Solstice, St. John's Wort and Depression
  

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By: Thomas Cowan, M.D.
Not so long ago at a medical conference, a colleague remarked that in many ways, with the explosion of SSRIs (Selective Serotonin Re-uptake Inhibitors) for the treatment of depression in the last 20 years, psychiatrists must feel like general practitioners did at the onset of the use of penicillin. With the introduction of penicillin, much in the practice of medicine changed. No longer was a strep infection a feared event and, to a large extent, mastoiditis (infection of the bone behind the ears following ear infections) and early deaths from pneumonia became a thing of the past. As time went on, however, people began to see the downside of antibiotics, and we now find ourselves in a kind of nightmare scenario in which micro-organisms have adapted to penicillin, new antibiotics are being developed but only slowly, and the whole spectrum of infectious disease, now in a changed and in some ways more virulent form, looms on the horizon. Perhaps it would have been better to think more deeply about the role of penicillin in the early days instead of waiting until we are fully in the midst of a crisis.

There are many parallels between what happened with penicillin and infectious disease and the current story unfolding with SSRIs and depression. A primary parallel involves diagnosis. I have pointed out in many places that “infections” are often not a primary event but rather a “cleansing” response. So too the whole diagnosis of depression is fraught with difficulty. As with all psychiatric illness based on a kind of subjective grading of symptoms, no two “experts” will agree on what is the actual definition of depression. The manuals of psychiatry give amounts of time and severity of symptoms, along with various somatic (body) reactions, but a constellation of symptoms is a different thing altogether than an actual definition of an illness. The bottom line is that the diagnosis of depression is based on the subjective understanding of the illness in the eyes of the psychiatrist. As many authors have pointed out – including Peter Breggin in Talking Back to Prozac, Thomas Szasz in The Myth of Mental Illness, Ivan Illich in Medical Nemesis, Robert Whitaker in Mad in America, and David Healy in Let Them Eat Prozac  – not only is there no consensus definition of depression, but the diagnosis varies widely across various cultures and has dramatically changed from an incidence of about one in 1,000 people in the pre-Prozac era to about one in eight or nine after the introduction of Prozac. Also, there are no studies that show that Serotonin levels have anything to do with the phenomenon we call depression (see Let Them Eat Prozac for documentation of these facts).

In my practice of medicine over the past 20 years, people with an incredible array of symptoms have come to me saying that they suffer from depression. They include people with persistent sadness, or at least sadness that is the primary emotion they feel or at least remember that they feel. People with difficulty concentrating call this depression; people who are shy and have difficulty finding success in social encounters, people who have difficulty holding a job, and people who are angry, suicidal, bored, or even those who are trying to starve themselves all relate to this title of depression. I am in no way saying that each of these people doesn’t have a legitimate complaint nor that I wouldn’t love to be able to help them come to a deeper understanding and healing in their lives; I just don’t think that each of them suffers from an illness called depression. What is it then?

In studying the life history of the plant St. John’s wort, the beginning of a deeper understanding of these disparate symptoms and phenomena can come into clearer focus. St. John’s wort is the predominant “natural” medicine used to treat depression and it has been used in this context since antiquity. In those days, the illness was called “melancholia” and St. John’s wort was the “cure.”

St. John’s wort is so named because it flowers in Europe on St. John’s Day (June 24) which is close to the summer solstice. This feast day celebrates the reputed birthday of John the Baptist, the prophet of the New Testament, who was by all accounts somewhat of a zealot, even perhaps what we would call today a madman. In former times, the celebration of the summer solstice and St. John’s Day was marked with a huge bonfire in the village square, an unusual happening seeing as how this would generally be one of the hottest days of the year. Like St. John himself, it’s a bit mad, or what we today call crazy, to do such a thing.

Remember, however, that the summer solstice follows soon after the Pagan festival of Beltane which in Europe was the day when the villagers lit huge fires, did ecstatic chants and drumming, wore masks, and were “allowed” to have sex that night with anyone of their choosing without repercussions (although I can imagine some interesting discussions in the homes in the following days and weeks). It seems as if in the interest of mental health people in the pre-depression era knew that a little craziness, or allowing oneself to more freely experience a wider range of emotions, from passion to ecstasy, was a way to allow a kind of freedom of the soul that had a hygienic, even therapeutic effect.

The plant, St. John’s wort, captures the spirit of the solstice, of John the Baptist, of the Beltane celebration and integrates that spirit into the human being as a medicine. It is not a medicine that treats depression for the simple reason that there is no such actual phenomenon as depression. Rather, it allows the possibility of an “unfreezing” of the emotional world so that a wider range of emotions can be experienced, a kind of physiological bonfire for the soul even though it may be the warmest day of the year.

It should come as no surprise that a plant that lights a fire would be most active at the time of the summer solstice. It should also be no surprise that this plant would actually store oil in its leaves, the red oil glands giving rise to the name Hypericum perforatum (perforated leaves), and oil being the warmth carrier in nature. And, it should be no surprise that the St. John’s wort warmth stimulates the enzymes in the liver that carry out detoxification, since the Greeks considered a congested liver as the source of melancholia.

St. John’s wort is not only a medicine for frozen souls, it is a teacher for our whole culture. This humble plant is calling us to give freer reign to our feeling lives, not so much so that we do crazy things, but so that we don’t. Repressed, hidden feelings, emotional wounds covered up become toxic and literally poison our livers. Narrowly defining our emotional lives creates resentment, anger, the feeling of powerlessness and then we strike out. In contrast to the metaphor that lives as St. John’s wort, Prozac and other SSRIs have little to teach us. They may alleviate the unpleasant feelings and severe despair that so many suffer from today, but in return there is a blunting of the whole emotional life, exactly the wrong direction we need to go. For those who wonder about the safety of these powerful medicines, you might want to check out the books mentioned above and the website, www.ssricitizen.org, which tells the harrowing story of one man’s descent into the hell of SSRIs and his uncovering of the truth of these drugs in the following years. And finally, I would call for the return of the community bonfire which can capture the warmth of community and the experience of joy that are so necessary for a healthy inner life.

Reprinted with permission from the Fourfold Path To Healing Newsletter, an online newsletter edited by Dr. Cowan – www.fourfoldhealing.com.




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