Use Natural Products
The history of conventional medicine illustrates quite clearly how a treatment that is in vogue at a particular time can later be viewed as completely irrational and counter productive with the passage of time. Were the physicians of the late 19th century as convinced about the efficacy of the dominant treatments of the time (such as blood-letting and the use of toxic compounds, including mercury) as today’s physicians are of their drug treatments? Undoubtedly, and sadly, the answer is yes. Certainly there are many safe and effective medical treatments, but I do believe there is a fundamental flaw in the use of most drugs. That flaw is that conventional drugs rarely produce a curative effect. Instead they simply act as biochemical band-aids to make us feel better.
In the relief of stress, anxiety, and insomnia this focus on symptom-relief often comes at a very high price. The drugs commonly prescribed are often highly addictive, create a dependency, interfere with normal physiology, and possess numerous side effects. Do not blindly be led into using drugs without first asking some important questions:
• What is the real benefit of taking this drug?
• What are the risks associated with either taking or not taking the drug?
• Are there any effective natural alternatives?
Before discussing natural products to use for stress, anxiety, and insomnia, it is important to mention that often people suffering from these conditions also suffer from depression, and vice-versa. This often reflects low levels of brain serotonin, an important neurotransmitter (a chemical messenger responsible for transmitting information from one nerve cell to another). Serotonin has been referred to as the brain’s own mood-elevating and tranquilizing drug. There is a lot of support for this sentiment. Because the manufacture of serotonin in the brain is dependent upon how much tryptophan is delivered to the brain, in experimental studies researchers can remove tryptophan from the subject’s diet and observe the effect it has. The results from these sorts of studies have contributed greatly to our understanding of just how vital proper levels of serotonin are to a positive human experience. Table 7.1 contrasts the different effects of optimal vs. low serotonin levels.
The lower the level of serotonin, the more severe the consequences. For example, low levels of serotonin are linked to depression with the lowest levels being observed in people who have committed or attempted suicide.
In the treatment of depression conventional medicine primarily focuses on increasing the effects of serotonin. Once serotonin is manufactured in the brain it is stored in nerve cells waiting for release. Once released, the serotonin carries a chemical message by binding to receptor sites on the neighboring nerve cell. Almost as soon as the serotonin is released enzymes are at work that will either break down the serotonin or work to uptake the serotonin back into the brain cells. Either event terminates the serotonin effect. It is at this point that various drugs typically work, either inhibiting the reuptake of serotonin or preventing its breakdown. Most popular drugs of this type are referred to as SSRIs, short for Selective Serotonin Reuptake Inhibitors (see chart below). As a result of inhibiting serotonin reuptake, there is more serotonin hanging around capable of binding to receptor sites and transmitting the serotonin effect.
Table 7.2 – Examples of SSRIs
• Citalopram (Celexa, Cipramil, Cipram, Dalsan, Recital, Emocal, Sepram, Seropram, Citox, Cital)
• Dapoxetine (Priligy)
• Escitalopram (Lexapro, Cipralex, Seroplex, Esertia)
• Fluoxetine (Prozac, Fontex, Seromex, Seronil, Sarafem, Ladose, Motivest, Flutop)
• Fluvoxamine (Luvox, Fevarin, Faverin, Dumyrox, Favoxil, Movox)
• Paroxetine (Paxil, Seroxat, Sereupin, Aropax, Deroxat, Divarius, Rexetin, Xetanor, Paroxat, Loxamine, Deparoc)
• Sertraline (Zoloft, Lustral, Serlain, Asentra)
• Vilazodone (Viibryd)
The effectiveness of antidepressant drugs has been the subject of several reviews. The results indicate that they have not been shown to work any better than placebo in cases of mild to moderate depression (the most common reason for prescription medication), and claims that antidepressants are more effective in more severe conditions have little evidence to support them.36, 37 In fact, the research indicates that SSRIs and other antidepressant drugs might actually increase the likelihood of suicides in adults and children.38
An additional alarming finding is that 25% of patients taking antidepressants do not even have depression or a diagnosable psychiatric problem.39 So the bottom line is that millions of people are using antidepressants for a problem they do not have, and for the people who have a diagnosable condition, these medications do not work in most cases anyway and may cause significant side effects. As one group of researcher concluded, “Given doubt about their benefits and concern about their risks, current recommendations for prescribing antidepressants should be reconsidered.” 36 This statement is a clear mandate to consider using natural medicine as a way to deal with the causes of these mood disorders.
