Herbs for Depression & Anxiety December 27, 2016 13:17
Try these natural and healing ways to combat and fight depression.
Depression and anxiety take an enormous toll on us. Depression increases the risk of a heart attack to almost three times normal—twice the increased risk attributed to smoking, hypertension, or diabetes; it literally hurts our hearts.
But how effective are antidepressants? A meta-analysis of all antidepressant studies from 1990 to 2009 showed that there was significant improvement in depression only in the most severely depressed group, which constitutes only about 13 percent of all depressed patients.
The effect of antidepressants on mild to moderate depression was not significant. Meaning, the participants were as likely to improve by chance as they were from taking antidepressants.
As depressing as the data on antidepressants is, there is hope! Many studies show decent efficacy of simple, safe behavioral treatments for depression. And data continues to accumulate that supports the use of various herbs and supplements. Here are some of the innovative ways that we are successfully approaching anxiety and depression.
Probably the best known herb used to treat both anxiety and depression is St. John's wort. It is used first-line in Germany for mild to moderate depres- sion and is well-established as an effective antidepressant—equivalent in effectiveness to prescription antidepressants—with fewer side effects. Like the SSRIs, St. John's wort also has an anti-anxiety effect that is nice for my patients with both depression and anxiety.
St. John's wort is my go-to herb for significant depression, and I often combine it with SAM-e for a faster ￼￼￼￼￼￼￼￼￼￼￼￼￼￼￼￼onset of action. The dose of St. John's wort is 450 milligrams twice daily. I typically have someone start on 450 milligrams in the morning for 3 days and then add the afternoon dose if it is well-tolerated. St. John's wort takes 4 weeks to achieve full effect, and its major risk involves interactions with other drugs and supplements. This can make it tricky to use in patients who are taking other medications, and, if you are taking medications, it should absolutely be monitored by your doctor to be sure that there are no toxic side effects.
I want to emphasize that St. John's wort decreases the potency of birth control pills—making pregnancy possible, even if you are taking them. It can also decrease the potency of hormone replacement therapy.
It is my newest favorite anxiety treatment that doesn't make you tired. It can be used as needed—when anxiety arises, or regularly, depending on your needs. It is a frequent flyer in my office for my patients who sometimes struggle with an overly anxious, busy, obsessive mind.
My other favorite treatment for mild anxiety is L-theanine, which is an extract from green tea. It increases GABA and dopamine and causes a calm alertness, without making you tired. I always think of those Zen monks in Japan sipping their green tea with calm alertness.
L-theanine also enhances attention, focus, memory, and learning, which is pretty darn cool. This is another frequently prescribed supplement in my office because of its lovely effects and lack of side effects. It can be used at 100 to 400 milligrams up to twice daily on a regular basis, or simply as needed.
Valerian root is my favorite herb for sleep, and the most effective, according to research. It is also a great anti-anxiety herb, but, unlike lavender or L-theanine, it will definitely make you tired! It's a good option for more severe anxiety spells and for evening use, when you will no longer be driving or working.
Valerian can be taken during the day in very small doses, 20 milligrams or less. In fact, it is widely available in "sleep teas" at a dose of about 20 milligrams. For sleep, or more severe anxiety in the evening, I use doses as high as 600 milligrams. It is important not to combine valerian with alcohol or other depressant medications.
Kava has been used as a therapeutic tea in ceremonies in the Polynesian islands for centuries. It is nonaddictive and has been shown to be effective￼￼￼￼￼￼￼￼￼￼￼￼￼￼￼￼in generalized anxiety disorder. Kava has a feel similar to alcohol—relaxing and anxiety-reducing, but with no addictive quality. Some studies over a decade ago showed that kava caused liver toxicity, but those studies used the incorrect parts of the kava plant, and the supplements had contaminants in them.
Still, I am cautious and would never use kava in a patient with any history of liver abnormalities. It can be used in most people in the evening, with good effect. It is not typically recommended long-term, but can be very effective for bouts of anxiety. The dose is up to 120 milligrams of kavalactones twice daily. Kava is also available in much smaller doses in tea form.