The Natural Pharmacy: Herbal Medicine for Depression

“The physician is nature’s assistant.”              Galen, 2nd century AD

Depression has come more and more to the forefront in health care in recent years. A great percentage of ailments that individuals present to their doctors today seem to have some form of mental/emotional complication which can be perceived as depression. The millions of individuals suffering clinical or symptomatic depression can experience great benefit from some specific attention to their own health as well as guidance from a health professional who understands the basic tenets of natural medicine.

Natural medicine, including herbs, diet, and other non-invasive therapies, is particularly appropriate in treating the underlying causes and symptoms associated with depression. Unlike conventional, allopathic medicine, natural medicine works in a gradual manner, is humanly comprehensible and may even be considered to be ordinary– like ordinary magic. Natural medicine is consistent with the rhythms of nature and how nature is organized. Historically, there has been a commitment in medicine to do no harm, and when you are using natural substances such as herbs and working at a gradual pace, the likelihood of doing harm is almost completely eliminated.

Underlying Causes and Symptoms of Depression: A Mirror Image

A fundamental principle of natural medicine is that physiology and psychology are intimately related. In examining the medical literature it is fascinating to note that the symptoms and causes of depression can often be interchanged. For example, some of the symptoms associated with depression include chronic fatigue syndrome, insomnia, excessive sleep, loss of appetite, excessive appetite, headaches, backaches, joint aches, bowel disorders, as well as feelings of worthlessness and inadequacy. On the other hand, the causes of depression read like a mirror image: tension, stress, chronic headaches, chronic stomach aches, bowel problems, chronic nutritional deficiencies, chronic allergies, chronic physical disorder, poor diet, excessive sugar and caffeine intake, endocrine disorder such as hypothyroidism, endometriosis, lack of sun exposure, and assaults from the environment such as toxic metals.

In effectively dealing with the underlying causes and symptoms of depression, I have found that it is important to discover the individual’s weakest physical link. The weakness may be a nutritional problem, undiagnosed hypothyroidism, chronic yeast or viral infection, intestinal parasites, seasonal affective disorder (SAD), or something as basic as dehydration (often seen in professional athletes) or lack of potassium. I try to determine these potential problems before prescribing dietary changes, exercise, nutritional supplements, homeopathy and/or specific herbs or herbal combinations for treating depression or its associated symptoms. The following are some examples of common causes I have observed to be underlying my patients’ depression.

Hypothyroidism, for example, often has numerous associated mental symptoms. Patients suffering from hypothyroidism very often feel like they cannot cope, life is simply too much, and find themselves withdrawing from the world. Typically, patients experience a tremendous mental shift after appropriate treatment for hypothyroidism.

To test yourself at home for an underactive thyroid, keep a thermometer by your bed at night. In the morning, when you wake, immediately place the thermometer under your arm and hold it there for fifteen minutes. This may seem like an eternity but it is important to be still. Any motion may give a false reading. Do this for five consecutive days. If the reading is consistently 97.6 degrees Fahrenheit or lower you may have an underactive thyroid and you should consult with your physician.

There are certain nutrients, which are used to enhance thyroid activity. Kelp, seaweed, which contains iodine, is often useful in supplementing thyroid function. L-tyrosine, an amino acid, is also effective in stimulating proper thyroid function and fighting depression associated with depressed thyroid function. A naturally oriented health care practitioner may also prescribe a thyroid glandular. The B vitamins are also very important to improve energy and assure proper glandular function.

Adaptogenic herbs, specifically Eleutherococcus senticosus, better known as Siberian ginseng may also be considered in cases of hypothyroidism. This herb helps to regulate the entire endocrine system, including the thyroid and adrenal function.

As for dietary considerations, sufficient protein is necessary for hypothyroidism. Raw cruciferous vegetables, such as: broccoli, cabbage, kale may suppress thyroid function. These vegetables in their cooked state are not problematic but should only be used in small amounts in their raw state.
Our diet also has a tremendous impact on our moods. Since the dawn of civilization people have used food to alter their mood. Alcohol, sugar and stimulants such as coffee have been utilized for this purpose. Until recently scientists were not convinced of the effect of food upon mood, but in the last ten years they have finally acknowledged that food can affect how you feel, think and act. I find that poor dietary habits are not the exception but the rule among my depressed patients. Most people suffering from depression usually have marginal nutritional deficiencies associated with changes in mood and even altered brain waves, including deficiencies in B vitamins, selenium, potassium and amino acids. Memory loss, confusion, depression, irritability, and anxiety have all been linked to dietary indiscretion.

Potassium deficiency, in particular, is another common cause of depression. Women who are particularly low in potassium can have acute episodes of depression accompanied by fits of crying with no seeming cause. One woman who came into see me began crying within sixty seconds although we were not discussing anything particularly emotional. When I asked her what was wrong, she said, “I don’t know. All of a sudden I just start crying.” I gave her an old naturopathic remedy, apple cider vinegar, honey and water, and within a few sips, she started calming down and feeling better. She took that simple formula with her meals for a month or so and the crying stopped.

