Use of Complementary and Alternative Medicine among Women with Depression

By Gayle Walter, MPH
Adjunct Professor, Kaplan University School of Health Sciences

Depression is one of the most prevalent mental disorders in the general population, and one of the most undertreated.1 Survey results from the National Comorbidity Survey Replication distributed between 2001–2003 reported that only 37.5 percent of people with major depression received conventional treatment for their disorder.2 More recent statistics from 2005–2006 also demonstrate that despite the availability of treatment, only 29 percent of all individuals with depression reported contacting a medical professional in the past year.3 Many individuals do not pursue conventional medical therapies because they may have suffered negative side effects from the medications, the medications conflict with their values and beliefs, or the conventional therapies seemed ineffective.4 With the increased growth in the use of complementary medicine, a number of community studies have been conducted concerning the use of complementary and alternative remedies. 
    
A study by Wu et al. (2007) investigated the patterns of and reasons for the use of complementary and alternative therapies among women with depression, focusing on popular types of alternative therapies, including manual therapies (which include massage and acupressure, herbs, and vitamins).  The authors sampled a group of 220 women with depression, screened from a nationally representative telephone survey of 3,068.  Of the 220 women who participated, 54 percent reported using complementary and alternative medicine within that past year, thus proving that alternative forms of treatment are being used.  Mental health professionals and other health professionals should increase their own awareness of the types and benefits of complementary and alternative therapies that their patients may be using and improve communications with their patients about the benefits and potential risks of those therapies.

 

Several herbal supplements are available to improve psychological and cognitive function in people with mental health disorders.5 Herbal supplements are more conventional in European countries because herbs are classified with other pharmaceutical products and routinely prescribed by physicians.  Herbs are preferred because they are less likely to cause side effects; if side effects do occur, they are usually in a much milder form.6  (A combination of herbs is sometimes more effective and preferred method for treatment of depression.7)  The two most common herbs for depression and anxiety are Kava kava and St. John’s wort.  Kava kava has recently been voluntarily removed from the market in certain countries because of allegations of liver toxicity that have subsequently been rejected.  Though many countries still uphold the ban on Kava kava, the United States no longer bans its use and sale.8 The recommended dosage for treating anxiety and depression is 60 to 70 mg three times daily. For insomnia, the recommended dosage is 180 to 210 mg taken 45–60 minutes before retiring.9  St. John’s wort is a well-researched herbal product primarily used for mild to moderate depression.  The usual dosage is 300 mg (in capsules) three times daily.  Perhaps the greatest advantage of St. John’s wort is patient compliance due to reduced side effects. 

 

Finally, as an increasing number of women choose alternative forms of therapies to help treat anxiety and depression, it is important for health care providers to be educated on the various types of herbal supplements that are becoming more common in today’s society.  This is key in assisting patients with making the appropriate decisions on their treatment regimens, whether it is due to reduced addiction potential, cost, or side effects.


References

1. Ping Wu et al., “Use of Complementary and Alternative Medicine among Women with Depression:  Results of a National Survey,” Psychiatric Services 58 (2007): 349–356.
2. Philip S. Wang et al., “Twelve-Month Use of Mental Health Services in the United States: Results from the National Comorbidity Survey Replication” Archives of General Psychiatry, 62 (2005): 629–640.
3. National Center for Health Statistics, “Depression in the United States Household Population, 2005-2006,” NCHS Data Brief, No. 7 (September 2008).
4. Wu et al.
5. Linda C. Tapsel et al., “Health Benefits of Herbs and Spices: The Past, the Present, the Future,”  Medical Journal of Australia, 185, (2006): S1–S24.
6. Mark S. Micozzi,  Fundamentals of Complementary and Integrative Medicine, 3rd ed. (St. Louis:  Saunders Elsevier, 2006).
7. Holistic Online (2007), Herbal Medicine in Depression, www.holisticonline.com/remedies/depression/dep_herbs_1.htm (accessed April 13, 2009).
8. Kava Banned Countries, www.konakavafarm.com/kava-banned-countries.html (accessed April 13, 2009).
9. Mark S. Micozzi,  Fundamentals of Complementary and Integrative Medicine, 3rd ed. (St. Louis:  Saunders Elsevier, 2006).


Gayle Walter, MPH

Gayle Walter is an adjunct professor at Kaplan University and teaches courses such as Contemporary Diet and Nutrition and Research Methods for Health Sciences.  She also works for the University of Dubuque in the Department of Natural and Applied Sciences and Physical Education. Ms. Walter received her Master of Public Health from Walden University in 2007 and is currently enrolled in the doctoral program in public health with an emphasis on community health promotion and education. She currently resides in Dubuque, Iowa, with her family.

Kaplan Higher Education Corporation is a division of Kaplan, Inc., a subsidiary of The Washington Post Company.

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