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Morwenna Given, B.A., M.A.(Oxon), BSc, mOHA, BHG, RH
Medical Herbalist
www.medicusherbis.com
We combine the art of holistic treatment and
the science of plant healing properties to help
people achieve optimum health
We are specialists in the use of medicinal plants
and their ability to resolve disease
Our practice is based on internationally
accepted scientific evidence (including McGill and McMaster)
We have the ability to treat in combination with
orthodox drugs
6 years of training in University, Hospital and
Clinic settings
Training includes the Western bio-chemical
physician model
Additional training in pharmacology,
biochemistry, phytochemistry and phytotherapy
to treat medical conditions with plant medicine
and to work alongside conventional medicine
Plant medicine has been shown to be safe and
unlikely to have unwanted side effects
Medicinal plants have been shown in tests and
trials to be highly effective and in some cases
better than pharmaceutical drugs
Herbal medicine is derived from the flowers,
fruits, leaves, stems, and roots of plants to
maintain a complex synergy of natural organic
chemical compounds
Depressed mood for most of the day, every day,
for 2 weeks, anhedonia, plus 3 or more of:
   Change in appetite/weight
   Agitation
   Change in sleep patterns
   Anxiety
   Feelings of worthlessness
   Decreased ability to concentrate
   Recurrent thoughts of death or suicide
Phobic experiences e.g. Agoraphobia
Panic experiences e.g. Escape Attacks
General anxiety disorders which involve
abnormal levels of agitation and/or worry
& in association with other diseases
Abnormal Biochemistry
    The causes of major depressive disorders have not been
    clearly defined
    It involves disturbance in neurotransmitters and hormones
    in the central nervous system
Nutritional Deficiencies
Neurotransmitter problems
Hormonal imbalances
Reaction to lifestyle/events
Other somatic causes e.g. Multiple Sclerosis, Menopause
Men are from Mars, Women are from Venus
  Women – 3 forms of Estrogens, Progesterone, and
  other Endocrine hormones

  Men – Testosterone, Pregnenolone (DHEA) (DHT)

  Change in Age - for both men and women
A substance produced in the body from a gland
(brain/thyroid)
Carried to other parts of the body to elicit a
response from a tissue structure or chemical
receptor
Hormones are found all over the body
Progesterone has a Sedative effect (calms)
Estrogen has an Anxiolytic effect (anxiety)
High progesterone converts to high Androgens
which make people more aggressive
Low progesterone results in lack of drive
Thyroid
  This organ/gland is a major player in depression
  and anxiety
  Ontario has endemic sub-clinical hypothyroidism
  The conventional doctor has no drugs for this
  problem
  Ontario has sub-clinical levels of Vitamin D
The body has a close physiological relationship
between the endocrine and nervous systems
Our emotions in the brain create peptides
which affect hormones – peptides are chemical
messengers
Regulated by horizontal, vertical and diagonal
axes from the brain to the body
The Hypothalamus – Composer
  The Pituitary – Conductor
  The Endocrine Glands – Musician
  The Cells of the Glands – Instruments
  The Hormones – Musical Notes
  The Receptors - Audience

When one aspect does not function normally, the body tries to adjust.
An unsuccessful adjustment leads to anxiety and/or depression.
Stress is the body’s response to any demand.
How we deal with it can be good or bad.
  Hans Seyle (Canadian) defined GAS (General
  Adaptation Syndrome)
  3 stage process:
       Alarm
       Resistance
       Exhaustion
  Stress is cumulative and over time exhausts the
  adrenal glands
  Artists are a small business / huge stress burden
NO clear data but @30- 20% of the general
population.
Functional disorders @ 5% of the population
with a known high proportion of artists
 “November 10, 2011 — Creative individuals have a disproportionately higher rate of
mental illness, including schizophrenia and bipolar disorder, and they and their
relatives are more likely to work in artistic and scientific occupations, according to
new research published in the November 2011 issue of the British Journal of
Psychiatry.” Medscape



Research focusses on sub-groups & the how but
not the why
Respiratory


GIT
                    Genito
                    urinary
       General
        Body

CVS
                    Tension


      Insomnia
Paracelus

The nervous system has 2 complimentary
halves:
Parasympathetic – normally dominant
     Associated with rest, digestion, we are naturally lazy!