L-tryptophan, an essential amino acid is the precursor to one of the most important neurotransmitters, serotonin. Tryptophan helps to raise the levels of serotonin in the brain. Serotonin is needed to regulate sleep, secrete pituitary hormones, and perceive pain. Serotonin is most often abnormally low in depressed people. Tryptophan is found abundantly in milk and turkey. After a carbohydrate rich meal, insulin causes competing amino acids such as tyrosine, phenylalanine, and leucine, to leave the blood and enter muscle tissue. With fewer amino acids vying for entry, more tryptophan enters the brain and is converted into serotonin. Increased serotonin levels results in increased relaxation and drowsiness. You can try this out on yourself. Try eating a meal high in carbohydrates, pasta with a fruit dessert and see how you feel compared with a high protein lunch, fish with vegetable.

Eating higher protein meals will increase the amount of the amino acid tyrosine in the blood. Through research it has been demonstrated that for tyrosine to be effective therapeutically, it is best taken in supplement form with a small amount of carbohydrate. The carbohydrate stimulates insulin secretion, which reduces the levels of other competing amino acids, and allows easy entry of tyrosine into the brain. An increase in brain tyrosine will ultimately increase the levels of catecholamines, particularly dopamine. Clinically, tyrosine is effective in treating depression associated with fatigue due to low normal thyroid and or adrenal function.

Another common example involves intestinal parasites. Feelings of gloom and doom are often associated with a serious infestation of intestinal parasites. Patients suffering from parasites often feel that their world is coming to an end. I once treated a couple who had contracted an unusual disease while traveling in Africa. They were diagnosed at UCLA Medical Center with Ross River Disease. The man was also diagnosed with an unusual intestinal parasite. Both of them were survivalists who were extremely paranoid and felt like the world was coming to an end. They periodically traveled to the wilderness with their guns and camouflage gear. After treatment with an herbal milk thistle extract combination and two nutritional supplements, lipoic acid and pine bark extract, their physiology improved and the digestive symptoms associated with the parasitic infection cleared up they had an extreme shift in the mental outlook. Soon they began to store their guns in the basement, made fewer trips to the wilderness, and the woman decided to burn the camouflage gear.

Candidiasis, a chronic yeast infection of candida albicans, also has associated mental symptoms including feelings of disorientation, confusion and being out of control. On the physical level one may experience joint and muscle ache and pain, as well as bodily pain that is not associated with any apparent cause. Several years ago a professional wrestler came to see me suffering from apparent arthritis and depression. He had been around the medical block, seeing orthopedic surgeons, internists, and endocrinologists. Finally, he came to my office bringing in stacks of blood work. I examined him and gave him an extensive questionnaire. Nearly two-thirds of his answers pointed to candidiasis and one of his primary symptoms was depression. We began treating him with pau d’arco, bifidus, a two thousand year old Chinese herbal formula for joint pain and a series of homeopathics. Within ten weeks all of his pain disappeared and his depression lifted simultaneously.

Herbal Medicine: A Natural Approach

Herbal medicine has a long and respected history, and holds a valuable place in the treatment of mental/emotional disorders such as anxiety and depression as well as the vast majority of health problems. Utilizing the leaves, flowers, stems, berries, and roots of plants to both prevent and treat illness, herbal medicine not only helps to alleviate symptoms but also helps treat the underlying problem, as well as strengthen the overall functioning of a particular organ or body system.

Throughout history, herbs have been used for medicinal purposes in traditional cultures worldwide. Asia, Europe, the Middle East, Africa, and the Americas all have a rich history of herbal healing. In China, authoritative texts on herbal medicine compiled over four thousand years ago are still in use today. Texts from the ancient cultures of India, Egypt, and Mesopotamia describe and illustrate the use of many medicinal plants. Ancient Ayurvedic medical treatises discuss herbs such as turmeric, gotu kola, neem, ashwaganda, and ginger, which are being researched today for their therapeutic properties. Traditional cultures in Europe prior to the Roman conquest also relied on herbs for medicine. In Europe, homegrown botanicals were the only medicines readily available from early Christian times through the Middle Ages.

The Rise of Modern Medicine and the Decline of Herbalism

As in Europe, the early American colonists relied upon herbs for medicine and this reliance continued until the early twentieth century. The first U.S. Pharmacopeia, published in 1820, included an authoritative listing of herbal drugs, with descriptions of their properties, uses, dosages, and tests of purity. Following periodic revisions, the U.S. Pharmacopeia became the legal standard for medical compounds in 1906.

In the early twentieth century, however, the science of pharmacology began to focus on capturing the patentable active properties of plants by identifying, isolating, extracting, and synthesizing individual plant components, rather than studying and utilizing the medicinal properties of the whole plant.

Pharmaceutical laboratories began to replace the herbal apothecaries as the providers of drugs protected by patents. The use of herbs in the United States, previously considered mainstream medical practice, began to be considered unconventional, unscientific and fell into relative obscurity. With the progression of modern medicine in the twentieth century, most physicians have come to rely on the Physician’s Desk Reference (PDR), an extensive listing of chemically manufactured drugs, as opposed to the U.S. Pharmacopoeia with its reliance on herbal compounds.

Modern Resurgence of Herbal Medicine

Today, there is an amazing resurgence among both consumers and the medical community in the medicinal use of herbs. The are many reasons for this phenomenon.

First, the current crisis in health care calls for more cost-effective remedies, and an emphasis on prevention. Second, consumers are looking at the rise in popularity of alternative and conventional medicine that has brought herbal medicine to the attention of millions of consumers and health professionals. Third, the enormous body of research from around the world has finally shown the medical community that herbal medicine has moved beyond folk medicine and anecdotal reports.

