A friend of mine has told me alternative therapies such as massage or acupuncture will help me. I’m not sure if I should try them.

Answer

Massage and acupuncture can help to release and balance bodily tensions. As with all other therapies, we need to learn to control and^fnanage the anxiety and attacks ourselves. While we are learning the management skills, massage and acupuncture can be useful in reducing anxiety and tension. In the long term they can help keep our bodies relaxed.

Question

lam not happy about taking prescribed medications and I am wondering if herbal medications and vitamin therapy would help me instead.

Answer

Herbal and vitamin preparations are used regularly by many people. They can be bought over the counter or prescribed by a herbalist or naturopath. They can be helpful in easing the condition, but again they do not teach us the necessary skills for the long-term management of the disorder.

There is, however, one note of caution regarding these and other medications. Some people have reactions to them which are put down to anxiety; yet when the medication is discontinued the reactions disappear. If we are using these preparations, we must be aware of how we feel after taking them. We should not assume any new sensation or symptom is part of the disorder. It may be a reaction to the medication.

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When depressed, people with SAD tend to oversleep. Often they just feel like curling up in bed and being left alone. They empathize with hibernating bears who are free to laze away the winter without the responsibilities that beset us humans all year round. Such responsibilities often overwhelm the person with winter depression, who can barely rouse herself and get going, let alone tackle the chores, work and personal commitments that are part of ordinary living. Overwhelmed by these demands, the person with SAD feels like a failure and anxiety and depression are always close at hand. One source of comfort is often food, especially sweets and starches, which are consumed in great amounts, resulting in unwelcome weight gain.

Seasonal affective disorder is extremely common and has been estimated to affect about 5 per cent of adults. Another 15 per cent are estimated to suffer from a milder form of the condition, subsyndromal SAD or the winter blues. Although most people with the milder version of SAD do not seek out medical attention, the dark short winter days nevertheless interfere with their productivity and creativity and make life feel dreary and dull. It is estimated that approximately one in five people suffers from emotional or behavioural disturbances as a result of the winter.

Light deprivation for any reason will tend to depress these susceptible individuals. Two or three cloudy days in a row, a windowless office or the scarcity of light in their ground-floor flat are all quite likely to lead to a lack of energy and a slump in mood.

Once the connection is made between the amount of environmental light and the drops in mood, however, the condition feels immediately less burdensome. As Sarah put it, ‘understanding the problem is half the battle.’ The other half of the battle can be won with the help of light therapy, St John’s Wort and other antidepressant strategies.

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According to Dr Michael Liebowitz of Columbia University in New York, a pioneering researcher in the field of social phobia, there are several lines of evidence suggesting that brain pathways involving the neurotransmitter dopamine are disturbed in social phobia. To a somewhat lesser extent, pathways involving serotonin also seem to be involved in this condition. Studies indicate that anti-depressants may be of some value in the treatment of social phobia. As St John’s Wort has been shown to influence both dopamine and serotonin pathways, there is reason to consider that the herbal remedy might be of some benefit in social phobia. As several of the stories in this book have indicated, after starting the herbal remedy a number of people report becoming more outgoing and less shy, and more willing to take the initiative in a social or work situation.

Currently social phobia is a greatly undertreated problem, in part because it is not recognized by clinicians but perhaps also because the very symptoms of the condition – fear of being judged and humiliated – may prevent people from bringing their problem to the attention of a professional. For these people, an herbal remedy that can be purchased over the counter may be enormously appealing. Although formal studies of this use of the herb are needed, early evidence suggests that if you are painfully shy or afraid of making a social overture or asserting yourself, St John’s Wort may really be worth a try.

As we can see, there are many possible roles for St John’s Wort in everyday life – for stress, low energy, down feelings, insomnia, premenstrual symptoms and painful shyness. Small wonder that the ancients thought this herb capable of miracles, and attributed magical powers to it.

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