Botanicals for Mental Wellbeing

Overview
Both anxiety and depression are extremely common across the world, with an estimated 264 million
people suffering from anxiety and 322 million suffering from depression, according to the World Health
Organization. Anxiety and depression, along with concerns about the cost, ineffectiveness, or side
effects of standard pharmaceuticals, are common reasons that people seek out herbal medication.
Anxiety and depression can cause significant symptoms and disruption in daily life, and may contribute
to insomnia, another common reason people seek out botanicals. These factors can disrupt a person’s
mental wellbeing, and we’ll identify some of the most common botanicals used for these conditions.
We’ll also look at the use of botanicals for dementia, which affects up to 50 million people worldwide,
with rates that are on the rise.

Kava (Piper methysticum)

The kava plant, native to the South Pacific, has a rich tradition of
use both therapeutically and for ceremonial purposes. In one
traditional kava ceremony, the root of the plant is cut into small
pieces which are chewed and then spit the pieces into a round
wooden bowl. The roots are then mixed with coconut milk and
the drink is shared. From a scientific standpoint, the chewing
helps release the active ingredients in the kava plant, which
could also be achieved by grinding or pounding the roots.

Today we know that the kava plant is rich in as kavalactones,

which act as a mild muscle relaxer and help ease anxiety. Kava is
thought to work in a similar way to benzodiazepine
pharmaceuticals, but with milder and less sedating effects.
It is safe for short-term use, but long-term use should be
avoided due to concerns it may harm the liver. Avoid using kava
in any person who has a known liver disease, drinks a lot of
alcohol, or takes any medications that affect the liver. If you
know that a patient is taking kava, it would be best to measure
their liver function tests every few weeks.

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Botanicals for Mental Wellbeing

Lemon balm (Melissa officinalis)

Lemon balm is a delightful and versatile herb. Historically, it’s
been referred to as the “gladdening herb” or “heart’s delight,”
due to relaxing properties that promote a sense of calm and
wellbeing. This gentle nervine relaxant can help reduce stress
and ease mild anxiety. Thanks to its carminative properties, it
can also ease mild stomach discomfort. A great way to consume
lemon balm is in a cup of tea in the evening to help unwind and
relax. Lemon balm has an excellent safety profile. This is a
wonderful herb to get to know and very easy to grow at home.

Passionflower (Passiflora incarnata)

Passionflower is a beautiful plant, known for its showy, colorful
flowers and edible fruit. It grows well in tropical climates. The
aerial parts of the flower are used as a nervine relaxant and it
also has anti-inflammatory properties. The German Commission
E has approved the use of passionflower for the treatment of
insomnia and nervousness.
Another frequent use of this botanical is in combination with
skullcap for narcotic withdrawal, although clinical evidence for
this is lacking. Passionflower has been studied1 in combination
with clonidine, a pharmaceutical used in the treatment of opiate
withdrawal. Opiate withdrawal has physical symptoms, such as
elevated blood pressure, nausea, vomiting, abdominal cramping,
and diarrhea, in addition to emotional symptoms of anxiety,
drug cravings, irritability, and depression. Study results found
that a combination of passionflower and clonidine was effective
in reducing emotional symptoms and physical symptoms of
narcotic withdrawal vs. clonidine alone, which only improved
physical symptoms. Passionflower should not be used with
monoamine oxidase inhibitors (MAOIs) or other sedative agents.

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Botanicals for Mental Wellbeing

Chamomile (Matricaria recutita)

Chamomile is a member of the daisy family. It has a rich
tradition of use for its relaxing properties, and its carminative
properties make it effective in easing mild indigestion. It’s
frequently paired with other botanicals to help with insomnia.
Chamomile has an excellent safety profile and is a gentle herb
that’s easy to use. Avoid in any people who have an allergy to
the ragweed or daisy family. It’s also best to avoid in any person
who is on blood thinner medication.

Hops (Humulus lupulus)

Many people are familiar with hops from its use in brewing beer;
hops gives beer its bitter taste. Hops also has the ability to
promote relaxation and sleep—a quality first noticed in Europe
among workers in hops fields, who were falling asleep on the
job! Hops is frequently used in combination with other herbs to
help with insomnia. It also acts as a phytoestrogen, which means
it can mimic estrogen in the body. It’s unclear what effect this
may have, so err on the side of caution and do not use this plant
in women who have had breast cancer or are at an increased
risk for breast cancer. Hops does have a bitter taste, so be
mindful of this when recommending a tea. There are
standardized extracts available for those who don’t like the
bitter taste.

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Botanicals for Mental Wellbeing

Valerian (Valeriana officinalis)

Valerian has fragrant white or pink flowers that were used in
perfume many centuries ago. Today, valerian is frequently used
in combination with other botanicals as a popular sleep aid. It
should be noted that valerian does take several weeks to have
an effect, so it is not useful for acute insomnia. Valerian also can
be used in small doses throughout the day to ease mild anxiety.
In contrast to many pharmaceuticals used for insomnia, it has
the advantage of being non-habit forming.
It has a good safety profile, but should be avoided in
pregnancy/breastfeeding and in children under 3 years of age. It
is not recommended to use valerian as a tea as it has a very
unpleasant taste.

