Herbal remedy for depression?

May 24, 2005 9:16 PM

I need advice from people who have experience taking herbal remedies / vitamins, specifically for depression.

I was diagnosed with clinical depression and panic disorder about two years ago and was prescribed the highest dosage of Paxil. It definitely helped with my panic disorder, but never really seemed to change my depression. Actually, about a year into taking it, I became suicidal. After researching a little, I found Paxil is linked to increased suicidal tendencies so I immediately went off the drug cold turkey. Of course this was very dumb and I went through massive withdrawls but I didn't realize how dependent my body had become on it.

Which leads me to my question. It's been 3 months since I went off Paxil and I still have issues with depression. I'm not too keen on going on another prescription, but am curious about hermal remedies and/or vitamins I can take that might help. I have heard of St Johns Wort but does it actually work? Are there vitamins I should be taking? Certain foods I should be eating? Hearing from people with personal experience would be great.

posted by Ugh to health & fitness (22 comments total)

I've had moderate success with B12 in the past.

I've also found exercise to be helpful and extremely useful in at least temporarily changing mood and outlook. I know that may not be exactly what you're looking for, but I figured I would put it out there anyway.
posted by tozturk at 9:36 PM on May 24, 2005

I have personal experience with St. John's Wort and found it effective. I took it for about a year, tapered off as an experiment, and found that I didn't need it any more.

I experienced some sleeplessness when I first took it -- I suggest taking it in the morning. Other than that I had no side effects.
posted by bac at 9:36 PM on May 24, 2005

I've been taking St. John's Wort for about 10 years, and it works very well for me. Like any such remedy, be aware that it doesn't work for everyone, though more recent studies (where they actually used enough of the herb to make a difference) are showing real efficacy.

Be sure to start with at least 600 mg/day (I take a morning and evening dose). When I was starting, I took twice that much, and tapered off gradually.

I have severe endogenous depression, so it can work for more than mild cases.

Also, remember that Paxil is not the only medication available to you, and I definitely would try working with your doctor on a change of prescription. It's unusual for the first thing to work entirely. And just like drugs, it usually takes a few tries to find a mental health professional who works for you. Hang in there, but be sure you have a lifeline.

Lastly, exercise and sleep are easily as important as any herb or drug. I cannot emphasize this enough. Wait, I can at least do better than that, though:

Exercise and sleep are easily as important as any herb or drug!
posted by frykitty at 9:47 PM on May 24, 2005

I have to agree with tozturk. The only way I've found to effectively fight off depression and panic is through exercise (not necessarily gymrat stuff, more like running or fast walking 45 minutes a day) and cutting out cigarettes, caffeine and alcohol.
On preview, what Flykitty said. Best of luck, and hang in there.
posted by maryh at 9:58 PM on May 24, 2005

My doctor told me that St. John's Wort has been shown in preliminary studies to interfere with the birth control pill and, I assume, other hormonal methods of birth control. Just so you know.
posted by librarina at 9:58 PM on May 24, 2005

Ah! Thanks for all the advice so far. Our family has always had the mindset of "if your leg isn't actually missing from your body, then you don't need a doctor," which is why it took a lot for me to go to the doctor in the first place. The reason I am not interested in going back is because a) I felt my doctor was very patronizing and apathetic b) because of my negative experience with Paxil and c) because I currently have no insurance and can't afford either the visits or the prescriptions.

He did stress the importance of good sleep (i'm a life-long insomniac) but his solution was to put me on a high dosage of Klonopin which wasn't effective AT ALL. I guess I definitely need to start with my lifestyle. Beers, cigarettes, and caffeine are parts of my daily routine and exercise is not.
posted by Ugh at 10:56 PM on May 24, 2005

I'm heard good things from a pharmacist about SAMe, but no personal experience.
posted by thedevildancedlightly at 11:15 PM on May 24, 2005

In the past, I have had good experiences with St. John's Wort. It lessens the drag of depression but does not eliminate it totally. I think for most people it works in a more gentle way than, say, a prescription antidepressant. Watch out for sunburn, though. SJW really ups sun sensitivity that way.

