The Everything Guide to Herbal Remedies: An easy-to-use reference for natural health care

CHAPTER 10

Managing Psychological and Emotional Issues

Psychological (or neuropsychiatric) conditions—a broad term that encompasses cognitive (thinking), emotional, mood, social, and behavioral disorders—can range from mild to debilitating. These problems cause distress and reduce your ability to function professionally, psychologically, socially, and/or inter-personally. Conventional medicine typically treats psychological and emotional disorders with drugs, which can deliver a long list of side effects. But in many cases, herbs can offer a gentler, no less effective type of relief.

A Complex Problem

Modern medicine has come a long way in its understanding of the brain and the disorders that affect it. While earlier generations thought that neuropsychiatric disorders were best treated radically—with surgery, perhaps, or confinement in an asylum—we now know that mental illnesses, while they are centered in the brain, are quite often the result of biological, psychological, and social factors.

The National Institutes of Health estimates that more than 62 percent of Americans over the age of eighteen—one in four adults—has a diagnosable mental disorder. Serious disorders like depression, bipolar disorder, and drug dependence cost at least $193 billion annually in lost earnings alone and affect about 6 percent of U.S. adults—or one in every seventeen people.

Types of Disorders

Experts divide mental illnesses into a few categories, including:


• Mood Disorders include major depression and bipolar disorder and involve persistent feelings of sadness. In bipolar disorder (sometimes termed manic-depressive disorder), the feelings of sadness alternate with a sense of euphoria or mania.

• Anxiety Disorders are characterized by excessive nervousness or anticipation of disaster or danger, along with a general feeling of uncertainty. Anxiety disorders include phobias (such as a fear of heights or closed spaces), panic disorder, obsessive-compulsive disorder (OCD), and post-traumatic stress disorder (PTSD).

• Developmental Disorders are problems that generally appear in childhood or infancy, and include autism and attention deficit hyperactivity disorder (ADHD).

• Substance Abuse Disorders are centered on the abuse of alcohol and illicit drugs as well as prescription and over-the-counter (OTC) medications and substances like nicotine.

• Cognitive Disorders affect your reasoning and thinking. They include dementia, memory disorders, and Alzheimer’s disease.

• Stress, which involves heightened responses to the challenges of daily life that can produce psychological as well as physical symptoms.

The Mind/Body Connection

As a component of holistic medicine, herbalism is rooted in the belief that the mind and body are inextricably connected, both in sickness and in health. Thus, problems in the physical body often manifest themselves psychologically, and vice versa.

While psychological and emotional problems affect both genders, women are twice as likely to suffer from depression, post-traumatic stress disorder (PTSD), and panic disorder, in part because their bodies synthesize significantly less of the brain chemical serotonin, required for the healthy maintenance of moods. Women also seem to be more prone to addictions to alcohol, tobacco, and illicit drugs.

Indeed, conventional medical research supports the theory that mind and body work hand in hand, and many studies have found a link between mental and physical diseases. For example:


• Asthma is connected to depression and anxiety. A recent study found that teenagers with asthma are twice as likely to have depression or anxiety disorders than the teens without asthma. Other research has shown that asthmatic kids are more likely to have ADHD and other behavioral problems.

• Depression and anxiety are tied to heart disease. Research has shown that having either problem doubles your risk of developing coronary artery disease.

• Migraines are linked to mental disorders. People who suffer from migraine headaches are more than twice as likely to have mental disorders such as major depression, bipolar disorder, panic disorder, and social phobia.

• Diabetes is linked to Alzheimer’s disease. Having diabetes ups the risk of developing Alzheimer’s (the same holds true for high blood pressure and high cholesterol). Other research has found a connection between certain viral and bacterial infections and Alzheimer’s.

• Obesity can lead to mental illness. A recent study found that obese adults were up to twice as likely to suffer from depression, anxiety, dementia, and other mental problems. Another study found that obesity can up your risk of dementia by as much as 80 percent.

Conventional Versus Herbal Treatment

Conventional medicine typically deals with mental disorders with a two-pronged approach: cognitive-behavioral therapy and drug treatment.

Cognitive-behavior therapy, also known as “talk therapy,” is based on changing the behaviors, beliefs, and patterns of thinking that can contribute to problems like depression and phobias. Cognitive therapy can also help people manage feelings of shyness, anxiety, or anger.

Some conventional drugs can trigger psychological problems. For example, OTC decongestants often cause nervousness, the prescription acne drug isotretinoin (Accutane) can create depression and psychosis, and clarithromycin (Biaxin), an antibiotic, can cause hallucinations, nightmares, and manic behavior. In fact, the FDA is investigating a possible association between montelukast sodium (Singulair), a popular asthma and allergy drug, and suicidal behavior.

