Effective alternatives for depression

Conventional drug treatments for depression aren’t as effective as we’re led to believe, Cate Montana has found. But tradition and newer research reveals drug-free methods often work better, without all the side effects

Long ago, the Babylonians and Egyptians referred to today’s major depressive disorder (MDD) as “melancholia.” For the most part, ancient cultures around the world blamed melancholia on possession by evil spirits and demons. Sufferers were handed over to priests for “treatment”—typically beatings and other physical forms of abuse employed to drive the demons out of the possessed one.

By the time Greek and Roman physicians came along, melancholia was understood to be psychological in nature, and much more humane approaches such as exercise, diet, baths, massage, music and herbs like St. John’s wort were employed with some success.

Fast-forward several thousand years, and melancholia is an ever-increasing problem for global populations. Nearly one-third of all Americans have experienced MDD at some time in their lives. Research indicates that 22 percent of adults in the US have experienced depression so extreme they couldn’t work or manage daily tasks for two weeks or more.¹

Data from the Office of National Statistics (ONS) in the UK reveals that 20 percent of UK adults experience significant self-reported depression—twice as many as before the Covid pandemic.² Both countries have rates close to the estimated global rate of 19 percent for the disorder.

Depressive symptoms such as hopelessness, sadness, guilt, low energy, inability to concentrate, sleeplessness and oversleeping can last for weeks, and chronic conditions can ebb and flow for years. These symptoms are often accompanied by general anxiety and obsessive-compulsive disorder (OCD), varying from repetitive negative thoughts to self-damaging compulsive behaviors. Far more women are subject to MDD than men; one in four women aged 18–29 suffers from depression.¹

The standard treatment

Unfortunately, the usual treatment with antidepressants, such as SSRIs (selective serotonin reuptake inhibitors) and SNRIs (serotonin-norepinephrine reuptake inhibitors), is only marginally successful. A good number of people get temporary relief with medications only to experience a lessening of effectiveness over time.³

And, of course, as with any pharmaceutical drug, there are side effects, including weight gain, insomnia, nausea, dry mouth, headaches, sexual dysfunction, bowel issues and seizures.⁴

Some studies show that the use of SSRIs for depression may increase the risk of suicidal ideation and subsequent suicide.⁵ Other studies show that psychiatric treatment with antidepressants sometimes comes with “confounding variables” and “peculiar responses,” such as even greater depression and subsequent suicide—especially in the early stages of treatment.⁶

It’s not surprising that antidepressants don’t help much considering the “science” they’re based on is faulty—a review of hundreds of thousands of depression cases in 2022 found there’s no basis for the theory that low serotonin causes depression, as propagated by drug companies.⁷ And several reviews have shown a placebo works almost as well, implying the answer is a change of mindset, not brain chemistry.⁸

Alternative treatments

There are increasing numbers of alternative ways to treat depression. Some methods are ancient, tried and true, such as exercise, diet, baths, massage, music and herbs. Some are shamanic, such as heat therapies based on the therapeutic benefits of practices like spending time in a sweat lodge.

Then there are various therapies, like cognitive behavioral therapy, combined with the use of psychedelics like psilocybin (magic mushrooms) and other drugs, like LSD and the empathogen MDMA (3,4-methylenedioxymethamphetamine), commonly known as ecstasy. Other approaches are high tech, such as transcranial magnetic stimulation (TMS).

The following are a few of the most effective ones.

Heat therapy

Over the years, studies have indicated that simply taking a cold shower helped reduce depressive symptoms. That led to the hypothesis that depression was caused by a modern lifestyle that lacked sufficient “thermal exercise” (exposure to extremes of heat and cold) resulting in impaired brain function.⁹

Then there’s the discovery of heat shock proteins, which account for 5–10 percent of proteins in cells and are activated under stress such as high temperatures, protecting the body from the effects of stress. They perform many cleanup processes, including regulating proteins and cell death, which means they help prevent a wide range of chronic diseases.¹⁰

Other small studies revealed the odd fact that people with depression “run hotter” than other people. Finally, a study of 20,000 patients with depression published in April 2024 firmly established that this is indeed the case. People with depression consistently have higher average body temperatures.¹¹

All of these facts have led to an increased use of cryotherapy—ice baths and cold plunges—to reduce core temperatures.

However, thermotherapy, aka heat therapy or hyperthermia, and/or a combination of both cryotherapy and thermotherapy have been found to work even better. Jane Witt, trained in thermal healing practices under the auspices of Dr Susannah Sjoberg, uses contrast therapy—a combination of thermotherapy, cryotherapy and light therapy—to foster physical, emotional, and mental health and well-being.

