When medical colleagues discuss physical illness and mental illness, they are always surprised when I say that in my opinion, there is actually no such thing as mental illness. The truth is that the disorders we identify as depression, anxiety, obsessive-compulsive, and bipolar, to name only a few, are all rooted in brain physiology. It is all physical illness. When a person has multiple sclerosis, no one is surprised when walking is impaired. But when a person has a disorder of the brain, many feel sufferers should somehow be able to control their symptoms. Instead of treatment, we offer judgment.
As we continue to explore brain biology, we are finding that there are many factors that play a role in mental disorders, including genetic expression, toxic exposure, inflammation, and faulty glandular function, especially with the thyroid and adrenals. Stress is also a major contributor, as it causes brain changes and disrupts certain hormonal systems.
When brain biology has major impairment, we call it mental illness, and when there are minor dysfunctions, we say it is a mood issue—we are down in the dumps or stressed out. It is a continuum, and many of the integrative interventions used by natural medicine practitioners are useful for any level of dysfunction, whether mild or severe.
The two most prevalent problems are depression and anxiety. About 40 million Americans have some type of anxiety disorder, and nearly 20 million have major depression or a milder depression called dysthymic disorder.1 There are a great number of proven natural medicine interventions that can make a significant difference in anxiety and depression.
In anyone experiencing virtually any brain difficulty, whether depression, anxiety, or any other issue, my first recommendation is a quality omega-3 fatty acid. The one I use is not an oil, but a phospholipid extract of salmon that has a 2:1 natural ratio of DHA to EPA, which makes it perfect for brain issues of any kind.
Another intervention that I find quite interesting is a high absorption curcumin with turmeric essential oil for people with major depressive disorder. In a very recent study, this combination was compared to fluoxetine, the generic of a popular prescription drug called Prozac. In this study, the special curcumin was just as effective as the antidepressant medication, but via different mechanisms in the brain. Antidepressant medications target neurotransmitters, especially serotonin, but that is only part of the problem. It has been recently found that individuals with depression have higher levels of brain inflammation than those who do not. Also, their system to make new brain cells is impaired, called neurogenesis. Curcumin has been found to be a potent anti-inflammatory agent, and also stimulates neurogenesis— desirable effects for those with depression.2 That means the unique curcumin used in this study has antidepressant qualities not found in current medications used for depression.
Another effective intervention for depression is Rhodiola rosea. In a human study of mild to moderate depression, it was found that use of rhodiola was very beneficial. In a six week study, use of rhodiola improved scores of overall depression, insomnia, emotional stability and physical complaints.3 Ashwagandha is a prominent part of ayurvedic tradition that has antidepressant properties. In an animal model, ashwagandha was compared to the prescription antidepressant imipramine (one brand name is Tofranil) and the antianxiety drug lorazepam (one brand name is Ativan). It was found that this herb compared favorably to both prescription drugs for these indications, without the adverse effects.4
In addition to benefits for depression, rhodiola and ashwagandha are also adaptogens that strengthen the adrenal glands, which makes a variety of hormones that greatly influence energy and mood. Rhodiola has been found to be one of the most valuable adaptogens for improving resistance to the destructive effects of stress, and can increase energy, endurance and mental clarity in as little as 30 minutes.5 Additionally, in a human study, ashwagandha showed significant reduction in both stress and cortisol levels after 60 days of use.6 I find in practice that these herbs provide excellent benefits when used together.
When a person is under stress, hormones are released, especially from the adrenal glands, which redirect our body’s energy into acute, immediate survival mode. So the heart, breathing, and blood pressure all increase, in an effort to prepare us for physical action.
he gastrointestinal tract slows down— no need to digest food right now; immediate survival is at stake.
Conversely, the urge to urinate or defecate (pass stool) increases as the body lightens its load. Perspiration increases. The brain becomes hyperalert (no time to be sleepy when you are under attack!), the startle reflex becomes stronger, and emergency stores of sugar are dumped into the bloodstream by the liver to fuel our survival.Immune system activity weakens— it is more important to pour energy into other areas of the body dealing with strength and speed, instead of expending resources to kill germs. The emotion we experience is anxiety, and sometimes intense fear.
Believe it or not, all of this is a good thing, because we are sometimes faced with life and death situations. But what happens when you experience intense anxiety and fear with even the mildest of triggers, or no triggers at all? This is the major issue in chronic anxiety. People with chronic anxiety can have problems with constipation or loose stools, impaired GI functioning, trouble sleeping, reduced wound healing, more infectious diseases, hormonal imbalances, and even a mildly increase risk of cancer. They often report living daily with a sense of impending doom.
My favorite herb for helping people with any level of anxiety may be surprising— echinacea. Everyone has heard of echinacea for immune boosting, but it turns out there are unique compounds called echinacosides that are potent antianxiety agents when they are removed from one species of the plant, purified and concentrated. Therefore, taking the usual echinacea used for colds and flu does nothing for anxiety, but these isolated compounds have been shown to attach to cannabinoid receptors in the brain, which in turn elicits a sense of calm without sedation. In a clinical study of people with diagnosed generalized anxiety disorder, 20 mg of this extract twice daily reduced anxiety significantly the first day of use, and by over 25 percent after one week.
There were also no reports of drowsiness or confusion, or other adverse effects. After only one day of use, the participants experienced a significant reduction on the anxiety measurement scale, which increased to a 25 percent reduction by day 7. The participants did not have issues with drowsiness or confusion, and there was no interference with their daytime activities.
There are a wide variety of natural interventions for mood and mental health difficulties, but in this short space I have chosen to highlight a few that are my favorites, with clinical studies backing their effectiveness. Imagine how much suffering could be alleviated with natural and effective dietary supplements, if only this information were more available to those in need of care.
1 The Numbers Count: Mental Disorders in America. National Institutes of Health, available at: www.nimh.nih.gov/health/publications/the-numbers-count-mental-disorders-in-america/index.shtml.
2 Sanmukhani J, et al. Efficacy and safety of curcumin in major depressive disorder: a randomized controlled trial. Phytother Res. July 6, 2013.
3 Darbinyan V, et al. Clinical trial of Rhodiola rosea L. extract SHR-5 in the treatment of mild to moderate depression. Nord J Psychiatry. 2007;61(5):343-8.
4 Bhattacharya SK, et al. Anxiolytic-antidepressant activity of Withania somnifera glycowithanolides: an experimental study. Phytomedicine. 2000 Dec;7(6):463-9.
5 Panossian A, Wagner H. Stimulating effect of adaptogens: an overview with particular reference to their efficacy following single dose administration. Phytother Res. 2005 Oct;19(10):819-38. Review.
6 Chandrasekhar K, et al. A prospective, randomized double-blind, placebo-controlled study of safety and efficacy of a high-concentration full-spectrum extract of ashwagandha root in reducing stress and anxiety in adults. Indian J Psychol Med. 2012 Jul;34(3):255-62.