We explore 9 alternative and complementary options to medication for clinical depression
The number of antidepressants prescribed in England has almost doubled over the past decade, with 70.9 million prescriptions being given out in 2018 alone. Around 4 million of us are long-term antidepressant users in England alone. With many talking about the pressure they feel to stop taking medication for their mental health, it’s clear that opinions are divided on the best way we can manage depression.
Medication isn’t for everyone. As someone who’s been on (and off... and back on... and off again) a whole spectrum of meds for depression and anxiety, I know how much of a struggle the whole process can be.
Antidepressants are a great option for many people. You should never feel pressured to stop taking medication, try out alternatives, or be made to feel bad for seeking help in whatever form best works for you. Likewise, for those who feel that medication isn’t a route they would like to take, exploring alternative options shouldn’t be criticised or looked down on.
Some people may be concerned that medication alone merely masks the problems that have contributed to their depression, rather than helping treat the underlying issues or helping them to develop alternative coping mechanisms to challenge and cope with their feelings. Others may not like the thought of being on medication, or may prefer to explore more holistic options.
Whatever your reasons are for seeking out alternative options, the most important thing is that you are seeking help and support. Always speak with your GP before making any alterations to your medication or exploring new treatment options. Many holistic options provide positive benefits in conjunction with other clinically proven methods to help treat depression, such as antidepressants and talking therapies. Putting your own mental health and wellbeing first is what is most important.
We share nine complementary and alternative options to help you manage your depression.
1. Talking therapies
One of the most popular alternatives to antidepressants recommended by the NHS, talking therapies typically involve speaking with a counsellor one-to-one or as part of a small group.
Although there are many different counselling options available, cognitive behavioural therapy (CBT) is one of the most frequently used options to help treat depression. Recommended by experts for those with moderate to severe depression, CBT may be recommended alongside the use of antidepressants or by itself.
Recommended by the National Institute for Health and Care Excellent (NICE), CBT can help you better understand how you think and behave, helping you to recognise negative patterns and concentrate on overcoming negative thoughts. Available in-person or online, counsellor Gherardo explains:
“CBT is an active, directive, and time-limited therapeutic approach used to treat people suffering from depression. Based on the principle that a person’s feelings and behaviours are determined by the way they think about the world, these cognitions are based on assumptions (schema) developed from previous experiences.
“For example, if a person interprets their experiences in terms of whether they are competent and adequate, one of the schema could be ‘unless I do everything right, I am a failure’”
Other popular forms of talking therapies that can help with depression include counselling for depression (CfD), mindfulness-based cognitive therapy (MBCT), interpersonal therapy (IPT), psychodynamic therapy, and group therapy.
2. Exercise and wellbeing
Depression can leave you feeling lethargic and with low energy. Even simple, everyday tasks can suddenly feel much harder. Regular exercise can help to boost your mood, create a sense of achievement, and help you feel more able to face things.
Recommended for mild to moderate depression, adults are advised to try and complete at least 150 minutes of moderate activity each week. Even taking a brisk, 10-minute walk can help you to feel more relaxed and clear your mind.
If you’re unsure where to start, the NHS guide to exercise for depression can help. Discovering an activity you enjoy or that can fit seamlessly into your daily routine is key to keeping active. Signing up for a Pilates class, taking part in yoga therapy, or even just finding a walking buddy during your lunch break can all help.
If you haven’t exercised in a while or are worried about the potential effects on your health, speak with your GP about exercise on prescription. Many GP’s across the country can prescribe exercise as an option for a variety of conditions (including depression).
3. Mood and food
If can be easy to overlook the impact what we eat and drink can have. Making small changes to your diet may be able to have an impact on your mood, helping you to think more clearly and have more energy.
Making sure you eat regularly, stay hydrated, and get your five a day can all contribute towards boosting your mood. Decreasing your caffeine intake, ensuring you are eating the right kinds of fats found in oily fish, poultry, nuts, and seeds, as well as consuming enough protein can all help.
Nutritionist Sarah explains more about the impact personalised nutrition can have on depression.
“Nutrition is the cornerstone to good mental health. On the face of it, our diets may seem to be sufficient, but our digestion, absorption, health history and inherited health traits can affect the amount of nutrients our body needs. One or more of these factors can tip the balance towards poor mental health. A balanced approach to diet and lifestyle can also help you regain physical and mental wellbeing.
“Low levels of vitamin D can contribute to depression. If you spend a lot of time indoors, work night shifts or wear sunblock in the summer, then you might be at risk of vitamin D deficiency.
“Another important factor is the balance of essential fats. Too much vegetable oil, seed oil or hydrogenated fats and not enough omega 3 can lead to an imbalance that can contribute to low mood and depression.
“Vegetarians and vegans should be mindful about conversion issues that might affect their essential fats status. Theoretically, you should be able to get omega 3 fats from some seeds and nuts.”
