Non-RX supplements for attention/anxiety/depression issues?
October 26, 2017 7:35 AM   Subscribe

All standard YANMD disclaimers apply. I know and respect that "see your GP or a psychiatrist" is the usual response for questions like these but I have already gone that route multiple times with limited success (and several pretty wretched experiences). I don't currently have access to anyone, so I'd like recommendations for supplements or OTC products which would be helpful for moderate depression (mostly lack of motivation, pessimism, and rumination/anxiety).

My last psychiatrist wavered between an OCD diagnosis and an ADD diagnosis, which seems about right; I have difficulty with distraction and focus, but it’s hard to know whether it’s an attention problem or because I’m obsessively worrying. (No compulsions, just pure O, though sometimes the anxieties bother others around me — my anxiety about, say, losing my keys or wallet will prod me into pestering my partner and needing to know that they have their keys or wallet, that sort of thing.) I do the chronic-procrastination trick of waiting till the last minute and ginning up anxiety to propel me into Doing The Thing. It’s a bad strategy. Lately even that is not enough; it’s getting so I can’t see the point of doing most things, and so I’m just kind of… not?

These issues have persisted, in varying forms and to varying degrees, for about twenty years, now. Over those years I’ve seen five different professionals and I have tried a variety of medications with little success. My problems right now are low-grade (though persistent). I would drag myself back on the med-go-round if things were closer to life-threatening; as it stands, things just kinda suck. I distract myself from depression and anxiety by wasting time, and get stuck in procrastination loops where the tasks I really need to complete don’t get done; as I miss deadlines, I end up more anxious. And repeat. I have an end-of-day deadline right now and I already know I don’t have enough time to make it and I’ve been sitting at my desk all day. I am an idiot. I can’t keep doing this.

I have been prescribed a lot of SSRIs, I guess because I’ve usually led with “I dunno, I can’t get any work done and nothing means anything,” but none have had an effect (I’ve tried four). Zoloft in particular was a shitshow: I had miserable heartburn and stomach pain without fail, every dose, and for the three months I trialed it, that never let up. I also felt super-angry a lot of the time, something I never experienced before (or since, medicated or no). The doc at the time made me stay on the Zoloft despite the zero improvement and the side effects, but added Risperdal (without explaining why, but for the bad moods I guess?). He kept me on it even after I discontinued Zoloft and he tried me on other things. Wellbutrin was the one thing I’ve tried that worked a little, but when I asked to go up a bit from the initial dose to see if that would help more, the doc discontinued it entirely and told me Risperdal would work as a standalone treatment, which… it didn’t. At all. This sort of thing is why I’m not keen on trying shrinks again; that one was the worst by far, but the ones I’ve seen subsequently weren’t so helpful, either. I’m willing to give treatments a fair shot, and I understand side effects are to be expected and often do go away eventually, but since it would take several months even to get an appointment, since my insurance situation is pretty unstable and will be for the foreseeable future, since there are not many providers in my area, and since I’ve had trouble finding someone responsive, I’d like to try a different route. I'm also, to be honest, not very optimistic that there are workable RX options left out there? SNRIs have at least moved the needle a bit, but that's about all that has and it wasn't by much.

I've been trying 5HTP with a vitamin B-complex for the past three weeks. I haven't noticed much of an effect beyond stomach pain (similar to what I experienced with Zoloft, but considerably less severe). I know three weeks isn’t long, but the stomach pain isn’t improving much and I’d like to try something else, particularly since 5HTP supplementation is apparently not really a long-term solution anyway, from what I have read. I’m kind of not surprised it wasn’t effective because it seems like maybe serotonin is not the problem here, but I don’t know what non-prescription options for norepinephrine or dopamine exist out there.

Things I already do: eat well (no added sugar, few processed foods, fruit/veg, etc.), exercise ~ 3x weekly (as vigorously as I can, usually running), get at least 7h of sleep nightly with a (mostly) regular bedtime and rising time. I have been doing these things for about two years now (with the exception of the exercise, but I’ve been trying to keep it up). I’ve also been working on a meditation practice but it’s really not going so well; usually it turns into a rumination session so I’ve been less inclined to try. I already see a therapist.
posted by anonymous to Health & Fitness (18 answers total) 20 users marked this as a favorite
Oh god, I realize this is precisely not what you asked, but I’d be remiss if I didn’t tell you that Strattera, and then Effexor have been lifesavers from the tangled ADHD/OCD/GAD spaghetti that is my brains.
posted by chesty_a_arthur at 7:47 AM on October 26, 2017 [2 favorites]

I have depression, anxiety, and pretty bad ADHD. I feel I can relate.

Rather than spending money on (probably ineffectual) supplements and drugs, why not take that money and put it towards a relaxation and mindfulness activity. I mean, your goal here is to decrease your anxiety and feel happier, but it sounds like everything you're doing is frantic. Even this post read as very frantic.

I'd definitely focus on relaxing, positive self care, mindfulness, soothing activities, and meditation.
- If you're struggling with meditation, try some guided meditation programs/apps.
- alternative to meditation would be a hobby where your brain clicks into the "flow". Knitting, for example, is wonderful for me for entering a sort of meditative brain quieting state, and this is a proven phenomenon. It can be deeply satisfying, and you get warm things to wear out of it. Even if what you knit is crap it is still a great therapeutic activity.
- I think yoga in particular may be really positive for you. It can be very intense physically without being frantic.
- Massage therapy could also be good.
- I totally get why you are focusing on vigorous activity, but maybe being a little less vigorous and doing it daily would be better.
- You may need more than 7 hours sleep. I'm more of a optimal at 9 hours of sleep person, and I DEFINITELY feel way more anxious and depressed when I get less. I would try upping the amount of sleep you get to find your sweet spot.

