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Herbal Medicine for Anxiety and Depression: New Evidence

Dr. Eric Viegas, ND

March 2018

depression anxiety herbal medicine naturopath ottawa

 

Depression is estimated to affect 5.4% of Canadians aged 15+ (1).  1 in 8 adults will meet the criteria for a mood disorder in their lifetime (1). Women have higher rates of depression than men.

 

Anxiety can also be present with a diagnosis of depression, further impacting a person’s quality of life.

 

People living with depression experience a lack of pleasure in activities that once brought them joy, sleep issues, fatigue, guilt and feelings of worthlessness, memory and concentration issues, and thoughts of suicide.

 

Depression and anxiety also contribute to a high burden of stress in people with cancer.

 

In a survey of 3370 cancer survivors, 20% identified with moderate to severe levels of depression, and 40% were living with moderate to severe anxiety lasting 6 years after diagnosis (2).

 

Due to the large number of adverse effects, and interactions with chemotherapeutics, conventional antidepressant and anti-anxiety medications are not favourable for cancer people (3). It’s no surprise then that this population seems to favour herbal remedies for anxiety and depression.

 

A recent systematic review summarized the evidence from 100 single herb clinical trials for depression and anxiety from 1996-2016 (4).

 

Here are the top herbal remedies for anxiety and depression as identified by this study:

 

Lavender

A fragrant and relaxing plant to grow in your garden, lavender is also used in perfumes and aromatherapy products. Lavender extracts, taken orally, show a stronger anti-anxiety effect than placebo and are comparable in effect to prescription drugs (eg. paroxetine, lorazepam) in human trials. Lavender also has fewer adverse effects than these drugs.

lavender anxiety depression naturopath ottawa

A tea made from lavender buds may improve the effect of citalopram; a commonly prescribed antidepressant medication.

 

Passionflower

Used by Native Americans as a remedy to improve sleep and anxiety, passionflower tea may improve sleep quality. When used with clonidine, passionflower extract was also shown to improve mental-emotional well-being for people undergoing opioid withdrawal.

passionflower depression anxiety sleep naturopath ottawa

Compared to the anti-anxiety medications oxazepam and sertraline, passionflower extract was not more effective in reducing severity of symptoms, but it had much fewer adverse effects.

 

Saffron

A commonly used spice in South Asia and the Middle East.

saffron depression anxiety premenstrual naturopath ottawa

Saffron was found to be most beneficial for people that identified with mild to moderate anxiety. Some studies also showed that saffron was superior to standard antidepressant drugs (fluoxetine and imipramine).

 

Women who have a flare-up of anxiety and/or depression premenstrually also benefited from saffron extract.

Black Cohosh

Commonly found in most herbal preparations for menopausal symptoms, black cohosh may have a positive effect on hot flashes.

black cohosh depression anxiety hormones naturopath ottawa

One study using a patented extract called Remifemin® was shown to be as effective as low dose topical estrogen in reducing hot flashes, anxiety, and depression without the adverse effects of hormone therapy.

Chamomile

Popular in sleep teas, chamomile is an effective anti-anxiety herb for people dealing with mild to moderate anxiety.

chamomile anxiety depression naturopath ottawa

Chamomile was also shown to be effective in the long-term (the study looked at 38 weeks of treatment) but had no effect on relapse rates.

 

Chaste Tree

Another herbal remedy for hormonal issues, chaste tree/vitex is often taken for premenstrual and fertility issues.

chaste tree vitex anxiety depression fertility naturopath ottawa

Chaste tree, when compared to the antidepressant fluoxetine, was shown to be more effective in reducing physical symptoms associated with depression in postmenopausal women.

 

Always check with your doctor before starting any nutritional supplement, herb, or medication.

 

Follow the links for additional information on anxiety, insomnia, and fatigue.

 

References

 

  1. Pearson, Caryn, Teresa Janz and Jennifer Ali. 2013. “Mental and substance use disorders in Canada” Health at a Glance. September. Statistics Canada Catalogue no. 82-624-X.
  2. Inhestern, L., Beierlein, V., Bultmann, J. C., Moller, B., Romer, G., Koch, U., & Bergelt, C. (2017). Anxiety and depression in working‐age cancer survivors: A register‐based study. BMC Cancer, 17(1), 347.
  3. Fajemiroye, J. O., da Silva, D. M., de Oliveira, D. R., & Costa, E. A. (2016). Treatment of anxiety and depression: Medicinal plants in retrospect. Fundamental & Clinical Pharmacology, 30(3), 198–215.
  4. Yeung, K., et al. Herbal medicine for depression and anxiety: a systematic review with assessment of potential psycho-oncologic relevance (2018). Phytotherapy Research, 1-27.

