Are you depressed? If so, you’re not the only one. In fact, approximately 20.9 million American adults have a mood disorder, and approximately 14.8 million experience major depressions.1 The World Health Organization reports depression is the primary cause of disability among Americans ages 15 to 44. The U.S. Census Bureau further reported 3.3 million Americans suffer from chronic, mild depression.
The predominant chemical or biological theory of depression suggests it is caused by a decrease in the brain chemicals norepinephrine (NE), dopamine (DA) and/or serotonin (5-HT).2 In fact, conventional medical treatment uses anti-depressant drugs that can increase the amounts of these brain chemicals by blocking their breakdown or exit from the body. Prozac, for example, blocks the breakdown of serotonin. Another conventional medical treatment is psychological counseling, which considers one of the causes of depression to involve familial associations and/or other relationship problems or life circumstances. Most modern theorists would agree both biological and psychological factors play a role.
In addition to conventional treatment for depression, some complementary and alternative treatments also have value. This includes exercise, massage therapy, relaxation therapy and dietary supplement therapy. St. John’s wort (Hypericum perforatum) is probably the best known of the dietary supplement ingredients that are helpful for mild to moderate depression.
St. John’s wort has been used as medicine since the Middle Ages. Today, it is enjoying a resurgence because of its marked influence on depression. The clinical evidence is overwhelmingly in favor of St. John’s wort extract as a relatively risk-free anti-depressant suited for the treatment of mild to moderate depression. In one study, after four to six weeks, all patients showed a measurable improvement in anxiety, mood, loss of interest and more than half a dozen other psychometric measurements.3
Research on St. John’s wort extract is so extensive that it has been endorsed by the German government’s Commission E as indicated for impaired consciousness, depressive states, fear and nervous disturbances.4 Studies comparing St. John’s wort to placebo and various anti-depressant pharmaceuticals have validated its efficacy and demonstrated a therapeutic advantage over prescribed drugs.5 And, occurrence and severity of side effects with Hypericum extracts are clinically insignificant, especially compared to those of the pharmaceutical counterparts. For example, in one study comparing Hypericum to fluoxetine (Prozac) for mild to moderate depression, the researchers concluded, “When treating patients with mild to moderate depression, hypericum should be considered as one of the first treatment options based upon both efficacy and safety, particularly in cases where treatment is a choice between fluoxetine and hypericum.”6
St. John’s wort’s primary mechanism of action seems to be increasing serotonin levels.7 It may also increase some aspects of brain dopamine function in humans.8 Levels of these neurotransmitters are often inadequate in depressed individuals. There is some debate over the active ingredient in St. John’s wort—hypericin or hyperforin.9 Until the argument is settled, it is probably best to use a St. John’s wort product that is standardized for both its hypericin and hyperforin content.
Another interesting botanical in this area is Rhodiola rosea, which has been used in the traditional medicine of Russia, Scandinavia and other countries to treat fatigue, depression, impotence and nervous system disorders, while increasing physical endurance and work productivity.10
Modern scientific studies in cell cultures, animals and humans have revealed anti-fatigue, anti-stress, anti-hypoxia (protection against damaging effects of oxygen deprivation), antioxidant, immune enhancing and sexual stimulating effects.11,12,13,14,15,16 Of particular note are Rhodiola’s anti-fatigue and performance enhancing properties. A number of studies have shown Rhodiola increased physical work capacity and dramatically shortened the recovery time between bouts of high intensity exercise.17
Other current and evidence-based uses of Rhodiola include, but are not limited to, feelings of well-being and mental performance.18 In one study, a specific Rhodiola extract given in doses of 50 mg twice daily reduced mental fatigue and improved subjective well-being in students during an examination period.19 In another study, taking 170 mg/d of the same standardized Rhodiola extract seemed to reduce feelings of fatigue and improve mental performance in night shift workers.20
The psychostimulant effects of Rhodiola, 50 mg three times a day, were studied in 53 healthy subjects and 412 patients with neuroses and asthenic syndromes (fatigue, decline in work capacity, trouble falling asleep, poor appetite, irritability and headaches).21 Rhodiola alleviated fatigue, irritability, distractibility, headache, weakness and other vegetative symptoms in 64 percent of cases.
Rhodiola’s diverse effects may be partially explained by the fact that it is an adaptogen.22 This means that it contains natural bioactive compounds having the ability to increase a human’s resistance to different stress-related disorders, and help to normalize body functions. These bioactive compounds have been determined to be rosavins, and possibly salidroside.23 A standardization of about 3-percent rosavins (as rosavin, rosin, rosarin) and 0.9-percent salidroside should assure maximum activity.
There is no simple, all-inclusive answer to treating depression. However, working with a qualified health care professional to modulate levels of neurotransmitters with appropriate therapies can make a profound difference in many individuals.
Gene Bruno is the Dean of Academics and is on the faculty of Huntington College of Health Sciences (HCHS), an accredited distance learning institutions offering undergraduate and graduate degrees in nutrition, as well as diploma programs in nutrition and dietary supplement science. HCHS.edu, (800) 290-4226.
References
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