Herbal remedies have been used to treat depression and anxiety for centuries around the globe. Western societies, in particular, have moved away from traditional herbal treatments towards prescription medications. There are some proven herbal options that may be worth a try.
One in four women in the United States now takes a psychiatric medication.
According to a report from the National Center for Health Statistics (NCHS), the rate of antidepressant use in this country among teens and adults (people ages 12 and older) increased by almost 400% between 1988–1994 and 2005–2008.
The federal government’s health statisticians figure that about one in every 10 Americans takes an antidepressant. And by their reckoning, antidepressants were the third most common prescription medication taken by Americans in 2005–2008, the latest period during which the National Health and Nutrition Examination Survey (NHANES) collected data on prescription drug use.
Here are a few other stand-out statistics from the report on antidepressants:
23% of women in their 40s and 50s take antidepressants, a higher percentage than any other group (by age or sex)
Women are 2½ times more likely to be taking an antidepressant than men (click here to read a May 2011 article in the Harvard Mental Health Letter about women and depression)
14% of non-Hispanic white people take antidepressants compared with just 4% of non-Hispanic blacks and 3% of Mexican Americans
Less than a third of Americans who are taking a single antidepressant (as opposed to two or more) have seen a mental health professional in the past year
Antidepressant use does not vary by income status
So is it a good thing that so many more Americans are taking antidepressants? Many (perhaps most) mental health professionals would say, yes, because depression has been undertreated and because antidepressants are effective.
But there are also plenty of critics, as shown by this review in the New York Review of Books, who say the benefits have been overstated and that pharmaceutical company marketing is responsible for the surge in prescriptions.
Some experts believe that our modern lifestyle is making us more depressed, while others think that heavy promotion by drug companies and over-prescribing doctors are to blame.
But however you look at it, more people than ever are taking antidepressants, and natural options that work are needed more than ever.
Are Antidepressants Effective?
A meta-analysis of all antidepressant studies from 1990 to 2009 showed that there was significant improvement in depression only in the most severely depressed group, which constitutes only about 13 percent of all depressed patients.
The effect of antidepressants on mild to moderate depression was nonsignificant. Meaning, the participants were as likely to improve by chance as they were from taking antidepressants.
If you are taking an antidepressant and feel it is benefiting you, by all means keep taking it! For some, however, antidepressants are not effective and/or have side effects that make taking the drugs undesirable. For those seeking alternative treatments, there are some herbal options that may be worth a try.
Which Herbs Work for Depression and Anxiety?
- St. John’s Wort
Probably the best known herb used to treat both anxiety and depression is St. John’s Wort. It is used first-line in Germany for mild to moderate depression and is well-established as an effective antidepressant—equivalent in effectiveness to prescription antidepressants—with fewer side effects. Like the SSRIs, St. John’s Wort also has an anti-anxiety effect.
According to the National Institutes of Health (NIH), St. John’s Wort may help milder forms of depression, although its effects haven’t been conclusively proven either way. A 2008 review of 29 studies on St. John’s wort found that the plant was just as effective for treating mild to moderate depression as antidepressants, yet resulted in fewer side effects. On the other hand, the NIH’s National Center for Complementary and Integrative Health sponsored two separate studies that found it wasn’t better than a placebo for treating depression.
The recommended dose of St. John’s Wort is 450 milligrams twice daily. It is best to start at half dose for a few days and then increase to the full 450 mg. St. John’s Wort takes 4 weeks to achieve full effect, and its major risk involves interactions with other drugs and supplements. If you are taking medications, it should absolutely be monitored by your doctor to be sure that there are no toxic side effects.
I want to emphasize that St. John’s Wort decreases the potency of birth control pills. It can also decrease the potency of hormone-replacement therapy.
It’s important to note that St. John’s wort is known for interacting with lots of medications. This is especially true for blood thinners, birth control pills, and chemotherapy medications. Always check with your doctor before taking this herb.
- SAM-e
SAM-e is short for S-adenosylmethionine. This supplement is designed to act like a synthetic form of the body’s natural mood-boosting chemicals. According to the Mayo Clinic, SAM-e is regarded as a supplement in the United States — the FDA doesn’t consider it a medication.
SAMe isn’t approved by the FDA to treat depression in the U.S., but it’s used in Europe as a prescription drug to treat depression.
It is not recommended that you take SAM-e along with antidepressants. You should also be aware that SAM-e can cause health effects such as upset stomach and constipation if you take too much.
