Alternative medicine for depression

According to the National Comorbidity Survey Replication, only about 40% of people with major depression receive adequate conventional treatment, so it's important to get a better understanding of the other measures depressed patients are taking. A survey of American women indicates that a high proportion of them use alternative and complementary medicines for depression.

Researchers analyzed a national telephone survey of more than 3,000 women, with Mexican Americans, Chinese Americans, and African Americans somewhat over-represented in order to get a picture of ethnic differences. Of these women, 220 said they had been medically diagnosed with depression in the previous year, and 54% of them had used alternative medicine to treat the symptoms. The authors point out that the percentage would have been even higher if they had been able to include depressed women who never received a medical diagnosis.

The most popular alternatives were manual therapies, including chiropractic, massage, and acupressure, used by 26%; medicinal herbs and teas, used by 20%; and vitamins and nutritional supplements, used by 16%. Other unconventional remedies were yoga, meditation, tai chi, Chinese medicine, Ayurveda, and Native American healing.

Forty-five percent mentioned side effects of conventional medicines, and 43% said conventional medicines were ineffective. Seventeen percent said they could not afford conventional treatment. Sixty-five percent preferred a natural approach, 59% said that use of alternative remedies was consistent with their beliefs, 45% had become familiar with these remedies in childhood, and 39% had read or heard something about an alternative medicine. About one-third said a doctor had recommended alternative treatment, usually a manual therapy and almost never herbs or vitamins.

Although an alternative treatment that has not been studied scientifically should not substitute for an evidence-based medical treatment, the authors believe physicians should generally remain neutral about their patients' use of these remedies as supplementary. In particular, criticism of remedies accepted in a given culture or by a given ethnic group could be interpreted as disrespectful.

July 2007 update