Source :

Bupa Medical Consultant

More than just feeling unhappy, depression describes profound feelings of sadness which linger, interfering with a person's day-to-day life. There is not always a straightforward reason why depression strikes. Difficult life events such as bereavement or divorce can trigger depression, and depression also runs in some families. In many cases, it does not have a clear-cut cause. However, even if you can't pinpoint exactly why you've become depressed, there are effective treatments to help you to deal with it. Your GP can prescribe antidepressants, and some forms of counseling can help.

Some people are keen to find alternative treatments to control their depression. One of the most popular of these is the herbal remedy St John's Wort. Compared with taking prescription medicine, St John's Wort may seem a safe and natural way of treating depression. But what's the lowdown on this herbal remedy?

All about St John's Wort

St John's Wort is a plant with yellow flowers which has been used to treat mental disorders for millennia and is used by many people today to treat depression and anxiety. The herb is available from health food shops and chemists in the form of teas, herbal extracts and capsules.

In contrast with some other herbal remedies, the effectiveness of St John's Wort has now been backed up by medical evidence. One review of medical studies into St John's Wort concluded that the herb is more effective for the treatment of mild to moderate depression than a placebo (or dummy treatment). However it does not seem to be effective for more severe depression.

Complications and side-effects of St John's Wort

Because it is a "natural" medicine, some people believe that St John's Wort is automatically healthier and safer than a pharmaceutical drug. However, St John's Wort is associated with a range of side-effects, most commonly dizziness, a dry mouth, diarrhoea, nausea, increased sensitivity to sunlight, and fatigue.

The most worrying side-effect of St John's Wort is the fact that it has been shown to react with many prescription medicines, reducing their effectiveness. Medicines which St John's Wort may interact with include those used to control HIV infection and treat cancer, as well as migraine drugs, the contraceptive pill, and other antidepressants. For this reason, if you are taking any medicines, you should speak to your GP before taking St John's Wort.

Why hasn't my doctor recommended it?

You may find that your GP doesn't recommend St John's Wort. This may be because there is a great deal of vagueness surrounding the production, sale and general administration of herbs. This means that it often isn't possible to know exactly what you are getting when you buy a packet of St John's Wort. When a conventional drug is in development, scientists aim to isolate a particular active ingredient which will be used as the basis for that drug. But with herbal remedies, the whole leaf, root or flower of the plant is used.

If you have mild to moderate depression, there is a good chance St John's Wort will make you feel better. However, it is not a miracle cure. Herbal medicines can have side-effects and complications just as conventional medicines do. If you think that you have depression, it is wise to talk to your GP about all the treatments on offer. The more informed you are, the clearer choices you can make about your treatment.

What exactly are mild, moderate and severe depression?

You may have depression if you feel sad or low most of the time, have lost interest in things you used to enjoy, have no energy or feel really tired.

You doctor will ask you if you also have symptoms like:

• problems sleeping, or sleeping too much
• poor concentration or difficulty making decisions
• lower self-confidence
• poor or increased appetite
• thoughts of suicide
• agitation or sluggishness
• feelings of guilt for no reason

The more symptoms you have, the more severe your depression is likely to be. Four of the above symptoms together would typically be diagnosed as mild depression, five or six as moderate, and seven or more as severe. The treatments for mild, moderate and severe depression are different. For instance, lifestyle changes may shift mild depression, while severe depression may benefit from a combination to talking treatments and medication.