Herbal Medicine for Your Mental Well-Being
Nowadays, people suffer from various psychiatric disorders, especially depression and anxiety. As one of the most common forms of mental illness, depressive disorder profoundly impacts individuals and society. According to the World Health Organization (WHO), approximately 300 million people are living with depression and more than 260 million people with anxiety in 2017. In many cases, both conditions can be diagnosed at the same time. These numbers continue to increase, especially during the COVID-19 pandemic, due to the increased sensationalized news and misinformation and the fear of getting infected or family members. These psychiatric disorders not only affect the individual's work and daily life but also decrease their quality of life and perceived well-being. Therefore, seeking more effective treatment should be an essential consideration.
The Common Treatments for Depression and Anxiety Disorders
The methods commonly used to reduce anxiety and depression are pharmacotherapy and psychotherapy. Pharmacotherapy, also commonly referred to as pharmacological therapy or pharmaceutical therapy, refers to the treatment of disease through the application of medications (drugs). The drugs commonly used are conventional antidepressants such as selective serotonin reuptake inhibitors (SSRIs), serotonin and noradrenaline reuptake inhibitors (SNRIs), agomelatine, bupropion, mirtazapine and vortioxetine. However, this pharmacological therapy has many drawbacks. Most patients receiving pharmacotherapy often have high relapse rates or do not respond to conventional antidepressants. In addition, there are some side effects of conventional antidepressants, such as sexual dysfunction, metabolic syndrome, addiction, weight gain, etc.
Meanwhile, in psychotherapy, treatments that are often used are cognitive behavioral therapy (CBT), interpersonal therapy (IPT), and behavioral activation (BA). CBT focuses on identifying and changing the function, content, and structure of cognition associated with negative affect through the delivery of interventions. Furthermore, on IPT, the therapy focuses on encouraging the patient to solve interpersonal problems or be able to change his relationship with related issues. And lastly, behavioral activation can be defined as a brief psychotherapy approach that seeks to change how a person interacts with his environment. Although these three treatments can be effective treatments for depression, the use of these psychological treatments is still limited due to their high cost and the need for patient participation and motivation. Moreover, access to skilled providers is still inadequate, which makes these treatments less effective.
Herbal Medicine as an Alternative Solution
Many patients gradually turn to herbal remedies for multi-targeted antidepressants with low toxicity. Some meta-analyses on St. John's wort compared the effects of herbal medicines with selective serotonin reuptake inhibitors (SSRIs) or placebos and have found herbal medicines to be significantly better than placebo and to have similar efficacy to many conventional antidepressants. For example, Chamomile (Matricaria recutita) significantly can reduce anxiety symptoms and can be very well tolerated by the body without an increase in side effects at higher doses, compared to placebo; Echinacea or coneflower significantly can decrease anxiety over time (3 days); Gotu kola (Centella asiatica) significantly can reduce the amplitude of the startle response and reduced anxiety by 26%; and passionflower significantly can reduce anxiety symptoms in three clinical trials. Individual herbal medicines have also been investigated for their antidepressant effects.
Challenges in the Use of Herbal Medicines
In view that mental disorders such as depression and anxiety are often found together in a single patient, the healing mechanisms for those illnesses may be intertwined, whereby when several factors act on one target, activity in other areas may emerge. Of course, this can affect the treatment of other related mental disorders. Therefore, clinical trials are needed to determine safety in humans. Additionally, conclusive data showing the superiority of herbal medicines in reducing anxiety and depression in the ratio/risk over medicines are currently lacking. Due to the heterogeneity of previous trials, future studies should focus on using the standardized form of this product in large-scale trials with robust methodologies to determine its comparative effectiveness.
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