Healthy living strategies are the best treatment for depression, often recommended in addition to other treatments. These include regular exercise, a regular daily schedule, and a Mediterranean-type diet. Sleep hygiene is very important- bedtime at the same time every night, using the bedroom only for sleep or relations with partners, no electronics within 2 hours of bedtime, exercising during day but not close to bedtime, ensuring bedroom is dark and quiet at night. Being exposed to light in the morning and darkness in the evening has also been shown to help depression.

There is some evidence that certain vitamins and supplements can help mood.

Other non-medication treatments include phototherapy, Repetitive Transcranial Magnetic Stimulations (rTMS), and Electroconvulsive Therapy (ECT). Phototherapy is a mild but often effective treatment involving sitting in front of a light box for approximately 30 minutes every morning. The light box must be at least 10,000 lux (a measure of brightness). This is a common treatment for Seasonal Affective Disorder, a type of depression that tends to get worse in the fall and winter and better in the spring and summer. Seasonal Affective Disorder can be unipolar or bipolar. Patients with bipolar disorder may become manic or hypomanic in the spring and summer. Phototherapy is a common treatment for seasonal bipolar disorder since it is less likely to trigger mania than antidepressants do. If mania occurs phototherapy must be stopped.

rTMS is a fairly new, safe procedure in which magnetic pulses are applied to the prefrontal cortex of the brain, in the area thought to involve depression. Treatments are typically given 5 days per week for 4-6 months. Sessions usually last 30-45 minutes and have minimal side effects. The most common are temporary headache or face tingling. Rare side effects are temporary hearing loss (minimized by earplugs) or seizures. Because of the magnets, people with any metal in their head or necks (excluding braces or fillings) should not receive this treatment. Side effects are usually so minimal some people schedule sessions on the way to work. Because of the expense, rTMS is unlikely to be covered by insurance without 2 failed medication trials.

Electroconvulsive Therapy can be an extremely effective but frequently misunderstood treatment in which seizures are induced in the brain. The body is relaxed and does not manifest the seizure. The main risks are from the general anesthesia required. Despite its scary portrayal in old movies, it is usually very safe. The biggest side effect that I have seen is memory loss during the period it is given. During my inpatient psychiatry residency, it was a life-saving treatment for severely depressed patients. People would be hospitalized so depressed they could barely eat or move. Within a few ECT sessions, they would appear bright, motivated, and back to themselves.

Avoiding recreational drugs and excessive alcohol is another way to avoid depression and anxiety. Alcohol is a central nervous system depressant and can cause depressed mood and increased anxiety if consumed excessively. The recommendation of the. Is no more than one alcoholic drink per day and no more than 7 per week total for women and no more than two per day and no more than 14 total per week for men. Alcohol is spread throughout the bloodstream and can have ill effects on the brain, liver, kidneys, gut, and any other of the body’s organs.

People who abstain from alcohol can notice their mood improving within 2 weeks. People who drink excessively daily should be monitored by a physician since stopping abruptly can be dangerous for a heavy drinker.

Although marijuana is often labeled as “medicinal,” uses are still being investigated and there is no concrete evidence to date that it helps with any psychiatric condition.

There is also no data showing it to be safe when combined with medication. It can cause weight gain and poor motivation and concentration. Products are usually more highly concentrated than they were in the 1970s and therefore more addictive, with a strong withdrawal syndrome. People who use marijuana then abruptly stop can soon feel the opposite of how they felt when high- irritable, anxious, agitated, unable to eat or sleep. They consider this evidence that the marijuana has been helping them, not realizing their symptoms are part of a withdrawal syndrome. Marijuana is thought to be very harmful to brain development of youth under age 25.