“When I was in the military and lived overseas, I had the pleasure of living in Lithuania and Germany, and that’s where I really saw how thermal therapy was helping people with all sorts of different conditions, including depression,” says Witt. “After I left the military last year, I decided to study the world of sauna as a healing modality.”

At Fire & Ice near Leeds, UK (thisisfireandice.co.uk), Witt guides people through hyperthermia therapy using a traditional wood-fired Finnish sauna that gets up to 176–185°F (80–85°C).

“To the uninitiated, it sounds really perverse to put somebody who is already overly warm into heat,” she says. “But what the science is now showing is that the continued use of heat can lead to a lower core body temperature that endures for days beyond the actual treatment.

“That means you’re seeing results not just during the heat of the sauna itself, when the heat shock proteins are releasing and endorphins are releasing, but results that leave the body cooler for longer, which can lead to a reduction in depressive states for days.”

Researchers are still uncertain why depressed people have an elevated body temperature. Perhaps it indicates increased metabolic heat production. Or perhaps it indicates the opposite and a decreased ability of the body to cool itself.

Or perhaps a high body temperature points to imbalances in the central nervous system’s ability to process information from skin sensors or to issues with the immune system’s feedback abilities.

Whatever the cause, thermotherapy definitely helps. “I work with a veterans’ group, and a number of the members have been dealing with depression disorders as a result of service,” says Witt. “Not only is it helping the depression, I’m seeing a reduction in self-harming. The endorphin and the adrenaline rush of the sauna and cold water replaces the adrenal rush of self-harm.”

Studies show an integrated approach to major depressive disorder using cognitive behavioral therapy and biweekly whole-body hyperthermia sessions has therapeutic effects.¹² And whole-body hyperthermia alone has been shown to act fast and give a “prolonged therapeutic benefit.”¹³

Witt says another benefit of the sauna for treating depression is spending time there with other people. “It creates connection, and I see it giving people purpose and a reason to keep coming back. There’s a community that builds, and doing it together gives people time and space to open up and share their troubles. And that can really help, too.”

Psychedelic therapy

Lisa Ritter is a licensed professional counselor experienced in working with anxiety, depression, OCD, eating disorders and trauma. After 12 years working as a regular therapist, she was introduced to the use of psilocybin-assisted therapy.

Psilocybin, the active substance in “magic mushrooms,” is seen in modern society as a merely recreational “drug.” But shamans have been using psilocybin mushrooms for psychological healing purposes (along with other natural hallucinogens, such as peyote and mescaline) for uncounted generations.

Ritter was blown away by the results she saw, calling psilocybin-assisted therapy “the next great opportunity for healing.” She founded the Psilocybin Assisted Therapy Association in Portland, Oregon (pata-us.org), and has dedicated her life to helping people find their way to this kind of integrative therapy, which addresses all domains of life—mental, emotional, physical, social and spiritual—to enhance personal well-being and evolution.

“People are hearing about this, and quality information out there is scarce,” says Ritter. “Most people nowadays are looking for meaning, purpose and insight, and they want it quickly, which is why this kind of therapy is catching on.”

According to psychotherapist Mary Jane Wilt, owner of Whole Heart Counseling Services in Portland, Oregon (mjlpc.com), and graduate of the Integrative Psychiatry Institute, the speed of healing with psychedelic-assisted therapy is indeed impressive. “I’ve been working with trauma survivors for 20-plus years,” says Wilt, “and I am one myself. I’ve done 10 years in psychotherapy, so I know the power of psychotherapy from both sides of the fence.

“But working with patients and working on myself with psychedelic-assisted therapy, I’m seeing people doing five years’ worth of psychotherapy in five hours. It’s astonishing. You can’t get to the bottom of the stuff that people need to get to the bottom of without psychedelics—at least not in any other way that we know of to date.”

In layman’s terms, Wilt says conventional talk therapy is very linear and left-brain, which matches our trauma responses in the “default mode network” of the brain. The default mode network is where thoughts about ourselves and about our trauma experiences occur, and it’s active when we’re resting, which has been linked to depressive ruminating.¹⁴

Conventional therapy can get bogged down in the default mode network, but psilocybin and other psychedelic-assisted therapies activate the right brain. They bring up nonlinear thoughts, memories and associations, feelings and old emotions linked to traumas that can’t easily be activated by a left-brain approach.

“Psilocybin is a serotonin receptor agonist,” says Wilt. “It increases glutamate transmission and decreases neuro-inflammatory cytokines (small proteins important in cell signaling). It decreases amygdala reactivity through the prefrontal cortex and then decreases the activity of the default mode network, reducing the thoughts and beliefs we build up as defense mechanisms as a result of trauma.

