• Hypericum
• Aromatherapy
• Acupuncture
• Yoga & Meditation
• Light Therapy
• Music Therapy
• Prayer, drugs, alcoholism and depression
• Exercise
• Electro-acupuncture
• Therapeutic touch lifts moods
• Depression & St Johns Wort

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Hypericum & Depression

*A report in the British medical Journal highlights the use of Hypericum in the treatment of depression. Apparently, German doctors prescribed over 66 million doses of hypericum perforatum in 1994 and a review of 23 randomised clinical trials of hypericum extracts showed them to be superior to a placebo in the treatment of depressive symptoms.

The report acknowledges that hypericum "may offer an advantage in terms of relative safety and tolerability" over traditional pharmacological medicines. Furthermore, commercially available hypericum products are relatively economical as the herb is cheap to grow and easy to harvest.

Vervain, lavender and borage are all traditionally used nervine herbal remedies which can help counter depressed feelings. Ginseng is also commonly used to help overcome depression. It is, of course, important to consult a qualified practitioner to obtain the most effective course of treatment.

Psychiatric medications are notorious for undesirable side effects to the patient's mental and physical well-being and the need for safer antidepressants is now widely acknowledged. However, researchers have recently discovered one natural herbal remedy which is considered to be as effective as most traditional allopathic antidepressants but with the added advantage of being free from side effects. The herb in question is St John's Wort (Hypericum Perforatum).

St John's Wort was tested in a double-blind study of 105 patients suffering from mild-moderate depression. The patients were male and female , 20 to 64 years of age, and diagnosed as having neurotic depression or temporary depressive mood. They were then divided into two groups and monitored over a period of four weeks. One group were given 300mg of St John's Wort extract, three times daily, and the other group were given a placebo. All of the patients were given psychiatric evaluations before the start of the study , and after two and four weeks of treatment.

The results revealed that, after the four weeks, 67% of the Hypericum group had responded positively to the treatment without any adverse side effects whereas only 28% of the placebo group showed any signs of improvement.

The authors of the study state clearly that the study was deliberately confined to patients affected by mild forms of depression because, for those patients, the possible risks of traditional antidepressants often outweighed any expected benefits. Indeed many patients within that category were known to refuse medications because of the possible side effects. Therefore, whilst there was no evidence to suggest that Hypericum would be of any benefit to patients suffering from the more serious forms of depression, in relation to the lesser but more common forms of depression, the researchers recommend: 'Hypericum should be used as a remedy of choice'.

Harrer. G, and Sommer.H., Treatment of Mild/Moderate Depressions With Hypericum, Phytomedicine, Vol. 1, 1994, pp 3 - 8.

St John's Wort (Hypericum) beats depression
The number of visits to alternative medicine practitioners in this country is estimated at 425 million, which is more than the number of visits to allopathic primary care physicians in 1990. Patients' use of St. John's Wort (SJW) has followed this sweeping trend. The purpose of our study was to examine the reasons people choose to self-medicate with SJW instead of seeking care from a conventional health care provider.

The researchers used open-ended interviews with key questions to elicit information. Twenty-two current users of SJW (21 women; 20 white; mean age = 45 years) in a Southern city participated. All interviews were transcribed, and descriptive participant quotes were extracted by a research assistant. Quotes were reviewed for each key question for similarities and contextual themes.

Four dominant decision-making themes were consistently noted. These were: (1) Personal Health Care Values: the patients had a history of alternative medicine use and a belief in the need for personal control of health; (2) Mood: all SJW users reported a depressed mood and occasionally irritability, cognitive difficulties, social isolation, and hormonal mood changes; (3) Perceptions of Seriousness of Disease and Risks of Treatment: SJW users reported the self-diagnosis of "minor" depression, high risks of prescription drugs, and a perception of safety with herbal remedies; and (4) Accessibility Issues: subjects had barriers to and lack of knowledge of traditional health care providers and awareness of the ease of use and popularity of SJW. Also of note was the fact that some SJW users did not inform their primary care providers that they were taking the herb (6 of 22). Users reported moderate effectiveness and few side effects of SJW.

SJW users report depression, ease of access to alternative medicines, and a history of exposure to and belief in the safety of herbal remedies. Users saw little benefit to providing information about SJW to primary care physicians.