Finally, consumers are looking for safer remedies that do not have the dangerous and troubling side effects of many conventional drugs. For example, Prozac, the most popular SSRI (Selective Serotonin Uptake Inhibitor) anti-depressant drug in the United States for depression, has had a controversial history of serious side-effects, whereas the herb St. John’s wort, which research has demonstrated to be as effective as Prozac, has little known side effects.

The larger percentage of current research validating herbal medicine has been conducted abroad, particularly in Germany, Japan, China, Taiwan, France and Russia, with the German Commission E Monographs1 being probably the single most powerful collection of herbal research. As a result, we are now able to identify some of the specific properties and interactions of botanical constituents, as well as to better understand why certain traditionally used herbs are effective against specific conditions. Still, only about 5,000 of the estimated 250,000 to 500,000 plants (variation due to including or excluding subspecies) on the earth today have been extensively studied for their medicinal applications.

Herbs for Treating Depression

Depression is an illness, which involves the entire body. In naturopathic as well as Chinese medicine, herbs and herbal combinations may be used to bring balance back into the body, as well as counter fatigue and debility often associated with depression. I recommend, however, in using herbs for depression, that a person who is on antidepressant drugs should not stop or alter any currently prescribed medication without consulting with the physician.

Chinese medicine has long believed that certain physiological imbalances may lead to psychological depression. For example, if the energy of the liver is “stuck” you will more likely be chronically irritated and often depressed. If herbals are taken to “release” this block than according to Traditional Chinese Medicine, it is believed that you will feel better physically as well as psychologically.

In my own practice of twenty years, I have seen this proven time and again. Not too long ago, John, a thirty-six year-old male came to see me who had been on the anti-depressant drug, Paxil for two and half years. He said that he felt relief from the depression for the first year and a half, but now it had returned and his sex drive, which historically had been strong, had ceased for the last three years. John was also suffering from digestive problems. He was fearful of going off the Paxil because of his rage and what he called his “rager fits.” In the past, he experienced such intense anger, anxiety and agitation that he scared himself. After much discussion about going off the drug with his psychiatrist, she agreed to wean him slowly off the Paxil. As John decreased his dosage, he also began taking herbal and nutritional supplements.

When the day came for his last dose of Paxil, John came into my office angry and frightened, announcing: “Look at me, all 6″4″ and 225 pounds of me, when I get angry, I can not only be a horrible sight but dangerous, truly dangerous.” In Chinese medicine the diagnosis for John was “stuck liver qi” leading to agitation, irritability and anger, accompanied by a variety of digestive problems. He was given an herbal combination to “quiet and rebalance his liver qi.” Although this treatment plan may sound strange, Traditional Chinese Medicine has successfully used this methodology for over two thousand years.

After three weeks he came bouncing into my office and asked, “I feel better than ever but is this going to last?” I saw John once a month for the next three months. By his own admission, he claimed he was a “new man.” I placed him on a maintenance program for three months. John not only recovered his desire to live and his sex drive, he lost his chronic agitation and negativity, and went from chronic digestive problems to occasional discomfort when he overate.

Herbal medicine is perhaps one of the most respected of the ancient natural therapies that has stood the test of time. Today there is an enormous interest in medicinal plants, and a rediscovery of many traditional applications of therapeutic herbs. The World Health Organization reports that eight-five percent of the world’s population uses herbs as their main form of medical treatment. Here in the United States we are fortunate to be able to combine the best of modern medicine with the folklore of ancient herbal therapies.

Herbs are very much like the foods we eat, and in fact some of what we eat such as parsley, ginger, garlic, onion, thyme, rosemary are actually herbs and can be used therapeutically. Like food, herbs contain different therapeutic substances such as: vitamins, minerals, trace minerals, and active ingredients such as: volatile oils, alkaloids, flavonoids, bitters, mucilage, saponins, anthraquinones and tannins. Herbs may be used in many forms, such as teas, tinctures, capsules, tablets, caplets, lozenges, syrups, compresses, poultices, sprays, liniments, and oils.

It is important to remember that herbal preparations, whether they are intended for the common cold or depression, cannot stand alone in their effectiveness as a treatment. Herbs are a piece of the puzzle which includes a balanced diet suitable to one’s lifestyle and body type, exercise, and designated periods of rest in whatever form that may take (i.e. meditation, yoga, breathing exercises, sitting and reading a book, etc.)

Herbs are frequently divided into four main categories: relaxants/sedatives, restoratives, stimulants and anti-depressants. Some herbs may be easily grouped into more than one category because of their broad effectiveness. The following herbs are successfully used in treating various forms of depression.

Relaxant/Sedative Herbs

Within the herbal kingdom there are many nervous system relaxants/ sedatives primarily used for their anti-anxiety effect, including: Valerian, kava kava, hops, passion flower, chamomile, and Linden blossom. It is believed that herbs, which contain volatile oils, can directly affect the limbic system of the brain and induce a more relaxed state.

Kava Kava (Piper methysticum)

Native to the South Pacific islands, kava has been used in ceremonial beverages for centuries. The active principles in the root are a number of lactones known as kava pyrones. Through its relaxing effect on the central nervous system kava is beneficial in reducing anxiety, tension and restlessness. Kava kava is not generally used to treat clinical depression but to mitigate common stress related anxieties.

