication, and sometimes dangerously increases side effects.

"If St. John's wort is taken with an SSRI, you could experience serotonin syndrome. Both St. John's wort and SSRIs increase serotonin in the brain, which can overload the system and cause symptoms such as muscle spasms, heavy sweating, agitation, fever, diarrhea, tremors, confusion, and even hallucinations. If this goes untreated, it can be deadly," says Khurana.

St. John's wort is also not recommended if you have severe depression or bipolar disorder, are pregnant, looking to become pregnant, or breastfeeding. It also poses risks for those with ADHD, schizophrenia, and Alzheimer's disease. Possible side effects include stomach discomfort, hives, decreased energy, headache, restlessness, dizziness or confusion, and increased sensitivity to sunlight. Because of all of these risk factors, it is essential to talk to a healthcare provider before starting St. John's wort.

Amazon

NSF certified for sport

Active form of B-vitamins

Vegan

Allergen-friendly

High dose

Since a vitamin B deficiency is linked to depressive symptoms, you may choose to add a B-complex supplement to your regime. We are fans of the Thorne supplements for their emphasis on quality and the fact that many of them—including this Thorne B-Complex #6—are NSF Certified for Sport, a rigorous third-party certification that ensures that the supplement has what the label says (and nothing else). It contains the active form of B vitamins, which may help your body absorb them better, and doesn't contain any of the major eight allergens.

Of note, B-vitamin supplementation hasn't been shown to treat depression, especially among people who are not deficient. Also, it is possible for most people to meet their B-vitamin needs through diet unless you are vegan, in which case a B12 supplement may be helpful. While it's rare to have negative effects from consuming too many B vitamins, check in with a healthcare provider to make sure you aren't consuming more than the Tolerable Upper Intake levels.

Price at time of publication: $21 for 60 count ($0.35 per serving)

Key Specs

Form: Capsule | Dose: 1 capsule includes multiple vitamins | Active Ingredients: Thiamine, riboflavin, niacin, vitamin B6, folate, vitamin B12, pantothenic acid, choline | Servings Per Container: 60

Amazon

High dose shown in trials to provide benefit

Active form of folate

Allergen-friendly

May not be suitable treatment on its own

Expensive

Folate supplements are sold as either folic acid (which the body needs to convert to a form it can use) or folate (a term used to describe different forms of B9, including 5-methyltetrahydrofolate, abbreviated 5-MTHF), the active form of vitamin B9. Research suggests that high doses of methylfolate, in conjunction with antidepressants, may lessen depressive symptoms, especially in people with moderate to severe depression. However, folic acid has not been shown to provide the same benefit.

The benefits are more pronounced for people who don't consume enough folate in their diet. In addition, there are some people who have a gene mutation that reduces their ability to convert folic acid to methylfolate, in which case it is important to take methylfolate directly.

We like the Thorne 5-MTHF 15mg since it provides the active form of folate in the dose supported by research. While this supplement is not verified by one of our top third-party testing companies, Thorne is known for their high-quality ingredients, and they regularly screen for contaminants. Since this supplement is only effective alongside other depression treatments, it is important to consult with a healthcare provider and make sure it fits into your treatment plan before you start taking it.

Price at time of publication: $62 for 30 count ($2.07 per serving)

Key Specs

Form: Capsule | Dose: 15 mg | Active Ingredients: L-5-methyltetrahydrofolate | Servings Per Container: 30

Amazon

ConsumerLab.com top pick

Budget friendly

Moderate dose

Allergen friendly

May not be suitable for people with more severe symptoms

SAMe is a naturally occurring compound in the body that regulates hormones and is involved in the production of neurotransmitters dopamine and serotonin. SAMe has been used to try and treat depression for many years but is not as effective for most people as SSRIs and other antidepressants. However, more research is needed to determine potential clinical benefits today.

Studies have shown benefits to SAMe with doses ranging from 200 to 1,600 mg daily (in divided doses), so it's important to work with a healthcare provider that specializes in mental health and supplements to determine the best dose for you.

Nature's Trove SAMe was tested and approved as a top pick in a 2022 review of SAMe supplements through ConsumerLab.com's voluntary certification program. This verifies that the product contains what it says it contains without potentially harmful contamination. We also like that Nature's Trove SAMe contains a moderate dose of 400mg, which may lead to fewer side effects and be a good place to start—especially for people with mild to moderate depression.

It's free of the top eight allergens, is gluten-free, and contains no artificial colors or flavors. It's certified kosher and non-GMO, and is a budget-friendly choice.

Price at time of publication: $40 for 90 count ($0.44 per serving)

Key Specs

Form: Caplet | Dose: 400 mg | Active Ingredients: S-adenosyl methionine | Servings Per Container: 60

Just like medications, supplements can come with side effects. "SAMe can cause nausea and constipation. If SAMe is taken with many standard antidepressants, the combination may trigger mania in people with bipolar disorder," says Khurana.

SAMe is also converted to homocysteine in the body, which, in excess amounts, is associated with increased risk of cardiovascular disease (CVD). However, more research is needed to understand the connection between SAMe supplements and CVD risk. Consuming adequate B-vitamins in your diet may help your body get rid of excess homocysteine.

