Depression is a Thief
Depression robs us of our most treasured gifts: happiness, pleasure, comfort, and energy. Many people feel they have only the choice of taking prescription drugs that have significant side effects or continuing to live in misery. But there are botanicals that are even more effective than these drugs and can literally change lives for the better.
One such natural medicine is St. John’s wort (Hypericum perforatum). Shown in multiple studies to have an extraordinary impact on alleviating depression, this wonderful herb has not always lived up to its promise. Why? Mainly, it’s because of irregular dosing and lack of standardization to the most beneficial compound in the plant.
In this Terry Talks Nutrition®, we are going to look at the effective way to use St. John’s Wort to help people reclaim their lives from the insidious thief of depression.
What Causes Depression
The causes of major depression aren’t completely understood. They can have a genetic component, and people with parents who suffered from depression are typically more likely to experience it themselves. Certainly, traumatic events and chronic stress can bring about depression, as can hypothyroidism, cancer and cancer treatment, and lack of sleep. Nutrition – or the lack thereof – can’t be ruled out either.
In any case, during a depressive episode, our brain pathways don’t function properly. Signals that should get through – signals for joy, for example – simply don’t connect. The biochemistry behind all of this is extremely complicated and elusive. This may account for the astronomical amount of medications prescribed each year for depression, many of which try to inhibit the breakdown of specific neurotransmitters like monoamine oxidase inhibitors – MAOIs – which help prevent the breakdown of serotonin, epinephrine, and norepinephrine, or selective serotonin reuptake inhibitors – SSRI’s – which help keep circulating levels of serotonin available. These drugs attempt to alleviate depression by focusing solely on the communication signals, and trying to restore chemical signals that have been minimized by this disease. However, these medications bring many problems with them, too, and for many people, they may have to be switched often from one drug to the next.
The statistics for depression are daunting: over 15 million Americans suffer from the condition. While I believe depression is a serious disease, there are times when I have to wonder if there’s something of a “depression industry” going on. It seems that you can’t watch TV these days without seeing an ad pop up that recommends a prescription drug for this debilitating condition. Unfortunately, these medications are often risky and can create almost as many problems as they attempt to solve, including weight gain, loss of sexual feelings, altered thinking, joint stiffness, hair loss, and most paradoxically, suicidal thoughts.
However, there is hope. You don’t have to choose between feeling lost or hopeless or taking prescriptions with frightening side effects. Instead, you can look to a specialized extract of a time-tested botanical: St. John’s wort.
St. John’s Wort – Natural, Effective Hope for Depression
St. John’s wort (Hypericum perforatum) has a long history of use. Even though this perennial plant is native to Europe and Asia, it was introduced to North America over 300 years ago in the 1690’s, so it has become quite common.
Since that time, it has been heavily researched and studied. In fact, St. John’s wort has shown great promise in numerous double-blind, placebo-controlled clinical trials – without the side-effects that are often seen in conventional approaches.
One of the plant’s key compounds is hypericin, and clinical studies have found that St. John’s wort standardized at 0.3% hypericin has shown the most (and most consistent) benefits. Interestingly, hypericin – concentrated in the flowers and buds of the plant -- is generally a more stable component of St. John’s wort, (compared to hyperforin) and is easier to measure and standardize.
Over 26 clinical studies have found that St. John’s wort is effective for people with mild, moderate, and even severe depression. In most cases, St. John’s wort was far superior to the placebo. In others, it was at least equal to (if not slightly better than) the prescription medication. And it was certainly tolerated much better.
Impressive Clinical Results for St. John’s Wort
One multi-center clinical study in Germany divided patients into two groups; one taking St. John’s wort, and the other imipramine (a prescription drug for major depression) for 6 weeks. Both groups showed similar improvements, but St. John’s wort was much better tolerated. In fact, the researchers concluded that St. John’s wort was, “therapeutically equivalent to imipramine in treating mild to moderate depression, but patients tolerate hypericum better.” They also felt that St. John’s wort should be the first-line treatment, rather than some drug, because of being so much easier on people’s systems.
In a double-blind, placebo-controlled clinical study involving 105 individuals with depression for a total of 4 weeks, depressive symptoms were reduced by half. Of those in the St. John’s wort group, 67% responded to the botanical extract, which was provided at the standard dose of 300 mg, three times daily for a total of 900 mg per day.
