Beating the Moody Blues
Women are also more likely than men to suffer mood disorders, including depression and anxiety. For example, in a given year, almost 10 percent of the U.S. population suffers a depressive disorder, with nearly twice as many woman afflicted as men, according to the Society for Women’s Health Research.
“Mood disorders have become one of the major medical problems in the United States, and one out of three women are being treated for some mood-related condition due to the stress caused by the increased demands of work and family and the world in which we live,” said Ron Grossman, president of Crania Co.
Studies have shown that the rate of synthesis of serotonin and the level of serotonin in the blood are significantly higher in men than women.48,49 Because serotonin in the brain is required for mood maintenance, this may help explain the disparity in depression rates. In addition, serotonin, which is calming and sedating, works in complement with dopamine, an energizing neurotransmitter; when levels are unbalanced, mood disorders can develop.
A recent review published in the Journal of the American Medical Women’s Association selected certain integrated treatments for depression, based on the strength of evidence, and detailed not only their impact on depression, but also considerations specific to women, such as use in pregnancy or impact on hormone therapies.50 Among the treatments they addressed were folate, Hypericum perforatum, 5-hydroxytryptophan (5-HTP) and omega-3 fatty acids.
“As depression is more common in women than in men, and particularly during the transition time of peri-menopause, it is important to look at alternative remedies,” Hudson said. “For example, the most common manifestation of a folic acid deficiency is depression. And St. John’s wort is an incredibly effective plant for mild to moderate depression, even in comparative studies with antidepressants.
”Regarding folate, the researchers noted the evidence is positive for the B vitamin’s use to augment standard antidepressant treatment, even in women who are not deficient. And folate deficiency may play a role in the etiology of depression, possibly linked to hyperhomocysteinemia.51 Studies have shown individuals with the lowest levels of homocysteine had the fewest depressive symptoms, while those with the lowest levels of folic acid had increased depressive symptoms.52
The University of Arizona journal also noted St. John’s wort (Hypericum perforatum) has demonstrated efficacy in randomized controlled trials; however, its safety in pregnancy has not been established, and the herb has multiple drug interactions due to its effect on the cytochrome P450 (CYP) 3A pathway.53
In fact, St. John’s wort may prove very beneficial to depressed females. Its efficacy appears comparable to traditional antidepressant drugs in cases of mild to moderate depression.54,55 It may even have benefits to mood disorders linked to female hormone imbalance. In a double blind, randomized, placebo-controlled trial, 125 women with premenstrual syndrome took 600 mg/d of St. John’s wort or a placebo for two menstrual cycles; intervention appeared to help alleviate the anxietyrelated subgroup of PMS symptoms.56
Another botanical with positive mood effects is Apocynum venetum. A specialty extract of Apocynum venetum (as Posinol™, from OptiPure®) had a comparable effect to the pharmaceutical antidepressant imipramine in an animal model of depression,57 and appears to work not through the serotonin pathway, but impacts dopamine levels.58 In addition, Apocynum extract does not impact CYP3A activity.59
A combination of fresh hawthorn (Crataegus oxyacantha) flowers and terminal leaves may help to alleviate menopausal depression, according to Daniel Gagnon, medicinal herbalist and owner of Herbs Etc. Inc. “Hormonal shifts seem to be a major contributor to menopausal depression,” he noted, adding classic French herbal texts reference the ability of this herbal combination to alleviate menopausal depression. “I added fresh hawthorn flowers and terminal leaves to our Menopautonic™ formula, and women reported the felt a noticeable emotional lift.”
5-HTP was also found to have positive efficacy, as demonstrated in clinical trials, though its safety in pregnancy and breastfeeding has not been established.60 A Cochrane Database review on 5-HTP’s efficacy in depression found only two trials, involving a total of 64 patients, of sufficient quality to meet inclusion criteria; while the results of the studies found 5-HTP was better than placebo at alleviating depression, more clinical studies are needed to evaluate the substance’s efficacy and safety.61
Crania Co. developed a slow-dissolving lozenge containing 5-HTP, called CraniYums, designed to bypass the digestive system through sublingual absorption. The company supported a placebo-controlled study, conducted by Cheryle Hart, M.D., which found the use of CraniYums improved mood and decreased irritability in 78 percent of participants. Hart noted it is important to increase levels of serotonin and dopamine in a balanced way. “Excess serotonin can make you feel groggy, while too much dopamine can interfere with sleep,” she said. “By increasing levels of both in a balanced way, CraniYums has been shown over a few weeks to dramatically improve almost all of the classic signs of deficiency.”
One critical basic nutritional compound with benefits in mood support is the omega-3 polyunsaturated fatty acids (PUFAs). Studies suggest there is a causal relationship between omega-3s and depression, with higher long-term consumption of omega-3s associated with lower incidence of depression.62 The omega-3 eicosapentaenoic acid (EPA) may be particularly efficacious in this area, working synergistically with standard antidepressant therapies to improve response.63
“Research has linked consumption of essential omega-3 fats to anti-depressive effects,” Trautman said. “A number of population studies show a correlation between diets rich in fish consumption and lower rates of depression, which is not surprising considering no other organ in the body requires as many EFAs as the brain. The evidence is so strong that pharmaceutical companies are starting to use EFAs in the development of antidepressant drugs.”
Of particular interest for women’s health have been recent studies examining whether omega-3 PUFAs can impact postpartum depression. In a cohort of 380 women at six months postpartum, Australian researchers found a 1-percent increase in plasma docosahexaenoic acid (DHA) was associated with a 59-percent reduction in reporting of depressive symptoms.64 Similar results were found in a Dutch study examining plasma DHA status among women with and without postpartum depression; they found the postpartum increase of functional DHA status was lower in the “possibly depressed” group than the non-depressed group, leading the researchers to suggest increased DHA during pregnancy and after delivery may be prudent.65
Retailers can help their consumers get interested in health issues. “Consumers have the responsibility to look into key health issues, and retailers can help by providing scientific articles and references that support their endeavor,” Kendall said. “These women will find that putting this into practice takes diligence and hard work, but the rewards are worth it. If they apply the principles of health, they will have longer, more productive lives with less degeneration.”
