Depression is a condition that can really creep upon us. Unfortunately, it takes over our whole lives and can be crippling... getting out of bed and having a shower can be a mental WW3. Whilst herbal and nutritional interventions aren't everything with mental health, they have been shown to manipulate our brain biochemistry to help us get back on track naturally.
In the herbal world St John’s wort (Hypericum perforatum) has been traditionally used in China and European countries for centuries, being one of the oldest herbs it’s known for anti-depressant (Ng, 2017), anti-viral, vulnerary, anxiolytic, sedative, nootropic, anti-schizophrenic, analgesic (Ng, 2017)and nervine tonic internal actions in addition to topical anti-microbial actions (Bone, 2007).
[image of] St John's Worth herb and flowers
A 2017 meta-analysis comparing St John’s wort and Selective serotonin reuptake inhibitors (SSRI’s), showed promising results in favor of the herb in short-term and long-term clinical studies for the treatment of mild-moderate depression with limited side-effects/drop-out/remission rates compared to pharmaceutical drugs (Ng, 2017).
Depression pathophysiology has been linked to monoamine (dopamine, noradrenalin, serotonin) imbalances and secondary messaging abnormalities particularly linked to excess; cortisol, cytokines, glutamatergic transmission, endogenous opioid functionality and circadian rhythm disturbances (Saki, 2014).
Catechol-O-methyltransferase inactivates catecholamines (dopamine, adrenaline, norepinephrine), insufficient metabolism of these stimulating hormones can disrupt the hypothalamic-pituitary-adrenal axis, thus having a major negative cascade of effects on circadian rhythm (sleep/wake cycles), stress adaptation, gastrointestinal health, and is known for a significant etiology of depression (Gutiérrez, 1997).
Hypericum perforatum anti-depressant mechanism of action works via Hypericum flavonoids inhibiting monoamine oxidase (MOA) activity and the suppression of interleukin-6 release (Russo, 2013). It has also shown to gently inhibit the reuptake of serotonin, norepinephrine, dopamine, and gamma-aminobutyric acid via decreasing catechol-O-methyltransferase enzymatic activity (Russo, 2013).
St John’s wort has shown to significantly dampen beta-adrenoreceptors ligand binding and reduced cAMP, in addition to b1-adrenoreceptor plasma membrane density, therefore reducing the effects of heightened adrenal stimulation particularly after prolonged periods of heightened stimulation (Schmidt, 2015). St John’s also contributes to reducing sympathetic nervous system activity and nervous system nourishment through reducing glutamate activity and reducing voltage-gated/ion dependent conduction via its flavonoids (Schmidt, 2015).
A key chemical constituent called hyperforin has shown interesting effects with Ca2+ intracellular signalling resembling actions to that of brain-derived neurotrophic factor a protein that promotes neural health (maturation, differentiation, and maintenance) (Schmidt, 2015), particularly within the hippocampus the part of the brain that regulates emotion and is associated with memory (G., 2013).
So there you have it, a brief breakdown on how this wonderful little herb actually works. It's amazing what mother nature has given to help us on our healing journeys. Herbs are not a fast acting remedy and shouldn't ever be looked at as the 'be all and end all' to fixing your problems.
It is important that if you are taking medications, especially anti-depressants or other drugs affecting your mental health, that you seek guidance from a health professional. You shouldn't take St John's Wort in combination with any drugs unless under the care of a trained health professional.
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References
Bone, K. P. (2007). The Ultimate Herbal Compendium. Warwick, QLD, Australia: Phytotherapy Press.
G., W. C. (2013). Hippocampal physiology, structure and function and the neuroscience of schizophrenia: a unified account of declarative memory deficits, working memory deficits and schizophrenic symptoms. Behavioral sciences (Basel, Switzerland), 3(2), 298-315.
Gutiérrez, B. B. (1997). Association Analysis of the Catechol O-Methyltransferase Gene and Bipolar Affective Disorder. Am J Psychiatry, 154(1), 113-115.
Ng, Q. X. (2017). Clinical use of Hypericum perforatum (St John’s wort) in depression: A meta-analysis. Journal of Affective Disorders, 210, 211-221.
Russo, E. S. (2013). Hypericum perforatum: Pharmacokinetic, Mechanism of Action, Tolerability, and Clinical Drug-Drug Interactions. Phytotherapy Research, 28(5), 643-655.
Saki, K. B.-K. (2014). The effect of most important medicinal plants on two importnt psychiatric disorders (anxiety and depression)-a review. Asian Pacific Journal of Tropical Medicine, 7, S34–S42.
Schmidt, M. &. (2015). The mechanisms of action of St. John’s wort: an update. Wiener Medizinische Wochenschrift, 165(11 -12), 229–235.
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