Mindset and Holistic Health

Mindset and Holistic Health: What’s serving you, and what isn’t?

Dr. Eric Viegas, ND

 

mindset dr. eric viegas naturopath ottawa

I often have people with chronic illnesses approach me for treatment. Sometimes, they do quite well with just minor lifestyle and nutritional changes. These treatments can be thought of as addressing an underlying, physical, cause.

 

However, I have also treated cases that require healing of a deeper underlying cause.

 

Our minds and bodies are very closely connected to one another, and their influence on each other should not be overlooked.

 

There are numerous clinical studies emphasizing the importance of diet, exercise, and stress management when it comes to a healthy mood balance, but what about the other way around?

 

What about your mindset? What do you focus on in your attitudes, beliefs, and behaviours?

 

Can the connection between your physical health and your mindset (that is, your emotional health) be the underlying cause of your distress?

 

A good example of this is insomnia.

insomnia mindset dr. eric viegas naturopath ottawa

Chronic insomnia is a common problem for many Canadians. Since supplements are easy to get over the counter, I find most people self-prescribe remedies to help themselves sleep. In some cases, the self-prescription may work, but it will not deal directly with the underlying cause of insomnia if you don’t do the work of asking “why?”.

 

When you are trying to fall asleep how do you feel? Anxious? Frustrated? Scared?

 

Your individual emotional response to your insomnia is an important factor in assessing and treating it.

 

Taking a melatonin supplement recommended by a supplement store employee for insomnia may initially help you, but it does not address your underlying emotional health and mindset.

 

What makes you feel anxious? How long have you felt this way? Has the feeling changed with time? In what other areas of your life do you find yourself feeling that way? I often ask questions of this nature to understand a person as a whole being; what makes them who they are and how do they react to their stress on the physical, mental-emotional, and spiritual planes?

 

Asking non-directional questions, either with the help of a health professional or on your own, will help you to reframe your perceptions. When we take a step back from our habitual behaviours, attitudes, and beliefs we have the opportunity to foster a deeper understanding of why it is we do what we do.

 

Ultimately, the question of  “do these beliefs/emotions/thoughts serve you?” will arise, and it is not an easy question to answer.

 

Perhaps your anxiety is helpful when it comes to meeting deadlines at work. But, if you cannot recover from a stressful day with a healthy sleep because your anxiety is keeping you awake, then your mindset is not serving you as a whole person.

 

I am not a fan of New Year’s resolutions. In 2018, instead of making a New Year’s resolution, think about your emotional health. Ask yourself “what makes me feel this way?” and explore the inner workings of your mindset.

 

Bolster Your Immune System for The Holiday Season

Q&A: How Will My Immune System Survive The Holidays?

 

With winter and family holidays fast approaching, I am constantly asked about what can be done to bolster the immune system and reduce stress. Here are some easy tips to get you through the rest of the year.

 

Q: I’m travelling a lot over the holidays, what can I do to boost my immune system?

 

A: A recent study used elderberry to prevent the onset of influenza during air travel. The study looked at 600-900 mg of elderberry extract containing 90-135mg of anthocyanins. Study participants took 2 capsules per day for 10 days before air travel. Two to four days before departure, the dosage was increased to 3 capsules per day, until 4 days after arrival at their destination (1).

immune system dr. eric viegas

Anthocyanins belong to the flavonoid group of phytochemicals; commonly found in teas, wine, fruits, vegetables, nuts, olive oil, and cocoa. They add vibrant color to these foods, along with a potent antioxidant capacity. Recent research into the human effects of anthocyanins has revealed their ability to strengthen blood vessels, balance the immune system, and combat inflammation (2,3).

 

Of the 312 participants taking the elderberry extract, 29 developed a cold. The group taking the placebo treatment had greater symptom severity and over twice the duration of illness compared to the elderberry group.

 

For more information on how you can best avoid the cold and flu this year, click here

Q: I’ve heard sugar can compromise my immune system. What lifestyle behaviours can help me with my sweet tooth?

 

A: Sugar is a contributing factor when dealing with illness over the holidays. Try structuring your meals with a low carbohydrate content, and increase your consumption of proteins from meat and vegetable sources. Some good vegan sources of protein include pumpkin seeds, lentils, black beans, almonds, and tempeh.

healty immune system dr. eric viegas

Munching on high protein snacks will help to keep your blood sugar stable, increase feelings of fullness, and make it less likely for you to grab extra holiday treats.