Hypericum & depression - a review

Depressive disorders are often found to be chronic and recurring illnesses that lead to severe personal suffering for sufferers and their families. Major depression alone is estimated as the fourth most important cause of worldwide loss in disability-adjusted life years and is considered likely to become the second most important within 20 years. A continued quest for more effective treatments has spawned newer antidepressants and herbal treatments, which have contributed to explosive growth in antidepressant prescribing, increasing pharmacy costs, and wider choices for clinicians and patients.

A comprehensive evaluation of the benefits and adverse effects of newer pharmacotherapies and herbal treatments for depressive disorders in adults and children was undertaken..

Literature published between 1980 to January 1998 was identified from a specialized registry of controlled trials, meta-analyses, and experts. The registry contained trials addressing depression that had been identified from multiple electronic bibliographic databases, hand searches of journals, and pharmaceutical companies. The search, which yielded 1,277 records, combined terms "depression," "depressive disorder," or "dysthymic disorder" with a list of 32 specific "newer" antidepressant and herbal treatments.

Randomized controlled trials were reviewed if they (1) were at least 6 weeks in duration; (2) compared a "newer" antidepressant with another antidepressant (newer or older), placebo, or psychosocial intervention; (3) involved participants with depressive disorders; and (4) had a clinical outcome. 315 trials that met these criteria.

Data was independently abstracted from each trial by two persons. The researchers looked at the response rate, total discontinuation rates (dropouts), and discontinuation rates due to adverse events. Response rates were defined as a 50 percent or greater improvement in symptoms as assessed by a depression symptoms rating scale or a rating of much or very much improved as assessed by a global assessment method.

There were 264 trials that evaluated antidepressants in patients (adults and children) with major depression. Of these, there were 14 trials evaluating hypericum (St. John's wort), and a review of these studies revealed that the herb was more effective than placebo in treating mild to moderately severe depressive disorders (risk ratio 1.9, 95% CI 1.2 to 2.8). However, the question as to whether hypericum (St. John's wort) is as effective as standard antidepressant agents given in adequate doses was not established.

Mulrow CD, Williams JW Jr, Trivedi M, Chiquette E, Aguilar C, Cornell JE, Badgett R, Noel PH, Lawrence V, Lee S, Luther M, Ramirez G, Richardson WS, Stamm K. Treatment of depression--newer pharmacotherapies. Psychopharmacol Bull 1998;34(4):409-795

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Aromatherapy & Depression

Aromatic oils have been used for literally thousands of years in healing; for instance, lavender oil was used in ancient Egypt for healing skin complaints and Eucalyptus oil has been used for centuries to help clear sinus congestion. However, recent research by Dr G Schwartz, professor of Psychology and psychiatry at Yale University, revealed that certain aromas can even lower blood pressure. Some oils have been shown in research to have analgesic (pain reducing) qualities whereas others have been shown to be antibacterial, antiseptic and anti-inflammatory. Clinical trials have shown essential oils to be beneficial in alleviating labour pains, reducing emotional stress, improving circulation, and even in helping patients with mental disorders. (1)

The essential oils have a complex action on the body which is still not fully understood. This may be due to the fact that one oil can have hundreds of different compounds. Interestingly, your sense of smell is over 10,000 more sensitive than your sense of taste and researchers have shown how aromas cause a brain reaction, activating the hypothalamus gland, the pituitary gland and the body's hormones as well as stimulating the limbic system (centre for emotion and memory) in the brain.

Work carried out by Dr. Gary Schwartz, Professor of Psychology and Psychiatry at Yale University, found that the aromas of some essential oils by themselves affect the nervous system and even reduce blood pressure. The calming and relaxing effect of the essential oils and massage can help relieve accumulated tensions and anxieties.

The following essential oils are also beneficial in the treatment of depression as they have properties helping to balance and relax the nervous system .

Chamomile - relaxant and calmative
Clary Sage - antispasmodic
Cypress - anti-spasmodic
Lavender - relaxant and calmative
Marjarom - emotional balancer
Rose - anti depressant
Rosewood - calmative
Ylang Ylang - sedative and antidepressant

The therapeutic massage combined with selected essential oils makes aromatherapy an excellent aid in countering the effects of stress and inducing relaxation. Massage improves the blood circulation in several ways without putting additional strain on the heart. It helps the flow of blood through the veins and also stimulates the nerves which control the blood vessels. It has the added benefit of relaxing tense muscles and tight connective tissues which may have been constricting blood vessels and thus enabling blood to flow more freely. It is for this reason that soothing massage helps reduce emotional tension, it induces relaxation and calms stress-related cardio-vascular conditions.

