Treatment for Depression: Pharmaceuticals, Herbals, or Sugar Pills?

Consumers have spent billions of dollars filling prescriptions for antidepressants, and study after study has shown their efficacy. They can work. Research on the herb, St. John’s Wort (Hypericum perforatum) has also shown promise in treating depression. Both the natural herb and the medicinal drugs work well to treat depression. But so do sugar pills used as placebo!

Depression is the leading cause of disability worldwide according to the World Health Organization. One in twenty American over the age of 12 is depressed, with the highest numbers showing up in people age 40 to 59. Eighty percent of people with depression have difficulty functioning, and one-third report difficulty at work. This makes depression a worldwide epidemic. The number of doctor visits for depression reached over 25 million last year. Pharmaceutical medications were prescribed for nine out of ten patients, even while it’s known that overall antidepressants work on less than half of all patients. And only 30 percent of people who experience depression seek medical care of any kind.

In a study comparing St. John's Wort to the popular antidepressant, Zoloft, St. John's Wort cured 24 percent of the people who received it and Zoloft cured 25 percent. Those taking a sugar pill placebo reported even higher numbers—over 30 percent cure.

The positive effects of the sugar pills can possibly be attributed to the attention given the participants. During the study as much as 20 hours of time with experts may enhance the subjects’ well being. Much of the time is spent monitoring their feelings and behaviors. In comparison, the average time a person being treated for depression is likely to see their physician is only 20 minutes a month. This quality of attention is a likely reason that the placebo subjects do as well with placebo medication.

In 96 studies of antidepressants conducted between 1979 and 1996, over half showed no distinguishable effect between the antidepressant drug and placebo. The Prozac manufacturers ran five trials themselves in order to report two that showed positive effects from their product.

The effects of placebo are not only emotional but physical as well. Studies showed changes in the serotonin levels in those on placebo as well as those on conventional medicines and St. John’s Wort. However, once the participants on placebo were told that they were not on pharmaceutical medication, the good effects deteriorated demonstrating that belief in the curative power of antidepressant drugs has much to do with their effectiveness.

In addition, the placebo effect seems to be growing. Research at Columbia University demonstrated that the amount of participants who responded well to the placebos in clinical trials grew in over the last 20 years.  Brain scan imagery is now being used to identify areas of the brain affected by drugs and placebo. Placebo effects have been found in both the hippocampus and striatum areas of the brain.

Other natural treatments for depression include Omega-3 fatty acids, Vitamin B6, SAMe (S-adenosyl-L-methionine), 5-HTP (5-hydroxytryptophan), Vitamin D, and the herb Valerian. Proper sleep can also aid and heal mild depression.

It is important to consult with your health care professional if you experience any signs of depression. Before starting any treatment or self-care, ask your doctor about possible counterindications.