It's a wonderful concept. Feeling blue or worried, you run to the market and choose a natural remedy off the shelf. No stigmatizing visit to a psychiatrist. Nothing in your medical record to spook your life-insurance company. Hours or days later, you are more cheerful or calmer. Restoring your well-being with the least fuss and the least risk is an excellent guiding principle. If a supplement like SAMe or St. John's wort can lift your spirits without making you feel exposed or embarrassed, taking it may serve you well.
But be careful. Natural products are not always the best or safest treatments for depression and anxiety. Like all drugs, herbs and tonics have chemical actions. They come with their own uncomfortable and sometimes dangerous effects. And because dietary supplements are not regulated as drugs, their quality can vary from brand to brand and even from batch to batch. The U.S. Pharmacopeia has recently started a program to verify the strength and purity of supplements. As a result, finding a high-quality product will soon be as simple as finding one with a USP seal. Still, caution is in order. Here are some recommendations to keep in mind if you try a natural mood booster:
First, consider the risks. Keep your options open, but don't assume that alternative remedies are harmless. Besides causing side effects, they can interact badly with conventional medical therapies. For example, St. John's wort can change blood levels of prescription antidepressants and undercut the positive effects of some treatments for HIV or cancer. The herb also can complicate anesthesia during surgery.
Second, don't underestimate your problem. St. John's wort and SAMe are more appropriate for managing mild complaints than for treating major mood disorders. Severe depression and anxiety can sneak up on you, so don't take them lightly. The fear of being stigmatized may cause you to dismiss problems that deserve serious attention.
Third, talk openly with your doctor about the remedies you use. If the doctor scoffs or scolds, find another doctor--but if she respectfully voices concerns about your treatment and recommends traditional alternatives, please pay heed and make a reasoned decision. The best physicians embrace a self-guided approach to health and will help you weigh the merits of both conventional and complementary approaches.
Finally, don't ignore the reliable information available to you. For example, see the online resources from the National Center for Complementary and Alternative Medi-cine (nccam.nih.gov). Your doctor may even be able to help you sort through your options, making that office visit worthwhile.