- Lavender oil
Lavender oil has been used as an inhalant—in sachets, sprays, oils, and lotions—for centuries. The smell induces calm and sleep. Lavender oil is now available in an oral form, collected into microscopic bubbles and placed in a capsule that allows it to cross the intestinal barrier. Once it does, it induces calm and reduces anxiety. It is marketed as Lavela. It’s not addictive or dangerous.
Lavender is an anxiety treatment that doesn’t make you tired. It can be used as needed—when anxiety arises, or regularly, depending on your needs.
- Valerian root
Valerian works as a mild antidepressant and anxiolytic and has demonstrated through testing not to have a sedative effect. The extract phytofin Valerian 368 has been shown to have sleep-enhancing qualities.
Valerian root is the most effective herb for sleep, according to research. It is also a great anti-anxiety herb, but, unlike lavender or L-theanine, it will definitely make you tired! It’s a good option for more severe anxiety spells and for evening use, when you won’t be driving or working.
Valerian can be taken during the day in very small doses, 20 milligrams or less. In fact, it is widely available in “sleep teas” at a dose of about 20 milligrams. For sleep, or more severe anxiety in the evening, you can use doses as high as 600 milligrams. It is important not to combine valerian with alcohol or other depressant medications.
- Kava
Kava root has been used as a ceremonial tea in the Polynesian islands for centuries. It is non-addictive and has been shown to be effective in generalized anxiety disorder. Kava has a feel similar to alcohol—relaxing and anxiety-reducing, but with no addictive quality. Some studies over a decade ago showed that kava caused liver toxicity, but those studies used the incorrect parts of the kava plant, and the supplements used may have had contaminants in them.
Kava has been shown in several studies to have an effect similar to that of valium in treating anxiety. 300mg once a day causes a decrease in anxiety, while also improving cognitive function. This is in contrast to pharmaceuticals like valium, which help with anxiety but also decrease cognitive function
Kava should not be taken for more than 4 weeks, nor should it be taken if you have hepatitis or other liver problems.
- Rhodiola
Rhodiola (Rhodiola Rosea), sometimes called Arctic root or golden root, is considered an adaptogenic herb, meaning that it acts in non-specific ways to increase resistance to stress.
This herb grows at high altitudes in the arctic areas of Europe and Asia, and its root has been used in traditional medicine in Russia and the Scandinavian countries for centuries. Studies of Rhodiola rosea’s medicinal applications have appeared in the scientific literature of Sweden, Norway, France, Germany, the Soviet Union and Iceland. Rhodiola rosea is still widely used in Russia as a tonic and remedy for fatigue, poor attention span, and decreased memory.
A study published in 2007 in the Nordic Journal of Psychiatry, showed that patients with mild-to-moderate depression who took a rhodiola extract reported fewer symptoms of depression than those who took a placebo. A small human trial of rhodiola at UCLA published in 2008, reported significant improvement in 10 people with generalized anxiety who took the herb for 10 weeks. Side effects were generally mild or moderate in severity. The most common unwanted effects were dizziness and dry mouth. Rhodiola appears to work faster than conventional antidepressants, often in less than a week.
Tieraona Low Dog, M.D. say it is one of her favorite herbs for treatment of patients suffering from “21st century stress”: fatigue, mental fog, trouble concentrating, low energy and, perhaps, mild depression. She recommends using a standardized extract. Look for products that are similar to those studied in clinical trials containing 2-3% rosavin and 0.8-1% salidroside. Start with 100 mg once a day for a week and then increase the dosage by 100 mg every week, up to 400 mg a day, if needed.
- Ashwagandha
Ashwagandha, sometimes known as Indian ginseng, is an herb that has been used in Ayurveda, traditional medicine of India, that can be traced back 6000 years. Ashwaganda has been used for numerous conditions, many of which have been studied scientifically.
Ashwagandha has shown effectiveness in reducing stress hormones, promoting intellect and memory, protecting against neuronal injury in Parkinson’s, Alzheimer’s and Huntington’s. It can also reverse or slow neuritic atrophy and synaptic loss in those diseases.
A treatment group in a randomized, double blind study of Ashwagandha compared to placebo demonstrated that the blood cortisol levels after 60 days showed a marked decrease, and the side effects were minimal. Usage of ashwagandha was shown to be a good protector against stress.
Ashwagandha has also shown effectiveness in helping with bipolar disorder, by improving auditory-verbal working memory), a measure of reaction time, and a measure of social cognition.
Others studies have shown that Ashwagandha is effective as an anxiolytic, as a mood stabilizer, and in treatment of obsessive-compulsive disorder.
