Category Archives: Depression

St John’s Wort…A Holy Antidepressant?

St John’s Wort, (or for the sake of my fingers SJW) is a herb which has seen medicinal use for at least centuries. Early uses revolved around pain and wound healing, and it has not been until recently that SJW has achieved almost a cult following for its antidepressant qualities. But what is SJW good for, what are its risks, and how should it be used? We will explore that here.

What is SJW?

St. John’s wort (Hypericum perforatum), a plant that grows in the wild, has been used for centuries for mental health conditions. Many studies have been conducted to evaluate the effectiveness of St. John’s wort. Some studies have suggested benefit, but other studies have not.

Does it Work?

St John’s wort is a proven anti-depressant. When I say that people often think that means it will work for everyone, every time. However this is not how anti-depressant medications work. Because our ability to measure the chemical imbalances in our brains is essentially negligible, psychiatrists basically guess at what medication would be a good one to start with. A similar process is done with dosing, and often it takes months to find a dose that is effective for an individual. And that may be the best case when you don’t have to switch medication after a couple months of taking it.

While that may seem to many to be a condemnation of our current mental health system, it isn’t meant to be that at all. Instead we should all understand the limitations of the medical system we have, and be prepared for what we will get.

The Science

When researchers at the Rand Corporation, a nonprofit global policy think tank, looked at 35 studies using the herb for mild-to-moderate depression they found that, for their participants, SJW was just as effective as taking an antidepressant. Their review, published in the journal Systematic Reviews in 2016, also revealed that in studies pitting SJW against a placebo, SJW came out ahead. Even better, side effects were significantly lower for people on SJW than a medication. They had fewer stomach/intestinal or neurological problems, and lower rates of sexual concerns.

The scientific evidence is not entirely positive, as should be expected (for more info check out my post about how to read science). There were a handful of studies which were inconclusive, and another handful which showed SJW was less effective than a placebo.

While the researchers didn’t conclude why SJW wasn’t effective in those individuals, I suspect it had something to do with way SJW interacted with their brain chemistry. So if you take SJW, and it doesn’t work for you, don’t despair, that is an important data point, and one that you should share with your psychiatrist to help find you the medication that will work best.

How do you Use SJW?

St. John’s wort is most often taken in liquid or capsule form. The dried herb may also be used as a tea.

The most common dose used in studies has been 300 mg, three times a day as a standardized extract. Preparations in the U.S. have varied amounts of active ingredient in them. So be careful to note how much you’re getting in your tablets.

What are the side Effects

The most common side effects of SJW are :

  • Allergic reactions
  • Fatigue and restlessness with long-term use
  • Increased blood pressure
  • Increased sensitivity to the sun — especially if you are fair-skinned and taking large doses
  • Upset stomach

SJW is not recommended for pregnant women, children, the elderly. Research from the National Institute of Health has shown that St. John’s wort may reduce the effectiveness of several drugs, including birth control pills, drugs used to prevent organ transplant rejections, and some heart disease medications.

Combining St. John’s wort with certain antidepressants can lead to a potentially life-threatening increase of serotonin, a brain chemical targeted by antidepressants. Symptoms occur within minutes , and may include agitation, diarrhea, fast heartbeat, high blood pressure, hallucinations, increased body temperature, and more. If you experience these symptoms shortly after taking SJW, immediate call 911.

Conclusion

The bottom line for St John’s wort is that it works…but not for everyone

It is largely safe…but has some risks

But at the end of the day…don’t try to treat depression on your own. Depression can become severe if you don’t get effective, professional help. For some people, depression can increase the risk of suicide. Talk to your health care provider if you or someone you know may be depressed.

If you want to learn more about depression, check out my post here. Or if you just wandered in here, check out what Fully Human is all about or check out some of our anti-inflammation posts. Subscribe below to keep updated on how to bring your full self to life.

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Not Real Enough To Touch


“It’s all in your head.”

“Buck up”

“It’s not like you are actually in pain”

“I’m sorry I can’t see what is wrong with you”

“Oh, I wouldn’t take a sick day unless I was really sick”

-Well Meaning People

All of these quotes are things people have told me, either about my own depression, or about theirs. All of these have the same sub-text. Depression isn’t a ‘real’ condition, or illness. The ‘fake’ illness they talk about impacts nearly 15 million Americans’ daily lives; and nearly 4% of American adults reported having a suicidal ideation in 2018.


http://www.mentalhealthamerica.net/issues/state-mental-health-america

Let that sink in.

Millions of people every day are suffering from a disease that their peers belief isn’t real. Sometimes I compare this to me telling someone who broke their arm to ‘hold this’ because ‘well you still have an arm’. We would all agree that is cruel and borderline sadistic. But with mental disorders we can’t see the injury, so discount it as fake.

