(BlackDoctor org) -- For when it’s beyond a bad day: Learn more about symptoms and what you can do to overcome depression. According to research or other evidence, the following self-care steps may be helpful:

What You Need To Know:

• Get active
  Exercise that increases your heart rate at least three hours a week (or 30 minutes a day) may help boost your body’s natural mood-enhancers (endorphins)
  
• Check out St. John’s wort
  Take 600 to 1,200 mg a day of a standardized herbal extract containing of 0.3% hypericin to help with mild to moderate depression—but talk to your doctor first as St. John's wort can interact with certain medications
  
• Get enough iron
  A lack of iron can make depression worse; check with a doctor to find out if you are iron deficient
  
• Try B vitamins
  Take a supplement that contains folic acid and vitamins B12 and B6 to help correct deficiencies associated with depression
  
• Seek counseling
  A mental health professional may help you make a full recovery
  

These recommendations are not comprehensive and are not intended to replace the advice of your doctor or pharmacist. Continue reading the full depression article for more in-depth, fully-referenced information on medicines, vitamins, herbs, and dietary and lifestyle changes that may be helpful.

Dietary changes that may be helpful
Although some research has produced mixed results, double-blind trials have shown that food allergies can trigger mental symptoms, including depression. People with depression who do not respond to other natural or conventional approaches should consult a doctor to diagnose possible food sensitivities and avoid offending foods.

Restricting sugar and caffeine in people with depression has been reported to elevate mood in preliminary research. How much of this effect resulted from sugar and how much from caffeine remains unknown. Researchers have reported that psychiatric patients who are heavy coffee drinkers are more likely to be depressed than other such patients. However, it remains unclear whether caffeine can cause depression or whether depressed people were more likely to want the “lift” associated with drinking a cup of coffee. In fact, “improvement in mood” is considered an effect of long-term coffee consumption by some researchers, a concept supported by the fact that people who drink coffee have been reported to have a 58–66% decreased risk of committing suicide compared with non-coffee drinkers. Nonetheless, a symptom of caffeine addiction can be depression. Thus, consumption of caffeine (mostly from coffee) has paradoxically been linked with both improvement in mood and depression by different researchers. People with depression may want to avoid caffeine as well as sugar for one week to see how it affects their mood.

There is evidence that people with major depression may have insensitivity to insulin and impaired glucose tolerance. Whether treatment of impaired glucose tolerance helps depression is unknown, but a doctor can order laboratory tests to detect such abnormalities, and initiate treatment as appropriate.

The amount and type of dietary fat consumed may influence the incidence of depression. Previous studies have found that diet regimens designed to lower cholesterol levels may reduce death from cardiovascular disease, but may also heighten the incidence of depression. Does low cholesterol cause depression? It appears not, since studies have shown no adverse effect on mood in people taking cholesterol-lowering drugs. The connection more likely has to do with the balance of fats in the diet. Diets to lower blood cholesterol usually focus on restricting total fat intake while increasing the intake of polyunsaturated fats (e.g., corn and soybean oils). These oils are very high in omega-6 fatty acids, but the recommended diets otherwise lack important omega-3 fatty acids (EPA and DHA). A high intake of omega-6 fatty acids relative to omega-3 fatty acids and an inadequate intake of omega-3 fatty acids (e.g., from fish and fish oils) have been associated with increased levels of depression. People who eat diets high in omega-3 fatty acids from fish have a lower incidence of depression and suicide.

Lifestyle changes that may be helpful
Exercise increases the body’s production of endorphins—chemical substances that can relieve depression. Scientific research shows that routine exercise can positively affect mood and help with depression. As little as three hours per week of aerobic exercise can profoundly reduce the level of depression. One trial compared the effects of an exercise training program with those of a prescription antidepressant drug in people over 50 years of age. The researchers found the two approaches to be equally effective after 16 weeks of treatment.

Other therapies
Psychological counseling is an essential component of therapy.

Vitamins that may be helpful
Iron deficiency is known to affect mood and can exacerbate depression, but it can only be diagnosed and treated by a doctor. While iron deficiency is easy to fix with iron supplements, people who have not been diagnosed with iron deficiency should not supplement iron.

Deficiency of vitamin B12 can create disturbances in mood that respond to B12 supplementation. Significant vitamin B12 deficiency is associated with a doubled risk of severe depression, according to a study of physically disabled older women. Depression caused by vitamin B12 deficiency can occur even if there is no B12 deficiency-related anemia.

Mood has been reported to sometimes improve with high amounts of vitamin B12 (given by injection), even in the absence of a B12 deficiency. Supplying the body with high amounts of vitamin B12 can only be done by injection. However, in the case of overcoming a diagnosed B12 deficiency, one can follow an initial injection with oral maintenance supplementation (1 mg per day), even when the cause of the deficiency is a malabsorption problem such as pernicious anemia.

A deficiency of the B vitamin folic acid can also disturb mood. A large percentage of depressed people have low folic acid levels. Folic acid supplements appear to improve the effects of lithium in treating manic-depressives. Depressed alcoholics report feeling better with large amounts of a modified form of folic acid. Anyone suffering from chronic depression should be evaluated for possible folic acid deficiency by a doctor. Those with abnormally low levels of folic acid are sometimes given short-term, high amounts of folic acid (10 mg per day).

Preliminary evidence indicates that people with depression may have lower levels of inositol. Supplementation with large amounts of inositol can increase the body’s stores by as much as 70%. In a double-blind trial, depressed people who received 12 grams of inositol per day for four weeks had a significant improvement in symptoms compared to those who took placebo. In a double-blind follow-up to this trial, the antidepressant effects of inositol were replicated. Half of those who responded to inositol supplementation relapsed rapidly when inositol was discontinued.

Oral contraceptives can deplete the body of vitamin B6, a nutrient needed for maintenance of normal mental functioning. Double-blind research shows that women who are depressed and who have become depleted of vitamin B6 while taking oral contraceptives typic