St. John’s wort (Hypericum perforatum)

In ancient times, St. John’s wort was hung over doorways to
ward off evil, especially after the death of a loved one. In
modern times, it has been the subject of research for its
usefulness in treating mild-to-moderate depression. A Cochrane
Review2 from 2008 concluded St. John’s wort to be more
effective than placebo and as effective as standard
antidepressants. One major drawback to its use, however, is that
it interacts with a number of medications, including blood
thinners, oral contraceptive pills, immunosuppressants, and
other medications.
Avoid using St. John’s wort in any person who takes numerous
medications, any medications that are critical to life, and/or
medications with a narrow therapeutic window. It should also be
noted that St. John’s wort can cause photosensitivity, meaning it
can induce a sunburn quickly.

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Botanicals for Mental Wellbeing

Ginkgo (Ginkgo biloba)

Native to China, the ginkgo tree is now cultivated all over the
world. It’s notable for the brilliant yellow color of its leaves in
cooler weather. Ginkgo has received of attention in the medical
community for its use in easing symptoms of Alzheimer’s or
other types of dementia in older adults. While the exact
mechanism is unclear, it appears that ginkgo may help improve
circulation in the brain and have a protective effect on nerve
cells. While research is still inconclusive, there have been several
research trials reporting benefit for these symptoms. A
systematic review in 20103 concluded that ginkgo helped
improve cognition scores and activities of daily living scores in
Alzheimer’s patients. One study found ginkgo comparable to
Aricept,4 the standard pharmaceutical used for Alzheimer’s.
Hopefully, more research will continue to be done on this
botanical so more definitive conclusions can be drawn.
Ginkgo may interfere with blood thinners and with many other
medications, so it’s best to be diligent in obtaining an accurate
medication list for any person for whom you are considering
recommending ginkgo.

Rhodiola (Rhodiola rosea)

Also known as “arctic root,” the rhodiola plant grows well in cold
temperatures at high altitudes in the mountains of Europe and
Asia. Its root has traditionally been used to help improve mood
and concentration and to treat fatigue. You may recall from
Week 3 that rhodiola was of interest to Soviet researchers in
helping improve the stamina and endurance of elite athletes,
soldiers, and astronauts. Interest in this fascinating plant is due
to its properties as an adaptogen and its ability to help the body
combat physical and emotional stress. Today, rhodiola is used to
help with anxiety, depression, and chronic fatigue, although
research in these areas is very limited.
Rhodiolia is a very stimulating adaptogen and may increase
irritability in some people. At higher doses, it may induce side
effects like dizziness, dry mouth, and agitation. It should not be
taken with MAOIs.

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Botanicals for Mental Wellbeing

Ginseng (Panax ginseng)

Many people are familiar with this classic adaptogen, Panax
ginseng. The name Panax comes from the word “panacea,”
which roughly translates to “cure-all.” Ginseng is notable for its
fork-shaped root, which is the part of the plant that’s used
medicinally, especially in Traditional Chinese Medicine. This
adaptogen has historically been used for its ability to help fight
fatigue and prevent infections. Although the exact mechanism is
unclear, it’s purported that ginseng has these effects through its
anti-inflammatory properties, and that it decreases the stress
hormone cortisol. Ginseng is approved by the World Health
Organization and German health authorities to help treat mental
and physical exhaustion.
Drawbacks to the use of ginseng include its price tag: it’s very
expensive! This high cost also has a secondary effect: many
products on the market may be adulterated with cheaper plant
species or spiked with substances such as stimulants or caffeine.
It’s best to avoid powdered products of ginseng for this reason.
It’s also best to think of taking ginseng for “a season,” meaning
no longer than 12 weeks at a time. Ginseng should not be used
with anticoagulants.

References
1. Akhondzadeh, et al. (2001, Oct.). Passionflower in the treatment of opiates withdrawal: a double
blind randomized controlled trial. J Clin Pharm Ther. 26(5): 369-73.

2. Linde, K. & Berner, N.M. (2008, Oct.). St. John’s wort for major depression. Cochrane Database Syst
Rev. (4): CD000448.

3. Weinmann, S., Roll, S., Schwarzbach, C., Vauth, C., & Willich, S.N. (2010, March 17). Effects of Ginkgo
biloba in dementia: a systematic review and meta-analysis. BMC Geriatr. 10:14.

4. Mazza, M., Capuano, A., Bria, P., & Mazza, S. (2006, Sep.). Ginkgo biloba and donepezil: a
comparison in the treatment of Alzheimer’s dementia in a randomized placebo-controlled double-
blind study. Eur J Neurol. 13(9): 981-5.

 2018 Regents of the University of Minnesota. All rights reserved.