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synergy · 1
The Mocking 2016 meta-analysis pooled randomized trials in major depression: omega-3 supplements gave a small-to-moderate overall improvement, larger at higher EPA doses and in people already taking an antidepressant. The Mediterranean-style diet used in the SMILES trial (2017) also included eating more fish.
regulates · 5
Insomnia and depression are often intertwined: people with long-term insomnia are more likely to develop depression later (an observed association), and depression can make insomnia drag on and become chronic. Cognitive behavioral therapy for insomnia (CBT-I) is the first-line treatment for chronic insomnia (AASM 2021 guideline); antidepressants do not always fix the insomnia too, so both usually need treatment.
↔IBS
The gut-brain axis runs both ways: anxiety and depression are common in irritable bowel syndrome (IBS), and they in turn worsen bowel symptoms. Treating one often helps the other, but when IBS is treated with a tricyclic antidepressant the dose is usually lower than in psychiatry, aimed at gut pain and global symptoms rather than depression.
In the Cooney 2013 Cochrane review, exercise compared with no treatment or a control condition had a moderate pooled effect; in only the most rigorously designed trials, however, the effect was much smaller and no longer significant. So exercise helps with depression and can be considered alongside therapy and medication, but it cannot be called as strong as drugs. Myokines and brain-derived neurotrophic factor (BDNF) are candidate mechanisms still under study, not settled ones.
An underactive thyroid brings tiredness, loss of interest, weight gain and slowed thinking, which look much like depression. So checking thyroid-stimulating hormone (TSH) before treating depression is routine practice; depression is also more common in people with Hashimoto's thyroiditis than in others (an observed association).
←After birth and breastfeeding
Progesterone and estrogen fall sharply after birth. In an experiment with only 16 women that simulated high pregnancy hormone levels and then withdrew them, 5 of the 8 women with a history of postnatal depression developed clear depressive symptoms and none of the other 8 did, suggesting that some people are unusually sensitive to hormone withdrawal. The World Health Organization recommends screening for depression and anxiety after birth with a validated questionnaire.
contrast · 2
Burnout and depression can both bring tiredness and a lack of drive, and they are often confused, but burnout is tied to the work setting and eases when you leave it, while depression is a mood disorder that cuts across settings and flattens even the things you used to enjoy. The two can also coexist; low mood lasting more than two weeks, loss of interest, or thoughts of harming yourself call for an assessment by a psychiatrist or psychologist, not pushing through as if it were burnout.
Chronic stress keeps cortisol high in some people, and in animal studies that damages the hippocampus, a brain region that handles memory and helps put the brakes on emotion. Ashwagandha is sold to calm exactly this stress axis, and small trials saw lower stress scores and cortisol, but it is only an adjunct and cannot replace proper treatment for depression or anxiety.