I agree wholeheartedly with most of the sentiment expressed in tes' writeup above; however, there are two major issues in which we disagree: first, while psychotherapy may not have worked in tes' case, it is indeed an important component in the treatment of depression, especially moderate to severe depression. Second, I would argue that it is dangerous and irresponsible to suggest (as tes does) that people simply "give St. John's Wort a try" without first consulting a doctor.

While I mean no disrespect toward the author, it would seem that the crux of his writeup rests on an unfortunate premise, that is: "The goal of this node is to describe the concrete things about my life that I was able to change without the aid of anyone or anything else." (original emphasis)

It is a huge mistake on the part of the depressed person to "go it alone," as tes seems to suggest. Such was my sister's selected course of action for several years before she finally sought help. Only then was it discovered that her depression was a symptom of a larger condition (Borderline Personality Disorder), a condition that is rarely successfully treated without prescription medication and, yes, psychotherapy.

I realize that tes is simply relating his own experiences on the subject—furthermore, I realize that the majority of his "methods of living and dealing with depression" are undoubtedly quite helpful to those who have already been diagnosed with mild depression...but therein lies the rub: it is very important that individuals suffering from depression actually receive a diagnosis before they try to follow anybody's self-help recommendations.

Also, despite our pill-popping culture, it is important to realize that taking St. John's Wort, an over-the-counter food supplement (unregulated by the FDA), is not an appropriate response to chronic depression. As I alluded to earlier, depression can be a symptom of other, far worse conditions, making it very important that individuals suffering from depression meet with a doctor and receive a diagnosis before trying to self-medicate themselves with "herbal remedies."

But besides the whole "you might be suffering from something other than mild depression" problem, there are other reasons why you shouldn't take St. John's Wort without first consulting a doctor. Many of these issues are covered in the St. John's Wort node, so I won't go into all of them here, but suffice it to say that this "natural substance" is a quite powerful drug, one that has been shown to cause terrible (even life-threatening) complications when combined with other medications, including certain antibiotics, oral contraceptives, protease inhibitors (used in the treatment of HIV), the heart drug digoxin, the blood thinner warfarin, and others.

Furthermore, a 2001 placebo-controlled study published in JAMA found that St. John's Wort was ineffective in treating individuals with severe depression. Consider that in light of other (FDA-approved) drugs—such as Prozac, Paxil, Zoloft (and other SSRIs), Wellbutrin, and Effexor—all of which have been clinically shown to be quite capable of treating mild, moderate, and severe depression. The moral of the story? Get a doctor's opinion first. If a doctor suggests you take St. John's Wort (which s/he probably won't), only then should you feel free to "give it a try."

Again, the main point of this writeup is simply to urge any individuals suffering from depression to seek a medical diagnosis from an actual medical doctor. Depression is a dangerous disease that should not be taken lightly and should not be self-diagnosed. If your doctor finds that you suffer from mild to moderate depression, then most of the suggestions in tes' writeup above are fantastic. But please, get a diagnosis...don't try to go at it alone.

Source: Information above regarding St. John's Wort, it's (questionable) effectiveness, and it's (questionable) safety, comes from the Berkeley Wellness Letter, specifically "Another Look at St. John's Wort and Depression" from the August 2001 issue.