While antidepressant drugs are at best only marginally successful in alleviating depression, they do produce many side effects. Approximately 20% of patients experience nausea; 20% headaches; 15% anxiety and nervousness; 14% insomnia; 12% drowsiness; 12% diarrhea; 9.5% dry mouth; 9% loss of appetite; 8% sweating and tremors; and 3% rashes. SSRIs also definitely inhibit sexual function. In studies where sexual side effects were thoroughly evaluated, 43% of men and women taking SSRIs reported loss of libido or diminished sexual response. There is also a significant risk for weight gain and the development of type 2 diabetes.
SSRIs, WEIGHT GAIN, AND DIABETES
A little-appreciated side effect of SSRIs is weight gain. Statistics show that once weight gain begins while taking these medications it usually does not stop. These drugs induce weight gain because they alter an area of the brain that regulates both serotonin levels and the utilization of glucose.40 While the human brain usually makes up 2% of our overall body mass, it is so metabolically active that it uses up to 50% of the glucose in the body for energy. Evidently the SSRIs disrupt the utilization of glucose in the brain in such a way that the brain senses that it is low in glucose. That sets in motion very powerful signals to eat. And typically, if a person already has sugar cravings or other food urges, they will be dramatically enhanced by the drug. Other changes produced by the drug will lead to insulin resistance, setting the stage for inevitable weight gain and, perhaps, even type 2 diabetes. Studies have shown that individuals predisposed to diabetes are 2–3 times more likely to become diabetic if they use an anti depressant medication.41
ALTERNATIVES TO SSRIs
There are effective alternatives to antidepressant drugs. For example, there are a number of lifestyle and dietary factors that lead to reduced serotonin levels. Chief among these factors are cigarette smoking, alcohol abuse, a high sugar intake, too much protein, blood sugar disturbances (hypoglycemia and diabetes), and various nutrient deficiencies. All of these factors have one thing in common – they lower serotonin levels by impairing the conversion of tryptophan to serotonin. A health-promoting lifestyle and diet go a long way towards restoring optimal serotonin levels and relieving depression. But, in the interim, natural agents like 5-HTP , S- adenosylmethionine (SAMe ), or lavender extract can provide the boost in mood needed to help make important changes in diet and lifestyle easier to accomplish. Both natural agents are discussed below and a program for weaning off of SSRIs is given below.
5-HTP is the direct building block for serotonin. It exerts significant advantages over L-tryptophan . While only 3% of an oral dose of L-tryptophan is converted to serotonin, more than 70% of an oral dose of 5-HTP is converted to serotonin. In addition to increasing serotonin levels, 5-HTP causes an increase in endorphin levels. Numerous double- blind studies have shown that 5-HTP is equal to SSRIs and tricyclic antidepressants in terms of effectiveness, but is less expensive, better tolerated, and associated with fewer and much milder side effects.42, 43
In many studies of depression, researchers use a rating scale called the Hamilton Depression Scale (HDS). The HDS score is determined by having the test subject complete a series of questions in which he or she rates the severity of symptoms on a numerical basis, as follows:
1 – present but mild
2 – moderate
3 – severe
4 – very severe
Symptoms assessed by the HDS include depression, feelings of guilt, insomnia, gastrointestinal symptoms, and other bodily symptoms of depression (e.g., headaches, muscle aches, heart palpitations), and anxiety. The HDS is popular in research because it provides a good assessment of the overall symptoms of depression. Table 7.3 shows the results of a study comparing 5-HTP to tryptophan and a placebo.