Kava is excellent for helping to relax because there is no loss of mental clarity. It is also helpful in dealing with insomnia as it promotes restful sleep. What is most remarkable about Kava, however, is that it not only does not produce toxic side effects, there are no symptoms of withdrawal, such as found with drugs like benzodiazepine.

For example, several years ago, Elizabeth, a thirty-eight year old female, came into my office complaining of anxiety and difficulty calming her mind, and also reported bouts of insomnia. She was a successfully Hollywood talent agent and would often keep late hours. “I’m not crazy, like I don’t feel I need psycho meds, I just need to be toned down a notch.” After a week of 37.5 mg of kava in the morning and 75 mg. at night, Elizabeth phoned and said she was considerably more relaxed and her sleep was normal. She continued this dosage of kava for three more weeks, and then decreased it until she was only using it once in a while when she felt she needed it.

As for the chemistry of kava, we know that psychotropic drugs effect brain chemistry. The drug, Benzodiazepine, for example, increases the activity of gamma-aminobutyric acid or GABA in the limbic system, producing a sense of calmness. The amygdala, a small organ the size of a large pea in temporal lobe of the brain, regulates sensations of anxiety, and is also a site for benzodiazepenes. In 1991 a study was done that identified amygdala as the preferential site for kavalactones, the active ingredient in kava.

It is recommended to avoid using kava with alcohol, antidepressants or other drugs, which can affect the central nervous system. In Germany, kava extracts are approved for use with nervous anxiety, stress and unrest, but not to be used in cases of pregnancy or while a mother is lactating.

Valerian Root (Valeriana officinalis)

With a long history of use in European traditional medicine, valerian root is a strong calmative that exerts a mild sedative effect on the central nervous system. The active ingredients of valerian, valepotriates, and its sedative properties were discovered in 1966, and quickly became the subject of a large amount of scientific research in Germany.

Valerian root is most helpful for insomnia, restlessness, and anxiety. It helps one to fall asleep faster and provides a deeper, more restful sleep. In Germany, valerian root is approved as an over-the-counter medicine for “states of excitation” and insomnia due to nervousness.2 A scientific team representing the European community has reviewed the research on valerian and concluded that it is a safe nighttime sleep aid. These scientists also found that there are no major adverse reactions associated with its use, and unlike barbiturates and other conventional drugs used for insomnia, valerian does not have an adverse reaction with alcohol, and is not addictive like some conventional benzodiazepine medications. 3

Approximately one-third of the adult population suffers with some kind of sleep disorder. I have found valerian to be very useful for helping to gently regulate sleep. In fact, I have a very personal story about valerian. When I first met my husband, I noticed that he had a bottle of Xanax and Valium in his bathroom. I asked him what he did with these and he said, “What do you think?” I explained to him that if he was thinking about being my husband, I didn’t think it was acceptable for him to be taking Valium at bedtime. “Are you serious?” he responded. “Yes,” I answered. Well, to make a long argument and story short, it has been ten years and my husband sleeps regularly with the occasional help from a valerian herbal combination, and on the rare evening when he is very stressed he may add a kava combination as well. What he most likes about not using Xanax and Valium is the fact that he wakes up feeling fresh instead of drugged or confused.

Passion Flower (Passiflora incarnata)

Passion flower has a long tradition of use for its mildly sedative properties. This herb has been approved in Germany as an over-the-counter drug for states of nervous unrest.4 Passion flower is very often combined with other calmatives, including chamomile, skullcap, and valerian. These calmatives are even more effective when they are combined with calcium and magnesium. Research also shows that passion flower extract has antispasmodic and hypotensive properties.5

Skullcap (Scutellaria lateriflora)

Skullcap is a calmative that has traditionally been used to relieve tension headaches, anxiety, insomnia and premenstrual tension. Skullcap’s effectiveness is enhanced when combined with such herbs as valerian, chamomile, passion flower and/or vervain. The herb also has a tonifying effect on the liver, helps regulate cholesterol, and has been shown to increase the high-density lipoproteins (HDL) or good cholesterol.

Chamomile (Matricaria recutita)

Chamomile is an important sedative herb and nerve tonic. In Europe, it is widely used as a digestive aid in the treatment of heartburn, nausea and flatulence; as a mild sedative helpful with insomnia; and as an anti-inflammatory. Chamomile is licensed in Germany as an over-the-counter drug for gastrointestinal spasms and inflammatory diseases of the gastrointestinal tract often associated with nervous disorders.

Hops (Humulus lupulus)

Hops, with both calming and sleep-inducing properties, is used in Europe for nervous tension, restlessness and excitability, as well as sleep disturbances. This helpful herb has also been licensed in Germany for sleep disorders and states of unrest and anxiety. However, unlike other sedatives, hops does not lead to dependence or withdrawal symptoms, and there are no reports of adverse side effects.6

Linden Blossom (Tilia europea)

Linden blossom has been used for centuries by Europeans in the treatment of nervous tension. It is also believed to reduce hardening of the arteries. Linden blossom is commonly prescribed throughout Europe for patients with anxiety and cardiovascular history.

Anti-Depressant Herbs

St. John’s wort is the best known of the anti-depressant herbs, although many Chinese, Ayurvedic and Native American herbal combination remedies can also sustain anti-depressant effects. These combination remedies, however, are best prescribed by a health professional who is knowledgeable of herbal medicine.