4. The power of sleep
Your lack of or poor quality sleep can have a bigger impact on our sense of wellbeing than you may realise. The more tired you feel, the more difficulty you will have in coping with unexpected challenges (as well as day-to-day life); the more difficulty you have in coping, the lower your self-esteem may fall. As you feel unable to cope, your feelings of anxiety and stress rise, leading to further trouble sleeping.
Breaking the cycle of sleep problems can be tough. Overcoming poor sleeping habits can help you to combat negative thoughts, feelings of depression and anxiety, as well as enabling you to feel less lonely and isolated (as increased energy levels may allow you to become more social and do things you previously didn’t have the energy for).
Establishing a routine each night can help you to feel more relaxed and calm. Incorporating mindfulness into your evening can help you to recognise, slow down, and even stop negatve reactions that may have become habit. It can also help you to see issues that may be causing you anxiety or distress more clearly, achieve better quality sleep, and increase your overall sense of wellbeing.
Discover simple ways you can get a better night’s sleep, find out more about how you can prevent poor-quality sleep from increasing your anxiety levels, or try these seven ways to find mindful moments in your day (as recommended by counsellor Fiona).
5. Explore art therapy
If you find it difficult to express yourself verbally or feel like you have a mental block when it comes to talking about depression, anxiety or stress, art therapy may be able to help. Using art and artistic mediums to help you explore your thoughts and emotions, this kind of therapy offers a practical way to feel more connected with the world around you, share your feelings without having to verbalise them, and find new ways of expressing yourself.
As one therapist explains: “People sometimes describe that when they are depressed they feel like they are in a dark tunnel which appears difficult to escape from. When feeling like this, it can be challenging to find a way to communicate with others. It may be that there are no words to accurately describe how you are feeling.
“Others find that no matter how much they talk about their feelings, it doesn’t appear to help and they need other ways to help express themselves fully. Art therapy can help people by providing a connection between their inner thoughts, feelings, and communication with others.”
Available in one-to-one sessions or as part of group therapy, art therapy may involve painting, sculpting, drawing, collaging, or any number of other forms of artistic expression.
If you are looking for a way to get started independently, creating an art journal can offer a therapeutic way of tracking what you are feeling. Drawing or creating something each day can help you to keep in touch with your feelings and may help prompt you to consider your actions.
6. Depression coaching
You’ve probably heard of counselling for depression, but have you heard of depression coaching? Often recommended in addition to (rather than instead of) talking therapy or medication, working with a depression coach can help you to follow through with your therapeutic goals. As coach and counsellor Julie explains:
“Through the coaching process, you may or may not find the lightbulb moment of the underlying reason for depression. Whereas, in counselling, that is the purpose and intention so that you can then make informed choices in the future. With coaching, this element of looking back can be ‘bypassed’ – instead, we focus on what changes can be made in the present, and what outcomes we would like in the future.”
Coaching can play an important role, offering encouragement and support if you are struggling to engage with daily activities, or have trouble coping with symptoms of depression. Often focusing on how you can overcome negative feelings and emotions, as well as how you can rediscover your motivation, meeting regularly with a coach can offer a boost in energy and optimism.
7. Ecotherapy and getting back to nature
In essence, ecotherapy looks to restore your sense of wellbeing through contact with nature. Working on the idea that our separation from nature impacts our overall sense of emotional wellbeing, as well as our behaviour towards our environment, many believe that spending time forest bathing, exercising outdoors, or even growing your own food can have positive effects on your mood, relaxation, physical and mental health.
As one person explains to Mind: “Nurturing something else into life has really helped my wellbeing – gently caring for something helped me learn to care for myself.
“It helps to keep me calm and physically healthy, and I love taking the time to be mindful of all the beautiful green spaces around me, even when living in a city. Watching the birds and squirrels always has a calming effect and takes me out of my own head.”
8. Self-care (isn’t selfish)
Making time for self-care is an important part of managing your overall health and wellbeing. While many of us may assume self-care means making time for long baths, regular meditation, or pricey fitness classes, those are just a few of the ways some people choose to practice self-care.
In essence, self-care is a conscious effort to do things you will enjoy and/or benefit from, to help improve your mental and physical wellbeing. This can help you to identify your needs, and begin taking steps to meet them.
For one person, self-care may be making time to go on a walk through nature without their phone to distract them, or giving themselves a creative outlet through journaling. For another, it may be listening to podcasts whilst tackling a stack of laundry that has been weighing more heavily on their minds than they may have realised.
Discovering what self-care means to you is about focusing on what will give you the opportunity to rest and refocus; that may mean doing something alone to help you recharge, or being social and spending quality time with others. There is no right or wrong answer.
9. Support groups
Isolation can be one of the toughest parts of depression. Finding others who have been through similar experiences and have a greater understanding of what it can feel like to be depressed can offer a sense of camaraderie, emotional support, and validation.
Support groups, unlike group therapy, focus on bringing together people dealing with the same (or similar) issues or concerns in a safe space. Both offer the space to share in a group setting, helping you to increase your sense of self-awareness, make new connections, and gain a sense of community.
Discover more about the differences between group therapy and support groups, or find more information about support groups in your area.
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