A randomized, double-blind, 6-week study comparing St. John’s wort to fluoxetine (an SSRI commonly marketed as Prozac®) found the botanical to be just as effective as the drug, but, once again, St. John’s wort’s safety was found to be “substantially superior to fluoxetine”. The fluoxetine group, by contrast, reported agitation, dizziness, tiredness, anxiety, and erectile dysfunction. In fact, here the authors of the study concluded, “Although hypericum (St. John’s wort) may be superior in improving the responder rate, the main difference between the two treatments is safety. Hypericum was superior to fluoxetine in overall incidence of side-effects, number of patients with side-effects, and the type of side-effect reported.”
Another placebo-controlled, double-blind efficacy trial of St. John’s wort published in the American Journal of Psychiatry showed impressive results for individuals with major depression. The researchers found that the 300 mg dose, 3 times daily of hypericum was “safe and effective for those with moderate to mild depression. They also concluded that the 900 mg per day dosage “led to global reduction of depression-related core symptoms, assessed with the melancholia subscale of the Hamilton scale.”
For major depressive disorder, St. John’s wort has been found to be better than prescription drugs as well. In a double-blind, placebo-controlled study in Boston, patients received 900 mg of St. John’s wort, 20 mg of fluoxetine, or a placebo. The authors concluded that “St John's wort was significantly more effective than fluoxetine and showed a trend toward superiority over placebo.”
Then Why Does St. John’s Wort Have Inconsistent Results?
There are two big problems with many of the St. John’s wort supplements on the market.
One is that many contain little – if any – of the key compounds needed for effectiveness. The most important compound is hypericin, and it is found in the flowers and aerial parts of the plant. There is little in the stem and virtually none in the roots. When St. John’s wort became enormously popular, unscrupulous companies decided to turn St. John’s wort waste material into money, so they cleaned up stems and roots, ground them up and sold them as St. John’s wort powder. Were they “legally” St. John’s wort? Yes. Did they do anybody a bit of good? No. Therefore, MAKE SURE you buy St. John’s wort only from reputable companies that you trust, and make sure they are standardized to 0.3% hypericin.
Secondly, St. John’s wort is ineffective if it is not dosed at the proper amount, and missing doses over time can lead to a greatly reduced impact on depression.
The vast majority of St. John’s wort products call for taking multiple doses throughout the day (generally 300 mg three times daily). But we all know that it is human nature to forget the occasional dose, or to simply decide it isn’t necessary when things start to feel better. In fact, research verifies that when people need more than one dose per day of a medication or supplement, only about 50% take the recommended amount.
St. John’s wort works best when it is taken at a consistent 900 mg a day. That is why I recommend a once-daily St. John’s wort that provides the full 900 mg amount in a form that remains in the bloodstream for 24 hours or more.
Any Concerns with St. John’s Wort?
Overall, St. John’s wort is very liver healthy, and increases the liver’s ability to detoxify certain compounds. That’s a good thing most of the time, but some prescription drugs get “detoxified” so quickly that they aren’t fully effective. Because St. John’s wort could reduce the effectiveness of other medications, always discuss its use with your doctor before adding it to your regimen. And, if you are considering adding St. John’s wort to your prescription antidepressant, check with your prescribing physician first. The combination of prescription antidepressants with St. John’s wort should only be done under the oversight of a healthcare practitioner.
Additionally, sun sensitivity was noted occasionally during clinical trials of St. John’s wort, but generally only at doses that went above the recognized 900 mg levels, and even then, only rarely. In fact, clinical studies using doses as high as 1,800 mg did not show a photosensitive effect.
There is Hope!
If you have had a difficult time just getting through the regular challenges of the day, or for that matter, don’t feel like getting out of bed in the morning, St. John’s wort may be nature’s gift to you. It has been clinically proven safe and effective, and has none of the dangerous side effects that plague common synthetic drugs. But you need a consistent, 900-mg amount each day. I believe St. John’s wort is one of the premier natural medicines, and should be a first-line of defense to help you feel vibrant, healthy, and happy again.
If you want to feel happy, vibrant, and healthy again, I recommend taking a once-daily St. John’s wort extract that provides the full 900 mg amount.