 

Q:What about stress and my immune system? My family drives me crazy over the holidays, and I know I’m going to get sick because of the added stress…

 

A: Stress is an inevitable part of everyone’s lives. Unfortunately, you can’t pick your family, but you can build your resilience to the added stress that comes with holiday get togethers.

 

Daily yoga is an excellent way to tone your nervous system and help you keep a cool head when dealing with added stress.

healthy immune system dr. eric viegas

A recent systematic review of 11 studies found that yoga enhanced the production of the body’s own antioxidants vitamin C and glutathione in healthy, diabetic, prediabetic, hypertensive, and renal disease patients. As a result, there was a significant reduction of oxidative stress after a session of yoga (4).

 

The great thing about yoga is that you don’t need to go to a class to reap the health benefits. A quick search of youtube will get thousands of results for many different types of yoga; one for every person’s unique needs.

 

Have a safe and happy holiday!

 

References:

 

  1. Tiralongo E, Wee SS, Lea RA. Elderberry supplementation reduces cold duration and symptoms in air-travelers: a randomized, double-blind placebo-controlled clinical trial. Nutrients. 2016;8(4):182.
  2. Lila, Mary Ann. “Anthocyanins and Human Health: An In Vitro Investigative Approach.” Journal of Biomedicine and Biotechnology 2004.5 (2004): 306–313. PMC. Web. 2 Nov. 2017.
  3. Youdim K, Martin A, Joseph J. Incorporation of the elderberry anthocyanins by endothelial cells increases protection against oxidative stress. Free Radic Biol Med. 2000;29(1):51–60.
  4. Pal, R. & Gupta, N. (2017). Yogic practices on oxidative stress and of antioxidant level: a systematic review of randomized controlled trials. Journal of Complementary and Integrative Medicine, 0(0), pp. -. Retrieved 2 Nov. 2017, from doi:10.1515/jcim-2017-0079.

Insomnia: When Counting Sheep Won’t Help Ewe

Insomnia Dr. Eric Viegas Naturopathic Medicine Ottawa

Insomnia: When Counting Sheep Won’t Help Ewe

Dr. Eric Viegas, ND

 

If you have chronic trouble sleeping then chances are you are one of the estimated 3.3 million Canadians struggling with insomnia. ‘Insomnia’ refers to the disruption of: time taken to fall asleep, amount of time asleep (versus time in bed) through the night, waking up too early, and feeling unrefreshed on waking.1 Insomnia is extremely frustrating, and can be a fearful prospect knowing that it can lead to impaired memory and concentration.1 As a result, insomnia can predispose you to be more accident prone at home, on the road, and in the workplace.1 Insomnia exists as its own disorder, but it is also associated with a large number of physical and mental illnesses. For example, mood disorders like depression and anxiety are both associated with insomnia.1

 

So what can be done to help you get a better night’s sleep? First, it is important to identify the underlying cause of your insomnia. If you are sensitive to light and noise, make sure your bedroom is as dark as possible and remove any electronics that might be distracting you from falling asleep. The ‘blue light’ emitted from our TVs, laptops, and mobile phones all effect the release of melatonin from our brains.2 A small amount of melatonin, one of the most well known natural sleep aids, is secreted by your pineal during the day. At night, melatonin secretion spikes to help us get to sleep. Exposure to ‘blue light’ before bed suppresses melatonin secretion and tricks our bodies into thinking we should be awake.2 If you are not willing to give up your bedtime electronics, you can reduce ‘blue light’ exposure by turning down the brightness of the device, and/or downloading an app (eg. Twilight). The long term use of benzodiazepine medication for anxiety and panic disorders can deplete the brain’s supply of melatonin.3 Overtime, a disruption in circadian rhythm reduces normal sleeping habits. Melatonin supplementation can help with normalizing circadian rhythm, and alleviating withdrawal symptoms from anti-anxiety meds.3 Insomnia, fatigue, ADHD, IBS, and breast cancer risk, are all associated with melatonin deficiency.3 Symptoms of fibromyalgia, bulimia, neuralgia, certain forms of depression, and certain postmenopausal problems improve with melatonin supplementation.3 Other common underlying causes of insomnia include mood disorders, hormone imbalance, sleep apnea, chronic pain, and exercising too close to bedtime.