In another study, 5-HTP was compared with the SSRI fluvoxamine (Luvox).43 Fluvoxamine is used primarily in the United States as a treatment for obsessive compulsive disorder (OCD), an anxiety disorder characterized by obsessions and compulsions affecting an estimated 5 million Americans. Fluvoxamine exerts antidepressant activity comparable to (if not better than) other SSRIs like Prozac, Zoloft, and Paxil. In the study, subjects received either 5-HTP (100 mg) or fluvoxamine (50 mg) three times daily for six weeks. The assessment methods used to judge effectiveness included the HSD, the self-assessment depression scale (SADS), and physicians’ assessments (Clinical Global Impression). As indicated in Table 7.4, the percentage decrease in depression was slightly better in the 5-HTP group (60.7% vs. 56.1%). The 5-HTP was quicker-acting than the fluvoxamine, and a higher percentage of patients responded to 5-HTP than to fluvoxamine.
The advantages of 5-HTP over fluvoxamine were really evident when looking at the subcategories of the HDS: depressed mood, anxiety, physical symptoms, and insomnia, as shown in Table 7.4. However, perhaps more important than simply relieving insomnia is 5-HTP’s ability to improve the quality of sleep. By contrast, antidepressant drugs greatly disrupt sleep processes. The bottom line is that 5-HTP is equal to or better than standard antidepressant drugs, and the side effects are much less severe. In addition, many people prefer to use a natural substance like 5-HTP rather than synthetic drugs.
In the study comparing 5-HTP with fluvoxamine, here is how the physicians described the differences among the two groups: “Whereas the two treatment groups did not differ significantly in the number of patients experiencing side effects, the interaction between the degree of severity of the side effects and the type of medication was highly significant: fluvoxamine predominantly produced moderate to severe side effects, and 5-HTP produced primarily mild forms of side effects. Fourteen (38.9%) of the patients receiving 5-HTP reported side effects compared with 18 patients (54.5%) in the fluvoxamine group. The most common side effects with 5-HTP were nausea, heartburn, and gastrointestinal problems (flatulence, feelings of fullness, and rumbling sensations). These side effects were rated as being very mild to mild. In contrast, most of the side effects experienced in the fluvoxamine group were of moderate to severe intensity. The only subject to drop out of the 5-HTP group did so after five weeks, while four subjects in the fluvoxamine group dropped out after only two weeks. On the basis of studies on weight loss, the longer 5-HTP is used (e.g., after 4–6 weeks of use), the less the problem with mild nausea.”
Another alternative to SSRIs is SAMe , a compound that our bodies naturally produce, and which is involved in the manufacture of important brain chemicals including neurotransmitters and phospholipids like phosphatidylcholine and phosphatidylserine. Normally, the brain manufactures all the SAMe it needs from the amino acid methionine. However, SAMe synthesis is impaired in depressed patients. Supplementing the diet with SAMe in depressed patients results in increased levels of serotonin, dopamine, and phosphatidylserine , and improved binding of neurotransmitters to receptor sites, resulting in increased serotonin and dopamine activity, and improved brain cell membrane fluidity, and thus significant clinical improvement.44
The results of a number of clinical studies suggest that SAMe is one of the most effective natural antidepressants. Unfortunately, its use is still limited due to its high price, since many of the clinical trials used injectable SAMe . However, more recent studies using oral preparations have demonstrated that SAMe is just as effective orally as it is when given intravenously. SAMe is better tolerated, and gets results faster, than typical antidepressant drugs. Overall, in the double-blind studies comparing SAMe to antidepressant drugs, 76% of the SAMe group showed significant improvements in mood compared to only 61% in the drug group.45, 46
No significant side effects have been reported with oral SAMe . Generally the dosage for SAMe is 200 mg twice daily. If after two weeks no significant improvement is noted, the dosage can be increased to as much as 400 mg four times daily. Individuals with bipolar disorder (manic depression) should not take SAMe . Because of SAMe’s antidepressant activity, these individuals are susceptible to experiencing hypomania or mania (a state of heightened euphoria, mood, and/or energy) as it can aggravate the manic aspect of their condition. This effect is exclusive to some individuals with bipolar depression.
