According to the World Health Organization (WHO), mental health is essential to an individual's well-being, influencing their ability to manage stress, realize their potential and contribute to society. It affects personal development, decision-making, communication and relationships. The rapid evolution of modern society and changes in lifestyle have led to an increase in mental disorders. It is estimated that one in eight people worldwide suffers from mood disorders of varying degrees and severity.
Among the most common mental disorders is depression , which causes sadness, hopelessness, and loss of interest in daily activities. The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-5) distinguishes several types of depression, including major depressive disorder (MDD) and dysthymia . Women are more vulnerable to depression, with 5% of adults suffering from it (6% of women and 4% of men). Globally, approximately 280 million people suffer from depression.
Subthreshold depression (SD) , or subclinical depression, is a form that does not meet the diagnostic criteria for MDD, but can still significantly impair quality of life. The prevalence of SD ranges from 2.9% to 9.9% in primary care and up to 17.2% in community settings. SD is also a risk factor for the development of MDD, particularly in the elderly population.
Treatments for depression include psychotherapy and the use of psychotropic agents, especially antidepressants . However, approximately 30% of patients do not respond to conventional antidepressant medications, a condition called refractory depression. In these cases, alternative treatment options such as increasing the dosage or combining it with other medications are recommended.
Additionally, environmental, cultural, and lifestyle factors, such as diet, exercise, and alcohol and drug abuse, can influence mental health. Individuals with mental disorders often also suffer from sleep disturbances . Sleep is crucial for maintaining health and homeostasis, supporting cognitive function, and relieving stress. Sleep deprivation (SSD) is a known risk factor for depression, with studies showing a strong association between SSD and depressive symptoms.
Improving your diet and taking nutritional supplements can be effective strategies for treating mild forms of depression or as a support for antidepressant therapy. Some nutritional supplements also show benefits for sleep, improving the quality of rest and promoting emotional balance.
Among the most effective supplements against depression and anxiety, we find vitamin D , antioxidant vitamins (A, C, E), polyunsaturated fatty acids (PUFA), N- acetylcysteine (NAC) , S- adenosyl methionine ( SAMe ) , probiotics and prebiotics , and some essential minerals such as selenium , zinc , magnesium and **copper.
This article will explore the role of SAMe in the management of subthreshold depression and major depressive disorder, as well as the contribution of melatonin in improving sleep quality, which is closely linked to mood regulation.
SAMe : Role in Depression
S - adenosyl -L-methionine ( SAMe ) is a molecule produced by our body, discovered in 1952 by the Italian researcher Giulio Cantoni. SAMe is involved in numerous biochemical processes, such as the synthesis of neurotransmitters and potential epigenetic mechanisms. SAMe is mainly produced in the liver by the conversion of L-methionine and plays a fundamental role in cellular function, including transmethylation and the synthesis of polyamines .
Clinical studies have shown that SAMe , administered orally, can cross the blood-brain barrier and improve neurotransmitter levels in the brain, with positive effects on depression. Some studies show that SAMe is as effective as tricyclic antidepressants (TCAs) in treating depression, with the advantage of a faster onset of action.
In a randomized controlled trial, patients treated with SAMe (800 mg daily) showed significant improvement in depressive symptoms compared to placebo. Additionally, SAMe enhanced the efficacy of selective serotonin reuptake inhibitors (SSRIs) , suggesting that it may also improve cognitive symptoms related to depression.
Melatonin: Regulation of Sleep and Mood
Melatonin is a natural hormone produced by the pineal gland that regulates the sleep-wake cycle and affects mood. Recent studies suggest that melatonin may be useful for improving sleep quality, reducing symptoms of insomnia associated with psychological disorders, including depression .
Melatonin has also been studied as a potential complementary treatment for mood disorders, with evidence suggesting improved mood through improved nighttime sleep.
Conclusions
In summary, S- adenosyl -L-methionine ( SAMe ) and melatonin are two supplements with significant potential benefits in the treatment of depression and sleep disorders . While SAMe acts directly on the metabolism of neurotransmitters and can support the effectiveness of other antidepressants, melatonin is proposed as a valid ally in improving the quality of sleep, an essential factor for mental and physical well-being. The combination of these two supplements, together with a balanced diet and a healthy lifestyle, could represent an effective strategy for the treatment of disorders related to mood and sleep.
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