Exploring Ashwagandha: Depression, Stress, And Mental Health

According to the American Psychiatric Association, depression affects one in 15 adults (about 6.7%) in a given year. Depression is more than feeling sad; it can affect a person’s work, personal relationships, family dynamics, and daily life in several ways. Trying to live with depression on your own without therapy or medication can be challenging. However, some people may worry about the potential side effects of prescription medications and be hesitant to take antidepressant medications. Instead, they may seek out holistic options and natural remedies, such as ashwagandha for depression. As a natural remedy for depression, ashwagandha may also provide stress relief and anxiety reduction for some individuals. However, research confirming its benefits is mixed and can vary by dose and study design. Below, we explore ashwagandha and its potential benefits, as well as other natural approaches to relieve depression symptoms, including lifestyle changes and psychotherapy.

Ashwagandha depression: Does it work for mental health conditions like depression and anxiety?

Ashwagandha has been touted as a possible treatment for depression, but individuals may wonder if it works well enough to replace antidepressant medications. While ashwagandha may not be as effective as antidepressants, it may be helpful as a supplement for some people. 

However, before taking a natural supplement for depression, ensure you research what scientific literature says about the efficacy of such remedies. In addition, discuss these supplements with your doctor to ensure they have no interactions with current medications or treatments. In some cases, supplements might not be recommended, and everyone is different. 

What is ashwagandha, and what can it do?

Ashwagandha, sometimes called Indian ginseng, Indian winter cherry, or poison gooseberry, is a perennial nightshade shrub with small bell-shaped flowers and orange-red fruit.  Ashwagandha is considered a type of adaptogen, which helps to regulate the body's response to stress. By modulating stress hormones, adaptogens may provide stress-relieving effects. 

Both ashwagandha and ashwagandha extract are potent and could have an off-putting smell for people who are sensitive to smells. Some may compare the smell to that of a horse. 

Ashwagandha as a treatment for stress, anxiety, and other ailments

The word ashwagandha comes from two words in Sanskrit that can mean “horse” and “smell,” respectively. In the past, some thought that the plant could give individuals the same strength and virility as a horse. For thousands of years, people have used the ashwagandha plant’s stem and berries to make medicines that may treat various aging-related diseases, as well as:

• Chronic stress
• Anxiety
• Arthritis
• Asthma

The medical herb is commonly used in Ayurvedic medical systems, an Eastern medicine system that originated in India. 

Ashwagandha as an adaptogen

In the United States, ashwagandha root extract is typically sold in health stores, mostly for the plant’s anti-anxiety benefits supported by preclinical and clinical studies. Ashwagandha is an adaptogen, which the Cleveland Clinic describes as “plants and mushrooms that help your body respond to stress, anxiety, fatigue, and overall well-being. Some findings also indicate that ashwagandha can improve mental clarity, memory, and focus. Additionally, it may benefit those with obsessive-compulsive disorder and depression.

How ashwagandha may affect stress, anxiety, and mood pathways

Chronic stress is known to be detrimental to mental health, placing individuals at an increased risk of developing stress-related disorders and mood disorders, such as anxiety and depression. As an adaptogen, ashwagandha can help in modulating stress hormones, which are related to stress-induced anxiety and stress-related mood symptoms. 

Stress systems and cortisol

Cortisol is considered a key hormone in the body’s stress response, and both high and dysregulated cortisol levels are associated with the development of mood disorders. In addition to mood instability, prolonged cortisol dysregulation can also affect memory, decision-making, and executive function. 

Inflammation, oxidative stress, and the immune system

Findings indicate that the central nervous system (CNS) and the immune system respond to stressors through multiple pathways, resulting in elevated pro-inflammatory cytokine levels. 

Oxidative stress, which results from an imbalance between the body's natural defense mechanisms and reactive oxygen species, can cause cellular damage or even cell death, contributing to the development of neurological disorders. Inflammation markers, such as the release of inflammatory cytokines, can also impact mood regulation, which can contribute to depression. For instance, findings suggest a significant link between chronic inflammatory conditions associated with immune dysfunction and major depressive disorder. 

Potential benefits and effects of ashwagandha

The following are possible health benefits of ashwagandha (Withania somnifera) supplementation. However, speak to your doctor before taking any supplement, as taking too much or taking it alongside other supplements, medications, substances, or vitamins may result in adverse effects.