CAFFEINE IN DEPRESSION AND ANXIETY
The importance of eliminating caffeine was stressed in Chapter 3 in regards to improving sleep quality. It also seems important in people prone to feeling depressed or anxious. Several studies have looked at caffeine intake and depression. For example, one study found that, among healthy college students, moderate and high coffee drinkers scored higher on a depression scale than did low users. Interestingly, the moderate and high coffee drinkers also tended to have significantly lower academic performance.47 Several other studies have shown that depressed patients tend to consume fairly high amounts of caffeine (e.g., greater than 700 mg/day).48, 49 In addition, caffeine intake has been positively correlated with the degree of mental illness in psychiatric patients.50, 51
The combination of caffeine and refined sugar seems to be even worse than either substance consumed alone. Several studies have found an association between this combination and depression. In one of the most interesting studies, 21 women and 2 men responded to an advertisement requesting volunteers “who feel depressed and don’t know why, often feel tired even though they sleep a lot, are very moody, and generally seem to feel bad most of the time.”52 After baseline psychological testing, the subjects were placed on a caffeine- and sugar-free diet for one week. The subjects who reported substantial improvement were then given either a capsule containing caffeine and a Kool-Aid drink sweetened with sugar, or a placebo capsule containing cellulose and a Kool-Aid drink sweetened with an artificial sweetener, for up to six days. About 50% of the test subjects became depressed during the period where they were getting caffeine and sucrose.
Another study using a format similar to the Kool-Aid study found that 7 of 16 depressed patients were depressed during the caffeine and sugar challenge, but symptom-free while on the caffeine- and sugar-free diet and during the cellulose and artificial sweetener test period.53
The average American consumes 150–225 mg of caffeine daily, or roughly the amount of caffeine in 1–2 cups of coffee. Although most people appear to tolerate this amount, some people are more sensitive to the effects of caffeine than others. Even small amounts of caffeine, like what is found in decaffeinated coffee, are enough to affect some people adversely. The bottom line appears to be that anyone with depression or any psychological disorder should avoid caffeine completely.
NUTRITIONAL PRODUCTS FOR STRESS AND ANXIETY
L-theanine was discussed briefly in Chapter 3. It is a unique amino acid found almost exclusively in tea plants (Camellia sinensis). Clinical studies have demonstrated that L-theanine reduces stress, improves sleep quality, diminishes PMS symptoms, heightens mental acuity, and reduces the negative side effects of caffeine. These clinical effects are directly related to L-theanine’s ability to stimulate the production of alpha brain waves (a state often achieved by meditation and characterized by being relaxed with greater mental focus and mental alertness) as well as reduce beta-waves (associated with nervousness, scattered thoughts, and hyperactivity).21
L-theanine has been approved for use in Japan as an aid to conquer stress and promote relaxation. It is a very popular ingredient in functional foods and beverages as well as dietary supplements designed to produce mental and physical relaxation without inducing drowsiness. L-theanine is fast acting. Generally, the effects are felt within the first 30 minutes, and have been shown to last up to 8–12 hours.
Based on the results of clinical studies, it has been established that L-theanine is effective in the range of 50–200 mg. If you have high levels of stress take at least 100–200 mg 1–3 times daily. Although L-theanine is completely safe and without any known adverse drug interaction, as a general guideline it is recommended to take no more than 600 mg within a six-hour period and no more than 1,200 mg within a 24-hour period.
GABA (gamma-aminobutyric acid) is a natural calming agent found in the brain. In fact, it is one of the brain’s most important neurotransmitters. It appears that many people with anxiety, insomnia, epilepsy, and other brain disorders do not manufacture sufficient levels of GABA . Many popular drugs such as Valium, Neurontin, baclofen, and Valproate act by increasing the effects of GABA within the brain.
