Do You Need a Happy Pill?

Discover natural treatments for depression.

By Sharecare Expert Robin Miller, MD

I see a lot of depression in my practice, and my experience treating it has been pretty typical: About 70 percent of patients feel somewhat better when they go on antidepressants, but only 40 to 50 percent no longer feel depressed. As success rates go, that's disappointing. So I've been searching for something that could be used along with an antidepressant or on its own.

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And I've found it. It's a vitamin. It's safe, with no more side effects than a placebo. And it really does work.

The vitamin is a form of folic acid (one of the B vitamins pregnant women take to help prevent birth defects) called L-methylfolate. It's used to make serotonin, norepinephrine and dopamine, brain chemicals that are key to mood regulation.

The problem is that many people are walking around with deficiencies of L-methylfolate - and this may help explain a lot of stubborn cases of depression.

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Why are so many people deficient? Blame their genes. Before the body can use folic acid to make those depression-fighting brain chemicals, an enzyme has to convert the vitamin into L-methylfolate. But a lot of people have mutations on the gene that makes that enzyme. If you have one mutation, your ability to convert folic acid goes down by 34 percent. If you have two mutations, your conversion ability goes down by 71 percent.

The treatment is simple: a prescription for L-methylfolate. If given in the right amounts (7.5 to 15 milligrams), it can improve mild depression in a matter of weeks. It also seems to help people with major depression. In one recent study, when doctors gave patients L-methylfolate in addition to an antidepressant, 18.5 percent improved compared to just 7 percent of patients who took an antidepressant alone.

If you're depressed, and especially if you're depressed even while taking medication for depression, ask your doctor to test you for the genetic abnormality that I mentioned. The blood test is called MTHFR (the name of the gene involved). It just makes sense. If your levels of "happiness" chemicals are genetically low, why not find a healthy way to boost them?

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