Researchers looked at 47 different studies involving over 4,000 people with chronic fatigue syndrome (CFS) to see which non-medicine treatments work best for depression. They found that changing what you eat was the most helpful approach, followed by traditional treatments like moxibustion (a heat therapy) and acupuncture. This is good news because it means people struggling with both fatigue and depression might find relief through simple lifestyle changes rather than just taking more pills.

The Quick Take

  • What they studied: Which non-medicine treatments work best to reduce depression in people who have chronic fatigue syndrome
  • Who participated: Over 4,000 people across 47 different research studies who had chronic fatigue syndrome and depression or depressive symptoms
  • Key finding: Diet changes were the most effective treatment, showing about 5.6 times more improvement in depression symptoms compared to doing nothing. Moxibustion (a traditional heat therapy) came in second with about 2.9 times more improvement.
  • What it means for you: If you have chronic fatigue and depression, paying attention to what you eat might be one of the most helpful things you can do. However, talk to your doctor before making major changes, as this research shows promise but isn’t a replacement for medical care.

The Research Details

Researchers conducted a network meta-analysis, which is like a super-study that combines information from many smaller studies to find patterns. They searched nine different medical databases for all randomized controlled trials (the gold standard of research) published up until March 2025 that tested non-medicine treatments for depression in chronic fatigue patients. They included 47 studies total with 4,028 participants. Each study was checked for quality using a standard tool to make sure the results were trustworthy. The researchers then used special computer software to compare all the different treatments against each other and against doing nothing (control groups).

By combining many studies together, researchers can see the bigger picture instead of relying on just one study. This approach is especially useful when individual studies are small or have mixed results. It helps doctors and patients understand which treatments are most likely to actually work.

This is a well-designed analysis that followed proper scientific methods and was registered before the study was completed (which prevents researchers from cherry-picking results). The researchers looked at the quality of each included study. However, the individual studies included varied in quality, and some treatments had fewer studies supporting them than others, which means some findings are stronger than others.

What the Results Show

Diet therapy showed the strongest effect, with depression symptoms improving about 5.6 times more than in people who didn’t change their diet. This was followed by moxibustion (a traditional Chinese medicine technique using heat), which showed about 2.9 times more improvement. Combining acupuncture with moxibustion and acupoint embedding (a technique where small seeds are placed on specific body points) showed about 3.2 times more improvement, while acupuncture combined with moxibustion alone showed about 2.5 times more improvement. All of these treatments showed better results than doing nothing at all.

The analysis looked at multiple types of non-medicine treatments, including various traditional Chinese medicine approaches and dietary interventions. The researchers found that treatments combining multiple techniques sometimes worked better than single treatments, though diet therapy alone was still the most effective overall. The consistency of results across different studies was generally good, meaning the findings weren’t just flukes.

This research builds on earlier studies that suggested non-medicine treatments might help with depression in chronic fatigue patients. Previous research has shown that depression makes chronic fatigue worse, so finding effective treatments for depression is important. This analysis is one of the first to directly compare multiple non-medicine approaches side-by-side to see which works best.

The studies included came from different countries and used different methods, which can make comparisons tricky. Some treatments had fewer studies supporting them, making those results less certain. Most studies came from China, so the results might not apply equally to all populations. The quality of individual studies varied, and some didn’t use the best research methods. We don’t know the long-term effects—studies only looked at short-term improvements. Finally, the exact type of diet changes that worked best wasn’t always clear from the studies.

The Bottom Line

If you have chronic fatigue and depression, consider talking to your doctor about dietary changes as a first step (moderate confidence). Traditional treatments like moxibustion and acupuncture may also help, though more research is needed (lower confidence). These should complement, not replace, any medical care your doctor recommends. Start with one change at a time so you can see what helps.

People with chronic fatigue syndrome who also experience depression or low mood should pay attention to these findings. This is also relevant for doctors treating these patients. However, if you have severe depression, you still need professional mental health care—these treatments are additions, not replacements.

Based on the studies reviewed, most people saw improvements within a few weeks to a few months of making dietary changes or starting other treatments. However, everyone is different, so it might take longer for some people. Don’t expect overnight changes.

Want to Apply This Research?

  • Track your mood daily using a simple 1-10 scale and note what you ate that day. Look for patterns between specific foods and how you feel over 2-4 weeks.
  • Start by adding one anti-inflammatory food to your diet (like fatty fish, berries, or leafy greens) and remove one processed food. Track how your energy and mood change over two weeks before making additional changes.
  • Create a weekly mood check-in and food log. Every Sunday, rate your overall depression symptoms and energy levels, then review what dietary patterns correlated with better weeks. Adjust your diet based on what you notice.

This research summary is for educational purposes only and should not replace professional medical advice. Chronic fatigue syndrome and depression are serious conditions that require proper medical evaluation and care. Before making significant dietary changes or starting new treatments, please consult with your healthcare provider. This analysis shows promising results, but individual responses vary, and what works for one person may not work for another. If you’re experiencing severe depression or suicidal thoughts, seek immediate professional help.