For years I've been reading about sleep deprivation as a 'reset' button for depression, but as a snore whore it appalls me to even think of trying it.
posted by DawnSimulator at 11:36 PM on May 24, 2005

Exercise. I'll smoke, drink, and caffienate you under the table, but the older I get the more I realize nothing makes me quite as happy as riding my bike. It's like flying, all at once calming and peaceful and relaxing and conversely aggressive, challenging, and as fast or as slow paced as I want it to be - all with the added benefits of getting exercise. It doesn't have to be riding a bike, but get some exercise. There are worse ways to get some action, though.

Eat well. Even if you like to recreationally/habitually abuse yourself with drink, smoke, and/or drugs, that doesn't mean you can't eat well. The two aren't mutually exclusive. Just because I drank the better part of a fifth of Vodka yesterday doesn't mean I'm forbidden from enjoying a nice, organic salad and a ton of purified water today. In fact, that's all the more reason to. And if you eat right, you don't have to buy vitamins at all, because most research shows isolated vitamins aren't really the best way to get your micronutrients.

Avoid heavily processed foods, avoid fast food like crazy, avoid meats with hormones and other additives, avoid dyes and colorings, avoid pesticides.

While you're at it, if you can manage it, avoid television like the plague. Besides the frequently entirely unrealistic worldview broadcast/network/cable TV presents - which can be psychologically daunting in itself - there's a phenomenon called photoneuralsynthesis or something like that, AFAIR.

Specific frequencies of flashing light will stimulate specific brain-wave states. At 30 FPS, putting aside the content of the medium of TV, television can stimulate someone into "high beta", which is associated with anxiety, "over" arousal, fight-or-flight responses and the like.

I've used St. John's Wort, but I get the feeling that it shares similar (but vastly milder) side effects as compared to SSRIs and other anti-depressants - namely dependence, probably in the form of "artificially" sustained or elevated serotonin levels above the natural baseline of the individual.

Plus, St. John's Wort never seemed to be dramatically successful enough for me personally, but then my tolerances for just about everything in general tend to run, erm, high.

DawnSimulator: Hrmpf. Maybe that explains why about once a month or so I just want/have to stay up for about 24 hours. It's fun and makes me feel good for days/weeks afterwards.
posted by loquacious at 12:09 AM on May 25, 2005

For a while I took a vitamin/mineral supplement designed to help with depression and anxiety, and I don't know that it did anything for me. However -- while St. John's Wort is not entirely innocuous -- I don't think you're risking anything by taking a nutritional supplement, so why not give it a shot? Even if it doesn't do anything, you might find some affirmation in a regular gesture toward self-recovery.
posted by ori at 2:42 AM on May 25, 2005

Omega-3 fatty acids are also supposed to help depression. You can either take fish oil or flax oil supplements, or you can add lots of fish or flax seed to your diet. Personally, I've gone the flax route, since I don't trust fish not to be filled with heavy metals and other such contaminants.

I can't say how the work very accurately, since I haven't been taking flax oil in a vacuum. I have tried St. John's Wort with mild success, but exercise has been the best thing for me.
posted by ursus_comiter at 5:40 AM on May 25, 2005

my partner tried both st john's wort and vitamin b (perhaps 12, perhaps a mix?). the st john's wort seemed to make no difference at all (although we have some lovely glass bottles as a result), but the b definitely helped, especially with the cyclic part of the depression related to pmt.

but - unsolicited advice ahead - it sounds to me like you need to talk to your doctor more. in my experience of people who have been depressed, the relationship between doctor/psychiatrist and the depressed person was critical. if you don't trust your doctor, find another. you should have been aware of the risks with the drug before starting, and you and the doctor should have been monitoring the progress, and you and the doctor together should have worked out how to come off the drug. there are some amazing drugs out there these days - find a doctor you can trust and talk to and take advantage of them, rather than trying to solve a very hard problem on your own.
posted by andrew cooke at 6:11 AM on May 25, 2005

