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Natural remedies for depression and their risks

Key points

  • Natural does not mean safe in dementia—St. John's wort, melatonin, and CBD oil all carry risks of drug interactions, falls, and worsened confusion.
  • Always get a proper diagnosis before trying any remedy; depression symptoms can mimic other medical conditions like infection or medication side effects.
  • Non-drug approaches (routine, light exposure, meaningful activities, therapy) have stronger evidence than supplements for treating depression in dementia.
  • If you try a supplement, start at the lowest possible dose, monitor for side effects, and never combine multiple remedies without medical supervision.
  • Consult the doctor or pharmacist before starting any natural remedy, especially if your loved one is on blood thinners, antidepressants, or dementia medications.
  • Keep a symptom diary to track what works and what doesn't—this helps you and the doctor make informed decisions.

General caregiving information, not medical advice. Check medications and major care changes with your clinician.

Step-by-step

  1. Step 1: Get a proper diagnosis first. Before trying any natural remedy, ask the doctor: 'Could this low mood be from a medical issue like a UTI, thyroid problem, or medication side effect?' The source emphasizes that depression symptoms can be a sign of another disorder, so rule out physical causes first.

  2. Step 2: Start with non-drug approaches that have strong evidence. The source passages note that depression treatments involving certain types of therapy plus positive lifestyle changes are probably more effective than medication in dementia. Try increasing exposure to natural light during the day, maintaining a regular routine, and creating a calming evening environment (as the source suggests for sundowning).

  3. Step 3: If you're considering St. John's wort, talk to the pharmacist about every single medication your loved one takes—including over-the-counter drugs. St. John's wort can interact with blood thinners (like warfarin), antidepressants (risk of serotonin syndrome), and dementia drugs (like donepezil). The source says it 'can work as well as antidepressants' but also warns that natural doesn't always mean safe.

  4. Step 4: For sleep issues, try melatonin only after consulting the doctor and starting at the lowest possible dose (0.5–1 mg). The source notes that melatonin is generally safe but carries a small risk of increased drowsiness or falls in older adults with dementia. Never combine melatonin with sedatives or sleep aids without medical supervision.

  5. Step 5: If you're curious about CBD oil, know that the evidence is mostly anecdotal. The source mentions that many caregivers find CBD oil helpful anecdotally, but the medical community hasn't done enough studies to confirm safety or effectiveness in dementia. Start with a very low dose and monitor for side effects like drowsiness, dizziness, or changes in appetite. Discuss with your clinician first.

  6. Step 6: Consider omega-3 fatty acids (fish oil) as a potential support, but don't expect a quick fix. Some studies suggest omega-3s may help mood, but the source doesn't specifically endorse them for dementia depression. They are generally safe but can thin the blood, so check with the doctor if your loved one is on blood thinners.

  7. Step 7: Use behavioral activation—a simple, evidence-based technique. The source recommends setting realistic goals, breaking large tasks into small ones, and participating in activities that make you feel better, such as mild exercise or going to a movie. For someone with dementia, this might mean a short walk, listening to favorite music, or looking at a photo album. Do what you can, as you can.

  8. Step 8: Monitor for worsening symptoms. If you try a natural remedy and see increased confusion, agitation, falls, or new physical symptoms (like headache or digestive issues), stop immediately and call the doctor. The source warns that early attention to symptoms of depression may help prevent development of a more serious depression over time.

  9. Step 9: Keep a symptom diary. Write down what you try, the dose, and any changes in mood, sleep, appetite, or behavior. Share this with the doctor. This helps distinguish between what's working, what's not, and what might be causing harm.

  10. Step 10: Remember that natural remedies are not a replacement for professional care. The source is clear: 'So-called natural remedies for depression aren't a replacement for medical diagnosis and treatment.' Use them only as part of a comprehensive plan that includes counseling (like cognitive behavioral therapy), medication management if needed, and caregiver support.

What not to do

  • Don't assume 'natural' means harmless. Common mistake: giving St. John's wort because it's 'herbal' without checking interactions. Why it backfires: it can cause serotonin syndrome (agitation, confusion, rapid heart rate) when combined with antidepressants, or reduce the effectiveness of dementia drugs. Instead: always run any supplement by the pharmacist or doctor first.

  • Don't use melatonin as a daily sleep aid without medical supervision. Common mistake: giving melatonin every night for weeks. Why it backfires: it can cause daytime drowsiness, increase fall risk, and may not address the underlying cause of sleep problems (like pain, anxiety, or dementia-related circadian disruption). Instead: use it only occasionally and at the lowest dose, and prioritize non-drug sleep hygiene (consistent bedtime, limited caffeine, calming routine).