In summary, put more effort into being calm and relaxed.
posted by PuppetMcSockerson at 7:56 AM on October 26, 2017

How do you find low-cost retreats? That sounds great to me too.
posted by bbqturtle at 8:30 AM on October 26, 2017

Vitamin B is nature's anti-depressant. Take a B supplement religiously. It takes a few weeks to kick in, and it's a low grade experience, so you won't feel bouncy or anything, but it will help. You'll notice if you stop taking it.
posted by janey47 at 8:34 AM on October 26, 2017

This isn't a supplement, but I recommend Mark Freeman's videos a lot for anxiety/OCD and attention.

Also, Wellbutrin at 300mg worked better than 150, FWIW. The max dose is 450mg so I have no idea why your shrink would have resisted it. It may be possible for your GP to prescribe it though, if you tell them that it was helpful for you.
posted by en forme de poire at 8:40 AM on October 26, 2017

Nthing fish oil. The psychiatrist I see has told me "all the psychiatrists are taking it."

I don't have your exact constellation of symptoms, but I did struggle with mood and motivation, and I took Meriva for an unrelated issue (heel pain) and it improved my mood noticeably. I don't know if OCD is related to inflammation, but depression is, and the Meriva helped.

Also if you do go back to Rx meds, I'd consider another trial with Wellbutrin at the higher dose. It helped me for a long time. Eventually it stopped helping, but I'm talking like 15 years.
posted by tuesdayschild at 10:12 AM on October 26, 2017

Ugh, I typed up a whole rambling thing about all the supplements I tried that didn't help, and all the antidepressants I tried that didn't help or had deal-breaker side-effects (including SSRIs and SNRIs). Long story short: I've just started Wellbutrin, and it is working REALLY nicely for me. I worked my dosage up gradually, which I understand can help minimize new-med side-effects, and just this morning bumped up to 300mg from 225. I don't know how I would be functioning at all, the shit life has been throwing at us lately. (A lot of med-resistant people respond to Remeron as well, I'm told. Both are "atypical" anti-depressants.)

I get that proper medical care is hard right now, but you have evidence that Wellbutrin worked for you in the past. I don't think it would be unreasonable to go to your PCP (or however it works where you live) and say, hey, this worked a little for me before and I'd like to try again at a higher dose. I say this from long experience: don't waste your time in this headspace if there is a possibility of help. This is your life.

Aside from that -- something that significantly reduced my stress (which has been long-running and contributes a lot to my current state) was a 4-week online mindfulness based stress reduction course called Be Mindful.

I'm sorry that doesn't help with supplements. I guess I'll throw in probiotics, since it hasn't been mentioned. Helps some people. Here is one option.
posted by moira at 11:26 AM on October 26, 2017 [4 favorites]

I find that St. John's wort helps for simple depression. However, you should read the disclaimers and warnings at this link to see if it is a good fit for you.
posted by Lynsey at 11:52 AM on October 26, 2017

This may come off as flippant and it isn't meant to be, but if you find that caffeine does not exacerbate any of your other issues, it is the natural thing to use to combat ADHD. It's a legal stimulant that tends to help most people, but it definitely can help those with ADHD. A relative of mine made it through a PhD program on a combination of lots of coffee and pot. I don't recommend the marijuana, but the coffee part seems solid. However, be aware that caffeine can foster a dependency/addiction and that it has multiplicative effects if you ever do go on a stimulant medication.
posted by Hactar at 11:56 AM on October 26, 2017 [1 favorite]

You might take a look at The Mood Cure- some libraries have it as well. It's all about supplements worth trying for these conditions and has suggested combinations, dosages, some potential interactions, etc. A few of them, several amino acids, helped my mood and (to a degree) my ability to focus until my blood pressure became a concern due to stopping exercise.
posted by JulesER at 1:01 PM on October 26, 2017

> I don't recommend the marijuana, but the coffee part seems solid

I'll recommend the marijuana, then. I took CBD for a while to see if it would help with my headaches, and it seemed to help with my ADHD. I've spoken to other people who've had the same experience.
posted by The corpse in the library at 1:56 PM on October 26, 2017

Seconding fish oil, for the ADHD specifically. I've heard it mentioned as a "can't help to try" thing in many books. Here's a critical appraisal summarizing some of the published research.

I don't have ADHD but I've used it as a supplement for chronic pain and depression, without any noticeable side effects. At the very least, it makes me feel noticeably more awake and less sluggish.
posted by fire, water, earth, air at 3:42 PM on October 26, 2017 [1 favorite]

Following the advice in this book has helped me with my depression and anxiety. It's all basically harmless, healthy habits type stuffs - including some supplement recommendations along the lines of fish oil.
posted by Brain Sturgeon at 10:29 PM on October 26, 2017

L-tyrosine for ADHD.
posted by thesockpuppet at 3:15 AM on October 27, 2017

For the OCD/anxiety side, consider trying inositol.
posted by Salamandrous at 3:21 PM on October 28, 2017

My psychiatrist recommended mega-doses of Vitamin D3. I take 1 of these every week, especially during fall and winter as the days are short.
posted by Coffeemate at 2:36 PM on October 29, 2017

Definitely O3/fish oil. That worked for me for more than five years, until last year's election. My doctor recently put me on St. John's Wort and the generic OTC version of Deplin. (I can't take regular SSRIs or other ADs, unfortunately.) I also take a lot of vitamin D, and after my last round of tests, I'm on iron (Vitron C) and a sublingual B12.

If I had to pick one, I'd go with O3s. Can you get blood tests to determine if you have any deficiencies? If so, I'd start there.
posted by instamatic at 8:11 PM on November 25, 2017

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