Post Partum Depression, Depression & Mood Swings
While there is no question that relaxation techniques, enough sleep and a diet low in processed, chemical filled foods, will help improve anyone’s mood, there are a few herbal and other types of supplements which may help as well. Their value is that they are lower in cost and have fewer side-effects than conventional anti-depressants. The comparison of dependency rates in usage of conventional versus alternative anti-depressants has not been established through any long term clinical studies.
St. John’s Wort
Extracts of this herb have long been used in folk medicine. In Germany, St. John’s wort is licensed for the treatment of anxiety, depression and sleep disorders. The extracts that make up this herbal remedy contain many different chemical classes, so the “active agent” is a matter of uncertainty. The use of St. John’s wort extracts to treat mild to moderate depression is supported by over twenty alternative clinical studies. Its efficacy is comparable to standard tricyclic antidepressants but the severity of side-effects is lower for St. John’s wort. Therapeutic response should develop in days to weeks with minimum treatment duration of four to six weeks in any reported study. Side-effects include fatigue, allergic reactions and stomach discomfort.
An amino acid supplement, S-adenosylmethionine (ah-de-no-sil meh-thio-neene) has been used by some psychiatrists in the treatment of depression, for the past 20 years, predominantly in Europe. Substantial claims for the use of SAMe in the treatment of osteoarthritis, liver disease, fibromyalgia, and chronic pain have been made in books published in the popular literature in the past two years. Because it is a supplement and does not require prescription it is easily accessible. Its alleged versatility made it very popular when information on it was first published. Unfortunately, while SAMe may have value in the treatment of mild depression, it fell short of the mark when patients in my practice tried it on their own. The problem with SAMe is that dosing is critical and unless taken under the supervision of a knowledgeable physician, results are usually poor, the patient becomes discouraged and discontinues it. The over-the-counter recommended dosage for SAMe is much less than the therapeutic dosage needed for optimum results, making it potentially dangerous for a patient to self-medicate and reach the desired outcome.
When using alternative anti-depressants in my practice, the results I find are mixed. The cost of the medication often becomes prohibitive at the dose levels patients require to feel significant improvement in their symptoms. As a consequence the use of conventional medications, covered by insurance, becomes more attractive. On the other hand, some patients have reported significant relief of temporary depressive episodes and did take SAMe or St. John’s wort for periods of a few months. With St. John’s wort the problem with allergies significantly limits its use. I selectively recommend using either SAMe or St. John’s wort for mild depressive episodes, while balancing hormone levels, for short periods of time (no longer than six months). The side-effects of these alternative anti-depressants are far less than those of prescription medications and the addictive tendencies appear to be lower.