 

The need to be busy has has left us overworked and overtired. When our bodies are in a constant state of stress, our systems shift from ‘rest and digest’ to ‘fight or flight?’. As a consequence, our adrenal glands secrete more cortisol; a hormone responsible for increasing blood sugar, and the breakdown of fat & muscle, for the energy to get us away from danger. Cortisol spikes in the morning to get us out of bed, and is very low at night to help us fall asleep. In a chronically stressed state, high cortisol will worsen insomnia and–if left untreated–will eventually lead to adrenal fatigue. Speak to your naturopathic doctor about your health concerns to help determine the underlying cause(s) and help tailor a treatment plan specific to your individual needs. Acupuncture, nutritional changes through diet and supplements, counselling, and sleep hygiene advice are all parts of naturopathic treatment that can help get you back to sleep and leave you feeling well rested.

 

References:

 

  1. Tjepkema M. “Insomnia”. Statistics Canada Health Reports. 2005 17(1): 9-25.
  2. 2. Schmerler, Jessica. “Q&A Why is Blue Light Before Bed Bad For Sleep?” Scientific American. Nature America, September 2015.
  3. Rohr UD, Herold J. “Melatonin deficiencies in women.” Maturitas. 2002 Apr 15(41): 85-10.

10 Ways to Kick Fatigue

Fatigue Dr. Eric Viegas Naturopathic Medicine Ottawa

10 Ways to Kick Fatigue

Dr. Eric Viegas, ND

 

  1. See your doctor: Fatigue has many root causes, and your naturopathic doctor can perform relevant assessments to determine what the best course of treatment should be.  
  2. Learn to say No: It’s easy to be inundated with favours, errands, and requests from your family and friends. Sometimes the best option when you are struggling with fatigue is to simply say, “No”. Establishing and maintaining boundaries in your personal and professional life help in your recovery from fatigue. It may seem selfish, but if you don’t have enough energy for yourself, how can you help other people?
  3. Get a good night’s sleep: This one is kind of a “no-brainer” when it comes to fatigue. Practicing good sleep hygiene will enable you to have a more restful sleep. Keep your room as dark as possible, and use a night mask if your bedroom still seems too bright. Avoid using your cell phone, computer, and TV before bed as the blue light these devices emit will affect your brain’s ability to give you a deep sleep. Keep the bedroom for sleep and sex only, this will help establish healthy sleep habits. If urinating at night is an issue, avoid drinking liquids within 2 hours of bedtime.
  4. Invest in gentle exercise: In our society, there is a focus on being busy. It’s assumed that if you aren’t always on the go, then you must be lazy. The same rhetoric seems to be true for the fitness industry. Most people feel that they need to exhaust themselves at the gym in order for workouts to be beneficial. However, if you’re struggling with fatigue, the best workout is a gentle one. Your body needs time to recover. 5×5 workouts (5 reps, 5 sets) with moderate to heavy weight will work out your muscles, get your heart rate up, and won’t deplete your energy reserves as much as high volume workouts.
  5. Practice Mindful Eating: This is a tricky one, because it’s easy to mindlessly eat in front of your phone, computer, or TV. Taking your time when eating can help to relax your nervous system and jumpstart your digestion. Share a meal with your friends. When your digestive system functions better, so will your immune system, and you’ll be able to recover from fatigue faster.
  6. Drink Plenty of Water: Water between meals will help move sluggish bowels and help you deal with the indoor dry heat this winter.
  7. Avoid Stimulants: Although it may seem like a good idea in the short term, coffee and other drinks that contain caffeine should not be consumed in excess. Overtime, caffeine addiction can worsen stress and anxiety, and affect sleep patterns. Instead, opt for herbal teas like peppermint, ginger, and lemongrass. These herbal teas can help ease nervous tension, and won’t cause an energy crash during your busy day.
  8. Practice Self-care: Do some yoga, get a massage, go for a walk in the snow, hang out with friends, paint, laugh, sing….Spending time doing the things you love will reduce stress and improve your mood. In Chinese Medicine, frustration, irritability, anger, and insomnia can sometimes be tied to a stagnation of energy flow. The best way to maintain a healthy flow of energy is to express your creative side.
  9. Eat to maintain stable blood sugar: Low blood sugar, known as hypoglycemia, is a common cause of fatigue. Avoiding processed and packaged foods that contain high amounts of simple sugars is an easy way to keep blood sugar stable. Instead of sugary cereal for breakfast, opt for oats. Add sources of good fat and protein like eggs, avocado, nuts, and lean meats. Fiber from fruits and vegetables will also aid in healthy blood sugar levels.  
  10. OM Yourself: Meditation can help increase energy and focus. You’ve probably heard this many times, but think that either you don’t have enough time in your day, or that you simply can’t sit still for that long. It’s okay. Start small, no one became a yogi overnight. Even if it’s a 1 minute meditation, that amount of downtime is still good for your body and mind.