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Depression: The Symptoms

Some people say that depression feels like a black curtain of despair coming down over their lives. Many people feel like they have no energy and cannot concentrate. Others feel irritable all the time for no apparent reason. The symptoms vary from person to person, but if you feel "down" for more than two weeks, and these feelings are interfering with your daily life, you may be clinically depressed.

Most people who have gone through one episode of depression will, sooner or later, have another one. You may begin to feel some of the symptoms of depression several weeks before you develop a full-blown episode of depression. Learning to recognise these early triggers or symptoms and working with your doctor or therapist will help to prevent the depression from worsening. Depression can severely disrupt your life, affecting your appetite, sleep, work and relationships.

The symptoms that help a doctor identify depression include:

• constant feelings of sadness, irritability or tension;
• decreased interest or pleasure in usual activities or hobbies;
• loss of energy and feeling tired, despite lack of activity;
• a change in appetite, with significant weight loss or weight gain;
• a change in sleeping patterns, such as difficulty in sleeping, early morning waking, or sleeping too much;
• restlessness or feeling slowed down;
• decreased ability to make decisions or concentrate;
• feelings of worthlessness, hopelessness or guilt;
• thoughts of suicide or death.

If you are experiencing any or several of these symptoms, you should talk to your doctor about whether you are suffering from depression. Symptoms of depression may surface with other mood disorders. They include seasonal major depression (also known as seasonal affective disorder), postpartum depression and bipolar disorder.

St John's Wort to treat depression

The herbal depression treatment supported by the strongest evidence is St. John's Wort (Hypericum perforatum) extract. Over twenty clinical studies have demonstrated that pharmaceutical-grade St. John's Wort extract effectively relieves depression. In fact, studies comparing high-quality St. John's Wort to prescription antidepressant drugs (such as Paxil ®, Zoloft ®, and Prozac ®) show that St. John's Wort works just as well or better than these drugs, but causes fewer side effects. Therefore, the most effective herbal treatments for depression are those that contain a full dose of pharmaceutical-grade St. John's Wort extract.

Effective in treatment of depression?

Not everybody agrees with these conclusions. "Cancer Research UK" for example, is of the view that St Johns' Wort does help treat mild to moderate depression but it doesn't work as well as antidepressant drugs for more severe depression and it can have side effects in the same way as prescribed antidepressants. Furthermore, St Johns Wort should not be taken with other types of antidepressants because they could interact. It may also interact with:

• The contraceptive pill
• Some chemotherapy drugs
• Some anticoagulant drugs
• Some HIV drugs
• Some epilepsy drugs

So if you are taking any sort of medication, do not take a herbal remedy without consulting your doctor.

If you do decide to take St John's Wort, bear in mind that not all herbal treatments for depression with St. John's Wort are equal. Many products contain a low-quality form of St. John's Wort or don't provide the herb in the full dose. The quality of herbal medicines is not controlled as closely as pharmaceutical medicines. The contents of a herbal remedy can vary a lot between different brands and sources. So keep in mind that the results of the trials that seem to establish St John's Wort efficiency in the battle against depression can only apply to the particular St John's Wort preparations tested in these trials.

The appropriate dosage

High-quality St. John's Wort extracts contain at least 3% hyperforin, and the best pharmaceutical-grade products are standardized to a minimum of 5% hyperforin. (Hyperforin is the active antidepressant compound in St. John's Wort.) And, since the effective daily dosage of St. John's Wort is 900 mg for mild-moderate depression and 1800 mg for severe depression, herbal treatments for depression that provide 450 mg per capsule are superior to those that provide only 100-200 mg per capsule. Another herbal compound which seems to be effective for depression is 5-HTP (5-hydroxytryptophan), a natural amino acid extracted from the Griffonia simplicifolia plant. When taken alone, doses of 150-300 mg per day are effective. In herbal treatments for depression that combine 5-HTP with St. John's Wort, a daily dose of 25-100 mg 5-HTP is sufficient. In conclusion, if you decide to rely on herbal rather than pharmaceutical medication, keep in mind that the best herbal treatments for depression are those containing proven ingredients in the proper doses and potencies and manufactured with strict quality-control procedures. For effective depression relief, a herbal treatment for depression that combines the proven dose of pharmaceutical-grade St. John's Wort extract with 5-HTP, B vitamins, and mood-related nutrients has been shown in research to be effective.

In any event, an accurate diagnosis is required before treatment is started. Most GPs now recognise the part played by natural remedies and will not discourage you from taking them. However, it is important you do not try self-medication before you have an opinion from your GP on whether the symptoms you are experiencing are, in fact due to depression and not some other problem which may mimic the symptoms of a depressive disorder.