To try St John's Wort rather than going to GP?

[MonaLiPeach]

I'm a healthcare professional so am paranoid about going to GP with anything mental health related.

After the week from hell however, I feel totally flat. Melancholy and like I just can't be arsed with anything anymore.

I've read St. John's wort has excellent reviews and I've ordered a pack to be delivered today. AIBU to expect hippy tablets to actually work? Are they a placebo?

You’re probably aware but check any interactions with any other medication you may be taking

I'm not taking anything else. Was considering taking sleeping tablets on top but apparently this is a no no

I think they’re meant to work a bit. Is it the oral contraceptive pill they interact with? Can’t quite remember.

I’d also try excercise.

I’ve been on the cusp of going to the gp for depression and managed to kind of sort it myself in that way. Clearly just minor depression, but the idea of gp was enough to make me take some action.

I do have a gym membership but can't find the motivation to go. When I do go however, I feel a definately lift in mood.

The adaptogen Ashwagandha is also quite effective, and worth a shot. Solgar and a young brand called True Veda (I like supporting small start-ups like them) are available on Amazon and both have great reviews.

St John’s Wort made me feel a bit odd when I took it. Exercise definitely helps.

I have heard good things about SJW. Why not?

I take ashgawanda - more for fatigue - and I really like it

Also try a good probiotic and cut down sugar

St John's wort works for me, I've taken it about three times in my life when I've had low mood (not really proper depression) and just felt very flat, and each time I have noticed an improvement, although I'm not 100% sure that was the tablets as my mood may well have lifted anyway. I've had good experiences with it, though, pretty recently.

It's not a 'hippy' medicine in that it's used in other countries such as Germany within their healthcare systems to medicate low/moderate depression. It isn't a branded pharma product though.

In meta-analyses, standard anti-depressants come out crap anyway!

This is some evidence on its efficacy:

bjp.rcpsych.org/content/186/2/99

www.nhs.uk/news/2008/10October/Pages/StJohn'swortanddepression.aspx

I like it as I've never had any side-effects with it unlike with one other drug I tried.

I would also put together a package though of changes if you feel low- so eating regularly, drinking water/drinks regularly, doing one 30 min walk a day, perhaps some mindfulness or relaxation exercises off the web, book some nice things to do like go to the cinema or see a friend.

In other words treat yourself nicely and with compassion, as you obviously need a bit more care right now.

This is not offered as a solution for major depression, I hasten to add, just that low 'meh' mood which can be really common at this time of year. I find that just taking lots of actions makes me feel better about my life, even if I can't say which one improves the situation.

High Dose vitamin D worked for me - removed my residual melancholy and made me bright and happy in midwinter but I would ask your doctor - should be prescription only (20,000 units daily)

It is not a placebo, nor is it homeopathy ( water or sugar) it is a strong drug. Herbal drugs are still drugs. Surprised you don't know better.

Go to a doctor.

Made me worse, far worse!

I would go to a doctor - would you have to disclose treatment for depression to your employer? Are you worried about confidentiality?

It's not a licensed drug, but does contain pharmacologically active substances. Producers of supplements containing it have to have MHRA approval, unlike vitamins etc.
It can interact with contraceptives, anti-inflammatory epileptic drugs etc. so treat it as a "proper" medicine and not just a pick-me-up.

Ignore inflammatory, that was autocorrect, just anti-epileptic!

Before trying St johns, I think you should first explore the possibility that you might be deficient in something (Vit D, magnesium, iron, zinc, etc).

Modern diet/agriculture and lifestyles mean that most people are deficient in something or another these days.

St John's Wort made my husband so much worse. Not just depressed but extremely agitated and aggressive.
He wasn't on any other medications at the time. It was such a shock to see the transformation it caused within a day of starting it. Be careful.

AIBU to expect hippy tablets to actually work? Are they a placebo?

Placebos work.

I'm wondering why being a health care practitioner means you would meet want to go to the GP about depression. HCPs were part of the human race last time I looked and employers are not allowed to discriminate on the grounds of mental health difficulties or any other disability.

As Dara O Briain says:
'I'm sorry, 'herbal medicine', "Oh, herbal medicine's been around for thousands of years!" Indeed it has, and then we tested it all, and the stuff that worked became 'medicine'. And the rest of it is just a nice bowl of soup and some potpourri, so knock yourselves out.'
Actually SJW does have some pharmacological effect but it doesn't meet the UK threshold for something which is effective enough relative to the downsides - toxicity, side effects. Why would you want to take something like that when there are more effective things with lower toxicity and less side effects available? And which somebody with training and knowledge can support you in taking safely alongside other measures to improve your health.
When people say exercise they don't necessarily mean flog yourself at the gym. You're better off getting a brisk walk in the open air or doing something physical which immediately gives you pleasure, makes you feel good straightaway. The gym is for when you're feeling a bit better. If you can face it, the endorphins will do you a ton of good, but forgive yourself if you don't feel up to it right now. Hope you feel better soon

Are you an HCP in your own GP surgery? I can't think why you would be worried otherwise? Even if you work in your GP surgery surely it looks better to seek help and show you are aware that you have a problem and are trying to do something about it?

YABVU. You know you are. St Johns Wort tablets can vary in dose from batch to batch.
Your employer cannot legally discriminate against you because of a minor health problem such as taking anti depressants.

It is not true that other anti-depressants such as SSRIs are necessarily safer or with fewer side effects:

www.ncbi.nlm.nih.gov/pubmed/27468236

It is not conventionally prescribed by medics in the UK, and given that there isn't any compelling reason to do pharma trials costing millions on it, it's likely the evidence base will remain poor. I've made my own decision based on the evidence and my own experience with it.

But I wouldn't be discouraged from going to the GP, as it's good to know all the options and how they could help you.