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Comment by intopieces | Hacker News Reader

Saint John's Wort in conjunction with therapy is one that comes to mind. All antidepressants should be combined with active, regular therapy. Often the cause of depression is not chemical imbalance, but an actual issue in the person's life.

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St John's wort can have serious drug interaction consequences, so talk to a pharmacist if you're already taking any other meds.

St John's wort is not sold as a medicine so the products you can buy are subject to much lower levels of quality control. St Johns Wort varies in quality across different brands.

Here's a big problem - in the US St Johns Wort isn't regulated like a drug, it is regulated as a supplement. Which in practice means when you buy a bottle of St Johns Wort it can contain almost anything and may or may not contain any actual St Johns Wort.

Plus St Johns Wort interacts with practically everything.

Sources: http://www.nytimes.com/2010/05/26/health/policy/26herbal.htm...

>16 of the 40 supplements tested contained pesticide residues that appeared to exceed legal limits, the investigators found. In some cases, the government has not set allowable levels of these pesticides because of a paucity of scientific research.

http://www.nytimes.com/2013/11/05/science/herbal-supplements...

>DNA tests show that many pills labeled as healing herbs are little more than powdered rice and weeds.

>Two bottles labeled as St. John’s wort, which studies have shown may treat mild depression, contained none of the medicinal herb. Instead, the pills in one bottle were made of nothing but rice, and another bottle contained only Alexandrian senna, an Egyptian yellow shrub that is a powerful laxative.

http://well.blogs.nytimes.com/2014/10/21/dangerous-dietary-s...

>out of more than two dozen supplements that were pulled from shelves after they were found to contain anabolic steroids or powerful prescription drugs, roughly two-thirds were back on the market a year later with the same illicit ingredients

> Often the cause of depression is not chemical imbalance, but an actual issue in the person's life.

Not trying to be contrary, but do you have a source?

I met a Swedish nurse who worked in a ward where they treated young people who'd had mental breakdowns. She said the most common cause was a tough life situation. In the short term they would prescribe drugs, but ultimately their treatment was focused on changing that persons life to remove the negativity which spurned the breakdown. Whether it be encouraging them to get a new job or move out of their current living/ relationship situation.

OTOH, plenty of people go through tough life situations without suffering mental breakdowns.

I think it's more complicated than a simple either-or proposition.

I would be more happy to accept the idea that depression was usually a result of a chemical imbalance in your brain if this was able to be reliably diagnosed by measuring the balance of chemicals in your brain, rather than the current method of divining the supposed chemical imbalance by filling in a short questionnaire.

Warning: Saint John's Wort can cause cataracts if used for a long time.

That is highly disputed - there is only one study suggesting a correlation (not causation).

The causation is simple - hypericin becomes toxic when activated by light. While that doesn't mean that it definitely causes cataracts, given available data I think it's more likely that it does.

http://www.ncbi.nlm.nih.gov/pubmed/16814590 http://www.ncbi.nlm.nih.gov/pubmed/19739671

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