  • Don't combine multiple natural remedies or mix them with prescription drugs without professional advice. Common mistake: giving St. John's wort plus melatonin plus an antidepressant. Why it backfires: unpredictable interactions can lead to sedation, serotonin syndrome, or liver strain. Instead: pick ONE supplement to try, and only after discussing with the doctor.

  • Don't stop prescribed antidepressants abruptly to switch to a natural remedy. Common mistake: thinking 'natural is better' and stopping the prescription cold turkey. Why it backfires: withdrawal symptoms can include severe mood swings, agitation, and even suicidal thoughts. Instead: talk to the doctor about a gradual taper if you want to try a natural approach, and never stop a medication without medical guidance.

  • Don't rely on CBD oil as a primary treatment for depression. Common mistake: using high doses of CBD oil hoping it will cure depression. Why it backfires: it may cause drowsiness, dizziness, or liver issues (especially with other meds), and there's no strong evidence it works for dementia depression. Instead: use it only as a possible adjunct, and only after discussing risks and benefits with the clinician.

  • Don't ignore the possibility that depression is actually a side effect of another medication. Common mistake: trying natural remedies for low mood without reviewing the medication list. Why it backfires: many drugs (like beta-blockers, benzodiazepines, or even some dementia meds) can cause depression-like symptoms. Instead: ask the doctor for a medication review to see if any drugs could be contributing.

Practical tools

  • The Supplement Safety Checklist

    Before giving any natural remedy, print this checklist and go through it with the doctor or pharmacist: (1) What is the exact name and dose? (2) Does it interact with any current medications? (3) Is it safe for someone with dementia/Lewy body/Parkinson's? (4) What side effects should I watch for? (5) How long should we try it before evaluating? Keep a copy in your care binder.

  • The 'Start Low, Go Slow' Rule

    Always check with the doctor or pharmacist before starting any supplement, and before applying this rule. Use these doses only as a starting point after getting approval from a healthcare professional. For any supplement, start at half the lowest recommended dose for adults. For example, if melatonin is typically 3 mg, start with 0.5–1 mg. For St. John's wort, start with 300 mg instead of 900 mg. Wait at least 3–5 days before increasing. This minimizes risk of falls, sedation, and interactions. Write down the dose and date in a log. If you notice any increased confusion, dizziness, or unsteadiness, stop immediately and call the doctor.

  • The Non-Drug Mood Booster Menu

    Create a list of 5–10 free or low-cost activities that have helped in the past: listening to favorite music, looking at old photos, a short walk outside, petting a cat or dog, watching a funny video, calling a friend, sitting in the sun for 10 minutes, or doing a simple puzzle. Offer one each day. The source says 'participate in activities that make you feel better, such as mild exercise, going to a movie or a ball game.' Adapt for your loved one's abilities.

  • The 'What to Say' Script for the Doctor

    When you call the doctor, say: 'My loved one has dementia and seems depressed. I'm considering trying [name of supplement]. Can you tell me if it's safe with their current medications? What dose should I start with? Are there any side effects I should watch for? And are there non-drug options that might work better?' This gets you clear, actionable advice.

  • The Fall Risk Awareness Card

    Write on a sticky note or index card: 'Any new supplement can increase fall risk. Watch for dizziness, drowsiness, or unsteady gait for the first 72 hours.' Place it on the fridge or medication station. The source warns that some depression medicines (and by extension, supplements) are associated with an increased risk of falls. If you see any wobbling, stop the supplement and call the doctor.

  • The 'One Change at a Time' Rule

    Never start two new supplements or change two medications at the same time. Wait at least one week between changes. This way, if a side effect appears, you know exactly what caused it. Keep a simple log: date, supplement/dose, mood rating (1–10), sleep quality, and any side effects.

Discuss with your clinician

Ask the doctor: 'Is it safe to try St. John's wort with my loved one's current medications, especially their dementia drug and any blood thinners?'

Ask the pharmacist: 'Can you check for interactions between melatonin and all of my loved one's prescriptions, including over-the-counter drugs?'

Ask the doctor: 'What is the safest starting dose for [supplement name] given my loved one's age, weight, and dementia stage?'

Ask the doctor: 'Could the depression symptoms actually be caused by a medication they are already taking?'

Ask the doctor: 'If we try a natural remedy, how long should we wait before deciding if it's working, and what side effects should prompt us to stop?'

Ask the doctor: 'Are there any non-drug therapies (like cognitive behavioral therapy or light therapy) that might work better for my loved one's depression?'

Related guides

Sources