Sympathetic – alarm state
     Associated with adrenaline, raised heartbeat, digestion
     stops

 Continual activation leads to adrenal stress
Based on an internationally recognized scale
(DSM-1V-TR)
Resulting in a differentiation between a
functional disorder versus a general anxiety
disorder – schizophrenia vs. post natal
depression
Functional disorders involve the psyche (mind)
General anxiety disorders are somatic (body)
Usually involve drugs e.g. SSRIs, MAOIs,
tricyclic antidepressants, and nor adrenergic
selected re-uptake inhibitors
BUT…
  They have about 5% efficacy
  They do not address the causes
  They have serious side effects – addiction et al
The body only ‘the mind and the body cannot be
separated’ (Socrates)

 treat the CAUSE balancing the regulation of
parasympathetic/sympathetic nervous system
  correct the balance of hormonal activity –
centrally and peripherally
 ensure the body drains and eliminates properly
with good blood flow to the tissues
 TREATMENTS are INDIVIDUAL.
Adaptogens – ginsengs, withania, schizandra
Provide an increase in the body’s non-specific resistance to damaging man made
factors and related illnesses

  Nervines – valerian, St. john’s wort, skull cap,
rose and so on depending on the condition
 Anti Spasmodic – snowball – relaxes smooth
muscle
 Bitters – chamomile, century – anti anxiolytic
and stimulates elimination
High in Vitamin C
Effective in anxiety
associated – meno-
pause, diabetes,
bereavement
Arctic Rose - Adaptogen
    Adaptogens normalise the body via the HPA
 They support the body through periods of
extensive stress without any negative side effects
     Long / short term use

 Phytomedicine. 2010 Jun;17(7):481-93. Rosenroot (Rhodiola rosea): traditional use, chemical composition,
pharmacology and clinical efficacy. Panossian A, et al

  The adaptogenic, cardiopulmonary protective, and central nervous system activities of Rhodiola rosea have been
attributed primarily to its ability to influence levels and activity of monoamines and opioid peptides such as beta-
endorphins. (Altern Med Rev 2001;6(3):293-302)

 Ecdysteroids – ability to correct DNA – extensive Russian & Scandinavian research
Adaptogen
   Has the ability to raise thyroid hormones to normal levels
in conjunction with other plants
  It also works thru the HPA and balances estrogen
  Increases white cells
  Normalizes hemoglobin
  Significant glucocorticoid effects
  Anti mitotic effect in metaphase cells
  Sedative, hypnotic
  Bacteriostatic
Nervine
    Wonderful multi purpose plant.
  Anti depressant, anti cancer, anti bacterial, anti
viral, balances serotonin/dopamine
   Hormone balancer
   Better than conventional SSRI’s
  2009 confirmation for safe use in severe depression and moderate depression in 2005; 2009
confirmation of year long use safe and effective in mild to moderate depression.
 2009 double blind trial confirming use in perimenopausal women in controlling hot flushes and
better sleep.( in Quebec!!)
 2009 Meta analysis showed Hypericum to be as effective as SSRI's with less adverse effects
Nervines
  Anti anxiolytic for the GABA pathways, helps with
insomnia
2008 in vivo confirmed mechanism of gaba pathways of anxiolytic effects, effect
similar to diazepam. Phytother Res. 2011 Jun;25(6):838-43.

  Affects the HPA, relaxes the arteries, acts on Gaba and
serotonin pathways
  Calms/balances hormones, helps with insomnia, anti
viral, anti bacterial, acts on the thyroid peripherally
Confirmation of vaso relaxant effect on heart endothelium 2008.
Plants work better
       together !!