Decreased cortisol levels 

Ashwagandha root extract may reduce cortisol levels, contributing to reducing stress levels and potentially supporting healthy thyroid hormone levels. Cortisol is a stress hormone, and too much cortisol can lead to anxiety. Because this supplement can reduce cortisol levels in some people, ashwagandha may be a useful natural option for reducing stress in chronically stressed adults experiencing mild anxiety levels.

Decreased insomnia

Research shows that taking ashwagandha may also promote restful sleep by improving sleep quality. The plant’s species name—somnifera—means “sleep-inducing” in Latin. One randomized, double-blind, placebo-controlled trial published in 2019 concluded that ashwagandha root extract improved insomnia in certain populations compared with a placebo group. However, before taking ashwagandha for improving sleep quality, speak with a healthcare provider to discuss any potential interactions with any other medications you’re taking.

Increased fertility is one of the effects of ashwagandha

Research suggests that ashwagandha may help improve semen quality in men experiencing infertility, potentially due to its hormonal and vitality effects. For three months, the study treated 180 men with Somnifera root powder and measured “sperm concentration, motility, lipid peroxide, and hormonal perturbation.” The authors concluded, “The results suggest that Withania somnifera may be used as an empirical therapy for clinical management and treatment of infertility.”

Anti-inflammatory properties of ashwagandha

Ashwagandha has shown potential anti-inflammatory properties due to its ability to reduce pro-inflammatory cytokines, which may help chronic inflammation. While these findings support the use of ashwagandha in alternative medicine, particularly for its anti-inflammatory effects and steroidal lactones, ongoing research, further studies, and trials are needed to confirm these effects.

Ashwagandha and depression: How stress and anxiety overlap with depression

Ashwagandha depression: Research on ashwagandha for depression and anxiety

Another systematic review published in the Journal of Alternative and Complementary Medicine suggests that taking ashwagandha may reduce stress and anxiety, which can sometimes coexist with depression. According to the American Journal of Psychiatry, “Anxiety and depressive disorders are among the most common psychiatric illnesses; they are highly comorbid with each other, and together they are considered to belong to the broader category of internalizing disorders.”

Can ashwagandha treat depression? 

While ashwagandha may help alleviate symptoms of depression, this adaptogen may not be enough to address major depression or clinical depression. However, an international task force created by the World Federation of Societies of Biological Psychiatry (WFSBP) and the Canadian Network for Mood and Anxiety Treatments presently recommends a daily dosage of 300 to 600 mg ashwagandha root extract for generalized anxiety disorder (GAD), which often co-exists with depression.

Study results can vary 

Among the studies on ashwagandha's stress-relieving effects, findings published in the Journal of Experimental Pharmacology suggest that ashwagandha can provide stress-relieving and anti-anxiety effects. However, significant differences were also noted in efficacy according to administration in a dose-dependent manner. Additional research on Ashwagandha is needed to confirm its contraindications, optimal dosing based on body weight, and duration of use. Research on the safety of chronic administration is also ongoing, taking into account population differences. 

What animal studies measure and why it matters

Researchers typically use animal models to examine how human diseases respond to certain interventions following stressful and traumatic events. The Chronic Unpredictable Mild Stress is one rodent model that is often used for evaluating depression. Some common behavioral tests used in studies include: 

• The forced swim test exposes animals to stress and tests for depression-like behavior while evaluating the efficacy of antidepressant compounds 
• The open field test for evaluating locomotor activity and the effects of pharmacological compounds
• Elevated plus maze test for assessing the causes of anxiety-like behavior and anti-anxiety activity of specific agents, such as ashwagandha. This test evaluates rodents' engagement with spaces of open and closed arms, which can indicate anxiety-like behaviors or anti-anxiety behaviors, respectively

One study evaluated the results of these tests on rodents exposed to unpredictable stressors for a prolonged period, noting that anxiety-like behavior tends to occur. The researchers then evaluated sustained-release single doses of ashwagandha for its anti-depressant and anti-anxiety effects at a dose of 100mg/kg. Their findings indicate that Ashwagandha may act as a mood stabilizer and could be potentially used to prevent stress-induced neurological disorders, among other benefits. 

Positive control comparisons in studies

Tests in animal models also include a positive control to validate experimental results. A positive control group produces a known or desired effect. In the study mentioned above, the researchers used escitalopram, a known selective serotonin reuptake inhibitor (SSRI) class of antidepressant.  