There are dozens of supplements marketed to support mental health, improve mood, and reduce depressive symptoms. However, most of them are not well supported by research. In some cases, there may be a benefit for some individuals, but more quality research is needed to make strong recommendations.

There is a well-established connection between the gut and the brain, and research has suggested a relationship between your gut microbiota (the colony of bacteria found in the gut) and depression.

People with known digestive disorders may benefit from a probiotic and experience some mood benefits as well. However, more research is needed to understand the best dose and the specific types of probiotics. In addition, research has shown no real benefit to otherwise healthy people.

It's always helpful to talk with a healthcare provider, especially one that specializes in digestive health, to determine if a probiotic supplement might help you.

"The 5-hydroxytryptophan supplements, also known as 5-HTP, may increase serotonin levels and positively affect mood," says Khurana. Our bodies naturally make 5-HTP from L-tryptophan (an amino acid found in some protein-rich foods), which they then convert into both serotonin and melatonin. This is why this supplement is marketed for both depression and sleep. However, there is very little research testing this supplement, so it's unclear how helpful it actually is—and at what dose.

5-HTP supplements also come with serious side effects, including serotonin syndrome if taken with SSRIs. "Some people taking 5-HTP have experienced mania or suicidal thoughts as well," says Puello.

It's believed that curcumin may benefit people with depression by reducing inflammation. However, there's limited research to test the benefits, and the current quality of evidence is low. Participants in most of the studies looking at turmeric or curcumin (the active compound in turmeric) were also taking antidepressants.

There are dozens of vitamin, mineral, antioxidant, and herbal supplements that are marketed to treat depression, with varying levels of data to support their use. While supplements on their own are not likely to completely treat depression, there are some that may offer benefits in conjunction with other treatments. "Success or failure with a supplement could depend on a wide range of factors, such as age, gender, race, concurrent conditions, other supplements and medications, and even more," says Jennifer Hanes, MS, RDN, LD.

Additionally, "when considering natural remedies for depression, it's important to understand that natural remedies can take longer to take effect than prescription medication," says Sharon Puello, MA, RD, CDN, CDCES.

It's vital to work closely with a healthcare provider, including someone who specializes in mental health, when considering supplements as part of your treatment plan.

Those who may be more likely to benefit from supplements for depression include:

People with nutrient deficiencies. In the cases of vitamin and mineral supplements, more is not necessarily better. However, "B12, folate, magnesium, and zinc deficiencies seem to worsen symptoms of depression and potentially reduce the effectiveness of the medications," says Hanes. Correcting vitamin D deficiencies is essential for overall health, and it may also help with depression. It is therefore important to work with a healthcare provider to supplement if you have a deficiency in a specific nutrient.

People taking certain antidepressant medications. SAMe, methylfolate, omega-3s, and vitamin D may also be particularly useful when combined with antidepressant medications. Additionally, "EPA has shown to quantifiably improve response to various antidepressant medications," says Hanes. However, there may be risks of interactions with certain medications, so please talk to a healthcare provider before adding in these supplements, especially if you are taking medications.

People who don't respond well to medications. "Those most likely to benefit from herbal supplements may include people who cannot tolerate or are resistant to more standard treatment for depression, including psychotropic medications and psychotherapy," says Steinberg.

People with mild symptoms. There is some evidence to support the use of certain supplements like St. John's wort, especially among people with milder symptoms. However, it doesn't come without side effects and interacts with many medications, so proceed with caution and discuss symptoms and treatment options with a healthcare provider.

The best way to determine if one of the many depression supplements available is right for you is to work closely with a healthcare provider. "Since herbs and other supplements are not monitored by the FDA, you don't always know if what you're getting is safe, so everyone should be cautious," says Steinberg. However, there are certain people who should avoid or be extra cautious about using some of the supplements—especially the herbal supplements.

Everyone is different, and what works for one person may not work for another. "It's important to know that herbal supplements can actually significantly worsen a patient's depression," says Gauri Khurana, MD, MPH, psychiatrist and clinical instructor at Yale University School of Medicine.

Those who should be extra cautious about certain supplements include:

People with moderate to severe depression. "Those with moderate to severe depression (rather than mild symptoms) should definitely seek out a mental health professional for more standardized approaches for treatment. While it may be a more cost-effective approach (for some), supplements should not be a stand-alone treatment for this group," says Steinberg.

People taking SSRIs (selective serotonin reuptake inhibitors) such as Prozac, Zoloft, Lexapro, or Celexa. Both St. John's wort and 5-HTP are known to potentially cause something called serotonin syndrome when taken in combination with SSRIs. Both SSRIs and these supplements increase the amount of serotonin in the brain and can lead to an overload. This can result in mild symptoms like changes in blood pressure, tremors, nausea, and vomiting or more life-threatening symptoms including seizures, renal failure, and respiratory failure.

