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As if depression or anxiety is not enough to deal with, many people have to deal with both. Alarmingly, about 85 percent of people with depression also experience some anxiety; about 90 percent of people with anxiety suffer some depression (Eur Arch Psychiatry Clin Neurosci 2016;266(8):725–736). When people suffer from depression and anxiety simultaneously, the condition is more disabling and harder to treat.
There is also a condition called Mixed Anxiety and Depressive Disorder (MADD), in which neither one predominates or is severe enough to warrant a psychiatric diagnosis separately, but, combined, do warrant a diagnosis.
Several natural supplements are effective for treating both depression and anxiety. Knowing about these treatments can be important from a perspective of cost and of effectiveness.
Saffron
Perhaps the most exciting new herb for depression is saffron. Saffron matches antidepressant drugs. When people with depression were given 30 mg of saffron extract or 100 mg of the drug imipramine, the improvement was equal in the two groups, but the saffron was better because it was safer (BMC Complement Altern Med 2004). When 15 mg of saffron petal extract or 10 mg of Prozac are taken twice a day by people with depression, saffron brings about a significant effect that is equal to the effect of Prozac (J Ethnopharmacol 2005;97:281-284; Prog Neuropsychopharmacol Biol Psychiatry 2007;31:439-442). Meta-analysis of saffron and depression have found the herb to be better than placebo and at least as good as drugs with the advantage of being safer (J Integr Med 2013;11:377-383; Hum Psychophar-macol 2014;29:517-527).
The recent evidence has only gotten stronger. A 2018 meta-analysis of seven double-blind studies found that in each study and combined, saffron was better than placebo and as good as drugs (Neuropsychiatr Dis Treat 2018 May 21;14:1297-1305). A 2019 systematic review and meta-analysis concluded that saffron is better than placebo, as good as drugs and that adding it to drugs is better than drugs alone (Nutr Rev 2019 May 28:nuz023). A 2020 systematic review and meta-analysis again found saffron to beat placebo and equal the drugs (J Nerv Ment Dis 2020 Apr;208(4):269-276).
Saffron is also a remarkable herb for anxiety. A meta-analysis of six studies demonstrated superiority to placebo (Nutr Rev 2019 May 28:nuz023) and double-blind research has proven it to be a match for the drug citalopram (Pharmacopsychiatry. 2017 Jul;50(4):152-160).
What about people with depression and anxiety? A double-blind study gave 54 people with both mild to moderate depression and anxiety, according to the Beck Inventory, either a placebo or saffron for 12 weeks. The saffron group had significantly greater improvement in depression than the placebo group with a two-point greater improvement. The saffron group also had a significantly greater improvement in anxiety: the improvement was three points better than the placebo group (J Complement Integr Med 2016;13(2):195-199).
A second study has added to the evidence. Sixty people with mild to moderate depression and anxiety were given the SSRI citalopram or 30 mg of saffron for six weeks. The response to both treatments for depression and anxiety was significant and equal, meaning that saffron was as good as the drug (Pharmacopsychiatry 2017;50(04):152-60).
Lavender
This gentle herb is as powerful as anti-anxiety drugs. Lavender oil capsules were compared to the benzodiazepine lorazepam in a three-week study of people with generalized anxiety disorder (GAD). The results were the same for both treatments: lavender produced a 45 percent improvement on the Hamilton Anxiety Scale (HAMA) and lorazepam produced a 46 percent improvement. Unlike benzodiazepines, though, the lavender oil was safe, non-sedating and non-addictive (Phytomed 2010;17(2):94-9).
Lavender can also compete with antidepressant drugs. People suffering from depression were given 60 drops of lavender tincture and placebo or 100 mg of the antidepressant drug imipramine and placebo or 60 drops of lavender and 100 mg of imipramine. After four weeks, all three groups improved significantly. The group taking both imipramine and lavender experienced a significantly greater improvement than those taking either treatment alone, suggesting that people on imipramine may be able to reduce their dose of the drug, and, therefore, its side effects, by adding lavender (Prog Neuropsychopharmacol Biol Psychiatry 2003).