The treatment dosage in humans is one 300 mg capsule of high-concentration full-spectrum extract from the root of the Ashwagandha plant twice daily. Again, all studies showed only minimal side effects and no major side effects were noted.
One 2012 study of 64 volunteers randomized asked subjects to take either ashwagandha or a placebo twice a day for 60 days. The ashwagandha group’s capsule contained 300 mg of a concentrated extract made from the root. During the treatment period, regular telephone call check-ins assured volunteers were consistently taking the herbs or placebo, and were used to note any adverse reactions. The treatment group given the ashwagandha root extract exhibited a significant reduction in anxiety scores after two months relative to the placebo group, without side effects. Most notably, serum cortisol levels were substantially reduced in the herbal group. Cortisol is the stress hormone that goes up when we are stressed out. Cortisol also creates longer-term fatigue and mental fogginess, and brain structures for emotion and memory are damaged when cortisol is too high.
Several studies, including one published in the journal Phytomedicine back in 2000, have found that ashwagandha works as well as, or better than, antidepressant drugs at relieving anxiety and treating depression symptoms. And ashwagandha naturally prevents stress-induced free radical damage without causing harmful side effects.
- Chamomile (Matricaria recutita or Chamaemelum nobile)
Chamomile is particularly beneficial for those dealing with both depression and anxiety.
There are two main species of chamomile used medicinally, German or wild chamomile (Matricaria recutita) and Roman or English chamomile (Chamaemelum nobile).
German chamomile is more commonly used but both offer very similar health benefits.
Recently, a study was conducted comparing chamomile extract with placebo for treatment of generalized anxiety disorder. After 8 weeks of this randomized, double-blind study, results showed that people with Generalized Anxiety Disorder had a statistically significant reduction in anxiety.
- Ginko Biloba
Ginkgo extract is widely used in Europe where it’s available by prescription or as an approved over-the-counter medication.
In one year alone, West German doctors wrote 5.24 million prescriptions for ginkgo leaf extract.
Here in the US, ginkgo is sold as a nutritional supplement, usually as a standardized Ginkgo biloba extract made from dried ginkgo leaves.
Standardized extracts are currently used for treating of a wide range of conditions including memory loss, concentration problems, mental confusion, depression, anxiety, dizziness, tinnitus, and headache.
Ginkgo is believed to work by increasing blood supply, reducing blood viscosity, boosting neurotransmitters, and reducing harmful free radicals. It can help to treat depression by increasing uptake of both serotonin and dopamine, neurotransmitters often low in those with depression.
Ginkgo extract can also reduce symptoms of anxiety and stress by lowering levels of the stress hormone cortisol.
Ginkgo leaves contain long-chain alkylphenols which are highly allergenic. These are similar to the irritating compounds found in poison ivy, poison oak, and poison sumac. If you have a known allergy to any of these plants, it’s best to avoid taking ginkgo.
A typical ginkgo dose is 40 mg three times a day for a total of 120 mg.It’s usually advised to start at a low dose and take with meals to avoid gastrointestinal distress.Doses of up to 240 mg per day are often recommended for therapeutic purposes.
- Maca (Lepidium meyenii)
Maca has been traditionally used in Peru to treat depression in men and women and to stimulate libido.
In a 2008 study published in the journal Menopause, researchers found that maca helps reduce anxiety and depression symptoms in women with menopause. A group of 14 postmenopausal women completed a randomized, double-blind, placebo-controlled, crossover trial. One group was given 3.5 grams of Maca powder per day, while the other group was give a placebo. At the end of the 12-week trial the researchers reported, “… significant reduction in scores in the areas of psychological symptoms, including the subscales for anxiety and depression and sexual dysfunction after Maca consumption.“ The researchers conclude that Maca is indeed effective for treating psychological symptoms like anxiety and depression. Another study published in 2006 treated mice with depression over a 21-day period using Red, Black and Cream colored Maca roots. They discovered that while Black Maca helped improve cognitive function the most, all colors of Maca were helpful for depression.
- Rosemary
Rosemary is a woody plant, and its leaves are used for flavoring meats, potatoes, cooking oils, and many other seasoning purposes. This seasoning shows good effects as an antidepressant and anxiolytic. The active ingredients are rosmanol, circimaritin, and salvigenin make it a great addition to the spice medicine cabinet.
Rosemary is great with many Middle Eastern dishes, and also can be used in peas, lamb, veal, and fish.
- Thyme
Thyme is a great source of lithium and tryptophan. Both can help as mood stabilizers and sleep and calming aids in the small doses available simply by using the spice in cooking.
Use thyme with garlic as a rub for roasts. It’s also good with eggplant dishes featuring peppers.