“And when we bypass those automatic repetitive stories, the deeper truths of what we experienced and felt can surface. The right brain has tremendous capacity for helping us heal.”

Studies show that psilocybin taken with therapy is very effective for treating MDD.¹⁵ Even single-dose trials show a significant reduction in depression—including treatment-resistant depression.¹⁶ But Wilt stresses that it’s not the psilocybin that does the healing. It’s not even the treatment. Psilocybin is simply an aid to the psychotherapy.

“You can’t have lousy psychotherapy and just expect the psilocybin to take the work to another level,” she says. “But with good psychotherapy, all the studies about MDD and psilocybin say overwhelmingly that the effects are immediate and durable for the length of the study, most of which are around 12 months. So, the effects stay at a high level.”

Psilocybin treatment can be accompanied by side effects like headache, nausea and suicidal thoughts, making it vital to use it under the supervision of an experienced therapist.

Transcranial magnetic stimulation

Another highly effective method of treating MDD is transcranial magnetic stimulation (TMS). The human body and brain are electrical in nature, so it’s not surprising to find there are effective ways to stimulate the brain electrically and create impressive changes in mood.

The therapy, introduced in the 1990s, involves pulsing magnetic fields through a small electric coil. The stimulation produces electrical currents in brain tissue in specific areas related to different disorders.

For example, when treating depression, the prefrontal cortex is the specific target.¹⁷ The prefrontal cortex, anterior cingulate cortex and pre-supplementary motor area are targeted when treating OCD. People suffering from schizophrenia, who often hear “voices,” have their auditory cortex stimulated.

Wherever they target, the electromagnetic fields stimulate biochemical releases in the brain, including the production of neurotransmitters, and help increase neurological activity and neuron growth.

Studies show TMS effectively treats depression in patients who are treatment-resistant with no adverse side effects except for occasional short-term headaches in some patients.¹⁷ TMS might also reduce treatment time while rapidly reducing depressive symptoms.¹⁸

And it’s effective for treating OCD symptoms,¹⁹ which often accompany depression. The Food and Drug Administration (FDA) has approved it for treating both conditions in the US, and the National Institute for Health and Care Excellence (NICE) and Medicines and Health products Regulatory Agency (MHRA) have approved it for treating depression in the UK.

Treatment protocols

Here are some of the most effective ways to use alternative treatments for depression.

Thermotherapy

Get in a sauna one to three times a week. Start with 15-minute sessions and build up to 20 minutes maximum, a total of 60 minutes per week.

Jane Witt advises, “I wouldn’t really recommend anything longer than 20 minutes per heat session. Long sessions actually start becoming detrimental to a client’s health rather than beneficial.”

To make it easier, Witt recommends combining a sauna session with your regular workouts at the gym. Most gyms have a sauna, and you can build it in at the end as part of your regime.

Psychedelic therapy

Find a licensed psychedelic-assisted therapist to help you during and after psilocybin sessions. See the Psilocybin Assisted Therapy Association’s website (pata-us.org) for useful resources.

Transcranial magnetic stimulation

Find a licensed therapist and choose the type of coil you want to use.

• Figure-eight coil. Choose between (1) once a day for 20 minutes for 36 days and (2) 10 times a day for five minutes for five consecutive days.
• H-coil. The Stanford protocol, known as SAINT (Stanford Accelerated Intelligent Neuromodulation Therapy), uses neuroimaging (MRI) to guide precision placement of an H-shaped coil—providing accuracy within 1 mm—and calls for 10 five-minute treatments a day for five consecutive days.

Low-frequency stimulation of less than 1 Hz (one pulse per second) has an inhibitory effect. At higher frequencies of more than 5 Hz, the effect is excitatory.¹

To find a TMS provider near you, try the Clinical TMS Society (CTMSS, clinicaltmssociety.org) or see ‘TMS: An Effective Non-Drug Treatment for Depression.’

Light therapy

Bright light has a strong positive impact on mood because of the body’s many circadian and non-circadian processes. Bright light therapy has long been used to treat seasonal affective disorder (SAD), but it’s effective for chronic depression as well.²

To treat MDD and SAD, spend 30 minutes in front of a light source with an intensity of 10,000 lux (light boxes are widely available online). Early morning treatments have the greatest effect.

Bright light therapy also helps increase alertness and can regulate the body’s circadian rhythms. Side effects with this treatment are mild and may include headache, eye irritation, nausea and diarrhea.