St. John’s wort (Hypericum perforatum) is an effective nervine tonic with an anti-depressive action that has been used by Europeans as an anti-anxiety remedy for centuries. It actually has a 2,400 year history of safe and effective use, and, in fact, Hippocrates himself used St. John’s wort. In Germany, more than fifty percent of depression, anxiety and sleep disorders are treated with hypericum. This herb also has anti-viral properties, and is commonly used for PMS, menstrual cramps, as well as menopausal stress that triggers irritability, anxiety and depression.

St. John’s wort has traditionally been taken internally to treat neuralgia, anxiety, tension, and depression. Indeed, convincing research has demonstrated that St. John’s wort is an effective remedy for mild to moderate depression. The therapeutic effectiveness has been shown to be often similar to that of the SSRI anti-depressant drugs Prozac, Zoloft, and Paxil, however, St. John’s wort, has far fewer side effects and is available over-the-counter for a fraction of the cost of prescription anti-depressants.

Depression is believed to stem from a chemical imbalance in the brain. Depressed levels of the three neurotransmitters: serotonin, norepinephrine and dopamine leads to what we know as depression. Conventional, allopathic medicine has solutions for low levels of serotonin and norepinephrine but dopamine deficiency is still not clearly resolved. Recent research has implied that hypericum acts somewhat like a combination of serotonin, norephinephrine, and dopamine. Currently there are psychiatrists who are actually using St. John’s wort conjunctively with serotonin re-uptake inhibitors such as Prozac, Paxil, and Zoloft and weaning their patients off of the prescription drug. The prescription drug that hypericum should not be mixed with is any MAO inhibitor. This could possible result in elevated blood pressure, increased anxiety, muscle tension, fever and mental confusion. If you are wanting to try St. John’s wort, please do not stop or alter any currently prescribed medication without consulting with your physician.

It should be noted that St. John’s wort must normally be taken for two to ten weeks for the herb to take hold and help to regulate and balance mood. I have seen it work as quickly as three days, but like conventional mood regulators it is best to give it some time to be substantially effective.

The common dosage for St. John’s wort is 300-400 mg. two to three times daily depending upon the severity of the depression. I have begun treatment with as little as 150 mg. three times daily depending upon the sensitivity and body weight of the patient. Obviously, serious, chronic depression should not be self-diagnosed or self-treated.

Restorative Herbs

Restorative herbs help to renew the vitality of the nervous system and are thus commonly used in treating depression and its associated symptoms. Nervous system restoratives include: St. John’s wort, oatstraw, vervain, motherwort, ginseng, ginkgo biloba, Siberian ginseng, lemon balm, borage, rosemary, Fo ti, and dong quai.

Siberian Ginseng (Eleutherococcus Sentiocosus)

I have used Siberian Ginseng in my practice for many years for a wide range of physiological and psychological problems. Although it is not a true form of ginseng, it has many of the properties of ginseng and is such a powerful adaptogen that it was given the name “Siberian” or “Russian” Ginseng. Siberian Ginseng has been used extensively in Russia to improve performance and resistance to disease. Russian cosmonauts used Siberian Ginseng prior to and during their space flights to help them stay awake and alert. Russian Olympic athletes were required to take Siberian Ginseng during training as well as during the Olympic Games.

Siberian Ginseng is noted to effect kidney function, adrenal function, and thyroid function. It helps to increase the good (HDL) cholesterol, and is a blood pressure regulator. It has also been shown to increase biological resistance. and has a tremendous capacity to reduce side effects of numerous allopathic medications, including chemotherapeutic agents. In my own practice I have found this herb in conjunction with milk thistle seed and pycnogenol to be very effective in reducing the side effects of cortisone: weight gain, swollen face, depression, and swelling throughout the body; as well as the side effects of chemotherapy and radiation.

Siberian Ginseng is also specifically used to control stress. This herb can reduce the activation of the adrenal cortex in response to stress as well as preventing stress-induced lymphatic congestion. Siberian Ginseng is an effective herb for chronic fatigue as many people suffering from this syndrome have a good deal of lymphatic congestion in addition to being depressed. It is also useful when fatigue is associated with insomnia, agitated depression and nervous exhaustion.

The most extensive research on Siberian Ginseng, however, relates to its brilliant ability to regulate blood sugar. I have observed people in my practice with serious hypoglycemia, a common cause of depression, make tremendous strides with the use of this herb, especially when combined with small amounts of the trace mineral chromium.

American Ginseng (Panax quinquefolius)

American Ginseng, a true form of ginseng native to the United States, contains significant amounts of trace minerals which are increasingly difficult to obtain today in our mineral-depleted soil. This herb is effective in enhancing physical and mental performance as well as mood. Any long-term use of this herb should be supervised by a knowledgeable health professional.

Chinese Ginseng (Panax Ginseng)

Ginseng has a long history of use and a wide range of possible therapeutic applications. Thus, the term “Panax” which derives from the Latin word panacea meaning “cure all.” A powerful adaptogen, Panax Ginseng helps the body to cope with stress through its effects upon the functioning of the adrenal gland.7 Other important properties include antioxidant, antihepatotoxic (liver protecting), and hypoglycemic effects.8,9

Panax ginseng is very effective in small doses, especially in men over forty-five who may be experiencing mild depression due to a drop in hormone levels. However, some people who take Chinese ginseng for depression become anxious and irritable due to its stimulating nature. Proper dosage for an individual must be determined as serious side effects including headaches, skin problems, and other reactions can occur if ginseng is abused. Any long-term use of this herb should be supervised by a knowledgeable health professional.