In fact, massage treatment alone has been shown to be an effective treatment to help patients with depression. In one study conducted at the University of Miami, 52 teenagers hospitalised for depression were split into two groups. For 5 days, the first group were each given a 30 minute massage and the second group watched television. The massage group felt less anxious, more co-operative, had lowered pulse rates and lower levels of cortisol ( a chemical produced under stress) in their saliva.(3)

Guidelines for using aromatherapy essential oils: -
Essential oils can be used at home in one of the following ways:-

Massage - mix 5 -10 drops to 10 ml of a vegetable base oil.
Baths - add 5 -10 drops to a pre-run bath and swish.
Inhalation - add 2 - 3 drops to a bowl of steaming water, cover head with a towel.
Tissue - put one drop on a tissue and inhale when required.
Room - put between 1 - 10 drops in a humidifier filled with water or on a piece of cotton wool and place on a radiator.

IMPORTANT NOTE: Do not take any oils internally or use on babies under 18 months. Always consult a qualified aromatherapist before using any essential oils to treat a health problem, or if you are pregnant or breastfeeding.

(1) Massage Therapy, Adam J Jackson (Optima 1993)
(2) The Complete Book of Massage - Clare Maxwell Hudson Dorling Kindersley 1988 p.18
(3) Massage Therapy, Adam J Jackson (Optima 1993)

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Acupuncture & Depression

Acupuncture has traditionally been successfully employed in China to treat most illnesses. There are several controlled medical studies confirming that acupuncture is an excellent therapy in the treatment of depression.

In one study in Italy involving 50 patients, auricular acupuncture (acupuncture treatment to the ear) was found to be effective in reducing anxiety and depression levels (1) . In another study at the Wayne County General Hospital in Michigan, USA, acupuncture treatment was given to 85 patients all suffering from psychological disorders (including depression). The treatment was shown to be beneficial in over 78% of the patients. (2) There is therefore little doubt that acupuncture is a prime therapy to consider in helping overcome depression.

Traditional acupuncturists treat the whole person rather than a disease and therefore attempt to get to the root cause of the problem rather than treating the symptoms and, like other holistic practitioners, will consider all lifestyle and environmental factors before commencing treatment.

(1)Ear acupuncture in psychosomatic medicine: the importance of the Sanjiao (triple heater) area. Romoli M; Giommi A S.I.R.A.A.-Societa Italiana di Riflessoterapia, Agopuntura, Auricoloterapia, Prato, Italy. Acupunct Electrother Res (UNITED STATES) Jul-Dec 1993, 18 (3-4) p185-94
(2) An introduction to sequential electric acupuncture (SEA) in the treatment of stress related physical and mental disorders. Chen A Department of Anesthesiology, Wayne County General Hospital, Westland, Michigan. Acupunct Electrother Res (ENGLAND) Oct-Dec 1992, 17 (4) p273-83,

Acupuncture is not commonly associated with mental depression, but researchers at Institute of Acupuncture and Moxibustion, China Academy of Traditional Chinese Medicine, Beijing recently demonstrated that acupuncture may offer a therapeutic option for depressive patients.

Twenty patients suffering from mental depression were treated by needling at the extra channel points for a period of six weeks and the effective rate of the treatment was found to be 90%. At the same time, the researchers monitored a control group of an additional twenty one depressive patients who were treated with amitriptyline. Anxiety, cognitive disturbance, retardation, sleep disturbance and feelings of despair were all measured with Hamilton's scale and then analysed.

The results showed that there was no statistical difference in the response rate in the two groups. Both the acupuncture and control groups showed an obvious decrease in the mean value, and the change in anxiety somatization was considerably greater in the acupuncture group as compared with that in the control group. Analysis of brain wave patterns demonstrated that the acupuncture treatment had a positive influence on the patients’ brain waves. 

The researchers concluded that six weeks of acupuncture resulted in s decrease of slow wave delta and increased the fast wave alpha , all significantly different as compared with that before and during the treatment.