Exercise

Exercise is an effective way to mitigate depression.³ Moderate-intensity exercise reduces depressive symptoms, but increasing the frequency, duration or intensity has been found to make it even more effective for people of all ages suffering from depression.⁴

Supplements and diet

Depression has been linked to low levels of the neurotransmitters serotonin, dopamine, GABA and noradrenaline, aka norepinephrine, in the brain, though the connection isn’t necessarily causative. Supplements that raise their levels in the brain may help you feel better.

To increase serotonin levels

• L-tryptophan: an amino acid used to make proteins, 8–12 g daily in three or four doses
• 5-HTP: an amino acid used to make serotonin, 100 mg twice daily
• Vitamin D: 50,000 IU per week for eight weeks
• Probiotics: Bifidobacterium longum, Bifidobacterium bifidum, Lactobaccillus reuteri, Lactobaccillus plantarum and Lactobaccillus helveticus, 1–10 billion CFU per serving each
• Omega-3 fatty acids: 250–500 mg combined EPA and DHA

To increase dopamine levels

• Caffeine: green tea, black teas, coffee
• Probiotics: see above strains and dosages
• Turmeric: 500 mg twice daily
• Ginkgo biloba: the antioxidant-rich fan-shaped leaves of the ginkgo tree, renowned for its brain benefits; 40 mg three times daily or 80 mg twice daily
• Chocolate: always a mood enhancer; no recommended amount is established, but choose a high cacao percentage and be moderate

To increase GABA

• Gamma-aminobutyric acid (GABA): a neurotransmitter that relaxes the brain by inhibiting excitation; take 100–200 mg daily as a supplement or consume GABA-rich foods such as spinach, kale, broccoli, beans, peas, sweet potato, barley

To increase noradrenaline/norepinephrine

• Noradrenaline: a neurotransmitter and hormone that promotes alertness and focus; eat proteins containing the amino acid tyrosine, which the body uses to make noradrenaline, such as meats and poultry, coldwater fish, beans, almonds, avocados, bananas, pumpkin seeds, sesame seeds

Other supplements for depression

• Magnesium: 500 mg daily for eight weeks
• Vitamin B12: 2.4 mcg daily as an oral supplement or, as an injectable supplement, 100 mcg daily for one week, then 100 mcg every other day for 14 days, then 100 mcg every four days for up to five weeks
• Vitamin B3 (niacin): 250 mg daily
• John’s wort: a plant that studies show is as effective as SSRIs for mild to moderate depression; 300 mg three times daily, but should not be used with certain antidepressants, such as citalopram, nefazodone, fluoxetine and fluvoxamine

A psilocybin-assisted therapy story

Mary Jane Wilt didn’t suffer from depression. But she had intense OCD as a result of childhood trauma that went unhealed despite conventional psychotherapy.

“I always had to have something going on that was more intense than the internal chaos,” she says. “Something intense enough to cover that original emotional neglect and pain. So, education, exercise and caretaking were my go-tos. And all my compulsive activities looked really good from a social perspective, so they never got uncovered as compulsions.”

Totally unfamiliar with any sort of psychedelic-assisted therapy, Wilt was asked to “sit” with several people who were desperate for help and wanted to use psilocybin and other psychedelic substances as part of their healing. She was deeply impressed with how deeply people were seeing into their psyches and how raw and real the emotions and memories were.

So, she decided to take her own psychedelic journey. “It was probably the most concentrated three hours of pain of my life,” she says. “I just wept from my guts because it brought up for me the emotional neglect, the physical neglect and abuse that were all part of my family of origin.

“What that first psilocybin journey did was allow me to feel all that pain without any of the self-protective measures I’d developed over the course of my life, without the masking of any of my normal thoughts and coping mechanisms.”

Unfortunately, at that point, Wilt knew nothing about integration work and psychedelics. It was a powerful experience, but she didn’t know what to do with it. Many years and many psilocybin journeys later, and now officially trained to do psychedelic-assisted therapy, she understands what needed to be done.

“If only I’d had an integration therapist there to ask me just one question, it would have led me to the depths of myself and made sense of issues that had plagued me all my life. Just one question, like: ‘So what have you done with all of that pain all this time?’

“If I’d had the slightest guidance, every compensatory compulsive behavior I’ve ever had would have instantly been clear to me, because all that compulsive behavior was tied to the original wounds. I would have been able to go back to the very first time that hole was made in my soul and repair everything.

“It’s all in the integration. Psychedelic-assisted therapy is like five hours of a magnifying glass on your unconscious world. And then, for weeks after, months after, while the brain is still plastic from the journey and the effects of the psilocybin, you’re in process with a skilled therapist, making sense of it all. It’s truly amazing.”

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