Ashwagandha and depression: Safety, side effects, and who should avoid ashwagandha

While ashwagandha root extract may reduce depression symptoms for some individuals, speak with a healthcare professional before taking any supplement, especially if you take other medications. For example, ashwagandha may not be recommended for those who are taking sedatives, thyroid medications, diabetes medication, or medication for high blood pressure.  Those who are pregnant, have a hyperthyroid, or have certain autoimmune conditions may need to avoid ashwagandha. 

In some cases, the strength or quality of natural remedies like ashwagandha extracts may vary across products, so exercise caution when trying these products. In addition, this supplement has not been approved by the FDA for treating any condition. Despite preliminary evidence that it may be helpful for stress reduction, anxiety, and depression, it is not an evidence-based treatment. Moreover, while ashwagandha may help a person experiencing mild symptoms of depression, it may not be enough to address clinical depression, such as major depressive disorder.  

The BetterHelp platform is not intended to provide any information regarding which drugs, medications, or medical treatments may be appropriate for you. The content provides generalized information that is not specific to one individual. You should not take any action without consulting a qualified medical professional.

Lifestyle management options for depression

While the medical community conducts additional research into how ashwagandha root extract affects depression, other approaches may also help manage symptoms and don’t require medication. Consider trying the following approaches to relieve depression:

• Exercise regularly: Exercise releases endorphins, which are one of the body’s “feel-good” chemicals. Taking walks, practicing yoga, or engaging in other forms of movement or workouts may also raise the dopamine level in the brain, subsequently lifting your mood. If you’re new to exercise, you may want to avoid strenuous exercises like running, which could wear you out quickly. Consider an exercise class, beginner’s yoga, or going for walks. 

• Partake in what you love: Depression can make you lose interest in previously pleasurable activities. To combat this symptom, consider making plans with someone to engage in one of your favorite activities. Doing so may help you combat low motivation. You might set a time to go out for dinner, go hiking together, see a movie, or choose another fun activity. With time, you may begin to enjoy your favorite activities again.
• Follow a routine: Depression symptoms may cause you to deviate from your well-structured daily plans. Setting a daily routine of tasks you would like to accomplish each day may help you manage depression symptoms more effectively.
• Talk to someone: Reaching out for help is sometimes mistakenly seen as a weakness, but it takes strength to seek support. Talking to someone like a loved one or a professional may help you alleviate symptoms of depression.

Support options for people with depressed mood or depressive disorder

Regardless of the potential benefits of ashwagandha, a person experiencing clinical depression may require more intensive, evidence-based treatments. Several FDA-approved treatments can be used to treat depression other than antidepressants, including:

• Talk therapy: One specific type of talk therapy, called cognitive-behavioral therapy, can be effective in relieving depression and may improve cognitive performance, as shown in a meta-analysis. CBT helps individuals identify and reframe unhelpful patterns of thinking and behaving that may be contributing to their symptoms. 

• Transcranial magnetic stimulation (TMS) therapy: TMS is a noninvasive therapy that uses magnetic pulses to treat depression symptoms. A crossover study examining the effects of TMS indicates it might be effective for those who do not respond well to antidepressants and standard treatment. 

• Electroconvulsive therapy (ECT): ECT is a procedure performed under anesthesia where a medical professional will administer an electric current through the brain to treat depression symptoms. ECT is typically considered when other treatments have not relieved depression symptoms. A randomized controlled trial supports its effectiveness in severe or treatment-resistant depression.

Getting support for mental health

If you’re experiencing symptoms of depression and ashwagandha or other remedies don’t provide enough relief, you may benefit from speaking to a licensed therapist. Seeking the support of a therapist may be an effective way to ease the symptoms of depression and develop a plan of action toward long-term wellness. They may also refer you to a psychiatrist or other physician who can prescribe medication and provide depression treatment planning.

A therapist can provide individualized techniques for stress management, teach coping skills, and provide evidence-based techniques for managing symptoms of depression. 

Online therapy can help people with depressive moods and other mental health conditions

If your symptoms of depression make it difficult to leave home to see a therapist, you might consider online therapy through a platform like BetterHelp, which has been proven to be effective by numerous peer-reviewed studies. With online therapy at BetterHelp, you can discuss your symptoms with a licensed therapist via audio, videoconferencing, or live chat if you feel more comfortable. You can also contact your therapist in between sessions through in-app messaging, and they’ll respond as soon as they can.

One systematic review published in the journal JMIR Mental Health found suggests that online therapy may be effective for both anxiety and depression. The researchers concluded that the “results suggest that digital interventions can support sustained and clinically meaningful improvements in depression and anxiety.”