The herbalists of ancient times knew about the powers of St. John's wort, and they used it for a wide variety of ailments. However, Western medicine discarded the ancient knowledge, dropping the study of herbs from medical school curricula. In its assumption that the old teachings were unscientific old wives' tales, the medical profession lost touch with these gifts of the natural world.

In this chapter, we'll first look at the history of this fascinating plant. I'll then discuss St. John's wort's antidepressive effects and its numerous other benefits.

An Ancient Medicine Rediscovered
St. John's wort presents a wonderful paradox. Known to healers for thousands of years, it has become an overnight sensation in the modern media. No doubt utilized by some of the earliest civilizations, the oldest records of its use come from Greek and Roman times, according to herbalist Christopher Hobbes. Dioscorides, the foremost Greek herbalist, recommended it for sciatica and malaria relief, and as a diuretic and female tonic. Pliny the Elder, the Roman naturalist, found it effective against snakebite when mixed with wine. (We're not sure whether the wine was to be mixed with the herb, or just drunk to take one's mind off the pain!)

The botanical name Hypericum comes from the Greek words yper, meaning upper, and eikon, or image. The Greeks and Romans believed that St. John's wort protected them from evil spirits and witches' spells, and often placed the herb in their homes and above statues of their gods. Perhaps the spirits and spells referred to depression and anxiety, mental disorders with no obvious physical cause.

The early Christians incorporated many ancient beliefs into their new religion. Preexisting spring rituals, for instance, were renamed as saints' feast days. In this tradition, Christian mystics named Hypericum after St. John the Baptist. It was traditionally collected on St. John's Day, June 24, and soaked in olive oil for days to produce a blood-red anointing oil, said to symbolize the blood of the saint.

By the thirteenth century, belief in the herb's mystical power was well established. People brought the flowers of the plant into their houses on Midsummer Eve, or St. John's Eve (June 23), to protect them from the powers of evil. In another common practice, they put the plants under their pillows on St. John's Eve. According to legend, the saint would appear in a dream, give his blessing, and protect the sleeper from dying during the following year. St. John's wort was also burned in bonfires on St. John's Eve to drive away evil spirits, purify the air, and protect crops.

According to the traditional doctrine of signatures, an herb's physical appearance gives an indication of its specific healing power. Red plants, reminiscent of blood, were felt to be good for wound healing. The red oil in St. John's wort was no exception. Crusaders not only carried the plant to protect themselves from sorcery, but also used the soaked flowers and leaves as an ointment to help heal the wounds of battle. Physicians in the sixteenth century found the herb to be very effective for treating deep wounds. The first London Pharmacopoeia, published in 1618, recommended that the flowers be placed in oil and allowed to stand for three weeks. The resulting tincture was used for wounds and bruises. Other traditional folk uses for St. John's Wort include the treatment of gout, rheumatism, and jaundice.

When the first European colonists arrived in North America, they found that the Native Americans were already familiar with the herb. The latter used it for diarrhea, fevers, snakebite, and wounds and other skin problems. It later served as a valuable medicine for treating soldiers' wounds during the Civil War. St. John's wort was also prescribed by the homeopaths of the period for a variety of ailments, as it is to this day. (For a list of the active ingredients in St. John's wort and their effects, see "The Many Active Ingredients in St. John's Wort" )

Unfortunately, toward the end of the nineteenth century, the medical establishment in the United States turned its back on traditional folk remedies. Teachings that had been passed down through the ages were dismissed as primitive superstition. Medical researchers considered most of the complex chemical constitution of a plant to be extraneous, and their objective was to isolate the plant's so-called "active ingredient." Now, of course, we realize these "extras" are often the ingredients that hold the secret to a plant's strength and healing power.

Medical authorities established what we now know as conventional medicine, focusing their attention on medical and surgical techniques, and manufactured drugs. They lobbied Congress and the state legislatures for the prohibition of herbal medicine, which had a chilling impact on the legitimate use of herbs to promote health. Current laws still restrict the use of specific healing claims on herbal medicine labels. Only recently has conventional medicine begun to explore once again the potential contributions that herbs can make to health.