It would have been helpful in interpreting the results if the researchers had used a third control group so that a placebo treatment could be included. However, despite this omission, and the obvious small numbers of participants, the study does demonstrate that acupuncture treatment may be a useful treatment to considered to help treat patients suffering from depression, and will initiate further research in this area of medicine.

Yang X; Liu X; Luo H; Jia Y. Clinical observation on needling extra channel points in treating mental depression. Institute of Acupuncture and Moxibustion, China Academy of Traditional Chinese Medicine, Beijing. Journal of Traditional Chinese Medicine (CHINA) Mar 1994, 14 (1) p14-8

Recent research has found that cerebral serotonin has anti-depressant and analgesic effects and there have ben reports that cerebral serotonin can be released by the stimulation of certain acupuncture points. Researchers at the Department of Anesthesiology, Wayne County General Hospital, Westland, Michigan, USA investigated these claims, observing the effects of sequential electric acupuncture treatment on eighty five (85) patients diagnosed with chronic physical disorders (e.g. intractable pain, headache) with most disorders complicated by reactive depression. Some of the patients’ problems were thought to be psychosomatic. However, the researchers found that the percentage of improvement from slight to remarkable in the physical disorders was 77.1% and the improvement seen in mental disorders was found to be even higher at 78.8%. The researchers concluded that sequential electrical stimulation to certain acupuncture points was found to be effective in the treatment of stress related physical and mental disorders. 

Chen A. An introduction to sequential electric acupuncture (SEA) in the treatment of stress related physical and mental disorders. Department of Anesthesiology, Wayne County General Hospital, Westland, Michigan. Acupunct Electrother Res (UNITED STATES) Oct-Dec 1992, 17 (4) p273-83,

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Yoga & Meditation & Depression

Yoga is a complete science, focussing on breathing, movement, posture and meditation. Specific exercises are taught consisting mainly of simple stretching, breathing and relaxation. There is a wealth of scientific research available confirming that advanced yogis have remarkable control over the functioning of their nervous system, heart and lungs. Subjects have demonstrated their ability to drastically reduce their heart beat and respiration for hours at a time under clinical studies. In one study involving 3,000 yoga students carried out by the Yoga Bio-Medical Trust (Cambridge, England), 84% of those people who were suffering from hyper-tension (and there were 150 in number), claimed that they had benefited from the practice of yoga. Controlled trials have confirmed that yoga promotes vitality and is effective in management of heart conditions, including high blood pressure.

Meditation and yoga are very gentle and powerful techniques to aid rest and relaxation whilst energising the body. In fact, Dr Bernie Segal, author of the best-selling 'Love, Medicine and Miracles' states that even for patients with cancer " I know of no other single activity that can by itself produce such a great improvement in the quality of life" (p149).

Dr Segal also cites the research of Dr Herbert Benson showing that meditation tends to normalise blood pressure, pulse rate, and level of stress hormones in the blood. It produces changes in brain wave patterns, showing less excitability and improves the white blood cell (immune) response as well as hormone response. It therefore must be considered as a vital and easily accessible aid to stimulate and augment recovery for patients suffering with depression.

Meditation : - Researchers at the School of Behavioural Sciences, James Cook University of North Queensland, Townsville, Australia recently demonstrated that meditation has an observable and measurable influence on both our hormone levels and moods which is similar to the changes experienced by long distance runners. 

The researchers studied the relationship between three hormones ( hypothalamic-pituitary-adrenocortical axis, beta-endorphin , corticotropin-releasing hormone and cortisol and mood changes in 11 elite runners and 12 highly trained meditators who were all matched in age, sex, and personality. 

Interestingly, the results revealed that despite the obvious metabolic differences between running and meditation, both of these activities produced similar hormonal changes. Compared to pre-test and control values, the subjects' moods were shown to be elevated after both activities with no significant difference between the two groups. Running produced significant elevations of beta-endorphins and corticotropin-releasing hormone, and meditation produced similar elevations in corticotropin-releasing hormone. When the results of the two groups were compared, there was found to be no significant differences between the respective influences on hormone levels and moods . The researchers concluded that both running and meditation have a positive influence on participants' moods which is thought to result from changes in plasma levels of corticotropin-releasing hormone which occur after both activities. 

