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These interventions may include yoga, tai chi, qigong, meditation, mindfulness, breath regulation techniques, and the relaxation response.30,31 One hypothesis is that mind-body interventions reverse expression of genes involved in inflammatory processes activated by stress.32 Physical activity has been shown to exert multiple physiological benefits in major depressive disorder, including increasing BDNF.33 Whether its walking, swimming, bicycling, dancing, or some other enjoyable activity, an exercise prescription is a vital component of a mood-boosting care plan

If serum B12 levels are persistently low, consider alternative therapy (e.g., intramuscular or subcutaneous vitamin B12 therapy)