Complementary and Alternative Therapies (CAM)

What is Complementary and Alternative Therapies (CAM)?

Complementary and alternative medicine (CAM) therapies are natural practices or products that have developed outside conventional medicine. They have three main categories:

• physical therapies, e.g. exercise, yoga, bright light, acupuncture
• nutraceuticals (vitamins and minerals), e.g. Vitamin D, folic acid, magnesium, omega-3 fatty acids
• herbal remedies, e.g. St. John’s wort, roseroot and saffron

Some of these treatments may work, but most have not been thoroughly tested.

• Compared to the huge amount of data on standard medications or psychotherapies, research on CAMs is still limited. Few CAM studies have consistently positive results. Due to poor study designs, the results of many studies may be difficult to replicate in the community.
• Most studies looked at CAMs in major depression, with very few studies in other common mental disorders, such as anxiety disorders, bipolar disorder or schizophrenia.
• Physical therapies have been far more investigated than nutraceuticals or herbal remedies.

How does Complementary and Alternative Therapies (CAM) work?

Physical therapies

Many physical therapies work by increasing people's ability to tolerate stress.

An example:

We are not absolutely certain, but scientific evidence suggests that yoga practice provides benefit by acting on stress reactivity. People with anxiety or depressive disorders are often highly sensitive to stress and have overactive sympathetic nervous system reactions (the excitation system “fight or flight” response). When a person is under stress or perceives a threat, the sympathetic nervous system kicks in (inner tension, sweaty palms, quickened heartbeat, etc.) to help them get ready to avoid that threat, with increased secretion of such hormones as adrenaline.

Yoga has been found to help improve stress tolerance by stimulating the parasympathetic nervous system (the calming system) and reducing the activity of the sympathetic nervous system. When stress tolerance rises, stress sensitivity is reduced and a person’s daily life can be more manageable.

Nutraceuticals, herbal remedies and supplements

Researchers are investigating the effectiveness of a range of nutraceuticals, herbal remedies and supplements as treatments for depression, anxiety and other mental illnesses. The Royal College of Psychiatrists has published a summary of what we know about some of the herbal remedies and supplements. The summary includes information about how each substance is thought to work, side-effects and interactions with medications.

Who can Complementary and Alternative Therapies (CAM) benefit?

Which CAMs appear to be helpful for mental illnesses?

Some CAMs may be beneficial in depression, either alone or when used with medication. These include exercise, yoga, bright light therapy, S-adenosylmethionine (an amino acid), omega-3 fatty acids and St. John’s wort.

No CAMs have sufficient positive data to be recommended for severe depression, anxiety disorders or schizophrenia.

Risk of Side Effects

The pros and cons of the specific CAM, and your personal health and medication status, are key factors to consider. Your family doctor or psychiatrist can provide comprehensive advice and should be consulted before CAMs are added to your existing health or treatment regimes.

Despite their perceived "naturalness," vitamins, minerals and herbal remedies can have side-effects similar to standard medications.

These side-effects may include nausea, diarrhea, sedation/insomnia, agitation and irritability, as well as more serious effects, such as induced mania and worsening of depression. They can also have cancer-causing, liver toxicity or anti-blood clotting properties, or they may interact negatively with existing medications (psychiatric or non-psychiatric) or medical conditions.

Herbal remedies, vitamins and minerals may block the action or increase the potency of medications used to treat mental health or other medical problems.

An important risk of pursuing a CAM therapy is the possible delay of other well-established treatments.

Note: This article is for general information only. There is no related program or service at CAMH.

Related Programs & Services

• Help for families from CAMH 
  
• ConnexOntario

Additional Resources

• Complementary and alternative medicines - 1: Herbal medicines and supplements
• Complementary and alternative medicines - 2: Physical treatments
• National Center for Complementary and Integrative Health (National Institutes of Health)