St. John’s Wort: Depression Treatment Options

When it comes to assessing natural remedies and alternative medicine, it can be challenging to determine what is safe and what works. Many of these substances have not been researched adequately, and they are often not approved by the Food and Drug Administration (FDA). On the other hand, many people have doubts about using modern medicine to treat depression, preferring natural remedies. If you are from the latter school of thought and live with depression, you might consider some of these alternatives, such as St. John's Wort (hypericum perforatum). You can usually find it in the dietary supplement aisle of many supermarkets.

According to the National Center for Complementary and Integrative Health, St. John's Wort is a wild plant that grows in parts of Europe and Asia. The plant is cultivated, the flowers are dried, and then the product is packaged into capsules or processed into oils. The active ingredients of St. John’s wort are thought by some to relieve symptoms of mild to moderate depression, but research results have been mixed. 

Below, we’ll weigh the pros and cons of using St. John's Wort. Before you use this information to aid in your decision to consider using St. John's Wort, it may be best to consult with a physician. A licensed professional can provide medical advice and discuss potential interactions between the supplement and any medications you currently take.

St. John's Wort: The potential benefits

A few clinical trials have suggested that St. John’s Wort (hypericum perforatum) can effectively reduce the symptoms of mild depression. In some studies, the supplement’s effects on major depression symptoms were observed to be greater than those of a placebo, but not by a wide margin. In a systematic review of 35 clinical trials, however, researchers found that St. John’s wort was “superior to placebo” when treating major depressive disorder.

Some people may consider taking a natural supplement such as St. John’s Wort to avoid the side effects or adverse drug interactions that may be caused by some antidepressants. For example, some antidepressant medications have been known to cause a few side effects, such as a reduction in sex drive. Some people believe they might avoid this effect by taking St. John's Wort to treat symptoms of depression. This may be true for some people, but there is no guarantee that St. John’s Wort will reduce depression symptoms. 

One other potential benefit of St. John’s Wort is that people who take it for depression may be more willing to commit to treatment than they would be if they were taking antidepressants. This could be due to various reasons, such as insurance hurdles or other financial stressors. Since treatment efficacy often depends on an individual’s adherence to the treatment, St. John's Wort may have an advantage in this sense. 

St. John's Wort: Potential disadvantages

Also, studies show that St. John’s Wort can interact with other medications, including antidepressants. Combining these substances in your body can cause your brain's serotonin levels to rise to potentially fatal levels—a condition known as serotonin syndrome. This can lead to high blood pressure and an increased heart rate, among other symptoms. 

Additionally, research suggests that St. John’s wort can cause or exacerbate symptoms of mania. Individuals with bipolar disorder or related conditions should seek the medical advice of a professional prior to using the supplement. If you take medication for depression or any other condition, it may be helpful to discuss St. John’s wort with a physician before taking it. 

St. John's Wort: Potential side effects

While the side effects of St. John’s wort (hypericum perforatum) are reported to be fewer than with antidepressants, this may not be the case for everyone. Some people report bouts of insomnia, nausea, and skin irritation. Everyone's body chemistry is different. Thus, there may be variance in the ways people react to treatment. This can also be true of antidepressant medications. If you are choosing this alternative option as a means of avoiding the potential side effects of antidepressants, it may be important to remember that both can produce side effects.

Also, some people who have taken St. John’s Wort have reported experiencing withdrawal symptoms once they stop. These can range from mild nausea to anxiety. As with any other form of treatment, it may be best to consult your primary care provider or another physician before making any changes. A physician can provide medical advice regarding safe use of St. John’s wort; for example, they may help you wean off the supplement gradually rather than quit cold turkey. 

St. John’s Wort hasn’t been thoroughly studied for treating severe depression. In many clinical trials conducted, the effects have only been shown to help those with mild to moderate symptoms. If you are experiencing severe depression or suicidal thoughts,* it’s recommended that you reach out for help immediately. 

If you are experiencing suicidal thoughts or urges, contact the National Suicide Prevention Lifeline at 988. Support is available 24/7.

What should I do?

As with many mental health conditions, medication is not the only treatment available. Many people have benefited from various forms of therapy for depression. If your symptoms make it difficult to leave home for traditional therapy, you may benefit from online therapy, which numerous studies have shown to be just as effective as in-office therapy, including for depression. 

Online counseling with BetterHelp

BetterHelp is an online counseling platform that can connect you with a therapist who specializes in treating depression. With online therapy, you can speak with a therapist via phone, live chat, or videoconferencing. You can also contact your counselor at any time through in-app messaging, and they’ll respond as soon as they can. This may be especially helpful if you experience symptoms in between sessions and want to write down what you’re feeling in the moment rather than waiting until your next session.

The efficacy of online counseling 

Research has shown that online therapy can be just as effective at reducing symptoms of depression as traditional in-office interventions. In a review of six decades of clinical studies, researchers found strong evidence for “the safety and clinical effectiveness of administering evidence-based psychotherapy for anxiety and depression via clinical videoconferencing among heterogeneous populations and age ranges, and in multiple care settings, with similar outcomes to in-person care.” They found that the videoconferencing intervention was feasible, acceptable, and safe in numerous settings.