Fitoterapia. 2011 Apr;82(3):474-80.
Pharmacological studies in an
herbal drug combination of St.
John's Wort (Hypericum
perforatum) and Passion Flower
(Passiflora incarnata): in vitro and
in vivo evidence of synergy
between Hypericum and Passiflora
in antidepressant pharmacological
models. Fiebich BL et al .
Department of Psychiatry,
University of Freiburg Medical
School,
Bitters
  The herbal family of bitters combine many
actions in one safe plant – anti anxiolytic, anti
bacterial, anti viral, cross the blood brain barrier,
hepatoprotective, sedative, HPA regulator, etc
  A Medical Herbalist treats the whole body - the
issue of elimination is critical for normal function
 Bitters support/stimulate/correct elimination
B6, B12, Folic Acid – Homocysteine
Thiamin
Omega 3 fatty acids EPA deficiencies
Iron Deficiency
Zinc Deficiency
Magnesium Deficiency
Low vitamin D – You are my sunshine!
Chocolate!!
    Low carb diet. Krikorian R, et al. Dietary ketosis enhances memory in mild
cognitive impairment. Neurobiol Aging 2 December 2010

   Omega 3 fats
   Food additives
  Many symptoms masked the cause – dietary
imbalances
Relaxation, Yoga, Visualization, Meditation
Gardening ‘smell the roses’
Recognize strengths and limitations
Psychotherapy
The compounds that I give do not come from
over the counter products
Only registered herbalists may compound and
use these products which are made under the
same regulations as drugs

If you self treat, you may cause further problems
Please do not confuse these plants/medicine with
supplements which by law cannot have medically
therapeutic effect.
For a complete copy of all references used in this
presentation (@15 pages), please email:
mrsmg@sympatico.ca

Please note that many peer reviewed articles are
based on supplements not whole plant extracts e.g.
Canmat 2009

All reference material is available on
Pubmed/Science Direct
THANK YOU




      Morwenna Given
Registered Medical Herbalist
 www.medicusherbis.com

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Treating Anxiety and Depression