PharmaGABA is a special form of GABA naturally manufactured from Lactobacillus hilgardii – the bacteria used to ferment vegetables in the preparation of the traditional Korean dish known as kimchi. Unlike chemically produced, synthetic GABA, PharmaGABA appears to be able to increase brain alpha waves and lower beta waves. Pharma- GABA is more powerful in this action than L-theanine , hence its effects are more noticeable.54 PharmaGABA has been shown to produce relaxation as evidenced by changes in brain wave patterns, pupil diameter, and heart rate, as well as to reduce other markers of stress including salivary cortisol levels. These effects are thought to be the result of activation of the parasympathetic nervous system rather than the PharmaGABA crossing the blood-brain barrier. Remember that activation of the parasympathetic nervous system produces the relaxation response.
Clinical studies with PharmaGABA have yielded some very interesting results. For example, one study had subjects who were afraid of heights walk across a long suspension bridge that spanned a 150-foot canyon. Halfway across the bridge a saliva sample was obtained and blood pressure was determined. What the researchers were looking for in the saliva was the level of secretory IgA – an important antibody in saliva that helps fight infection. During times of stress saliva levels of IgA typically drop, sometimes quite precipitously. This indeed happened when the subjects were given a placebo, but when they were given PharmaGABA the secretory IgA levels in the saliva were maintained halfway across the bridge and actually increased upon completion of the crossing.54
The typical dosage for PharmaGABA is 100–200 mg up to three times daily. Though no side effects have been reported, as a general guideline it is recommended to take no more than 1,000 mg within a 4-hour period and no more than 3,000 mg within a 24-hour period.
KEY BOTANICAL MEDICINES FOR STRESS
Several botanical medicines support adrenal function. Most notable are Chinese ginseng (Panax ginseng ), Siberian ginseng (Eleutherococcus senticosus ), rhodiola (Rhodiola rosacea), and ashwagandha (Withania somnifera). All of these plants exert beneficial effects on adrenal function and enhance resistance to stress, and are often referred to as “adaptogens” because they help us adapt to (cope with) stress. These plants have historically been used to:
• Restore vitality in debilitated and feeble individuals.
• Increase feelings of energy.
• Improve mental and physical performance.
• Prevent the negative effects of stress and enhance the body’s response to stress.
In addition, I have found the water-soluble extract of lavender to be another important botanical that helps people cope with stress and anxiety. It works primarily to improve mood and promote a greater sense of serenity.
Both Siberian and Chinese ginseng have been shown to enhance our ability to cope with various stressors, both physical and mental.55, 56 Presumably this anti-stress action is mediated by mechanisms that control the adrenal glands. Ginseng delays the onset and reduces the severity of the “alarm phase” of the body’s short and long term response to stress (the general adaptation syndrome).
People taking either of the ginsengs typically report an increased sense of well-being. Clinical studies have confirmed that both Siberian and Chinese ginsengs significantly reduce feelings of stress and anxiety. For example, in one double-blind clinical study, nurses who had switched from day to night duty rated themselves for competence, mood, and general well-being, and were given a test for mental and physical performance along with blood cell counts and blood chemistry evaluation.56 The group who were given Chinese ginseng demonstrated higher scores in competence, mood parameters, and mental and physical performance compared with those receiving placebos. The nurses taking the ginseng felt more alert, yet more tranquil, and were able to perform better than the nurses who were not taking the ginseng .
In addition to these human studies, animal studies have shown the ginsengs to exert significant anti-anxiety effects. In several of these studies, the stress-relieving effects were comparable to those of diazepam (Valium); however, diazepam causes behavioral changes, sedative effects, and impaired motor activity, while ginseng has none of these negative effects.
WEANING OFF PRESCRIPTION DRUGS
If you are taking any prescription drug for stress, anxiety, depression, or insomnia and wish to discontinue, you need to work with your physician. In general, discontinuing any drug for these conditions has to be done gradually – especially with the benzodiazepines. The same is true for SSRIs. Stopping an SSRI too quickly is associated with symptoms such as dizziness, loss of coordination, fatigue, tingling, burning, blurred vision, insomnia, and vivid dreams. Less often, there may be nausea or diarrhea, flu-like symptoms, irritability, anxiety, and crying spells.