But what if you suffer from anxiety and depression? When people with MADD were given 80 mg of lavender oil or placebo for 70 days in a double-blind study, scores on the HAMA dropped significantly more in the lavender group: 10.8 points versus 8.4. Depression scores also dropped significantly more in the lavender group: 9.2 points versus 6.1. People on lavender had better clinical outcomes and better improvement in quality of life (Eur Neuropsychopharmacol 2016;26:331–40).
When 160 mg of lavender oil a day was compared to the SSRI paroxetine in people with GAD, after 10 weeks, HAMA scores decreased by 14.1 points on lavender but only by 11.3 points on paroxetine. 60.3 percent of people on lavender oil reduced their HAMA score by at least 50 percent compared to 43.2 percent on paroxetine. 46.3 percent of the lavender oil group now had scores below 10 versus 34.1 percent of the paroxetine group. Interestingly for our topic, the lavender oil also showed “a pronounced antidepressant effect.” The researchers concluded that, for GAD, lavender oil is better and safer than paroxetine (Int J Neuropsychopharmacol 2014;17(6):859-869).
And one more cool thing about lavender, depression and anxiety. Anxiety, stress and depression during pregnancy can have a negative effect on the health of both the mother and child. So, in a double-blind study, researchers asked 141 healthy pregnant women to rub either placebo cream or lavender cream onto their legs for 10 to 20 minutes 1.5 hours before going to bed. The lavender cream contained 1.25 percent lavender essential oil. At the end of the eight-week study, there was significant improvement in anxiety, stress and depression in the lavender group compared to the placebo group. By the end of only the fourth week, there was already significant improvement in stress and anxiety (J Caring Sci 2015;4:63-73).
St. John’s Wort
And don’t forget St. John’s wort, the most important natural antidepressant of them all. One double-blind study demonstrated that St. John’s wort also reduces anxiety (Fortschr Med 1995;113:404-8).
5-HTP
Another important antidepressant is 5-HTP. In one impressive study, 43 percent of people who had not responded to any antidepressant drug were completely cured by 5-HTP. An additional 8 percent improved significantly (Neuropsychobiol 1980;6:230-40). A review of studies determined that 5-HTP is as effective as tricyclic antidepressant drugs (Biol Psychiatry 1981;16:291-310). And 5-HTP has beaten an SSRI antidepressant: 60.7 percent responded to the 5-HTP versus 56.1 percent to the drug. 5-HTP brought about a greater response, and it did it faster and safer (Psychopathology 1991;24:53–81). In a double-blind study, 5-HTP was the equal of Prozac (Asian J Psychiatr 2013;6:29-34).
And a placebo-controlled study has shown that 200 mg of 5-HTP significantly reduces the reaction to a panic challenge in people with panic disorders. There was improvement in anxiety, panic symptom score and the number of panic attacks (Psychiatry Res 2002;113:237-43).
Rhodiola
Rhodiola has the ability to calm you down and energize you at the same time. Rhodiola calms stress, improves well-being and decreases mental and physical fatigue. When 80 people with mild anxiety were given either 200 mg of Rhodiola rosea twice a day or nothing for two weeks, compared to the control group, the rhodiola group experienced significant reductions in anxiety, stress, anger, depression and confusion. They also had significant improvement in overall mood (Phytother Res 2015;doi:10.1002.ptr.5486). So, rhodiola helps both anxiety and depression.
Probiotics
A strange addition to the list is probiotics—not usually thought of as a psychological supplement. In the first ever study of probiotics and psychological conditions, people with depression had significantly better improvement in mood on a probiotic than on a placebo (Eur J Clin Nutr 2007;61:355-61). A second study found that a month of probiotics significantly improved depression and anger (Gut Microbes 2011;2:256-61). The same study also found significant improvement in anxiety. An earlier study had already hinted at an antianxiety effect for probiotics. A placebo-controlled study of people with chronic fatigue syndrome found that probiotics significantly reduced their anxiety scores (Gut Pathology 2009;1:6-10). So, add probiotics to the list too. VR
Linda Woolven is a master herbalist, acupuncturist and solution-focused counsellor with a virtual practice in Toronto, ON, Canada. For comprehensive natural help with your health, make an appointment to see Woolven. Woolven and Ted Snider are the authors of several books on natural health. You can see their books at www.thenaturalpathnewsletter.com. They are also the authors of the natural health newsletter The Natural Path. The Natural Path is a natural health newsletter specifically designed to help health food stores increase their sales by educating their customers. The Natural Path contains no advertising and never mentions a brand name. To Increase Your Sales by Educating Your Customers, Start Giving The Natural Path Newsletter to Your Customers Today! Contact Snider at tedsnider@bell.net or at (416) 782-8211.
