Mood Disorder improvement with herbal products, vitamins, diet and food - How to Improve or enhance mood with natural supplements
Feb 20 2014 by
Ray Sahelian, M.D.

There are many herbs and nutrients that have been tested in relation to mood improvement, and many of these supplements are believed to have a role to play in treatment. Unfortunately, most doctors are not as familiar with these natural remedies as they should be. I hope the information I have provided here, and plan to update regularly, will offer some hope to those who have low mood, and also serve as a way for physicians to learn more about these alternative treatments.

Supplements, herbs, and vitamins used as mood medication
Exercise, proper diet, relaxation techniques, and yoga can help fight a mood disorder. If you have moderate or severe mood problem, or are currently taking pharmaceutical medicines for a mood disorder, discuss with your doctor before adding any supplements. Some of these supplements can be quite powerful and may interact with medicines.
  
Here is a list of nutrients and herbs for depression:

5-HTP may sometimes start working within hours. 5-HTP converts into serotonin, and important brain chemical involved in mood, appetite, and impulse control. 5-HTP suits those whose mood disorder is associated with anxiety, restlessness, or racing thoughts.
SAM-e a powerful nutrient that starts working within hours. A recent study found SAM-e was helpful even in those with low mood who did not respond well to Prozac and other SSRIs.
Sam-e is best suited for those whose mood disorder is associated with low energy, low motivation, and no anxiety. For those whose depression is associated with anxiety, 5-HTP is a better option. There is a risk for overstimulation with Sam-e use, hence dosage should be kept low and it would be good to take a day or two off when one notices overstimulation. SAM-e is not advised for manic depression.
St. John's wort usually takes a few days to work.
Acetyl-l-carnitine can lift mood and enhance mental activity. It is found in Mind Power Rx.
B vitamins including pantothenic acid have a mild but pleasant influence on mood. B complex vitamins including thiamine, riboflavin, pyridoxine, folic acid, vitamin B12, and pantothenic acid can improve mood. You may consider a B complex vitamin that supplies one to 3 times the RDA.
Fish Oils have mood balancing properties. Their effect is mild. I am not sure about krill oil and mood.

Mind Power Rx for Mood Support
Formulated to provide steady mental sharpness and focus all day, along with memory support.

Acetyl-L-carnitine
Carnosine antioxidant
Choline bitartrate
DMAE bitartrate
Trimethylglycine (TMG)
Tyrosine amino acid
Vinpocetine extract

Methylcobalamin is a form of vitamin B12
Pantothenic acid
Ginkgo Biloba leaf extract, Mucuna Pruriens extract, Ashwagandha extract, Bacopa monniera extract, Gotu kola extract, Reishi extract, Ginseng extract, Fo-ti extract, and Rhodiola extract.

Psychiatr Pol. 2013 May-Jun. Interactions between synthetic drugs used in treatment of selected central nervous system disorders and dietary supplements and herbal drugs. The risk of interaction between dietary supplements, herbal drugs and synthetic drugs increases when patients are treated chronically, e.g. due to impairment of central nervous system (CNS)--depression, psychotic disorders, Parkinson's and Alzheimer's diseases. On the basis of scientific literature, there was shown that simultaneous intake of antidepressants, antipsychotic drugs and herbal drugs or dietary supplements containing: St. John's wort, valerian root, ginkgo biloba leaf, hops, and food ingredients: dietary fiber or folic acid, may lead to interactions. Dietary fiber supplementation should be applied carefully during treatment of Parkinson's disease and in case of Alzheimer disease treatment--supplements containing ginkgo biloba leaf can increase the risk of interaction. Knowledge of these interactions is essential in effective treatment of this illness. However this area of science should be verified constantly due to growing number of new products registered as a supplements--often with complex composition.

Does food affect mood?
Certainly. Food has an influence on mood in the short term and the long term. I find eating fish improves mood and eating lots of junk food may improve mood temporarily but over the long run can lower it.

Menopause
The menopausal transition period is marked by hormonal fluctuations, and may be accompanied by vasomotor complaints, sleep disturbances, changes in sexual function, and increased risk for osteoporosis and cardiovascular disease. In addition, some women have an increased risk for developing a mood disorder.

Estrogen and Mood
Women are at higher risk throughout their reproductive lives than are men for mood disorders. Numerous molecular and clinical studies have pointed the finger to estrogen - endogenous, bio-identical, or synthetic - in modulating brain function including that related to mood. Sudden estrogen withdrawal, fluctuating estrogen, and sustained estrogen deficit are associated with significant mood disturbance. Clinical recovery from depression postpartum, perimenopause, and postmenopause through restoration of stable/optimal levels of estrogen has been noted.

Sleep Problems and Mood
If I were to choose one factor that has the most influence, it would be sleep. Many sleep problems can lower mood, including, for instance, obstructive sleep apnea. Obstructive sleep apnea syndrome (OSAS) is a common disorder in adults and children, which is characterized by repetitive transient reversible upper airway obstructions during sleep. Due to disrupted sleep architecture and intermittent hypoxemia, OSAS leads to impaired daytime functioning in various neuropsychological and affective domains. The most common abnormalities are executive dysfunction, impaired vigilance, low mood, and possibly anxiety and, in children, hyperactivity.