The Guest Your Brain Doesn’t need

Depression causes three fundamental changes in our brain, a resizing of core components, rewriting neural pathways and inflammation. Research is ongoing to determine if brain inflammation causes depression, or if it is a symptom the disease itself due to a change in how the brain absorbs oxygen.

While changes typically take a minimum of eight months to develop. The potential for near permanent dysfunction in memory, executive function, attention, mood, and emotional regulation exist after bouts of longer-lasting depression.

The Sizing Changes

Hippocampus

A 2016 international study published in the journal Molecular Psychiatry reports that 65% of all depressed patients have a smaller hippocampus. This is the region in the brain that controls emotions, learning and memory. According to PsychEducation.org, this shrinkage occurs because of the way depression kills existing hippocampal cells and prevents new ones from growing efficiently.

The report in Molecular Psychiatry goes on to say that this change is most pronounced in people with extended or recurring bouts of depression. So then, the longer someone goes without treating their depression, the harder it becomes to remember, and learn.

This is a bigger deal than it sounds because recovery from depression requires a relearning of how to feel; while a common treatment for the disease involves remembering. So in effect this disease attacks the very parts of the brain which would be most able to combat it.

Remember that next time you feel the need to tell a friend to ‘pull themselves out of it’.

The hippocampus

Prefrontal Cortex

The prefrontal cortex is the part of the brain that handles dopamine, norepinephrine and serotonin – hormones that control mood.As reported by Live Science, individuals with depression tend to experience shrinkage in this area due to the high amount of cortisol associated with depression. Depression also causes cells in the prefrontal cortex to become less dense.

The prefrontal cortex

amygdala

Another study published in the journal Molecular Psychiatry reports that major depressive disorder causes the amygdala to swell. This often results in sleep disturbances and makes the body’s hormone release process go haywire. At the root of this is the high levels of cortisol associated with depressive symptoms (and a key driver of our stress response).

The amygdala

Inflammation

There are links being made between inflammation and depression. It’s still not clear, as I mentioned above, whether inflammation causes depression or vice versa.

But brain inflammation during depression is linked to the amount of time a person has been depressed. The study I cited above shows that people depressed for more than 10 years showed 30 percent more inflammation compared to people depressed for less time.

Because brain inflammation can cause the cells of the brain to die, this can lead to a number of complications, including:

  • sizing changes
  • decreased function of neurotransmitters
  • reduced ability of the brain to change as the person ages (neuroplasticity)

These complications make it hard for people to learn, affect mood, and cause loss to memory. Young adults suffering from depression face the risk of severe mental limitations due to how rapidly their brains should be growing and changing.

Oxygen Deprivation

Depression has been linked to reduced oxygen in the body. These changes may be due to changes in breathing caused by depression. But like with inflammation which comes first and causes the other remains unknown.

Overall, the brain is highly sensitive to reductions in oxygen, which can lead to:

  • inflammation
  • brain cell injury
  • brain cell death

Inflammation and cell death can lead to a host of symptoms associated with development, learning, memory, and mood. Even short-term hypoxia (brain lacking oxygen) can lead to confusion, much like what’s observed with high altitude hikers (clearly a reason to not hike 🙂 ).

Treatments

We will explore herbal remedies later, but there are also other, non-prescription treatments which have see excellent results in clinical studies. While these treatments are very effective, they should absolutely never be used INSTEAD of seeing a trained and trusted mental health provider. I did that, and it led to the first of my suicidal ideations.

According to Dr. Majid Fotuhi, the best way to restore your hippocampus is to exercise. Research has shown that walking one mile a day lowers the risk of Alzheimer’s (another hippocampal shrinkage-related disease) by 48%. Another way to support your hippocampus is by getting lots of omega-3 fatty acids.

Gratitude activates your prefrontal cortex and gets its cells firing. This is super helpful when you’re suffering from a depressive disorder. It doesn’t have to be complex – just spend a few minutes at the end of each day writing what you are grateful for.

Hyperbaric oxygen chamber treatments, which increase oxygen circulation, have been shown to relieve symptoms of depression.

If you’re depressed, know that you’re not alone and that there are a number of helpful resources out there. Check out:

Next Time

The next few posts will be more about depression as a disorder, and ways we can treat it, or help others who are suffering from it. Odds are that at least 2-3 people you know suffer from depression, and almost none feel safe talking about it.

Do you want more about inflammation and its harm to the body? Check out some older posts here and here. We here at Fully Human have not yet launched our supplement to combat the symptoms of depression. But we hope to do so by the end of 2019. If you are one of the millions suffering from ‘regular’ inflammation, check out Freedom, the first supplement to combine clinical dosing, clinical timing and clinical frequency.