Drug Treatments

In many cases, conventional medicine treats mental disorders pharmaceutically. Most of the drugs used to treat mental problems fall into these categories:


• Antipsychotic medications

• Antimanic (or mood-stabilizing) medications

• Antidepressants

• Antianxiety medications

• Stimulants

Herbs: The Natural Alternative

While pharmaceutical interventions are certainly useful—and in some cases, essential—in treating psychological and emotional problems, many can be replaced or augmented with herbal remedies.

Many psychological and emotional problems respond well to herbal treatments—and some conventional doctors and mental health professionals are incorporating herbal remedies into their practices—but serious mental disorders require immediate medical attention. Moreover, some of the herbs used to treat mental problems (as well as other conditions) can interact with the prescription medications used by conventional practitioners. Be sure to talk with your doctor before using any herbal remedy to treat a psychological issue.

Handling Stress

Stress is a natural part of life. Quite often, it’s psychological stress that gets you out of bed in the morning or to the gym in the evening. It’s what makes you perform well at the office or in the classroom and do basically everything that you need to survive. Unfortunately, too much stress—problems that go on too long or demand too many of your resources—can wreak havoc on your health. Chronic, unresolved stress has been linked to a host of diseases, including cardiovascular disease and cancer. It’s also been tied to many mental disorders, such as depression.

Of course, facing a stressful event—even if it’s a terribly stressful one, such as the death of a spouse—doesn’t necessarily mean you’ll develop a mental illness. But stress can definitely up your chances of problems like depression or anxiety disorders. Herbs can help you deal with all kinds of stress—both psychological and physical.

• Ashwagandha (Withaniasomnifera)

Ashwagandha is an Ayurvedic remedy for stress-related anxiety and insomnia. Studies show it inhibits the release of stress hormones and calms the central nervous system.

• Lavender (Lavandula angustifolia)

The essential oil of this fragrant plant has proven antianxiety properties when applied topically or inhaled. In laboratory tests, it performed as well as the drug Valium.

• Ginkgo (Ginkgo biloba)

Ginkgo is famous for its brain-boosting powers. In the lab, it’s shown an ability to offset many effects of stress, such as memory deficits and depression.

• Asian ginseng (Panax ginseng)

Asian ginseng is one of the best-researched herbs around, and it has been used for centuries to help people manage stress. Recent research has shown it can protect the brain from the damage caused by chronic stress.

• Lemon balm (Melissa officinalis)

This herb relieves stress and induces relaxation. Research shows it can improve your mood, increase your alertness (and mental processing speeds), and produce a general feeling of well-being.

• Schisandra (Schisandra chinensis)

This herb balances your nervous and endocrine (hormone) systems and is particularly good at helping you manage psychological stress. Research shows it can increase your mental performance and adjust the levels of the stress hormone cortisol in your system.

• Saint John’s wort (Hypericum perforatum)

This herb has been shown to alleviate the cognitive effects of stress, such as lapses in working memory, as well as the decreased physical performance and feelings of anxiety that stress can also produce.

Stressful life events can trigger depression and can make a depressive episode more severe (and last longer). Research has shown that between 20 and 25 percent of people who experience a seriously stressful event become depressed. Studies of depressed people show that as many as 80 percent of them have experienced a major stress in the last six months.

Halting Anxiety

Anxiety disorders include several different conditions, such as generalized anxiety disorder (GAD), panic disorder, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), and phobias.

Anxiety disorders share a common feature: an uncontrollable and, in many cases unexplainable, fear or dread. In most cases, people with one type of anxiety disorder have another; anxiety disorders frequently accompany depression, as well.

Some anxiety disorders are treated with antidepressants like fluoxetine (Prozac), paroxetine (Paxil), and sertraline (Zoloft). Medications specifically made to treat anxiety include clonazepam (Klonopin), alprazolam (Xanax), and diazepam (Valium). Possible side effects include drowsiness, fatigue, loss of coordination, and mental confusion.

While serious anxiety disorders demand attention from a doctor (and may require the use of prescription drugs), many milder or episodic types of anxiety respond quite well to herbal remedies. For example:


• Hops (Humulus lupulus)

This is a traditional antianxiety treatment that helps relieve depression, as well. Hops also acts as a mild sedative.

• Kava (Piper methysticum)

Kava is the go-to herbal for anxiety, and has centuries of use (and research) behind it. The latest studies confirm its ability to relieve the symptoms of anxiety as well as the most frequently prescribed pharmaceuticals.

