Treating The Blues, an Herbal Approach
This paper is an assignment to write about herbal treatments for “the blues”, depressive states. Writing from my experience as a mental health provider I first want to say that for any condition the herbalist should have clear understanding of what is causing the problem. Depression is “pressed down energy” and it's etiology can be quite varied and thus should be the remedies. Diagnosis is a large topic which is beyond the scope of this paper and the training of an herbalist, so, in order to ensure one is treating the core issue, it may be wise to work in collaboration with a mental health provider as well as closely with the client.
To me there are two different ways of using herbs: nutritive herbs that are used regularly for food on an ongoing basis, and medicinal herbs that are employed to re-balance the system in the case of an affliction but are not used continually. These could impact the system negatively over time. Depression is a state of imbalance and in it's treatment I would want to make sure I am working to restore the innate health of the system without creating a dependency on a plant that is not meant as a food or would take over what the body needs to be doing for itself without outside help. Unfortunately in both the medical system and alternative health care people are often guided to use substances without getting to the underlying issues and truly alleviate the problem. While it is not at all true that everyone with depression needs medication, studies have shown that the most successful treatment for stubborn depression is a combination of psychotherapy and medication rather than just one or the other. If I am working with someone where we are spending more time managing their mood disorder than working with energy moving through the system to fcilitate life change, I will recommend an adjunctive herbal treatments. I will also offer this before talking about pharmacological interventions and have had very positive results when the client 1) uses clean and reputable herbs 2) has a fair amount of buy-in to the treatment and therefore takes the remedy regularly and tracks their progress.
Symptoms of depression usually start with difficulty concentrating and focusing and can include a change in sleep and/ or eating patterns- it can be either too much or too little of these; similar is the symptoms of too little movement and lethargy or evident agitation and irritation and restlessness. Loss of energy and fatigue, feeling worthless, dwelling on negative things, feeling hopeless, isolating, and at the worst, fixating on death or having suicidal thoughts or attempts are all symptoms of depression. It is common for people to feel down or depressed to some degree for short durations during life. This is called an exogenous depression and is usually situational. In these circumstances the herbalist can play a key role. Depression is often the result of trauma, it can be recent or distant including forgotten childhood trauma or chronic crisis. But when a mood problem persists it is important to take bolder action as the longer it goes, in my opinion, the more difficult the treatment. I repeat my earlier warning, an untrained person should not attempt to treat a clinical depression as this is a serious problem. But for other situations, here are some of my ideas about herbal approaches to depression:
For treatment beyond psychotherapy the first and foremost thing for me is always to look at diet and exercise. A sluggish and polluted system is under a great deal of stress which can take a toll on the body and effect one's mood and perceptions. Most people feel better when they eat fresh non-processed chemical free foods and get regular exercise with a variety of anaerobic movement and muscle building strength. But the fact that someone is unable to care for themselves in this way may be connected to the core issue of the disorder and changing this may require special care and persistence.
Caffeine is an antidepressant which works by stimulating the central nervous system and elevating serotonin and dopamine. Many many people in our culture are probably unknowingly using caffeine to self-medicate for depression. But there is a high likelihood that the long term result will be dependency resulting in headaches and other uncomfortable withdrawal symptoms when caffeine is not available. Also over time one may find that they need more and more (coffee), evidence that they are developing a tolerance. A problem results when they increase the dosage and there is risk of caffeine overdose. Symptoms include jitteriness and insomnia, nervousness and palpitations and can even go into a caffeine induced psychosis. So caffeine, although it initially works wonderfully, may not be a good treatment option. While Coffee is the main caffeine remedy in our culture, caffeine is also found in sodas and teas. And many many herbs contain caffeic acid as well, such as Guarana and Maca Maca (often touted as a depression remedy).