Ginkgo (Ginkgo Biloba)

Ginkgo trees are the oldest living trees on earth, first appearing about 200 million years ago. The leaves of the ginkgo tree contain several compounds called ginkgolides that have unique therapeutic properties. A standardized ginkgo extract has been developed in Germany to treat cerebral dysfunction with the accompanying symptoms of memory loss; dizziness, tinnitus, headaches, and emotional instability coupled with anxiety.

It has been commonly found that older individuals who are suffering from insufficient blood flow to the brain are especially susceptible to depression. In fact, many individuals over the age of fifty who are diagnosed as suffering from depression but are not responding to antidepressant medication, may be suffering from cerebrovascular insufficiency.10 One study reported that older patients suffering from depression who received 240 milligrams of Ginkgo biloba extract daily experienced significant improvements in mood, motivation and memory after only four weeks, and even more marked improvement by the conclusion of the eight week study.11

Dong Quai (Angelica sinensis)

Dong Quai, an adaptogenic Chinese herb that is excellent in treating numerous female health problems. In China, women begin taking Dong Quai when they start menstruating and then tend to continue taking for the rest of their life, often incorporating it into their diet. Dong Quai is normally taken in combination with other herbs, as it is a strong herb.

Dong Quai also has a sedative-like effect on the central nervous system and can also be useful in influencing mood. This herb is also helpful in depression as it has a protective affect on the liver, and in Chinese Medicine depression results when the liver becomes toxic or overburdened. For example, I have observed many patients suffering from acne whose dermatologists have prescribed Acutane, which often has a negative effect on the liver. Acutane causes an elevation of liver enzymes causing the individual to become very depressed. People with hepatitis also have elevated liver enzymes, which can lead to feelings of depression. The treatment plan in Chinese medicine for such cases is to detoxify and strengthen the liver, and Dong Quai can be effective as part of this treatment and alleviating depression.

Fo Ti (Polygonum multiflorum)

Fo Ti is a rejuvenative herb which, according to Chinese medicine, helps to normalize or strengthen the Earth (Pancreas and Stomach), Water (Kidney), and Wood (Liver) elements. According to Chinese medicine Fo Ti is also a “blood builder,” helping to fortify the blood. A good deal of depression is due to what Chinese medicine refers to as “blood deficiency,” a condition that is not only significant for women, as it is possible for men to have “weak blood.” Fo Ti is also used in Chinese medicine to stimulate vital energy (qi) promote fertility, enhance longevity and to increase overall vigor, and is beneficial for neurasthenia, insomnia, dizziness, and hypertension.

Borage (Borago officinalis)

Rich in minerals, especially potassium, borage has historically been used as a tonic, as it gently improves energy. Long ago I worked in an herb room with a master herbalist. People would visit and I would watch the herbalist prescribe various herbal preparations. I cannot remember one prescription for fatigue and depression that did not include borage. And each time he would prescribe it he would say, “I love borage.”

Lemon Balm (Melissa Officinalis)

Lemon balm is known to be antibacterial, antidepressant, antihistaminic, anti viral, carminative, and mildly sedating. Traditionally, it has been used for anxiety and depression as well as the common cold, indigestion, headache, flu insomnia and nervousness.

Oatstraw (Avena Sativa)

Oatstraw has been shown to be very effective as a sedative and has proven useful for some kinds of insomnia and nervous disorders. Oatstraw is especially effective for debilitation associated with anxiety or depression. In Europe it has been used for centuries to treat nervous exhaustion. This herb is used clinically in cases of drug withdrawal, such as stimulants, narcotics, tranquilizers, coffee, nicotine and alcohol. It is especially effective for depression associated with drug withdrawal. Oatstraw is high in silica and helps to enhance calcium absorption, which along with magnesium is very important in mood.

Several years ago, I treated a 26 year old male named Patrick. He was strong yet nervous professional athlete. He came to see me complaining about his nervousness before games and embarrassingly reported, disinterest in sexual relations with his wife. At the time I had a male intern, Jeff, who had passed by the waiting room while I was speaking with Patrick and noticed Patrick’s wife. “I can’t imagine having one moment of disinterest with her in my bed,” said Jeff . After we got over the rudeness of his comment, we realized that the problem was indeed with Patrick. The primary issue at hand was Patrick’s excessive nervousness prior to game time. The solution was not an easy one because I couldn’t prescribe anything that might make him sluggish or interfere at all with his physical and mental acuity. I chose oatstraw and prescribed two capsules two times daily. One month later Patrick came into my office beaming from ear to ear. “I have to tell you, I’m smooth as silk before a game and my wife and I are having sex again. I couldn’t ask for anything more.”

Rosemary (Rosmarinus officinalis)

Rosemary is known to be antibacterial, antidepressant, antifungal, antispasmodic, cardiotonic, carminative, circulatory stimulant, tranquilizing and sedating. This herb has been used historically for anorexia, anesthenia, depression, headache, insomnia, painful menstruation, and nervous exhaustion.

Vervain (Verbena officinalis)

Vervain is known to be an antidepressant, antihypertensive, antispasmotic and mildly sedating. It has been used historically for depression, headache, hypertension, insomnia, melancholy, menopausal symptoms, and nervous exhaustion.

