St. John’s Wort: Depression Treatment Options

By: Mary Elizabeth Dean

Updated May 19, 2020

Medically Reviewed By: Aaron Horn

Natural remedies and alternative medicine are a tricky subject to address. Many of these substances have not been researched adequately, and they are not recognized as a form of prescription medication by the Food and Drug Administration. On the other hand, many people are suspicious about "modern medicine," as we call it. This is because pharmaceutical giants have a less-than-optimal reputation for being more interested in your money than your well-being.

If you are a member of the latter school of thought and you suffer from depression, you might be considering some of these alternatives. One of the most popular supplements people turn to is St. John's Wort. You can easily find it in the supplement aisle of your nearest grocer.


For those who are not familiar, St. John's Wort is a wild plant (read: weed) that grows in parts of Europe and Asia. The plant is cultivated, the flowers are dried, and they are packaged into capsules or processed into oils and sold. The active ingredients are said to relieve symptoms of depression. Today, we are going to weigh the pros and cons of using St. John's Wort.

Before you use this information to aid in your decision to consider using St. John's Wort, it is always a good idea to consult with your doctor and mental health specialist as it relates to your depression treatment plan, as they know your personal medical history best and can advise you properly.

St. John's Wort: The Good

A few clinical trials have demonstrated that St. John's Wort can effectively reduce the symptoms of mild depression. The effects of the supplement were observed to be greater than that of a placebo, but not by a wide margin.

Modern anti-depressant medication has been known to bring with it a few side-effects, one of which is a reduction in your sex drive. It has been suggested that you will not experience this problem when using St. John's Wort to treat symptoms of depression. This has different implications for different people. If you are concerned about a lower libido, you might appreciate using this instead of prescription medications. Lowered sex drive, or a complete lack thereof, can have a negative effect on the health of a relationship or marriage, as well.

People who take St. John's Wort for depression seem to be more willing to commit to the treatment, as well. At least one trial has demonstrated that fewer people stopped their treatment midway when using this substance than when using anti-depressant medication. This could be due to a host of reasons, including third variables such as insurance hurdles or other financial stressors. Some people attribute it to fewer negative side effects. Since treatment efficacy depends on the patient's adherence to the treatment, St. John's Wort can certainly be more effective.

St. John's Wort: The (Potentially) Bad

In healthy amounts, it is usually a good thing to be skeptical. There is still a lot of mystery surrounding this method of treatment to manage depression, and it is good to keep that fact in the front of your mind.

While some clinical trials have been conducted on St. John's Wort, there have not been nearly enough of them for the medical community to reach a solid consensus. As mentioned before, the Food and Drug Administration does not consider this a form of medication, and as such, they have not allocated as many resources into researching it that they have with clinical anti-depressants.

In the trials that have been conducted, the results have not always been definitively clear. Some tests report a level of effectiveness higher than that of anti-depressants; other studies indicate a lower level of efficacy than anti-depressants. Yet other observations of St. John's Wort demonstrate that the effects are comparable to those of a placebo if there is any difference at all. The mixed results of these various studies suggest that the theory on which this treatment is based is not as sturdy as we might like it to be.

The purported lack of side effects can seem like a positive, but it might not be that simple. Our bodies exist in a constant struggle to maintain homeostasis or balance. The reason medications have side effects is because the substances you ingest shift your body's resources from one place to another in favor of "fixing" what is "broken." It is possible that St. John's Wort helps depression by supplying your body with something it is lacking. Should that not be the case, however, a lack of side effects might suggest that the substance is nothing more than a placebo. If no substantial change occurs in your body as a result of the supplement, is there any reason to assume that it is having an effect?

Furthermore, the lack of clinical trials means we cannot be completely certain of how it reacts with other medications. If you take it while you are receiving treatment for other conditions, such as cancer, there is no telling how the different treatment programs will be affected. This adds an element of risk that may not be tolerable for everyone, depending on your aversion to risk.


St. John's Wort: The Ugly

Speaking of risk, there are some ways in which taking St. John's Wort can be extremely dangerous. Again, a lack of clinical trials makes these conclusions hard to support empirically, but it cannot hurt to stay on the safe side. These are a few things that one must consider before undergoing this form of treatment.

If for some reason you are taking the supplement along with anti-depressants, the consequences can be catastrophic. The combination of the substances in your body can cause your brain's serotonin levels to rise to potentially fatal levels. That being said, if you are going to treat your depression, you are much better off choosing one option or the other rather than both. Doing them simultaneously will not increase your recovery time or amplify any positive effects that you might experience.

While the side effects are reported to be fewer than those of anti-depressants, this is not the case for everyone. Some people report bouts of insomnia, nausea, and skin irritation. Everyone's body chemistry is different. Thus there is variance in the ways people react to treatment. This is, of course, also true of anti-depressant medications. If you are choosing this alternative option as a means of sidestepping the side-effects of anti-depressants, it is important to remember that you are not automatically in the clear.

Some people who have taken the supplement have reported experiencing withdrawal symptoms once they stop. These can range from mild nausea to debilitating anxiety. As with any other form of pharmaceutical treatment, it is advisable to wean off the supplement gradually rather than quit cold turkey.

The most important thing to note is that this has never been asserted as a method for treating severe depression. In any of the clinical trials conducted, the effects have only been shown to assist those with mild symptoms. If your condition is life-threatening, it is imperative that you consult a mental health professional rather than trying to take the matter into your own hands. The difference can truly be life and death.

What Should I Do?

Given the circumstances outlined above, proceed with caution when considering the use of St. John's Wort to treat depression. Consult your doctor, medical professional, or mental health professional first if you are seriously considering this as a potential treatment option for yourself. If you are experiencing mild symptoms that St. John's Wort allegedly treats, there are a number of easy steps you can take. Being social, doing enjoyable and healthy activities, and being physically active are just three of many methods empirically proven to manage depression. Not only can you be sure of their effectiveness, but they could also end up costing you less than the supplements would.


If you are experiencing major depressive symptoms and came across this article looking for answers, strongly consider working with a mental health professional. Severe depression is not something to be taken lightly - a licensed, professional therapist is trained to help you manage your symptoms and work on finding coping skills and tools that work for you.

Therapy can help you more than a questionably-researched alternative treatment supplement ever could. The practices employed by psychologists and other licensed mental health professionals have been thoroughly researched.

Whatever you do, do not underestimate your own strength and ability to survive. Depression is a disease of illusion - it tricks us into thinking there is no way out, and that we should just give up. If you stick it out and do what you need to do by getting help for yourself when you need it, one day you will see the light of life again as you saw it before.

If you are looking for someone to help you manage your depression, or if you are struggling with any mental health or emotional issues, consider matching with a licensed therapist in your area by visiting

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