St. John's Wort -- A Hero's Journey  (June 24, 2016)

As you may already know, St. John’s Wort is an herb of European origin. It has many centuries of use substantiating its safety and effectiveness for mood disorders and a broad spectrum of other problems. There is more evidence for its ability to relieve the symptoms of depression than there is for any other natural substance. Even better, it has at least as much – probably more -- evidence validating its ability to relieve those symptoms than do Prozac, Zoloft, Celexa and Paxil. Hah!

Plus St. John’s Wort has far fewer side effects than those prescription medications do. As an added bonus, it has pronounced anti-inflammatory and anti-viral actions, which probably account for its very wide use in traditional European folk medicine. So -- where’s the love? Why don’t we hear about it anymore?

Now, I don’t have any trouble understanding why your basic medical types would dislike St. John’s Wort. It interacts enthusiastically with many medications and throws pharmaceutical monkey wrenches into the metabolism of anyone who’s taking other stuff besides it. Plus, like all herbal medicines, it doesn’t have just one active ingredient -- it has several, some of which are still unknown, which work together in some mysterious fashion to produce the end result.

Medical science in general hates that kind of thing. They prefer the illusion of control that they have using a single purified substance (which is what your basic prescription medication consists of). I say “illusion of control” because any profession that lays claim to be a healing one, yet is the third leading cause of death in the U.S., clearly has some basic delusions it needs to deal with.

But when the general public is choosing a treatment on its own, professional bigotry doesn’t come into it. You’d think if somebody tries something and it works, they’d just keep using it. So if it does what it's supposed to, but people aren’t using it so much anymore, what’s going on?

Here’s my theory. St. John’s Wort is no longer a go-to treatment precisely because it was, say 20 years or so ago, very much The Thing. Anything that goes through a period of fame and wild popularity eventually winds up being associated in people’s minds with things like bacon ice cream and polyester leisure suits, and will eventually be treated with the same disrespect. The sheer fact of having at one time been trendy puts this wonderful medicine into the category of Pet Rocks or beehive hairdos and thus, in the mind of the average person, unworthy of serious use or attention. People think of it as an outdated, passing fad that only an ignorant old hippie would still believe in.
 
The basic psychology of this is very interesting. Because it points up how unthinking the choices are that people make about even very serious matters like their health. I would go so far as to say the more serious the matter a person is dealing with, the more likely it is that they will be both emotional and irrational, about it.

And I’m not talking just about treating a medicine like it was a hair color. The latest and greatest health fad that bursts into view in the popular media is very often sold to us with an accompanying story that bears every resemblance to the “Hero’s Journey” discussed by Professor Joseph Campbell and popularized in stories like Star Wars, and is meant to appeal to us on an emotional, and not a rational, basis.
 
If you are interested in the details of this, here is a link to a brief discussion of the Hero’s Journey:

http://www.thewritersjourney.com/hero's_journey.htm#Hero

and here is one to a satire I wrote on a typical diet book, cruelly mocking it and its writer:

http://www.drdianeholmes.com/write-your-own-diet-book.html

You can see how similar the trajectory of the two stories are -- ordinary person/ordinary life, challenge, appearance of a mentor, the battle, the reward, and so on and so forth. You too can triumph over your problem with this brand-new magic sword!
 
Of course. many now-forgotten health trends never merited the respect they were given and, unlike Yoda, deserve to end up in obscurity in the swamps of Dagobah. But not St. John’s Wort. It’s too valuable a substance to be allowed to fall prey to the nutty ins-and-outs of human psychology.

That is because mild to moderate depression, for a longer or shorter period of time, is a very common thing. In Chinese medicine, depression is pretty much considered to be a normal aspect of the mental state of anyone worthy of being termed an “adult”. The emotion is considered to be derived from frustration and the blocked flow of energy an individual is employing in trying to bring about even his/her simplest wishes and desires. This should be a concept familiar to anyone who has ever dated, had a child or a bad hair day, or tried to park downtown without having to take out a second mortgage to do so.
 
We pick things up, play with them for a while, and then as the media hype fades, we drop them. And in the case of the use of St. John’s Wort for mild and moderate (and some say even severe, although there’s less evidence for that) depression, this is a crying shame. Bouts of depression are an inevitable part of life for anyone with a functional I.Q. and are nothing to be ashamed of.

Should you find oneself a bit blue for a few weeks because, say, the creek you used to play in as a child has been dammed up into a well-manicured duck pond in the middle of a subdivision that you can't afford to live in -- nay, probably would be afraid to even walk through because someone would call security -- it would be nice if you could pick up a relatively inexpensive bottle of Something to help deal with it until you are ready to face the World again, would it not?

So. There are health trends and fads, and then there are genuine discoveries and innovations. Sometimes it can be hard to tell at the time which category something falls into. But there is no longer any doubt at this point that St. John’s Wort is a very real and useful tool and that to treat it like a Chia Pet is a bad idea. Let’s not forget about it ever again.

--dr. diane holmes
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