  • 1. Morwenna Given, B.A., M.A.(Oxon), BSc, mOHA, BHG, RH Medical Herbalist www.medicusherbis.com
  • 2. We combine the art of holistic treatment and the science of plant healing properties to help people achieve optimum health We are specialists in the use of medicinal plants and their ability to resolve disease Our practice is based on internationally accepted scientific evidence (including McGill and McMaster) We have the ability to treat in combination with orthodox drugs
  • 3. 6 years of training in University, Hospital and Clinic settings Training includes the Western bio-chemical physician model Additional training in pharmacology, biochemistry, phytochemistry and phytotherapy to treat medical conditions with plant medicine and to work alongside conventional medicine
  • 4. Plant medicine has been shown to be safe and unlikely to have unwanted side effects Medicinal plants have been shown in tests and trials to be highly effective and in some cases better than pharmaceutical drugs Herbal medicine is derived from the flowers, fruits, leaves, stems, and roots of plants to maintain a complex synergy of natural organic chemical compounds
  • 5. Depressed mood for most of the day, every day, for 2 weeks, anhedonia, plus 3 or more of: Change in appetite/weight Agitation Change in sleep patterns Anxiety Feelings of worthlessness Decreased ability to concentrate Recurrent thoughts of death or suicide
  • 6. Phobic experiences e.g. Agoraphobia Panic experiences e.g. Escape Attacks General anxiety disorders which involve abnormal levels of agitation and/or worry & in association with other diseases
  • 7. Abnormal Biochemistry The causes of major depressive disorders have not been clearly defined It involves disturbance in neurotransmitters and hormones in the central nervous system Nutritional Deficiencies Neurotransmitter problems Hormonal imbalances Reaction to lifestyle/events Other somatic causes e.g. Multiple Sclerosis, Menopause
  • 8. Men are from Mars, Women are from Venus Women – 3 forms of Estrogens, Progesterone, and other Endocrine hormones Men – Testosterone, Pregnenolone (DHEA) (DHT) Change in Age - for both men and women
  • 9. A substance produced in the body from a gland (brain/thyroid) Carried to other parts of the body to elicit a response from a tissue structure or chemical receptor Hormones are found all over the body
  • 10. Progesterone has a Sedative effect (calms) Estrogen has an Anxiolytic effect (anxiety) High progesterone converts to high Androgens which make people more aggressive Low progesterone results in lack of drive
  • 11. Thyroid This organ/gland is a major player in depression and anxiety Ontario has endemic sub-clinical hypothyroidism The conventional doctor has no drugs for this problem Ontario has sub-clinical levels of Vitamin D
  • 12. The body has a close physiological relationship between the endocrine and nervous systems Our emotions in the brain create peptides which affect hormones – peptides are chemical messengers Regulated by horizontal, vertical and diagonal axes from the brain to the body
  • 13. The Hypothalamus – Composer The Pituitary – Conductor The Endocrine Glands – Musician The Cells of the Glands – Instruments The Hormones – Musical Notes The Receptors - Audience When one aspect does not function normally, the body tries to adjust. An unsuccessful adjustment leads to anxiety and/or depression.
  • 14. Stress is the body’s response to any demand. How we deal with it can be good or bad. Hans Seyle (Canadian) defined GAS (General Adaptation Syndrome) 3 stage process: Alarm Resistance Exhaustion Stress is cumulative and over time exhausts the adrenal glands Artists are a small business / huge stress burden
  • 15. NO clear data but @30- 20% of the general population. Functional disorders @ 5% of the population with a known high proportion of artists “November 10, 2011 — Creative individuals have a disproportionately higher rate of mental illness, including schizophrenia and bipolar disorder, and they and their relatives are more likely to work in artistic and scientific occupations, according to new research published in the November 2011 issue of the British Journal of Psychiatry.” Medscape Research focusses on sub-groups & the how but not the why
  • 16. Respiratory GIT Genito urinary General Body CVS Tension Insomnia
  • 17. Paracelus The nervous system has 2 complimentary halves: Parasympathetic – normally dominant Associated with rest, digestion, we are naturally lazy! Sympathetic – alarm state Associated with adrenaline, raised heartbeat, digestion stops Continual activation leads to adrenal stress
  • 18. Based on an internationally recognized scale (DSM-1V-TR) Resulting in a differentiation between a functional disorder versus a general anxiety disorder – schizophrenia vs. post natal depression Functional disorders involve the psyche (mind) General anxiety disorders are somatic (body)