Chart: Herbs for Depression and Related Symptoms

Herb Medicinal Use Part Used How Taken Possible Side Effects
American Ginseng Helps to strengthen Root Tincture, tea, Nervousness, insomnia
overall constitution capsule, tablet, Diarrhea
Helps to relieve extract, whole root
or debilitation after
an illness

Borage Adrenal restorative, Leaves Tincture, capsule, None known
tonic, nervine infusion

Chamomile Relaxes, induces Flower Tincture, tea, Possible allergic
sleep; soothes upset capsule, dried reactions in sensitive
stomach flowers individuals

Dong Quai Regulates menstrual Root Tincture, capsule Rare, mild. Some may
cycle, good for PMS tablets, whole root be allergic to dong quai.
and other discomforts (Often used in
of menstruation; combination)
promotes circulation;
immune enhancing;
liver tonic; analgesic

Fo Ti Invigorate liver and Root Tincture, capsule, Rare. Large dose may
kidneys, promote tablet, whole root result in numbness of
longevity, fertility and extremeties and skin
vigor; neurasthenia, rashes
insomnia, dizziness

Gingko Biloba Age-associated Leaves of Tincture, capsule Rare. Mild
memory loss; poor young trees gastrointestinal
circulation to upset in less
extremities; hearing than 1% of people.
loss; early stages of

Kava Kava Calms anxiety, Rhizome Tincture, capsule, Mild gastrointestinal
tension, conditions tablet upset
of restlessness

Lemon Balm Insomnia, nervous Leaf Capsule, dried leaf None known
disorders, sedative
spasm relief

Linden Blossom Nervous tension, Dried flowers Tincture, infusion, None known
anti-spasmotic tea

Oatstraw Insomnia, nervous tea, liquid, capsule None known
disorders, depression
associated with drug

Panax Ginseng Adrenal support Root Tincture, capsule Rare at recommended
from stress; tablet, extract, dosage; rare insomnia or
revitalizes those whole root overstimulation
suffering from
fatigue and debility;
endurance for athletes;
assists recovery from

Passion Flower Sedative for excess Whole plant Tea, tincture, fluid None known
nervousness and extracts
anxiety; can induce
sleep; dysmenorrhea;
high blood pressure;

Rosemary Anti-depressive, Leaves, twigs Tincture, infusion None known
circulatory and
nervine stimulant

Siberian Ginseng Fatigue; supports Root Tincture, capsule, Mild Diarrhea, may body during stress; tablets, powder cause insomnia in support during some if taken close to exercise; chronic bedtime
fatigue syndrome

Skullcap Sedative, nerve Leaf Tincture, tea Possible giddiness,
tonic capsule irregular heartbeat

St. John’s wort Mild to moderate Flowering Tincture, capsule May make skin more
depression tops tablets, extracts, light sensitive in fair-
tea skinned people.

Valerian Root Insomnia; mild Root Tincture, capsule May cause mild upset
anxiety and tablets, extracts, stomach in small
restlessness dried root, tea percentage of people

Vervain Depression, tension, Aerial parts Tincture, infusion None known
stress, strengthen
nervous system

Nervous System Stimulants

Nervous system stimulants such as coffee, black tea, green tea, kola nut, guarana, Gotu kola and Yerba mate can be very effectively used in short-term situations to “spark” the nervous system. They are all caffeine containing plants, and in large amounts caffeine has been shown to produce nervousness, insomnia, elevated blood sugar, elevated cholesterol levels, heartburn and irregular heartbeat. Amounts of caffeine can vary widely, even within the same product such as coffee, but the following are approximations of the amount of caffeine in commonly used food products:

8 oz. cup of coffee 50 – 100 mg.

8 oz. cup of black tea 40 – 80 mg.

8 oz. cup of green tea 20 – 40 mg.

800 mg. of guarana 30 mg.

6 oz. cup of mate 25-50 mg.

12 oz. can of cola type beverage 50 mg.

6 oz. cocoa 15 mg.
1 oz. bar of milk chocolate 6 mg.

Coffee beans contain approximately 1-2% of caffeine. With the popularity of coffee and coffee houses most Americans will be hard pressed not to admit to knowing the effects of a cup of coffee. When used sparingly as an herbal remedy, it is considered a very effective mental stimulant.

Tea, camellia sinensis, and green tea have also long been used as beverages, before, during and between meals throughout the world. More recently green tea has been especially associated with a variety of benefits associated with its antioxidant properties. As for mood, many people report feeling an emotional lift without the harshness of coffee when they drink tea.

There is a popular Chinese mixture of Kola nut, Gotu Kola, and Polygonum multiflorum. This mixture is believed to prolong life and enhance mood and sense of well being. In India there is an old adage concerning Gotu kola, “two leaves a day will keep old age away.” It is believed that Gotu kola will help to resolve various types of mental anxiety and nervous disorders.

Different Forms of Herbs

Herbs and prepared herbal compounds are available in different forms such as raw herbs, tinctures, extracts, capsules, tablets, lozenges, and ointments. Both individual herbs as well as complex herbal formulations can be found at your local health food store, pharmacy and in many grocery stores.

Whole Herbs

The use of whole herbs involves drying and then cutting or powdering plants or plant parts, to be used for teas or cooking.