To provide support when weaning off of SSRIs, 5-HTP , and/or SAMe can be used. A concern when mixing antidepressant drugs with 5-HTP is producing what is referred to as the “serotonin syndrome” – characterized by confusion, fever, shivering, sweating, diarrhea, and muscle spasms. Although it is theoretically possible that combining 5-HTP with standard antidepressant drugs could produce this syndrome, to my knowledge no one has actually experienced this syndrome with the simultaneous use of 5-HTP and an SSRI. Nonetheless, my recommendation is that you be closely monitored by your doctor, when using 5-HTP in combination with standard antidepressant drugs, for any symptoms suggestive of the serotonin syndrome. If these symptoms appear, elimination of one of the SSRIs entirely may be indicated. There is no concern with using SAMe and SSRIs simultaneously.
Employing all of the general measures given in the previous chapters, reduce the dosage of the SSRI by 50% and take 50 mg of 5-HTP three times daily and/or 200 mg SAMe daily. After two weeks, reduce the dosage of the SSRI by half again. Stay on this dosage for a month before finally discontinuing the SSRI. If needed the dosage of 5-HTP can be increased to 100 mg three times daily and the dosage of SAMe can be as high as 400 mg four times daily.
On the basis of the clinical and animal studies, ginseng appears to offer significant benefit to people suffering from stress and anxiety. Chinese ginseng is generally regarded as being more potent than Siberian ginseng, and is probably better for the person who has experienced a great deal of stress, is recovering from a long-standing illness, or has taken corticosteroids such as prednisone for a long time. For the person who is under mild to moderate stress and is experiencing less obvious impairment of adrenal function, Siberian ginseng may be the better choice. Dosages are as follows:
Chinese or Korean ginseng (Panax ginseng):
High-quality crude ginseng root: 1.5–2 g, 1–3 times daily
Fluid extract: 2–4 ml (½–1 tsp), 1–3 times daily
Dried powdered extract standardized to contain 5% ginsenosides: 250–500 mg, 1–3 times daily
Siberian ginseng (Eleutherococcus senticosus):
Dried root: 2–4 g, 1–3 times daily
Fluid extract (1:1): 2–4 ml (½–1 tsp), 1–3 times daily
Solid (dry powdered) extract (20:1 or standardized to contain more than 1% eleutheroside E): 100–200 mg, 1–3 times daily
RHODIOLA (RHODIOLA ROSEA)
Another useful botanical medicine to support stress management is Rhodiola rosea (arctic root), a popular plant in traditional medical systems in Eastern Europe and Asia, where it has traditionally been recommended to help combat fatigue and restore energy. Modern research has confirmed these effects and its adaptogenic qualities. However, the adaptogenic actions of rhodiola are different from those of the Chinese and Siberian ginsengs , which act primarily on the hypothalamus- pituitary-adrenal axis. Rhodiola seems to exert its adaptogenic effects by working on neurotransmitters and endorphins. It appears to offer an advantage over other adaptogens in circumstances of acute stress because it produces a greater feeling of relaxation and greater anti-anxiety effects. A single dose of rhodiola extract prior to acute stressful events has been shown to prevent stress-induced disruptions in function and performance, but like the ginsengs, it has also shown positive results with long-term use.57-60 In one randomized, placebo-controlled trial of 60 patients with stress-related fatigue, rhodiola was found to have an anti-fatigue effect that increased mental performance, particularly the ability to concentrate, as well as decreasing the cortisol response to stress.61
On the basis of results of clinical trials with a standardized rhodiola extract, the therapeutic dose varies according to the rosavin content. For a dosage target of 3.6–7.2 mg of rosavin, the daily dose would be 360–600 mg for an extract standardized for 1% rosavin; 180–300 mg for 2% rosavin; and 100– 200 mg for 3.6% rosavin. When rhodiola is used as an adaptogen, long-term administration is normally begun several weeks before the anticipated period of increased physiological, chemical, or biological strain, and continued throughout the duration of the challenging event or activity. When rhodiola is used as a single dose for acute stress (e.g., for an exam or an athletic competition), the suggested dose is three times the dose used for long-term supplementation. No side effects have been reported in clinical trials, but at higher dosages, some individuals might experience greater irritability and insomnia.
