Private insurance companies and even the NHS are in a position to influence the relative cost of St John’s Wort versus conventional anti-depressants. Should private insurers choose to reimburse patients for synthetic anti-depressants but not for St John’s Wort, they would make the herbal anti-depressant more expensive than synthetic ones for some patients. The current situation in Germany is that St John’s Wort is reimbursed by insurers if it is prescribed by a doctor but not if it is purchased over the counter. This seems like a reasonable guideline to follow in other countries as well.

The questions raised in this chapter, such as ‘Should people be encouraged to treat their own depressions?’ or ‘Should active antidepressants be available over the counter?’ are worth debating in their own right and will no doubt be discussed in the years to come. Given the economic and political stakes involved in these issues, however, it is important for the consumer to be aware of the potential biases of those who are most likely to be engaged in the debate even though these biases do not invalidate the content of their arguments. With this in mind, let us examine some of the controversies that have been raised in relation to St John’s Wort.

*40\75\2*

During the same year, he complained of nausea and severe abdominal pain. Hospital tests proved negative. He had his spectacles changed three times, trying to correct visual disturbances. So many things were going wrong, he thought his wife must have been right when she said, ‘It is all in your mind,’ although the severe pain he then developed in his right shoulder and in his neck, seemed real enough to him.

Now, eighteen months later, he feels better, but still has some symptoms. Insomnia, palpitations, headaches, and irritability are still a problem, but very much less than they were. He was never tempted at any time during those eighteen months to go back on the pills. He tried alcohol in the evenings, but it did not seem to help.

The experience has changed his attitude to life. He now makes time to relax each day during lunch. What used to be a hurried sandwich and numerous cups of coffee, is now a salad with meat or cheese and fruit, and fifteen minutes lying on the office floor listening to a relaxation tape and being aware of his breathing. He is amazed by how different he feels at the end of the day.

*70\49\8*

There are often amusing moments even in the most unhappy situations. Sharing these is good medicine. One group member turned the meeting into a pantomime when she described the panic attack she experienced whilst working as a sales demonstrator in a supermarket.

Another young woman announced that she had come to terms with the temporary incontinence, ‘All you need is to wear boots—you can slowly fill them up and nobody knows!’

Guard against endless discussions on how inappropriate or harmful your drug treatment has been. It is in the past. Air your views on the subject, then leave it behind.

If you are lucky enough to get through withdrawal without any drugs for symptomatic relief, be grateful, and do not scold those who cannot. They may be disappointed that they need anti-depressants or other drugs for a time. The aim is for everyone to be drug-free, but some people may need temporary medication to achieve this.

Remember too that you cannot know the medical history of others in the group and there may be a very good reason why they are on certain drugs.

*54\49\8*

Cut down on or give up sugar, all sugar products, and anything made with white flour.

Food allergies can cause or deepen depression. A diet of boiled brown rice and spring water for a few days has helped many people discover what foods they are allergic to. They can introduce one food at a time until they find out what is upsetting them. This diet also gives the liver and kidneys a rest, and enables the body to get rid of toxins.

You can be fat and yet still be undernourished. A healthy diet is essential in depressive illness.

You may still feel very negative, and feel that your efforts are in vain, but others may have noticed encouraging little signs in you.

*37\49\8*

This means not feeling in touch with reality, and feeling

Depersonalization

This can happen when anxiety levels are high. People who have never had drugs can also suffer this. Perhaps this is the main symptom that induces feelings of going mad. People feel they are not real, not in touch with themselves, and worry that their mental processes are going to break down completely. ‘I look in the mirror I know it’s me, but it does not look like me—I don’t really recognize my image.’

strange in familiar surroundings. People say ‘I walk into my kitchen and it does not look like my kitchen’. Some people say ‘How can it be anxiety. I am happy about cutting down my pills, and there is nothing in my life to make me anxious’. Even if this is so, your body (and therefore your mind) may still be in a state of stress because of withdrawal. Learn to relax and these feelings will disappear.

*17\49\8*