• Passionflower (Passiflora incarnata)

Recent research has shown that passionflower relieves anxiety symptoms as well as drugs, without the side effects. Other research shows it can relieve presurgery anxiety without unnecessary sedation.

• Valerian (Valeriana officinalis)

Valerian is a gentle sedative and mood stabilizer. Research shows that combining it with Saint John’s wort (Hypericumperforatum) or kava (Piper methysticum) can relieve agitation and anxiety.

Depression and Other Mood Disorders

Depression is the best known of the illnesses classified as mood disorders, a group of conditions that includes major depression, dysthymic disorder (which is a type of chronic, mild depression), seasonal affective disorder (SAD), postpartum depression (PPD), and bipolar disorder.

Major or Minor

Everyone feels sad sometimes, but when those feelings linger or are so intense that they interfere with your daily functioning, they could be a sign of depression. Mood disorders generally involve feelings of persistent sadness, hopelessness, and apathy, but major depression, as its name implies, can create serious problems in an individual’s personal and professional life and, in extreme cases, lead to suicide attempts.

Exercise is a proven remedy for many psychological disorders, including anxiety, depression, ADHD, and age-related dementia. Research shows that a half-hour a day of exercise, three to five days a week, can significantly improve depression symptoms. Even shorter bouts of exercise—ten to fifteen minutes of physical activity—have been shown to boost your mood.

Depression often runs in families and typically begins before age thirty. It’s much more common in women than in men. Both genetics and life experiences—nature as well as nurture—seem to play a role.

Depression is generally treated with antidepressants, which include old-school tricyclic antidepressants and monoamine oxidase inhibitors (MAOIs) as well as newer drugs called selective serotonin reuptake inhibitors(SSRIs). The SSRIs include fluoxetine (Prozac), paroxetine (Paxil), and sertraline (Zoloft). Over the past several years, drug companies have come up with a few more antidepressants, including venlafaxine (Effexor) and bupropion (Wellbutrin).

Side effects from antidepressants vary: Tricyclics and MAOIs have the worst, including constipation, bladder problems, blurred vision, and dizziness. SSRIs and the other new drugs can cause sexual side effects, headache, nausea, and agitation.

Bipolar Disorder

Bipolar disorder, also known as manic-depressive disorder, affects about 6 million Americans over the age of eighteen, or about 2.6 percent of the adult population. It encompasses two very serious mood problems: mania, which is a euphoric “high” that’s often accompanied by reckless or even dangerous behavior, and depression.

Most often, antimanic (or mood-stabilizing) medications are used to treat bipolar disorder. The best known is lithium (Eskalith), which can cause fatigue, nausea, and tremors. Some patients are given an anticonvulsant, such as divalproex sodium (Depakote), which can cause headaches, double vision, dizziness, and anxiety.

Although SSRIs are extremely popular (doctors wrote more than 31 million prescriptions in 2005), research shows that much of their perceived efficacy is due to the placebo effect and they actually work in less than half of the patients who try them. Some herbs and lifestyle factors (like exercise) have been shown to be just as effective.

While a serious or prolonged case of depression or bipolar disorder should be treated by a doctor, many people find that herbs can help relieve some symptoms. For example:


• Boswellia (Boswellia serrata)

Boswellia produces a fragrant resin that is used as incense. New research has shown that it contains a psychoactive compound that relieves depression and anxiety.

• Lemon balm (Melissa officinalis)

Lemon balm is used to treat depression and calm the highs of bipolar disorder.

• Rhodiola (Rhodiola rosea)

Rhodiola has been proven effective against the symptoms of depression, both as an adjunct treatment (it was studied along with a tricyclic antidepressant drug) and on its own.

• Saint John’s wort (Hypericum perforatum)

This is a classic herbal remedy for depression—and one of the most researched herbs being used today. While not every study has shown a significant benefit, most experts agree that Saint John’s wort can alleviate the symptoms of mild to moderate depression.


Attention Difficulties

Attention deficit hyperactivity disorder, or ADHD, is one of the most common mental disorders in children—and adults—today. The principal characteristics of ADHD are inattention, hyperactivity, and impulsivity. In most cases, ADHD shows up in preschool or early elementary school, but many people are not diagnosed until much later. It is estimated that between 3 and 5 percent of American children (and more than 4 percent of adults) have symptoms of ADHD.

Between 1993 and 2003, the use of pharmaceutical ADHD treatments tripled (and spending on them increased ninefold, to roughly $2.4 billion), according to the National Institute of Mental Health. Doctors in the United States prescribe more than 80 percent of the world’s ADHD medications.