Treating a Mood Disorder during Pregnancy
Mood disorders in pregnancy may have a negative effect on self care and pregnancy outcome that affects the mother directly and the child indirectly. Thus, some women may require pharmacological treatment. Pharmacotherapy of mood disorders during pregnancy implies specific considerations. There are many different psychotropic drugs, including with selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants (TCAs), other antidepressants, benzodiazepines, lithium, carbamazepine/valproic acid, lamotrigine and novel antipsychotics. However, the existing knowledge on the use of antidepressants and mood stabilising agents during pregnancy is hampered by a lack of results from randomised controlled trials. SSRIs and TCAs have not been associated with an increased risk of major malformations, but poor neonatal adaptation has been described. Benzodiazepines used in the first trimester have been associated with orofacial clefts. Mood stabilisers such as lithium, carbamazepine and valproic acid (sodium valproate) are associated with an increased risk of fetal malformations. Both benzodiazepines and lithium may cause adaptation problems in the newborn. In utero exposure to novel antipsychotics has not been associated with congenital malformations; however, the data are still limited. The knowledge about long-term neurobehavioural effects in the offspring is still limited for all agents and requires further investigation.
     The use of natural mood lifters during pregnancy has not been evualed thoroughly enough to make any definite recommendations. Possible adverse effects of fetal exposure must be balanced against the adverse effects of an untreated maternal mood disorder.

Cognitive Therapy may be of benefit
Cognitive therapy is a treatment process that allows patients to correct false self-beliefs that can lead to negative mood and behavior. Since thought can precede a mood, learning to substitute healthy thoughts for negative thoughts will improve a person's mood, self-concept, behavior, and physical state. Cognitive therapy appears to be an effective treatment for mood enhancement and when practices by an experienced therapist, can be comparable in effectiveness to antidepressants and interpersonal or psychodynamic therapy. The combination of cognitive therapy and mood enhancing drugs has been shown to effectively manage severe or chronic mood disorders. It is quite likely that cognitive therapy in addition to natural supplements, such as SAM-e, 5-HTP,  that improve mood, may work quite well, too.

Substance Abuse
Mood and anxiety disorders commonly co-occur with substance use disorders. Exploration of the neurobiology of substance use disorders and mood and anxiety disorders have found that the neural circuitry in mood, anxiety, and substance use disorders is clearly overlapping. These discoveries have encouraged the exploration of a number of drugs in the treatment of co-occurring mood, anxiety, and substance use disorders. The SSRIs have been investigated to a large extent.

Improve mood research
Modulation of mood and cognitive performance following acute administration of single doses of Melissa officinalis (Lemon balm) with human CNS nicotinic and muscarinic receptor-binding properties.
Neuropsychopharmacology. 2003.
Melissa officinalis (Lemon balm) is a herbal medicine that has traditionally been attributed with memory-enhancing properties, but which is currently more widely used as a mild sedative and sleep aid. In a previous study it was demonstrated that a commercial Lemon balm extract led to dose-specific increases in calmness, and dose-dependent decrements in timed memory task performance. The cognitive and mood effects of single doses of the most cholinergically active dried leaf were then assessed in a randomized, placebo-controlled, double-blind, balanced crossover study. These results suggest that doses of Lemon balm at or above the maximum employed here can improve cognitive performance and mood and may therefore be a valuable adjunct in the treatment of Alzheimer's disease. The results also suggest that different preparations derived from the same plant species may exhibit different properties depending on the process used for the sample preparation.

Mood enhancement questions
Q. Which of these mood enhancement nutrients is the best, lipoic acid or acetylcarnitine?
   A. Actually, I prefer a combination of small amounts of different nutrients as opposed to a high amount of just one. I don't see much of an effect by lipoic acid, and there may be a little bit of mood improvement with acetylcarnitine but alc is more of a mental enhancement nutrient.

Q. Does kava help with low mood?
   A. Kava may temporarily help for a couple of hours to relax and relieve tension, but it is not really appropriate to treat low mood.

Q. I drank alcoholically from about 35 to 50 years old. I stopped in 2005, with no relapses. Hooray for me! However, during my active addiction, I spent years medicated on SSRIs and Wellbutrin, hypertension meds, and a beta blocker for a heart rhythm problem. And, a couple of years on Glucophage. I'm off all meds now, having dropped 40 pounds, exercising regularly, and no booze. My question is in regard to my mood. There's a fragility of mood, e.g. easily discouraged, withdrawn, cry easily (not boo-hoo, but tear up), that was not true of me before recovery. Not one to overlook the obvious, I wonder to what extent I've damaged my brain during the years of ETOH and psych meds. I'm not having much success in finding research on this, and my hope is that you can refer me to resources. I want to understand what I've done to myself, and I very much want to learn paths to recovery and healing. I think I'll write a book, or at least an article, once I figure this out.
   A. Congratulations for all the self-improvement you have made, we are certain it was not easy. You may wish to read some ideas on natural methods and supplements on the depression page.

