Over the years, many folkloric and herbal remedies have entered the list of drugs used by mainstream medicine. Aspirin was taken from the bark of the white willow tree; North American aboriginals made a tea out of this bark to treat fevers. Digoxin, a medicine used to treat heart failure, was developed from the foxglove plant. Vincristine, an anticancer drug, came from the periwinkle.
One of the herbal compounds used most frequently for depression is St John’s wort, which is available off the shelf at chemists and health-food shops. This plant was known in Greek times; Hippocrates thought it was helpful in treating depression. The active ingredient, hypericum, has been shown to improve depression in some studies, but the evidence is not consistent. A 1996 analysis of twenty-three studies suggested that St John’s wort was effective in treating depression. A recent, more carefully controlled study in American universities concluded that there was no significant effect. This product is currently the best-selling antidepres¬sant in Germany. The recommended dosage to improve depression is 100 to 300 mg daily, divided into three doses, of a 3 per cent concentration of hypericum. Sedation and photosensitivity (an increased chance of sunburn) are two possible side effects at this dose. St John’s wort can interact with other herbal remedies, such as chamomile, valerian and ginseng, to cause sedation, altered states of consciousness and decreased alertness. As well, the effect of prescription antidepressants is exaggerated in someone who is already taking St John’s wort.
Valerian root, used since Greek and Roman times to induce sleep and decrease anxiety, is also available off the shelf. However, people who are sensitive to this compound can suffer liver damage even at average doses. If excessive amounts are used, anyone can develop headaches and excitability.
Melatonin is an amino acid that is sold in health-food stores in the United States. It is produced internally in the body, by the pineal gland, to set the body’s circadian (daily) rhythms. It has been recommended for people who suffer from jet lag, and it may also help with seasonal affective disorder. It is not currently available in the UK.
SAMe is a form of the amino acid methionine that has been sold in Europe by prescription to treat depression. Several studies have shown it to be effective in treating mild to moderate depression, but in very high doses; the dosage required costs about $30 US a day. Studies of SAMe’s effec¬tiveness are inconsistent, and some are too short in duration to be convincing. The amount of active ingredient varies greatly from brand to brand, and SAMe can interact adversely with other medications.
Eating specific foods may in certain cases help counter depression. Some depressed people are deficient in specific nutrients, even though they have no clinical signs such as anaemia. Two of the worst culprits are folic acid and vitamin B12. Other B vitamins, such as thiamine and niacin, are also thought to help counter depression. Some people are deficient in trace minerals such as zinc and magnesium. Essential amino acids and omega-3 fatty acids, found in fish oils, are also thought to help counter depression. If your diet includes whole, fresh foods from the fat, protein and carbo¬hydrate food groups, you are probably getting adequate supplies of most of these elements, and it’s unlikely that you require supplements. But it’s very hard to prove or disprove the alleged effects of trace elements such as magnesium, zinc, manganese and bismuth, as we can’t experiment by removing these elements from our diet to find out whether we will develop depression without them. Even if adding extra amounts makes us feel better, there may be other reasons – including the placebo effect – for the improvement. Cause and effect can’t be proven.
All in all – if your doctor believes that a complementary therapy isn’t hurting you, and if you feel better with it, that’s fine. But if your doctor warns you against it – or if you are promised an instant cure for an excessive amount of money – beware. There are no ‘magic bullets’ for depression so far, and the condition can make you very desperate. Don’t make yourself more of a victim.