Harte JL; Eifert GH; Smith R. The effects of running and mediation on beta-endorphin, corticotropin-releasing hormone and cortisol in plasma, and on mood. Biological Psychology (NETHERLANDS) June 1995, 40 (3) p251-65

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Light Therapy & Depression

Scientists at the Department of Psychiatry, St. Goran's Hospital, Stockholm, Sweden monitored ninety patients with major depressive disorder who were classified according to seasonal depression (60 patients of which 50 were women) and non-seasonal (22 patients of which 17 were women). All of the patients were also clinically evaluated and rated before and after morning (0600-0800) or evening (1800-2000) light treatment for ten days in a room with a luminance of 350 cd/m2 (approximately 1500 lx) at eye level. The patients’ mood ratings were assessed using both the Comprehensive Psychopathological Rating Scale and the Hamilton Depression Rating Scale.

The results showed that depressed patients with seasonal pattern improved significantly more than those with a nonseasonal pattern suggesting a specific therapeutic effect of light treatment in depressed patients with seasonal pattern. There were no significant differences in outcome when light treatment was given in the morning or in the evening, and neither were there differences between patients with and without atypical symptoms such as carbohydrate craving or increased appetite.

Researchers at the University Hospital, State University of New York (3) found that variability in pain intensity, demoralization and range of mandibular motion among patients suffering from myo-fascial face pain is associated with seasonal variations. 

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Music Therapy & Depression

Music therapy has been put forward as a cost-effective and accessible intervention for older adults experiencing symptoms of depression, distress, and anxiety. Researchers at Stanford University School of Medicine, USA monitored thirty older adults who had been diagnosed with major or minor depressive disorder. The participants were randomly assigned to one of three eight-week conditions: (1) a home-based programme where participants learned music listening stress reduction techniques at weekly home visits by a music therapist; (2) a self-administered programme where participants applied these same techniques with moderate therapist intervention involving a weekly telephone call; or (3) put on a waiting list and used as a control.

The results showed that the participants in both music conditions performed significantly better than the controls on standardized tests of depression, distress, self-esteem, and mood. These improvements were clinically significant and, the researchers noted that these benefits were maintained over a nine-month follow-up period.

Hanser SB; Thompson LW. Effects of a music therapy strategy on depressed older adults.
Stanford University School of Medicine. J Gerontol (UNITED STATES) Nov 1994, 49 (6) pp265-9

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Exercise & Depression

It is now well known that physical exercise can alter hormone levels within the body and have a positive effect on our moods, however new research has demonstrated that meditation offers similar benefits. Researchers at the School of Behavioural Sciences, James Cook University of North Queensland, Townsville, Australia studied the relationship between three hormones (hypothalamic pituitary adrenocortical (HPA) axis, beta-endorphin (beta-EP), corticotropin releasing hormone (CRH) and cortisol) and mood changes in 11 elite runners and 12 highly trained medidators matched in age, sex, and personality. 

Despite the obvious metabolic differences between running and meditation, the researchers predicted that mood change after both of these activities would be similar if they could be associated with similar hormonal changes. Compared to pre-test and control values, mood was shown to be elevated after both activities but there was no significant difference between the two groups. There were significant elevations of beta-EP and CRH after running and of CRH after meditation, but no significant differences were seen in the increases in CRH levels between the groups. CRH was found to be directly related to positive mood changes after running and mediation. Cortisol levels were also noted to be generally high but erratic in both groups. 

The researchers concluded that both running and meditation have a positive effect on our moods which is associated with the changes in relation to plasma corticotropin-releasing hormone. 

Harte JL; Eifert GH; Smith R. The effects of running and mediation on beta-endorphin, corticotropin-releasing hormone and cortisol in plasma, and on mood. Biol Psychol (NETHERLANDS) Jun 1995, 40 (3) p251-65

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Electro-acupuncture & Depression

Electroacupuncture (EA) stimulation has been found to influence the brain (norepinephrine metabolism in experimental animals). Preliminary clinical research has shown that EA treatment is as effective as amitriptyline for patients with depression.

Psychiatry Clin Neurosci 1998 Dec;52 Suppl:S338-40 Luo H, Meng F, Jia Y, Zhao X Department of Traditional Chinese Medicine, Institute of Mental Health, Beijing Medical University, PR China.

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