A variety of gentle plants are continually overlooked by both pharmacological medicine and clinical practitioners. This happens because it is easy to fall into the trap of looking for rapid-acting, potent plants with a specificity for a particular disease state. It is all too easy to overlook plants that act slowly and nonspecifically but in the end help address the root cause of the problem. Throughout history herbal practitioners have emphasized the importance of these “tonics” (sometimes referred to as neurotrophorestoratives) to help support the patient’s own healing process. Herbs that support the integrity and function of the nervous system are almost universally indicated for people with depression. Moreover, nervine tonics are usually called for because depression often exists as “a comorbid condition,” very often with anxiety or other mood disorders.
Avena saliva (oats) seeds (picked during the so-called milky stage) are one of the most highly reputed and gentle nerve tonics among the Eclectic physicians as well as European herbalists. Oat seed also has a reputation, however poorly substantiated, for relieving depression and thus cravings in people attempting to break their addiction to nicotine. It might be somewhat surprising to think of various hypnotic herbs as being helpful for depression. Logically one might assume that an herb that induces sleep would only worsen depressed moods. However, many such herbs were used traditionally for melancholic patients. This would include herbs like Melissa officinalis (lemon balm) leaf, Valeriana officinalis (valerian) root, Eschscholzia californica (California poppy) flower, Scutellaria lateriflora (skullcap) herb (must be fresh), Tilia cordata (linden) flower, Stachys betonica (wood betony) herb, and Passiflora incarnata (passionflower) herb.
It is possible that in higher doses these herbs are hypnotic but in lower doses more stimulating. However, it is more likely that the herbs are acting as tonics regardless of dose, and help bring the nervous system back into balance in a way that pharmacological medicine presently cannot comprehend or explain. With so many active constituents interacting with a multitude of cells, receptors, neurotransmitters, and other structures, it is not surprising that a complex result would occur. Actaea racemosa (black cohosh) root, Leonurus cardiaca (motherwort) herb, and Verbena spp. (vervain) herb were also traditionally used as nervines but are relatively specific for depression or other disturbances related to the menstrual cycle or menopause
in women. A recent open clinical trial confirmed that black cohosh helps relieve mood symptoms related to menopause, and that this benefit was magnified by combination with St. John’s wort. Though fluoxetine was superior to black cohosh for relieving postmenopausal moodiness, black cohosh was still helpful and had a better effect on relieving hot flashes in a double-blind trial. All three work as mild nervines in men as well.
All of these herbs can be administered as teas, tinctures, or in capsules. Capsules and herbs for teas should be no more than six months old, ideally, and should have been stored in airtight containers, in cool temperatures, and out of light prior to use. Usually, only small, local herb producers are reliable sources for herbs that have not been stored too long, it is otherwise difficult to assess the freshness of most commercial herbs and tea preparations on the market. Skullcap is far less active dried than fresh in the opinion of many practitioners, and should only be used as a tincture made from fresh plant or as a tea made from fresh leaf. As a tea, 2-3 tsp (5-10 g) of any of the herbs should be added to a cup of water and either simmered for 10-15 minutes (for roots) or steeped in hot water for 10-15 minutes (for soft parts of plants). The patient should drink at least 3 cups a day on a very regular basis, flavored if desired by mixing in some peppermint, ginger, or hibiscus. The usual tincture dose is 3-5 ml three times per day. Two approximately 500 mg capsules would be taken three times per day. All the herbs are completely safe. Rarely, patients may experience sleepiness or excessive stimulation, in which case the dose can usually be lowered without difficulty.
A far more powerful nerve tonic with definite dose-dependent effects is Pulsatilla spp. (pasque flower, pulsatilla) herb. In overdose this herb can cause extreme nervous system and cardiovascular suppression including coma and hypotension. In small doses, it is a mildly stimulating nervine and heart tonic with a strong reputation for relieving abnormal menstruation, nervous exhaustion, and melancholy. In slightly higher doses it becomes mildly sedative and significantly analgesic with an affinity for the gonads. As an antidepressant, mother tincture (1:10 weight:volume dilution) is recommended in the amount of 1-3 drops three times per day along with other supportive measures. Somewhat similar to skullcap, only fresh plant should be used as the dried plant is far less active.
Finally, Piper methysticum (kava) root is used as a nerve trophorestorative or tonic in people with depression manifesting primarily as anxiety. Kava has repeatedly been shown effective for relieving anxiety, as evidence by a meta-analysis of clinical trials. Unlike benzodiazepines used to treat patients with anxious depression, kava actually improves mental function. It is unknown how effective kava is for depression without anxiety, but Weiss does mention it for this situation. The usual dose of tincture is 3-5 ml three times per day. Extracts standardized to 30% kavalactones are also available; the usual dose is 70 mg three times per day.