As if depression or anxiety is not enough to deal with, many people have to deal with both. Alarmingly, about 85 percent of people with depression also experience some anxiety; about 90 percent of people with anxiety suffer some depression (Eur Arch Psychiatry Clin Neurosci 2016;266(8):725–736). When people suffer from depression and anxiety simultaneously, the condition is more disabling and harder to treat.
There is also a condition called Mixed Anxiety and Depressive Disorder (MADD), in which neither one predominates or is severe enough to warrant a psychiatric diagnosis separately, but, combined, do warrant a diagnosis.
Several natural supplements are effective for treating both depression and anxiety. Knowing about these treatments can be important from a perspective of cost and of effectiveness.
Saffron
Perhaps the most exciting new herb for depression is saffron. Saffron matches antidepressant drugs. When people with depression were given 30 mg of saffron extract or 100 mg of the drug imipramine, the improvement was equal in the two groups, but the saffron was better because it was safer (BMC Complement Altern Med 2004). When 15 mg of saffron petal extract or 10 mg of Prozac are taken twice a day by people with depression, saffron brings about a significant effect that is equal to the effect of Prozac (J Ethnopharmacol 2005;97:281-284; Prog Neuropsychopharmacol Biol Psychiatry 2007;31:439-442). Meta-analysis of saffron and depression have found the herb to be better than placebo and at least as good as drugs with the advantage of being safer (J Integr Med 2013;11:377-383; Hum Psychophar-macol 2014;29:517-527).
The recent evidence has only gotten stronger. A 2018 meta-analysis of seven double-blind studies found that in each study and combined, saffron was better than placebo and as good as drugs (Neuropsychiatr Dis Treat 2018 May 21;14:1297-1305). A 2019 systematic review and meta-analysis concluded that saffron is better than placebo, as good as drugs and that adding it to drugs is better than drugs alone (Nutr Rev 2019 May 28:nuz023). A 2020 systematic review and meta-analysis again found saffron to beat placebo and equal the drugs (J Nerv Ment Dis 2020 Apr;208(4):269-276).
Saffron is also a remarkable herb for anxiety. A meta-analysis of six studies demonstrated superiority to placebo (Nutr Rev 2019 May 28:nuz023) and double-blind research has proven it to be a match for the drug citalopram (Pharmacopsychiatry. 2017 Jul;50(4):152-160).
What about people with depression and anxiety? A double-blind study gave 54 people with both mild to moderate depression and anxiety, according to the Beck Inventory, either a placebo or saffron for 12 weeks. The saffron group had significantly greater improvement in depression than the placebo group with a two-point greater improvement. The saffron group also had a significantly greater improvement in anxiety: the improvement was three points better than the placebo group (J Complement Integr Med 2016;13(2):195-199).
A second study has added to the evidence. Sixty people with mild to moderate depression and anxiety were given the SSRI citalopram or 30 mg of saffron for six weeks. The response to both treatments for depression and anxiety was significant and equal, meaning that saffron was as good as the drug (Pharmacopsychiatry 2017;50(04):152-60).
Lavender
This gentle herb is as powerful as anti-anxiety drugs. Lavender oil capsules were compared to the benzodiazepine lorazepam in a three-week study of people with generalized anxiety disorder (GAD). The results were the same for both treatments: lavender produced a 45 percent improvement on the Hamilton Anxiety Scale (HAMA) and lorazepam produced a 46 percent improvement. Unlike benzodiazepines, though, the lavender oil was safe, non-sedating and non-addictive (Phytomed 2010;17(2):94-9).
Lavender can also compete with antidepressant drugs. People suffering from depression were given 60 drops of lavender tincture and placebo or 100 mg of the antidepressant drug imipramine and placebo or 60 drops of lavender and 100 mg of imipramine. After four weeks, all three groups improved significantly. The group taking both imipramine and lavender experienced a significantly greater improvement than those taking either treatment alone, suggesting that people on imipramine may be able to reduce their dose of the drug, and, therefore, its side effects, by adding lavender (Prog Neuropsychopharmacol Biol Psychiatry 2003).