  • 19. Usually involve drugs e.g. SSRIs, MAOIs, tricyclic antidepressants, and nor adrenergic selected re-uptake inhibitors BUT… They have about 5% efficacy They do not address the causes They have serious side effects – addiction et al
  • 20. The body only ‘the mind and the body cannot be separated’ (Socrates) treat the CAUSE balancing the regulation of parasympathetic/sympathetic nervous system correct the balance of hormonal activity – centrally and peripherally ensure the body drains and eliminates properly with good blood flow to the tissues TREATMENTS are INDIVIDUAL.
  • 21. Adaptogens – ginsengs, withania, schizandra Provide an increase in the body’s non-specific resistance to damaging man made factors and related illnesses Nervines – valerian, St. john’s wort, skull cap, rose and so on depending on the condition Anti Spasmodic – snowball – relaxes smooth muscle Bitters – chamomile, century – anti anxiolytic and stimulates elimination
  • 22. High in Vitamin C Effective in anxiety associated – meno- pause, diabetes, bereavement
  • 23. Arctic Rose - Adaptogen Adaptogens normalise the body via the HPA They support the body through periods of extensive stress without any negative side effects Long / short term use Phytomedicine. 2010 Jun;17(7):481-93. Rosenroot (Rhodiola rosea): traditional use, chemical composition, pharmacology and clinical efficacy. Panossian A, et al The adaptogenic, cardiopulmonary protective, and central nervous system activities of Rhodiola rosea have been attributed primarily to its ability to influence levels and activity of monoamines and opioid peptides such as beta- endorphins. (Altern Med Rev 2001;6(3):293-302) Ecdysteroids – ability to correct DNA – extensive Russian & Scandinavian research
  • 24. Adaptogen Has the ability to raise thyroid hormones to normal levels in conjunction with other plants It also works thru the HPA and balances estrogen Increases white cells Normalizes hemoglobin Significant glucocorticoid effects Anti mitotic effect in metaphase cells Sedative, hypnotic Bacteriostatic
  • 25.
  • 26. Nervine Wonderful multi purpose plant. Anti depressant, anti cancer, anti bacterial, anti viral, balances serotonin/dopamine Hormone balancer Better than conventional SSRI’s 2009 confirmation for safe use in severe depression and moderate depression in 2005; 2009 confirmation of year long use safe and effective in mild to moderate depression. 2009 double blind trial confirming use in perimenopausal women in controlling hot flushes and better sleep.( in Quebec!!) 2009 Meta analysis showed Hypericum to be as effective as SSRI's with less adverse effects
  • 27. Nervines Anti anxiolytic for the GABA pathways, helps with insomnia 2008 in vivo confirmed mechanism of gaba pathways of anxiolytic effects, effect similar to diazepam. Phytother Res. 2011 Jun;25(6):838-43. Affects the HPA, relaxes the arteries, acts on Gaba and serotonin pathways Calms/balances hormones, helps with insomnia, anti viral, anti bacterial, acts on the thyroid peripherally Confirmation of vaso relaxant effect on heart endothelium 2008.
  • 28. Plants work better together !! Fitoterapia. 2011 Apr;82(3):474-80. Pharmacological studies in an herbal drug combination of St. John's Wort (Hypericum perforatum) and Passion Flower (Passiflora incarnata): in vitro and in vivo evidence of synergy between Hypericum and Passiflora in antidepressant pharmacological models. Fiebich BL et al . Department of Psychiatry, University of Freiburg Medical School,
  • 29. Bitters The herbal family of bitters combine many actions in one safe plant – anti anxiolytic, anti bacterial, anti viral, cross the blood brain barrier, hepatoprotective, sedative, HPA regulator, etc A Medical Herbalist treats the whole body - the issue of elimination is critical for normal function Bitters support/stimulate/correct elimination
  • 30.
  • 31. B6, B12, Folic Acid – Homocysteine Thiamin Omega 3 fatty acids EPA deficiencies Iron Deficiency Zinc Deficiency Magnesium Deficiency Low vitamin D – You are my sunshine!
  • 32. Chocolate!! Low carb diet. Krikorian R, et al. Dietary ketosis enhances memory in mild cognitive impairment. Neurobiol Aging 2 December 2010 Omega 3 fats Food additives Many symptoms masked the cause – dietary imbalances
  • 33. Relaxation, Yoga, Visualization, Meditation Gardening ‘smell the roses’ Recognize strengths and limitations Psychotherapy
  • 34. The compounds that I give do not come from over the counter products Only registered herbalists may compound and use these products which are made under the same regulations as drugs If you self treat, you may cause further problems Please do not confuse these plants/medicine with supplements which by law cannot have medically therapeutic effect.
  • 35. For a complete copy of all references used in this presentation (@15 pages), please email: mrsmg@sympatico.ca Please note that many peer reviewed articles are based on supplements not whole plant extracts e.g. Canmat 2009 All reference material is available on Pubmed/Science Direct
  • 36. THANK YOU Morwenna Given Registered Medical Herbalist www.medicusherbis.com