DOSE:	600 mg	oral	St. John's Wort	(daily)
	60 mg	oral	Ginkgo biloba	(daily)
	300 mg	oral	Ginseng	(daily)

BODY WEIGHT:

145 lb

Starting medical school at 28 was an unsurprisingly difficult process. I was a confident, outgoing and reasonably successful, corporate-employed adult who decided on a drastic career change. One that, I might add, has proved intensely fulfilling MOST of the time. However, a few months into my first year I began to feel the effects of constant stress, lack of exercise, and continually new/frightening encounters with mortality, illness, etc. Exactly what you DON'T see on Grey's Anatomy magnified by 1000x. Except the excellent sex--I started a terrific relationship with another first-year student, but it was constantly imperiled by our coinciding cycles of exam stress and altering schedules.

Ten years prior, as a wild-n-crazy prerabbinic student at a small, crazy liberal arts college, I did my fair share of experimentation. That combined with a suffocating family life probably led to my first and only serious depressive episode. Yes, I was hospitalized and fully medicated on a three-year battery of Serzone, Celexa and then Paxil. The formal diagnosis was high generalized anxiety. Against medical advice, I deliberately took myself off the meds and lived quite comfortably for five years. I'm pretty bright, I knew I could handle my self care. And I did.

Then med school, and I felt a terrifying resurgence of the same emotions that preceded the depression all those years ago. Irritability, unprovoked crying, manipulative behavior in my relationship (could I get my girlfriend to come and take care of me, etc), apathy about friendships and school activities, distraction from work. In a panic that first winter I called my resident therapist (medical students typically get free therapy from the psych interns--they learn and we destress, it's a good relationship) and requested an immediate restart on a low dose of Paxil CR. I had tolerated it well--it seemed like a good idea. I won't go into the already well-publicized negative hype on Paxil here. Suffice to say after a few days of debilitating symptoms I knew I needed another route, one that wouldn't kill my sex drive or make me into a different kind of insane.

A few of my mentors in the ER and psych departments came over for dinner and found me noticeably upset with antidepressant withdrawal. We ate and talked and both of them, two guys from radically different medical backgrounds with conventional training in pharma-effectiveness, interventions, etc...said it definitively: GO HERBAL. St Johns Wort for the anxiety and low mood, Gingko for concentration, a VERY mild dose of Ginseng as needed for energy. Stay away from the ridiculous amounts of caffeine and nicotine and taurine, try to exercise, walk AWAY from unnecessary conflict, take study breaks. Voila. Unless I was teetering on the edge of a signficant suicidal episode, stay away from serious pharma intake.

I drove to GNC and browsed the herbal aisle, picking out the above with a bit of wry humor. I've never been one to put much faith in homeopathy, being an allopathic student. I like amino supplements for yoga and take a multivitamin, that's about as fruity and edgy as I got. I had not been told to take the herbals in the doses listed, I just did what the bottle said, used common sense (don't take a stimulant at 10pm, duh), and what little I had learned about absorption and retention in school helped as well.

I took the herbs and worked a week--it's always the week before a high-stakes exam in medical school--with my head down. And then on Friday afternoon, I took a long walk and mental stock. And I was feeling BETTER. Almost without even realizing it, I had increased energy, had cut down smoking to a single cigarette after dinner, had only drank two cups of tea over the course of the week, actively wanted and pursued exercise breaks, and remembered considerably more of the material. But the most dramatic effect was my mood. Other writers have written about euphoric onset with St. John's Wort. I can't say I had an MDMA-like moment, or anything remotely resembling antidepressant onset. What I had instead was an incrementally favorable stabilization of my mood. I felt proactive, positive as opposed to anxiety-driven and reactive. Note, my stresses had NOT decreased. Rather, my response to them was reasonable and, probably due more to the Gingko, I felt more predictive about my emotional reactions over the course of the day.

And if I needed any external validation, can we just say my girlfriend was *extremely* pleased at the changes, and continues to be so. Ginseng does help with peripheral blood flow during sexual excitement. I've noticed and it's great. Caffeine and nicotine, although stimulants, do not positively effect smooth muscle (in the genitalia) and constrict blood flow. It's in any pharm or histo book, so draw your own conclusions.

Do I intend to stay on this cocktail forever? Of course not. But I do highly recommend it as a starter attempt to combat anxiety and stress. TAKE WITH FOOD, ignore all that nonsense about effects diluted by stomach contents. You want a healthy gastric lining for years to come? Take the mild hit on effect.

Exp Year: 2007	ExpID: 69700
Gender: Female
Age at time of experience: Not Given
Published: Jun 16, 2009	Views: 41,386
[ View PDF (to print) ] [ View LaTeX (for geeks) ] [ Swap Dark/Light ]
St. John's Wort (142), Ginkgo biloba (195), Ginseng (144) : Combinations (3), Retrospective / Summary (11), Medical Use (47), Sex Discussion (14), Performance Enhancement (50), Depression (15), Multi-Day Experience (13), Health Benefits (32), Not Applicable (38)