For endogenous states and Seasonal Affective Disorder, aromatherapy is a wonderful and uplifting form of herbal treatment. These are not cures but are important supportive adjunctive therapies that can make a real difference in one's experience. Rose is uplifting and soothes the nervous system while impacting issues of the heart and desire. Lavender, Cleary Sage, Cardamom, Ylang Ylang and Sandalwood all elicit positive feelings in most people that affect the tension or lethargy that comes with depression. My preferred delivery system is via diffuser in a room where the client will be for a number of hours. It can also be mixed with a carrier oil and put directly on the skin, generally on the temples or wrists, or made into a face spray. But the best chance of smelling it for a long period of time allowing for a change in the neuro-network firing system of the brain is through the diffuser. This also allows the scent to go straight to the limbic system where it impacts the emotions.
In general, adaptogens are going to be helpful for depression. They help modulate stress through the adrenal system bringing balance to the hormones and rebooting the immune system. My favorite adaptogens are Ashwaganda and Shizandra (berry), Don Quai (for women) or Ginseng (for men). I have heard great things about Rhodeola although I have yet to meet this plant.
Rosemary tincture can help modulate a low to medium grade depression because it opens the blood flow to the brain and specifically the eyes. I have also read that it too modulates neurotransmitters. It is an herb of the Sun and a strong stimulant, although without the addictive tendencies of caffeine. I love to use it myself when dreary Seattle days and darkness are getting me down. I do consider it a tonic although even with Rosemary I would not use it on a regular basis or for years at a time. If the depression persists, a more varied treatment must be considered.
Melissa Officianalis is one of my favorite plants to recommend for depression. It is an herb of Jupiter and is therefore uplifting and expansive. I also perceive it as a Moon herb as the image I get from Lemon Balm is of Moonlight reflecting on the Water. The nectar of the Moon can be so gentle, soothing and healing, different than the excitement and stimulation of the Sun herbs. Be sure to observe your client and their symptoms well so you can better perceive which direction to go with the herbs. Certainly a dry and brittle person would be more suited to working with Lemon Balm than with the stimulating remedies, and visa versa for a more kapha person; one with a damp congested condition could benefit from the stimulating plants. Lemon Balm is a nervine and fortunately studies have proved it's efficacy in depression treatment. According to the journal Neuropsychopharmacology in July 2003, higher doses increase calmness while lower doses can increase memory and sharpness so again, observing and understanding the specifics of the experience of the person you are treating is key.
Artemesia Vulgaris: Because Mugwort is a nervine I know of herbalists who recommend it for depression and it is listed in several reputable texts. I have no experience using it for this purpose but it does regulate hormones in women which probably helps to balance hormone related depressive states. I do remember having Moxa (Chinese treatment of burning Mugwort on pressure points) during acupuncture and it causing a state of euphoria. Mugwort is also useful when treating addictions which often goes hand in hand with depressive problems. Do beware that it can be an abortifacient.
Rhodeola Rosea is mentioned with other adaptogens above. I have not used this plant yet but many studies have proven it is useful in treating of depression. It is said to greatly enhance physical well being as well as alleviate stress.
Hypericum, Saint John's Wort, is the big gun for depression for good reason. It is thought to function much as the pharmaceutical MAOI's and therefore needs some time before it's effectiveness is evident. I usually ask people to try it for 4-6 weeks before evaluating. I have had such good results with people taking 2-3 droppers of the tincture 3 times a day and after awhile they can usually reduce the dosage and frequency. I have seen many many people's pervasive despair remit with St. John's Wort and it allows the therapy to go from the crisis management of depression to being able to track and relieve the etiology. I do recommend people not start with this plant unless they are willing to take it from 8-18 moths while they do psychological work. This allows for the chance to both remove the blockages (often stuck energy associated with images from childhood) that caused the problem, as well as give the brain the opportunity to build new neuro-networks, patterns of information in the brain and nervous system, that will remain after the client goes off of the herb. I would not recommend that people self-medicate with St. John's Wort although I believe that many do. It is a plant of the Sun (as evidenced by it's vibrant yellow flowers) and according to Mathew Wood works especially on the solar plexus which allows for better food digestion; it relieves inflammation of the nerves and soothes the glandular organs and decongests the liver. It alleviates deep body tension is used as a pain reliever. It is important to not use St. John's Wort if other pharmaceuticals are prescribed as it can prevent them from being metabolized. It also is purported to cause Sun sensitivity so please warn people to stay out of the direct Sun when using this plant.