ADHD is typically treated with stimulant medications, such as methylphenidate (Ritalin) and amphetamine mixed salts (Adderall). Other ADHD meds include the drug atomoxitine (Strattera), which is a nonstimulant. Side effects can include decreased appetite, insomnia, anxiety, and headache. Here are some herbal alternatives for attention difficulties:


• American ginseng (Panax quinquefolius)

Like its Asian cousin, Panax ginseng, this herb is a traditional remedy for taming psychological and physical stress and sharpening mental powers. Research shows that it can alleviate the symptoms of ADHD.

• Ginkgo (Ginkgo biloba)

Studies show that ginkgo can sharpen your mind, whether you’re dealing with age-related decline or attention difficulties.

• Flax (Linum usitatissimum)

Flax contains alpha-linolenic acid (ALA), one member of a group of essential fatty acids called omega-3s, which have been shown to help with the symptoms of ADHD (and depression).

• Maritime pine (Pinus pinaster)

An extract from the bark of this French tree can reduce hyperactivity and increase attentiveness and concentration in people with ADHD.

Alcohol and Other Addictions

Addictions to alcohol, drugs, and other substances are an enormous problem in the United States and around the world, and are one of the biggest causes of preventable illness and death today.

Alcohol is a legal drug (for people twenty-one and older) in the United States, and most often it is a harmless part of our social lives. But excessive drinking can create enormous problems, including cirrhosis of the liver, heart disease, sexual dysfunction, and a cognitive disorder known as alcoholic dementia.

Marijuana is the most common illicit drug in the United States, although smoking it has been associated with short-term memory loss and other cognitive problems, elevated blood pressure and heart rate, and loss of motor skills.

Close behind marijuana are stimulants like cocaine and amphetamines, which can cause violent or erratic behavior, heart attack, seizure, or stroke. Opioids like heroin can damage the heart, lungs, and brain, and hallucinogens like ecstasy or LSD (“acid”) cause hallucinations and flashbacks—and possibly death.

Addictive substances also include legal drugs: tranquilizers like alprazolam (Xanax) and diazepam (Valium), painkillers like oxycodone (Oxy-Contin, Percocet), stimulants like methylphenidate (Ritalin), and sedatives like temazepam (Restoril) and triazolam (Halcion), all of which are highly addictive and can cause serious problems when abused.

Rates of prescription and over-the-counter drug abuse are climbing. According to the U.S. Department of Health and Human Services, non-medical use of prescription pain relievers was second only to marijuana among the types of illicit drug use in 2004. That same year, roughly 2 million people met the criteria for dependence or abuse involving a prescription drug.

Another legal yet addictive substance is the nicotine found in cigarettes and chewing tobacco. The U.S. Surgeon General has stated that the nicotine in tobacco products has addictive properties similar to heroin. According to government figures, nearly 58 percent of the nation’s 61.6 million smokers—35.5 million people—meet the criteria for nicotine dependence.

Conventional medicine typically treats addictions with a combination of counseling and medications. Alcoholics are given drugs to help them reduce their dependence on alcohol, and people with addictions to drugs like heroin are given methadone, a synthetic opioid that helps ease them off their drug habit.

Researchers are investigating an experimental drug called ibogaine, which is a naturally occurring alkaloid chemical in the African iboga shrub (Tabernanthe iboga) that seems to turn off the brain messages associated with addictive behaviors and thus may be useful in treating drug, alcohol, and other addictions.

While serious cases of dependence require medical attention, many people have found some herbal remedies helpful in breaking the cycle of addiction, including:


• Danshen (Salvia miltiorrhiza)

Studies show that extracts inhibit alcohol absorption, reduce alcohol intake, delay the onset of “drinking behavior,” and help prevent relapse drinking.

• Kudzu (Pueraria lobata)

Kudzu contains a chemical called diadzin that acts as an antidipsotropic (it causes a physical reaction when alcohol is consumed). Research shows it can reduce alcohol intake as well as the symptoms of withdrawal.

• Passionflower (Passiflora incarnata)

Passionflower reduces marijuana, nicotine, and alcohol withdrawal symptoms and helps relieve the sexual side effects of alcohol and nicotine abuse. It eliminates the addictive effects of drugs like morphine, and has been shown to be a useful adjunct therapy with the drug clonidine for opiate withdrawal.

• Saint John’s wort (Hypericum perforatum)

In addition to its antidepressant qualities, Saint John’s wort also sup-presses alcohol consumption (and performs as well as the prescription drug Prozac in treating alcoholics).