Acupuncture may improve depression by affecting the synthesis of neurotransmitters that control mood. Controlled trials have found electro-acupuncture (acupuncture accompanied by electrical currents) equally effective as antidepressant drug therapy without causing side effects. However, a controlled trial found that both real and fake acupuncture improved depression equally well compared to no treatment. It is well known that placebo effects are common in the treatment of depression, so more controlled trials are needed before accepting the usefulness of acupuncture for depression.
Many people who are depressed seek counseling with a psychologist, social worker, psychiatrist, or other form of counselor. An analysis of four properly conducted trials of severely depressed patients comparing the effects of one form of counseling intervention, cognitive behavior therapy, with the effects of antidepressant drugs was published in 1999. In that report, cognitive behavior therapy was at least as effective as drug therapy. While the outcome of counseling may be more variable than outcomes from drug or natural substance interventions, many healthcare professionals consider counseling an important part of recovery for depression not due to identifiable biochemical causes.
A rhythmic breathing technique called Sudarshan Kriya Yoga (SKY) may be an effective alternative to antidepressant drugs as an initial treatment for people with clinical depression. In a controlled trial, daily 45-minute SKY sessions six days per week produced a 67% remission rate among people with a diagnosis of depression. This effect compared favorably with the effects of electro-shock therapy and the antidepressant drug imipramine; however, no placebo was used in this study. SKY technique is taught by the Art of Living Foundation.
In a controlled trial, magnetic stimulation to the front of the skull and underlying brain produced modest reductions of depressive symptoms in depressed people who had not responded adequately to standard treatment. The procedure was performed by psychiatrists using sophisticated electromagnetic medical equipment, not a simple magnet.