Just a little side note along the lines of what librarina said. Herbal supplements should be considered drugs when figuring drug/drug interactions. Always include supplements when listing current medications to your doctor. Many doctors may not be well informed about risks but it is still good patient practice regardless of the MD's response.
As an example, St. John's Wort is additive with SSRIs and should be taken into account when dosing to avoid toxicities.
If you are taking high doses of an herbal supplement it is your responsibility to talk to your doctor and follow the current literature regarding drug/drug interactions and side effects.
posted by Corpus Callosum at 6:14 AM on May 25, 2005

Another vote for exercise and omega-3s. You can read about omega-3 and depression on the (commercial) Equazen website. I recall that it does take a few weeks of regular exercise to see a benefit comparable to taking antidepressants. Good luck!
posted by teleskiving at 7:12 AM on May 25, 2005

Nothing herbal ever worked for me, personally. I'm also a very, very, very strong believer in exercise, eating right, and getting sleep. For me, though, doing these things was not enough and I eventually had to try meds (I gave the natural way--exercise/eating right/etc.--a while before trying this...probably seven years). I found something that works tremendously well--I have the same problems as you. I would see a psychiatrist rather than your regular doc. It is extremely uncommon to start someone with an anxiety disorder (you mentioned panic) immediately at a high dose of antidepressants. They usually wean you on gradually...at least from what I've read and my experience. Despite your bad experience with paxil, I'd try something else before completely giving up on the meds side of things. But definitely see someone who knows more about the options out there.

Last thing--you mentioned caffeine...you probably already know this but caffeine is actually a trigger for panic attacks... I wouldn't necessarily cut it out completely, especially if you're addicted, but I'd definitely limit my intake if I were you. Same goes with the cigarettes.
posted by fabesfaves at 7:33 AM on May 25, 2005

St. John's Wort, as many have already pointed out, doesn't work for everyone. I've used it from time to time to get over small bouts of depression, and it works for very short periods of time.

The downside is that I find that I crash after using it or when the doses wear off; it gets harder to think and what little creativity I have to begin with vanishes altogether. Apathy becomes the order of the day. Since the crash can last for 24-36 hours for me, I've avoided using it. Taking more SJW to head off the crash doesn't work well.
posted by staresbynight at 8:00 AM on May 25, 2005

Evening primrose oil or anything containing borage oil is supposed to help with mood swings related to PMS (since I see you're female from your profile). See this link. However, IANAD. I suggest you consult your doctor. Also, be aware that herbal supplements can interfere with other medications you could be taking, like birth control pills for instance.
posted by cass at 9:28 AM on May 25, 2005

I had excellent results with 600 mg. of St. John's Wort daily. But listen to this, and listen carefully:

Stop drinking. That's means beer. Totally. Today. Then...

Start exercising.

You will be amazed. But stop drinking.
posted by shambles at 11:30 AM on May 25, 2005

I take St. John's wort, 5HTP (a serotonin precursor), and DLPhenylalanine (an amino acid that boosts endorphin levels), all three times a day. I've had great results. (And I've taken Prozac...)

I highly recommend seeing a naturopathic doctor, since herbs and amino acids work differently for everyone.
posted by Specklet at 12:15 PM on May 25, 2005

St John's Wort has SSRI activity (just like paxil, zoloft, and prozac) and some studies have shown that even among the same brand, the amount of activity from pill to pill of the St John's Wort preparations can be quite variable.

So I:

a) wouldn't expect it to have an effect very different from an SSRI and

b) would expect you to have negative effects similar to those experienced by people who take their SSRIs only sporadically.

Exercise, sleep and avoidance of alcohol will take you much further than any pill, extract, or whole plant. Healthy interpersonal relationships are also a great buffer against ill health of all sorts, mental and physical.
posted by ikkyu2 at 2:05 PM on May 25, 2005

ikkyu2, what you say is partially accurate: any variation in pill to pill of St. John's wort is much, much less than the variation in taking your prescription sporadically. (This I have experienced first-hand.)
posted by Specklet at 3:39 PM on May 25, 2005

I'd also say that SJW is effective in the short term, with 5HTP doing better in the long term, paired with fish oil, gingko, and a B vitamin.
posted by moonbird at 6:42 AM on December 17, 2005