ASHWAGANDHA (WITHANIA SOMNIFERA)
A patented extract of roots and leaves from Withania somnifera know as Sensoril has shown impressive clinical results in dealing with stress. Developed by researcher Dr. S. Ghosal, Sensoril was the result of intense scientific investigations on the anti-stress action of various compounds in ashwagandha. Sensoril is standardized to contain the proper amounts of oligosaccharides, glycowithanolides, and Withaferin-A, that research has shown to promote optimal anti-stress activity.
Sensoril is derived from the freshly harvested roots and leaves of specially cultivated ashwagandha obtained from Northern regions of India. The roots used in Sensoril are from plants not more than two years old, as roots from older plants, which are used in many commercially available extracts of ashwagandha, may contain very little, if any, glycowithanolides.
Sensoril works with the body’s natural biological systems to help restore balance to the body and normalize body functions. It helps to increase the body’s resistance to stress and reduce physiological responses to stress events. Sensoril delivers a variety of benefits that help maintain good health.62 Among other things, Sensoril:
• Helps counteract the negative effects of stress.
• Increases resistance to fatigue.
• Promotes mental clarity and concentration.
• Supports healthy weight management by inhibiting stress responses that can lead to overeating.
• Improves resistance to stress and tension.
• Helps protect against the effects of aging by protecting against free radical damage to cells.
• The typical dosage for Sensoril is 125 mg once or twice daily.
LAVENDER (LAVANDULA OFFICINALIS)
Lavender has long been used by herbalists as a treatment for anxiety, nervous exhaustion, and depression. Recently, this traditional treatment has been verified in a double-blind clinical trial.63 The findings of the study indicated that taking a moderate amount of lavender can reduce feelings of depression, anxiety, and helplessness. In the study, 45 adults between the ages of 18 and 54 who were diagnosed with depression were assigned to one of three groups. The groups received either (1) lavender extract plus a placebo tablet, (2) a placebo plus 100 mg per day of the antidepressant drug imipramine, or (3) lavender extract and 100 mg per day of imipramine. The study lasted for four weeks and scores from the Hamilton Rating Scale for Depression (HAM-D, a questionnaire used to evaluate the severity of depression, where higher scores suggest more severe depression) were evaluated initially and then weekly after the start of treatment. What the results indicated was that the lavender extract was just as effective as the drug, but without the side effects common to drug treatment for depression (dry mouth, weight loss or weight gain, low blood pressure, arrhythmias, and decreased sexual function).
The use of natural medicines as part of a stress management program can be tailored to your individual needs. Here is how I generally define the level of additional support that may be required:
LEVEL 1 SUPPORT
In addition to following the appropriate lifestyle and dietary approaches to stress reduction as well as regular utilization of techniques to calm the mind and body, Level 1 Support simply involves using natural products on an as-needed basis, such as following the recommendations in Chapter 3 for getting a good night’s sleep (e.g., 5-HTP , L-theanine, and/ or melatonin) or Chapter 4 for stabilizing blood sugar levels (PGX®), or taking L-theanine or PharmaGABA when experiencing situational stress.
LEVEL 2 SUPPORT
Level 2 Support involves all of the above and using either L-theanine or PharmaGABA on an ongoing basis due to more frequent feelings of stress or nervousness.
LEVEL 3 SUPPORT
Level 3 Support involves 1 and 2 above plus using one of the adrenal adaptogens on an ongoing basis, at the dosages recommended above.
LEVEL 4 SUPPORT
For people who are starting to experience or are experiencing significant signs of adrenal fatigue and generalized exhaustion, Level 4 Support is recommended. This level involves using all of the above plus a combination of the anti-stress botanicals. For example, two capsules of one formula I often recommend contain the following (the recommended dosage for Level 4 Support):
• Sensoril ...........................250 mg
• Siberian ginseng extract.....150 mg (standardized to contain 0.8% eleutherosides)
• Lavender extract (5:1) .......150 mg
• Rhodiola extract ................75 mg (standardized to contain 3.5% rosavins)