Depression: Herbal Alternative?

by Food and Drug Administration (FDA)

(Page 3 of 3)

Talking It Out

For severe depressive episodes, medications are often the first step because of the relatively quick relief they can bring to physical symptoms. For the long term, however, psychotherapy may be needed to address certain aspects of the illness that drugs cannot. "Although the biological features of depression may respond better to drugs," Laughren says, "people may need to relearn how to interact with their environment after the biological part of the depression is controlled."

"I wanted to talk things out and get better in that way," John says. "And even after the first couple of times I saw my therapist, I could do a little bit more. Talking with her gave me some reality that how I was feeling wasn't so abnormal, so unusual, or so terrible."

Anne explains, "It's just comforting sometimes to share the little day-to-day happenings in my life with someone who doesn't get to see them first-hand."

Some find support groups to be invaluable in helping them cope with their depression. "It's through talking with others with similar experiences," says Mary Rappaport, "that you can better understand what you're going through."

Changes in lifestyle are also important in the management of depression. Exercise, even in moderate doses, seems to enhance energy and reduce tension. Some research suggests that a rush of the hormone norepinephrine following exercise helps the brain deal with stress that often leads to depression and anxiety. A similar effect may be obtained through meditation, yoga, and certain diets.

A Bright Future

Like many others who have not had to face depression themselves, John's friends lacked knowledge about the disease. "I think the whole thing really affected my relationships with people," he says. "I was pretty much a jerk all of the time. I didn't want to talk to anybody. I just wanted them to leave me alone."

With the growing awareness of the seriousness of the disorder and the biological causes, the understanding and support of family and friends may be easier to come by. "The future looks very bright for individuals who in the past have often had to suffer alone," says Rappaport. "More and more people are coming out, which encourages people to talk about it." Among those who have "come out" recently to publicly discuss their personal bouts with depression are comedian Drew Carey and "60 Minutes" correspondent Mike Wallace.

Experts say that no one, young or old, has to accept feelings of depression as a necessary part of life. The National Depressive and Manic Depressive Association and other organizations offer medical information and referrals. By trying different options for facing their personal challenges, Anne and others have learned what treatments help them most. "All in all," Anne says, "I think my ability to weather the ups and downs of life has gotten better."

Researchers continue to make great strides in understanding and treating depression. For example, scientists are beginning to learn more about the chromosomes where affective disorder genes appear to be located. "While there is a long way to go in coming up with even more effective drugs," Laughren says, "there's much ongoing research and reason for optimism."

"An Herbal Alternative?"

St. John the Baptist's birthday is celebrated on June 24. It is also around this time that the pretty yellow flowers of St. John's wort, the plant named in his honor, bloom in Germany. The plant may be more than just beautiful. Hypericum, the concentrated extract of flowers and leaves, is thought by some to be effective in treating depression.

While the herb is the most-prescribed antidepressant in Germany, in the United States, St. John's wort is not an approved drug. Many health food stores in this country sell it as a dietary supplement, but FDA does not allow any antidepressant claims because it has not been proven to be a safe and effective drug for this use. "There's no particular reason to doubt that it might have biological effects," says Thomas Laughren, M.D., in FDA's division of neuropharmacological drug products. "Whether or not it is an effective antidepressant remains to be seen."

The National Institutes of Health is sponsoring studies to determine if St. John's wort is safe and effective as a treatment for mild to moderate cases of depression. One issue of concern is how the herb interacts with certain drugs, especially antidepressants that affect the brain chemical serotonin.

'If Someone You Know Is Depressed'

According to the National Institute of Mental Health, to help someone recover from depression:

• Encourage the person to make an appointment with a doctor, or make the appointment yourself. You may want to go along for support.
• Encourage the person to stick with the treatment plan, including taking prescribed medicine. Improvement may take several weeks. If no improvement occurs, encourage the person to seek a different treatment rather than giving up.
• Give emotional support by listening carefully and offering hope.
• Invite the person to join you in activities that you know he or she used to enjoy, but keep in mind that expecting too much too soon can lead to feelings of failure.
• Do not accuse the person of faking illness or expect them to "snap out of it."
• Take comments about suicide seriously, and seek professional advice.

About the Author

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