People taking other medications. St. John's wort interacts with several medications, including HIV drugs, some cancer medications, blood thinners, oral contraceptives, pain medications, and more. Similarly, SAMe (short for S-adenosylmethionine) can worsen manic symptoms of those with bipolar disease and interact with other medications including those to treat Parkinson's disease.

Pregnant or breastfeeding people. In general, herbal supplements are not well studied among pregnant and breastfeeding people. While vitamins and minerals are generally safe (and recommended) during pregnancy, it's always best to consult with a healthcare provider to ensure the levels you are taking are safe for you.

Our team works hard to be transparent about why we recommend certain supplements; you can read more about our dietary supplement methodology here.

We support supplements that are evidence-based and rooted in science. We value certain product attributes that we find to be associated with the highest-quality products. We prioritize products that are third-party tested and certified by one of three independent, third-party certifiers: USP, NSF, or ConsumerLab.

It's important to note that the FDA does not review dietary supplements for safety and effectiveness before they go to market. Our team of experts has created a detailed, science-backed methodology to choose the supplements we recommend.

Experts we interviewed for supplements for depression include:

Supplements that are third-party tested are sent to a lab where they are tested to ensure they contain what they say they contain and are not contaminated with specific high-risk, common contaminants. However, it's important to note:

Each supplement reviewed in this article comes in different forms. Please review our top picks to learn about the best form of each supplement.

It is essential to carefully read the ingredient list and nutrition facts panel of a supplement to know which ingredients and how much of each ingredient is included relative to the recommended daily value of that ingredient. Please bring the supplement label to a healthcare provider to review the different ingredients contained in the supplement and any potential interactions between these ingredients and other supplements and medications you are taking.

Many supplements (including St. John's wort, SAMe, and 5-HTP) marketed to treat depression can interact or lead to dangerous side effects when taken with antidepressants or other medications meant to treat mental illness. They may also interact with other medications and supplements. Therefore, it's vital that you discuss all supplements with a healthcare provider.

There is no standard dose for supplements to treat depression. In the case of vitamins, the recommended amount will vary by vitamin, and most manufacturers will use daily values, dietary reference intakes (DRIs), and adequate intakes (AIs) to determine dosage. Some manufacturers add more than the recommended amount of certain vitamins and minerals—as is the case with many B vitamins—since emerging research suggests there may be benefits to higher doses. In addition, the amount your body absorbs varies by vitamin, so doses higher than the recommended amount may be indicated.

When it comes to herbal and other supplements, there is also no standard dose, but most manufacturers will look to the research to determine an appropriate amount to include. The recommended dose may vary by symptoms and your individual health.

Your body filters out excess water-soluble vitamins (like B-vitamins), so it's difficult to overconsume these. However, fat-soluble vitamins like vitamin D are stored in fat tissues and can be dangerous in excess. While there is no upper limit (UL) established for omega-3s, high doses may interact with some anticoagulant medications. You can ensure you aren't exceeding the upper limits of any vitamin or mineral by running your supplements by a healthcare provider.

When it comes to other types of supplements like herbs and other compounds, safe amounts will vary and may depend on your health status and other supplements and medications you are taking. It's always best to discuss the dosing of any supplements with a healthcare provider first.

In most cases, natural supplements are not better. However, for someone who doesn't tolerate medication well or has not seen results from medication or other interventions, such as psychotherapy, a supplement may be a consideration. In addition, if there are true vitamin deficiencies, diet and supplements should be a first-line intervention.

"The treatment that the patient is willing to take is the best treatment. Some individuals really shy away from conventional medicine. In that case, working closely with a professional who can critically evaluate your bloodwork, lifestyle, and diet to identify potential areas of deficiency is key to determining a potentially beneficial supplement regimen," says Puello.

That said, for many people, supplements may not be enough. "There are serious consequences to not treating depression in an effective way, which may or may not include medications, but should generally include lifestyle changes and therapy, not just taking a supplement," says Hanes.

There are no vitamins that will treat depression if you aren't deficient. However, there is a link between vitamin B6, B12, and D deficiencies and depression. In the case of a deficiency, closing any nutrient gaps with supplements may help.

"SAMe and St. John's wort have been shown in studies to be helpful for anxiety and depression. Both anxiety and depression are modulated by a lack of serotonin, so antidepressants work for both disorders as would supplements that target one or the other," says Khurana. However, just like depression, anxiety can be a debilitating or life-altering illness and should be treated seriously. If you experience anxiety, always work with a healthcare provider to determine the best treatment option for you.

In short, it depends. In most cases, herbal supplements are not as effective as medication and do not have fewer concerning side effects. But for some people, they may be the best approach, especially if you have not tolerated or responded well to traditional treatment options or medications. It's best to discuss your specific situation with a healthcare provider and find a practitioner who is well-versed in herbal supplement use to help you navigate the best treatment option for you.

Some supplements can complement depression medications, but some supplements may interact with medications (depression related or otherwise). It's always best to check with your healthcare team before taking any supplement, even if it's herbal. For more information on individual supplements and interactions, check the National Institute of Health Office of Dietary Supplements and the National Center for Complementary and Integrative Health.

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