But what if you suffer from anxiety and depression? When people with MADD were given 80 mg of lavender oil or placebo for 70 days in a double-blind study, scores on the HAMA dropped significantly more in the lavender group: 10.8 points versus 8.4. Depression scores also dropped significantly more in the lavender group: 9.2 points versus 6.1. People on lavender had better clinical outcomes and better improvement in quality of life (Eur Neuropsychopharmacol 2016;26:331–40).
When 160 mg of lavender oil a day was compared to the SSRI paroxetine in people with GAD, after 10 weeks, HAMA scores decreased by 14.1 points on lavender but only by 11.3 points on paroxetine. 60.3 percent of people on lavender oil reduced their HAMA score by at least 50 percent compared to 43.2 percent on paroxetine. 46.3 percent of the lavender oil group now had scores below 10 versus 34.1 percent of the paroxetine group. Interestingly for our topic, the lavender oil also showed “a pronounced antidepressant effect.” The researchers concluded that, for GAD, lavender oil is better and safer than paroxetine (Int J Neuropsychopharmacol 2014;17(6):859-869).
And one more cool thing about lavender, depression and anxiety. Anxiety, stress and depression during pregnancy can have a negative effect on the health of both the mother and child. So, in a double-blind study, researchers asked 141 healthy pregnant women to rub either placebo cream or lavender cream onto their legs for 10 to 20 minutes 1.5 hours before going to bed. The lavender cream contained 1.25 percent lavender essential oil. At the end of the eight-week study, there was significant improvement in anxiety, stress and depression in the lavender group compared to the placebo group. By the end of only the fourth week, there was already significant improvement in stress and anxiety (J Caring Sci 2015;4:63-73).
St. John’s Wort
And don’t forget St. John’s wort, the most important natural antidepressant of them all. One double-blind study demonstrated that St. John’s wort also reduces anxiety (Fortschr Med 1995;113:404-8).
5-HTP
Another important antidepressant is 5-HTP. In one impressive study, 43 percent of people who had not responded to any antidepressant drug were completely cured by 5-HTP. An additional 8 percent improved significantly (Neuropsychobiol 1980;6:230-40). A review of studies determined that 5-HTP is as effective as tricyclic antidepressant drugs (Biol Psychiatry 1981;16:291-310). And 5-HTP has beaten an SSRI antidepressant: 60.7 percent responded to the 5-HTP versus 56.1 percent to the drug. 5-HTP brought about a greater response, and it did it faster and safer (Psychopathology 1991;24:53–81). In a double-blind study, 5-HTP was the equal of Prozac (Asian J Psychiatr 2013;6:29-34).
And a placebo-controlled study has shown that 200 mg of 5-HTP significantly reduces the reaction to a panic challenge in people with panic disorders. There was improvement in anxiety, panic symptom score and the number of panic attacks (Psychiatry Res 2002;113:237-43).
Rhodiola
Rhodiola has the ability to calm you down and energize you at the same time. Rhodiola calms stress, improves well-being and decreases mental and physical fatigue. When 80 people with mild anxiety were given either 200 mg of Rhodiola rosea twice a day or nothing for two weeks, compared to the control group, the rhodiola group experienced significant reductions in anxiety, stress, anger, depression and confusion. They also had significant improvement in overall mood (Phytother Res 2015;doi:10.1002.ptr.5486). So, rhodiola helps both anxiety and depression.
Probiotics
A strange addition to the list is probiotics—not usually thought of as a psychological supplement. In the first ever study of probiotics and psychological conditions, people with depression had significantly better improvement in mood on a probiotic than on a placebo (Eur J Clin Nutr 2007;61:355-61). A second study found that a month of probiotics significantly improved depression and anger (Gut Microbes 2011;2:256-61). The same study also found significant improvement in anxiety. An earlier study had already hinted at an antianxiety effect for probiotics. A placebo-controlled study of people with chronic fatigue syndrome found that probiotics significantly reduced their anxiety scores (Gut Pathology 2009;1:6-10). So, add probiotics to the list too. VR