In a tincture, alcohol is employed to extract and concentrate the active properties of the herb as well as to act as an effective natural preservative. A tincture is a very effective way to administer herbal compounds, as the body easily assimilates it and the herb is in a concentrated form. For the same reasons, tinctures are also cost-effective, however, the full taste of the herb comes through very strongly and some may find the taste to be bitter and unpleasant. Another concern when using tinctures is the presence of the alcohol. If you wish to lessen the amount of alcohol in a tincture, mix the appropriate dose with one-quarter cup of very hot water. After about five minutes, most of the taste of the alcohol will have evaporated away, and the mixture should be cool enough to drink.


Extracts can be made with alcohol (like tinctures) or the essence of the herb can be leached out with water. When purchasing a liquid extract of an herb, the only way to be certain of the extraction process (alcohol or water) is to read the label. Extracts offer essentially the same advantages and disadvantages as tinctures. They are the most concentrated form of herbal treatment and therefore the most cost-effective and have a virtually indefinite shelf life. They are also easy to administer, but have a strong herbal taste.

Capsules and Tablets

Capsules and tablets contain a ground or powdered form of the raw herb. They are considered the most convenient way to take an herb and one can avoid the unpleasant taste of the raw form. Clinically speaking, there does not appear to be much difference between the capsules and tablets in terms of therapeutic results. As finely milled herbs tend to degrade quickly, it is important that herbs be promptly encapsulated or tabeleted within twenty-four hours of being powdered. When buying herbs, read the labels to make sure fresh herbs have been used in the product. Capsules and tablets are not as strong and potent as tinctures and extracts, with the exception of certain herbal concentrates in capsule form.


Many delicious blends of herbal teas are now available to the public. You will find loose herbs that are ready for steeping, herbal formulations for specific health conditions, as well as convenient pre-bagged teas. Some teas such as spearmint, rosehips or lemon grass are generally intended for sipping or accompanying a meal. Other teas are consumed for their medicinal properties. For example, linden blossom, St. John’s wort and oatstraw tea can be used to enhance your mood, peppermint tea for indigestion or chamomile, valerian or hops teas to aid sleep. Steeping in boiled water for a few minutes will release the fragrant, aromatic flavor as well as the herbs’ medicinal properties.

Essential Oils

In most cases, essential oils are distilled from various parts of medicinal and aromatic plants. Essential oils are typically extremely concentrated and one or two drops of the oil often provide a sufficient dosage. Some oils can be safely applied directly to the skin, but most essential oils can irritate the skin so it is recommended to dilute them in fatty oils or water prior to topical application.

Essential Oils for Depression

The following essential oils can be used in an aromatherapy room diffuser to reduce depression, anxiety and stress, and enhance mood. Follow the instructions on your diffuser, but one or two drops should be sufficient for a small room, and five to ten drops for a larger room.

Bergamot (Citrus bergamia): Helps to balance the emotions and is excellent for reducing depression, anxiety, and insomnia.

German Chamomile (Matricaria recutita): An excellent antidepressant for individuals who are subject to stress, anxiety, oversensitivity, suppressed anger or insomnia.

Geranium (Pelargonium graveolens): Useful for relieving anxiety, stress, discontentment and depression.

Lavender (Lavandula angustifolia): Helpful for problems of the central nervous system, including nervousness, irritability, exhaustion, insomnia, and depression.

Rosemary (Rosmarinus officinalis): A stimulating herb that acts as an antidepressant. It also enhances memory, and balances the body and mind.

Therapeutic Massage with Essential Oils for Depression, Stress and Insomnia
A powerful aromatherapy recipe for relieving stress, depression as well as insomnia is to combine two drops of lavender and one drop of chamomile essential oils in three ounces of almond, olive or your favorite massage oil. Massage up and down each side of the spine from the cervical to the lumbar, before retiring to bed. Another recipe that is more stimulating, and therefore should be done during the day, is a combination of lavender, rosemary or peppermint essential oils. Combine one drop of each oil to three ounces of massage oil and massage up and down the spine.

Are Herbal Remedies Safe for Treating Depression?

If herbal remedies are used in the recommended doses adverse reactions or side effects are unusual. Problems are more likely to occur if an herb is overused. This can occur if the dosage is too high or if the herb is taken continuously for too long a period of time. Chamomile, for example, if given on a daily basis for too long, may cause an allergy to ragweed and the prolonged use of licorice can lead to high blood pressure.

Herbs should be used for set periods of time or alternated with another remedy or remedies. For example, if an individual has taken St. John’s wort for three months and is still feeling depressed, he should discontinue using the herb and try to find an appropriate alternate herb or herbal formula. On the other hand, if the individual is doing well on St. John’s wort after four to six months, they should still stop using the herb, and try another herb or herbal formula to deal with any other symptoms. For example, if the predominant remaining symptom is fatigue, one may want to take Siberian Ginseng; if the symptom is agitation, kava may be called for; if insomnia is the major complaint, valerian is the appropriate herb.

Moderation is the key when using herbs for therapeutic purposes. Consult with a qualified herbalist or health care professional if you have questions about the use of a particular herb or herbal formula.

Today, herbal medicine is enjoying a renaissance in the United States, and almost fifty percent of the American population use dietary and herbal supplements to improve their health. Consumers are becoming more and more informed about their health choices, and are looking to utilize the best that conventional medicine and natural medicine has to offer. Based on current trends, the twenty-first century has the potential of becoming the “healthiest” century in human history.

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Written by Janet Zand LAc OMD

Explore Wellness in 2021