St. John's Wort and Depression
Conventional medicine may be scratching its collective head about the value of St. John's wort, but that hasn't stopped ordinary people such as Kate from reaping its benefits, including its remarkable ability to fight depression.

Kate, a 48-year-old married author and public speaker, had a super-busy lifestyle, with frequent deadlines and an intense travel schedule, and it had caught up with her. "While on an impossible deadline, I had a total collapse. I was exhausted, stressed, and depressed. My doctor put me on Prozac, but it made me even more depressed, and then, I couldn't sleep. He gave me sleeping pills that zonked me, and that was it. I stopped the Prozac. Then I read about St. John's wort, and thought I'd try it, 250 milligrams twice daily. I figured it couldn't hurt! Three weeks later, my husband Mike suddenly noticed: 'You're different! You seem more relaxed, less tense. What's going on?'"

Kate hadn't told him she was taking St. John's wort, but her change in attitude was obvious. "One of the most dramatic things I began to notice is I felt happy and ebullient in the mornings, which I never was before. It was never like this on Prozac. I'm more energetic and focused, and there's more laughter!"

Her good news continued. "Our sex life has always been very sporadic and difficult. Four weeks after starting St. John's wort, we had a sexual experience that was distinctively different from any we have had in our twenty years together. I felt an openness, a sexuality, that was a pervasive feeling, coming from my very core. It was extraordinary for me, and Mike was just swept away. I don't think I'd ever felt that way, even when I was younger. And this openness has continued."

In a separate conversation with me, Mike was even more effusive than Kate. "I can't believe how she's changed. She's always been so tense, barely available, especially when she's stressed. Now, she's a delight. We are having the time of our lives!"

This all sounds too good to be true, you might say. Maybe it's an isolated incident, or simply the power of suggestion as a result of all the positive publicity surrounding St. John's wort. How representative is Kate? According to the research I have read, reports from other physicians and practitioners, and my own clinical experience-hers is not an isolated case.

In fact, one of my colleagues, a holistic physician, had been asked by a woman in his yoga class what he knew about St. John's wort. He gave her what information he had. Two months later, she came running up to him in class, exclaiming, "I must thank you. The St. John's wort changed my whole life, my outlook, everything. It's like a veil lifted from around my head. I've never felt so good. And I'm dreaming again, and remembering my dreams. I can hardly believe it!"

Contemporary Research Proves the Value of St. John's wort
In Germany, where herbal medicine is a standard part of the medical-school curriculum, 80 percent of German doctors prescribe herbs such as St. John's wort on a regular basis. Not surprisingly, a great deal of the research on this most valuable herb has been conducted in Germany.

Mild to moderate depressions respond well to treatment with St. John's wort. More than twenty studies involving thousands of patients confirm the herb's ability to reduce and often eliminate the symptoms associated with these conditions. Compared with both placebos-inert comparison substances-and various antidepressant drugs, St. John's wort has come out on top every time.

The herb's success rate as an effective antidepressant is between 60 to 80 percent, a rate equal to that of prescription drugs such as Prozac, with far fewer side effects. A drug monitoring study published in 1994 looked at the experiences of 3,250 patients who were treated with St. John's wort. It found that only 2.4 percent of these patients reported any side effects at all, a rather remarkable finding when you consider that Prozac produces side effects at least ten times more frequently, and that even the placebos produced side effects.

Scientists are not yet sure of exactly how St. John's wort works. For example, a preliminary National Institute of Mental Health (NIMH) in vitro, or test tube, study indicates that St. John's wort has a high affinity for GABA receptor sites in the brain (see Chapter 3 in St. John's Wort: Nature's Blues Buster). The amino acid GABA (gamma-amino-butyric acid), plays a role in mood regulation: GABA levels are low in people with depression, and GABA-enhancing agents show both antidepressant and antianxiety effects. Despite the herb's Valium-like effect on anxiety, there is a lack of sedation, which is an obvious advantage in treatment.

Let's see how St. John's wort can help several specific problems.