Anxiety, stress and depression are epidemic in contemporary life, as evidenced by the more than 200 million prescriptions written in the U.S. for antidepressants each year. To be sure, clinical depression is a serious illness, and requires a doctor's care. But many instances of anxiety and stress, as well as mild to moderate depression, can be successfully addressed with a combination of lifestyle adjustments, nutritional support and herbal remedies.

Lifestyle solutions

"Even before going the route of natural products in the form of dietary supplements or teas, you should ask yourself some questions," says Mark Blumenthal, executive director of the American Botanical Council, based in Austin, Texas. "Do you exercise? Do you practice centering techniques like yoga and meditation to relax the mind and therefore the body? Do these simple things before changing your biochemistry."

Retailers can offer customers support for this kind of lifestyle-based, mind-body approach to wellness in a variety of ways, including partnering with a natural healing center, or with local naturopaths, herbalists, massage therapists, yoga instructors and others who can offer classes and information co-sponsored by your store

. Herbal options

Christopher Hobbs, a Berkeley, Calif.-based herbalist and author of 25 books, helps many people get off prescription antidepressants and anti-anxiety drugs through alternative medicine. "[Antidepressants] have a lot of side effects, including memory loss and addiction, and frankly they aren't any more effective than herbal and natural treatments," he says. "For anxiety, there are a lot more specific herbal treatments than for depression."

Hobbs' first choice for stress is California poppy, which is non-habit-forming and has a mild sedative effect. Another recommendation is kava, which has strong clinical backing. "It's been targeted, probably unfairly, for causing liver stress in some people, but it's a powerful muscle relaxant," Hobbs says. He suggests using kava in tincture form, standardized to perhaps 20 percent kavalactones rather than a higher concentration, and taking it for a few weeks at a time.

For mild stress, Hobbs suggests certain types of herbal tea. "For the vast majority of people, three of the most effective herbs in tea form are chamomile, lemon balm and orange peel," he says. "Catnip is also a good choice, and all of these are safe for children."

Finding the right herb and dosage for an individual can be a matter of trial and error. "It's not possible to predict which herbs will be effective for any given person," says Dr. Ray Sahelian, Los Angeles-based author of Mind Boosters (St. Martin's Griffin, 2000). "For anxiety, I would choose passion flower, valerian and kava, which should only be used two or three times a week."

For mild to moderate depression, St. John's wort remains the herb with the most clinical backing. "It takes about six weeks to kick in, but it can be very effective," Hobbs says. "You should choose an extract standardized to 0.3 percent hypericin [St. John's wort's active ingredient], and it should be a dark purple-red; if it's pink, reject it."

The drawback of St. John's wort is that it interferes with a number of drugs that are metabolized through enzymatic pathways in the stomach and liver, including heart drugs, retroviral treatments for HIV and oral contraceptives. However, new research supports other up-and-coming herbals for depression.

"There are several recent studies from Iran on the use of saffron for depression, and the initial research is promising," Blumenthal says. "There's also a recent study on Rhodiola rosea for mild to moderate depression. "It's the first randomized, controlled study on rhodiola for depression, and it shows that rhodiola is able to lower the depression scores on two of the most commonly used depression scales."

As an adaptogen, rhodiola also has a normalizing effect on a variety of body systems. "Adaptogens are defined as natural substances with a high degree of safety in relatively large amounts, which can help the body normalize based on different types of stressors, whether it's heat, cold, fatigue, anxiety, etc.," Blumenthal says. "If you have high blood pressure, an adaptogen helps lower it; if it's low, an adaptogen helps raise it."

Adaptogens are thought to help the body respond to environmental stress in a healthier way, and are often recommended as general tonics. "Adaptogens are for long-term, as opposed to acute, conditions," Hobbs says. "Tonics such as reishi [mushrooms] and American ginseng are great for long-term use as general tonics, and help to balance the adrenals and hormone levels. Rhodiola is also considered an adaptogen, and helps normalize the nervous system, which is always good if the underlying thread is stress."

Supplement support

Certain basic nutrients can play a role in stress reduction. Magnesium, for example, is a key nutrient for relaxation, and must come from dietary sources. "As much as 90 percent of the population is magnesium deficient," says Ken Whitman, vice president of marketing for Whiteman-Hall, a Los Angeles-based manufacturer of Calm, an effervescent magnesium supplement. "Calcium allows the body to tense the muscles, and magnesium helps those muscles relax after a stressful event. But if the body is magnesium-depleted, it can't flow back into cells and push the calcium out, so you end up in a state of chronic stress." Whitman says hyperemotionality, apathy, apprehension, poor memory, headaches and insomnia can all be indicators of magnesium depletion.

There is also a number of nonherbal supplements that Sahelian recommends. "5-HTP is more of a balancer or relaxer, for people who have restless depression," he says, "while SAMe is more for people with low energy and depression. Both these remedies can start to work in a day or two."

SAMe, or S-adenosylmethionine, acts as a methyl donor, and is thought to improve mood by enhancing the effect of natural mood-boosters in the brain, like dopamine and serotonin. 5-HTP is essentially a type of tryptophan, which was banned by the U.S. Food and Drug Administration prior to the passage of the Dietary Health and Education Act after a tainted batch of Japanese tryptophan caused a number of cases of neurological damage. "Tryptophan is found naturally in turkey and milk, and is still allowed in infant formula," Blumenthal says. "The 5-HTP found on shelves is derived from an African herb called Griffonia simplicifolia."

Gamma aminobutyric acid, or GABA, is another mood-boosting supplement. Depletion of this an amino acid, which is produced by the brain, may result in anxiety and insomnia. However, Sahelian says GABA "doesn't easily cross the blood-brain barrier, so high doses are needed to have an effect."

By providing information on a variety of approaches to anxiety, stress and depression, including lifestyle changes, herbs and supplements for acute conditions, and tonic herbs for general wellness, retailers can help their customers ward off these conditions. "I believe that if more people were aware of these natural options" for stress, anxiety and depression, Sahelian says, "pharmaceutical drug use would plummet."

Mitchell Clute is a Fort Collins, Colo.-based freelance writer.

Natural Foods Merchandiser volume XXIX/number 2/p. 30,33