Q. For raising dopamine levels is SAM-e or L-tyrosine considered to be more effective? is it a question of getting what you pay for- L-tyrosine is a fraction of the price, does that translate to a difference in effectiveness? or is it a matter of trying both supplements and seeing which supports mood best for the individual?
   A. SAM-e is usually more effective but each person is different in which supplements improve or support mood enhancement.

Q. I am working on a story for a health magazine about ways to boost men's mood without the use of antidepressants. I would love to find out if men can boost their mood by having regular orgasms or sex. Are there any feel-good, mood-boosting chemicals released during sex that might help naturally boost a guy's mood? If so, how do they work in the body? How long do they last to help boost a guy's mood or help him relax, etc.? What else should men know about sex and their mood?
   A. Men can temporarily improve their mood through sex and orgasms which can last several minutes, hours, or days depending on the depth of connection and intimacy with the partner. Oxytocin is one major hormone that is released through orgasm and its effects normally last minutes or hours. If there is a connection and love with the partner, the afterglow of the sexual connection and mood lift can last a long time. However, in most men, sex is not a reliable and consistent way to improve mood. If there is no emotional connection with the partner, there can actually be a let down after the sexual act. Oxytocin is secreted from the pituitary gland. Oxytocin receptors are found in many parts of the brain and spinal cord, including the amygdala and brainstem. It's actions and biochemistry are too complex for the average reader.

Q. Do you have any thoughts on B12 and folate and their role in mood? How do folate and B12 work in the body to affect mood?
   A. Folate and B12 are vitamins that help in the formation of brain chemicals that are involved in mood. It is unlikely that there would be a significant mood lift in those who have normal levels of these vitamins in their body. However, those who do not ingest enough of these vitamins in their diet can have improved mood after taking them. A better option would be a B complex vitamin that has a combination of the B vitamins. It is best not to exceed 2 or 3 times the RDA for these vitamins. If a B complex supplement is not enough to help with mood enhancement, other natural options should be considered including 5-HTP, the serotonin precursor, SAM-e the potent methyl donor, and St. John's wort extract. B vitamins help form neurotransmitters such as serotonin, dopamine, norepinephrine, and others that are involved in mood.

A friend told me that serotonin is not the only chemical that affects mood; other chemicals are noradrenaline, dopamine, glutamine, GABA.
    Yes, many neurotransmitters, hormones, and other chemicals in the body influence how we feel or think.

About 4 years ago I started having some GERD problems, but was able to completely control them by strictly maintaining the diet / lifestyle changes. Almost a year ago I was able to release Lamictal that had been prescribed over a period of 14 years for bipolar II disorder (99% depression). I had a completely stable mood taking EMPowerPlus (mega doses of vitamins, minerals, aminos) and a few Total Amino Solution capsules per day, all recommended by my integrative psychiatrist. However after 2 months I developed LPR (laryngl-pharyngl-reflux) which I never had before. I felt that it very well could have been the EMPowerPlus since at that time I was opening the capsules up and mixing them in a smoothie and they seemed to burn my throat. I wasn't willing to stop taking them because I didn't want to go back to meds but still took the capsules without opening them up. After 2 more months the EMPowerPlus wasn't working so well and I became mentally depressed but not physically depressed as I had been before. So I stayed on the EMPowerPlus and added a large amount of the Total Amino Solution capsules to my routine and also added Kavinace (L-Taurine and B3) which completely took me out of the depression. I also started taking supplements for candida, i.e. caprylic acid, oil of oregano, aceytl-L carnitine and a hydrochloric acid supplements, all prescribed by a chiropractic internist. They really helped the candida very much but the LPR became worse. Now I've stopped everything including the Kavinace because it had a terrible affect on my sleep. I noticed an immediate improvement in the LPR. I have no idea what to do now in order to approach my mood disorder naturally and I don't need the candida supplements anymore. Do you think that amino acids could be the cause of this problem? What supplements should I absolutely avoid? I'm aware of the fish oil research and have taken it, but didn't notice improvement in mood. I've thought of doing large doses but wonder if that much oil could also worsen the LPR. I'd so appreciate your advice, including anything else I can do for the mood disorder. I'm a national speaker and my voice gets negativly affected by the LPR.
    I can't provide specific suggestions but this page and the page on depression have suggestions on nutrients and herbs that have an influence.

I'm taking "Mood Support" by Now Products. It contains mostly St Johns wort. I am experiencing sexual side effects, ie no sex drive. I'd like to switch to Sam-e (for depression) because Sam-e is not supposed to have those sexual side effects. Do you think its ok to just switch cold turkey....or slowly combine the two until I can wean off of St John's Wort.
   5HTP is more likely to cause sexual side effects. Most people can switch cold turkey but it is not easy to predict the reaction in any one person.