Melatonin for Depression, Anxiety & SAD Treatment

Melatonin is being used as a natural treatment alternative for depression and seasonal affective disorder (SAD), but how does it work and is it effective?

Melatonin is a neurohormone that is involved in regulating sleep patterns and can affect mood and energy levels. It has been used for improving secondary insomnia symptoms and impaired sleep patterns caused by depression, bipolar disorder, anxiety and schizophrenia.

While some studies have found benefits from taking melatonin supplements, others have found that this hormone can worsen dysphoria and negative feelings in some individuals with depression. It may also interact with some anti-depressant medications.

In one study, taking a slow-release melatonin supplement along with fluoxetine did not improve symptoms in patients with major depressive disorder (MDD). In another study, using slow-release melatonin with immediate-release buspirone did improve depression severity in patients with MDD.

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Melatonin and Depression

Melatonin is also known as N-acetyl-5-methoxy-tryptamine. It is a derivative of tryptophan, which is first converted into the neurotransmitter serotonin and can then be converted into melatonin.

This hormone is produced and released by the pineal gland [1], a small gland located almost in the middle of the brain. Release of melatonin is stimulated by perceptions of light and dark through the retina.

When the retina detects darkness or light, it sends a signal to the suprachiasmatic nucleus, which then relays circadian signals to the pineal gland.

The more “light” signals that reach the pineal gland, the less melatonin it releases. Alternately, “dark” signals cause the pineal gland to release large amounts of melatonin meant to prepare the body for sleep.

Research shows that individuals with depression typically suffer from sleep disruptions, which could worsen symptoms. In these cases, taking melatonin may help patients diagnosed with this mood disorder.

However, there have been contradictory results when using melatonin in clinical trials. It is unclear why melatonin seems to help patients with depression in some situations but does not improve symptoms in other situations.

In some cases, depression may be linked to a deficiency in serotonin. Since serotonin is the chemical precursor to melatonin, this could also result in low levels of melatonin being secreted by the pineal gland.

Theoretically, taking a melatonin supplement could improve sleep habits for people afflicted with low serotonin levels. However, more research is needed to demonstrate this.

Causes and Types of Depression

Biological and/or genetic causes of depression involve dysregulation of certain brain chemicals, specifically serotonin, dopamine, norepinephrine and epinephrine.

These hormones regulate mood, sleep, attention, motor activity and appetite. When brain receptors inhibit release of these hormones into the brain, mental and physical changes occur which may produce symptoms of depression as well as other mental disorders. [2]

Situational depression may be provoked by a traumatic life event such as a divorce, death of a loved one, sudden unemployment and ensuing financial problems.

This type of depression is referred to as “situational depression” because it has a direct cause. Once the problem is resolved, someone suffering situational depression generally does not continue experiencing symptoms of depression.

Sometimes counseling is all that is required for a patient to recover from situational depression, but medications can also be helpful as well.

Depression co-morbid with diseases such as Parkinson’s, Alzheimer’s, cancer, heart disease and diabetes can all instigate depression symptoms.
Dealing with the constant pain, hospitalization, the threat of death, worry and financial problems associated with a debilitating illness can precipitate depression in many individuals.

A program of supplements and counseling is frequently implemented in such cases to assist people who are dealing with a chronic illness.

Melatonin for Depression Treatment

Several research studies indicate that melatonin may help relieve symptoms of certain types of depression, such as seasonal affective disorder.

One study involving people diagnosed with seasonal affective disorder [3] found that, when given melatonin supplements in the afternoon, study subjects had “significantly decreased depression ratings” compared to another group with SAD who were given a placebo. [4]

SAD is a disorder linked to lower levels of daytime light in the winter months, when the days are shorter. It may be the result of a decrease in Vitamin D synthesis, which can subsequently cause lower levels of serotonin synthesis.

Melatonin and Treatment-Resistant Depression

In one study, subjects unresponsive to antidepressant medication were given five mg of SR-melatonin per day for two weeks and 10 mg per day for an additional two weeks while also taking antidepressants.

Results showed that SR-melatonin may be useful for relief of insomnia and some depression symptoms in those with treatment-resistant depression. [5]

Melatonin for Depression and Anxiety

In people with episodic or mild depression and anxiety, nocturnal melatonin exists in lower than normal amounts. [6]

In addition, the correlation between depression and melatonin levels is reinforced by chronobiological and epidemiologic evidence, i.e., evidence for seasonal affective disorders compared to non-SAD depression.

Furthermore, when people take beta-receptor blockers (drugs used to treat arrhythmia or hypertension), these medications appear to suppress melatonin secretion and cause neuropsychiatric issues such as insomnia, lethargy and depression. [7]

Does Melatonin Make You Depressed?

Currently, there are no clinical studies that indicate melatonin can induce depression or anxiety. However, the Natural Medicines Database notes that in some cases, melatonin can increase feelings of dysphoria in patients with depression.

The sleepiness produced by taking melatonin supplements may be misinterpreted by some as a sign of depression but research continues to show the positive effects of melatonin on depression as well as a variety of other health problems.

In fact, plasma and saliva measurements of melatonin reveal that a significant alteration in levels of melatonin, as well as timing of melatonin release by the pineal gland, exists in people diagnosed with acute depression, SAD and bipolar affective disorder.

Consequently, melatonin could be considered a “trait marker” and “state marker” for depression and mood disorders. [9]

Melatonin Antidepressant Side Effects

Formulated to target and regulate serotonin levels in the brain, antidepressants can help relieve symptoms of depression and anxiety but exert side effects that range from temporary to severe [10].

Side effects from antidepressants include:

• Nausea and vomiting
• Dizziness
• Recurring headache
• Nightmares/sleep disturbances
• Suicidal thoughts
• Weight gain
• Feeling fatigued upon rising in the morning
• Unusual behavior/personality changes

People taking melatonin for depression report minimal side effects that usually disappear after taking melatonin for about a week.

Drowsiness, light-headedness, decreased alertness and headache are the primary side effects experienced by most people taking melatonin for insomnia, depression and anxiety. [11]

Before Taking Melatonin for Depression

Talk to your physician before using melatonin for depression If you are taking medications for the following:

• Diabetes
• Psychiatric illnesses
• Blood clotting/bleeding disorders
• Low or high blood pressure
• Seizure disorders

Do not use melatonin for depression and anxiety without seeking medical advice if you know you are pregnant. Additionally, higher than recommended dosages of melatonin may interfere with ovulation and conception. [8]

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