I just picked up your magazine for the first time and was very impressed. Here’s a question for you: I have had depression (chronic, major depressive disorder, not bipolar) for about 10 years. I have been treated by a psychiatrist in combination with various prescription medications, with limited success. I have also tried St. John’s wort, with no success.
–P.R., Montreal, Quebec, Canada
Keville responds: Most herbalists, including myself, like the idea of using a holistic approach that incorporates diet, exercise, lifestyle and nutritional supplements along with herbs. St. John’s wort (Hypericum perforatum) helps many people, but it often needs to be taken for several months before you feel significant changes. Some people need to take at least the amount suggested on the label, which, for a tincture, is typically 20 to 30 drops taken three times daily.
Other herbs that may help are eleuthero (Eleutherococcus senticosus), Asian ginseng (Panax ginseng), wild oats (Avena sativa), gotu kola (Centella asiatica) and ashwaganda (Withania somnifera). There is also a Russian herb called rhodiola (Rhodiola rosea), just becoming popular in the United States, that helps the body adapt to stress. Sometimes ginkgo (Ginkgo biloba) helps. However, the best therapy is not just a matter of replacing a drug with an herb. You would probably benefit the most from a treatment plan specially designed for you. Consider seeing a holistic practitioner to help you with this.
Aromatherapy scents, such as lavender, chamomile, orange and especially neroli (also called orange blossom), usually have an antidepressant effect when inhaled. Use ones that appeal to you in a home diffuser, on a piece of fabric tucked into your pillowcase or as a room freshener.
You can supplement herbs and aromatherapy with acupuncture, massage and an exercise program. Also, be sure to have your thyroid checked to make sure it isn’t low. Nutritional supplements to consider include a form of tryptophan called 5-HTP, which helps increase the neurotransmitter serotonin. However, don’t take supplements until you learn more about them, and get a health professional’s OK before using them along with antidepressant drugs.
Khalsa responds: Ginkgo is known mainly as a treatment for cognitive disorders, such as Alzheimer’s disease. However, the herb is quite effective for depression as well. Ginkgo is known primarily to increase circulation and nerve function, so it seems a natural option to consider for depression. Sure enough, researchers began studying ginkgo for depression after noting mood improvements in patients taking the herb for cerebrovascular insufficiency.
In a 1993 German study, for example, 40 elderly patients with depression, who had not benefited fully from standard antidepressant drugs, were given ginkgo. After eight weeks, the Hamilton Depression Scale average score had dropped from 14 to 4.5. Truly remarkable.
Use a 24 percent standardized extract at a dose of 120 to 240 mg per day. If you’d like to use whole powdered leaf in capsules, seek out a good-quality source, and use up to 6,000 mg per day.
Kava (Piper methysticum), native to the South Pacific, excels in treating mood disorders. Known primarily as an anti-anxiety herb, kava also treats depression. Kava is an extensively researched herb, used widely in Europe. The active ingredients in kava (kavalactones) exhibit sedative, analgesic and muscle-relaxant effects. Many studies have proven kava to be equal — if not superior — to benzodiazepines, the Valium class of anti-anxiety drugs. Use a dose of standardized extract containing 100 to 200 mg of kavalactones per day for depression and anxiety. For sleep, use up to 250 mg of kavalactones before bed. Recent reports have linked kava extract with liver damage, so use this herb on a short-term basis only, preferably under the guidance of your health-care provider. Don’t use the herb if you have liver disease.
In my experience, cayenne (Capsicum annuum) and other chiles, especially red varieties, are excellent treatments for depression. I learned about chiles and depression from my mentor, Ayurvedic master herbalist Yogi Bhajan, and I’ve seen this remedy work countless times, even in cases of severe debilitating depression. Although the mechanism is not yet known, it’s been proven that chiles enhance production of endorphins, the mood-elevating brain chemicals responsible for the “chile-eater’s high.” Use cayenne capsules in gradually increasing doses (start with 1/4 of a capsule and increase by 1/4 capsule per day until you notice benefits), as your tummy tolerates. You probably can’t eat enough cayenne as a food spice to experience significant benefits, but if you enjoy spicy food, it might be worth a try.
The information offered in “Q & A” is not intended to be a substitute for advice from your health-care provider.
Kathi Keville is director of the American Herb Association (www.ahaherb.com) and author of 11 herb and aromatherapy books, including Herbs for Health and Healing (Rodale, 1996). She teaches seminars throughout the United States.
Karta Purkh Singh Khalsa has more than 25 years of experience with medicinal herbs. A licensed dietitian/nutritionist, massage therapist and board member of the American Herbalists Guild, he specializes in Ayurvedic, Chinese and North American healing traditions.