Are you desperate for a holiday? Feeling overwhelmed with work? Shouting at your kids for no reason? Waking up early anxious about everything you have to do? Feeling panicky before a meeting? Can't sleep because your mind won't stop replaying past conversations or planning future ones? Feeling depressed but don't know why?
Thousands of people go through this and worse every day and many end up in a doctor's surgery. Whether it's the old-style mother's little helper, Valium, or the much-hyped Prozac or another anti-depressant, or simply a sleeping pill, the answer to many problems seems to be "take a drug". However, it is no longer unusual to turn to complementary therapies for help in dealing with the demands of modern life. In the UK, practitioners of complementary therapies outnumber GPs and treat over four million people a year.
The solution to anxiety, depression or stress should be to take a herb or a vitamin, or to learn to meditate, according to Dr John McKenna, in Alternatives to Tranquillisers. In this self-help book, McKenna, who was born in Newry, Co Down, but now lives in South Africa, provides an overview of complementary therapies which have proved effective in combating stress, depression and anxiety - and gives advice on how to come off tranquillisers and sleeping pills. McKenna believes symptoms of stress such as insomnia, shortness of breath, fatigue, mood changes, irritability and palpitations, are a result of deep emotional and spiritual difficulties. "We have moved away from nature to a very unnatural way of life, we have moved away from an extended family to a nuclear family and to broken families. I also believe it is because we have sought comfort and happiness outside ourselves in material possessions, in other people and in success and we have been disappointed."
Herbal remedies are "worth a try", says Dr Patrick McKeon, psychiatrist and chairman of Aware, the charity for sufferers of depression. But he does not believe anti-depressants are over-prescribed. "Depression is under-diagnosed and under-treated," he says, pointing to unpublished research carried out by Aware which found 7 per cent of the workforce suffers from a major depressive disorder, and only one-quarter of sufferers will receive treatment or help. Before taking herbal remedies, says McKeon, it is important to consult a doctor, because depression can be caused by anaemia or thyroid problems. Previous research shows more than 200,000 people in the Republic suffer from major depression and one in three will have an episode of major depression in their life. McKenna, however, is opposed to drugs for the treatment of stress or depression. "Nature intended us to use herbs to heal ourselves," he says - and a growing number of people, including scientists and doctors, agree with that. Hailed as an alternative Prozac, one of the latest "feel good" wonder treatments is not a drug at all - it's a delicate yellow-flowering herb called hypericum, or St John's Wort. Dubbed the "sunshine herb", since a UK study found it reduces the symptoms of seasonal affective disorder by 40 per cent, it is also used to treat depression and mood swings in menopausal women.
Clinical trials show the ancient folk-remedy to be an effective treatment for depression, and in Germany, where it is available on prescription, it outsells Prozac by seven to one. A study published in the British Medical Journal showed St John's Wort was three times more effective than a placebo and just as effective as standard antidepressants, but without the side-effects. Recent evidence indicates that St John's Wort works in a similar way to mainstream selective serotonin re-uptake inhibitors (SSRIs), such as Prozac, which increases levels of serotonin, which facilitates the passage of information in the brain. Eighty per cent of customers at Dublin's General Health Food stores report "excellent results" when "feeling blue or a bit under the weather", although it can take three to four weeks before the benefits are noticeable.
"Prozac is over-prescribed," says Ian O'Flynn of the Herbal and Homeopathic Clinic, Bray, Co Wicklow. For depression, O'Flynn prescribes a herbal "cocktail": St John's Wort for long-term relief, quick-acting valerian to release anxiety in the short term, and kava kava from the South Pacific for mood change. "Nothing is off the shelf," says O'Flynn, who composes an individual mix of herbs for each patient. The little-known kava kava is "gaining a wonderful reputation for its calming and tension-relieving properties," says McKenna. The roots and rhizomes of this six-foot leafy shrub, a member of the pepper family, have been used for social, ceremonial and medicinal purposes by the Polynesians for thousands of years and it is now hailed in the US as a cure-all remedy for the stress-filled 1990s.
Side-effects, of skin disorders and insomnia, appear in heavy users of kava kava and it is not recommended for pregnant women, or for anyone who is severely depressed or already taking anti-depressants. Claims for kava kava's miracle properties do not end with anxiety - it is said to be effective for insomnia, asthma, headaches, genito-urinary tract infections, rheumatism, obesity, fevers, skin diseases and to relieve fatigue. Available from health-food shops in a homeopathic tincture or a capsule, kava kava is often mixed with valerian for sleeplessness, although suppliers warn kava kava alone may cause insomnia in some people.
At the Herbal and Homeopathic Clinic, the herbal preparations are only part of the picture - the homeopaths follow a holistic approach, treating the person as a whole, rather than as a collection of symptoms. "We give a person plenty of time to talk. We get to know details of the cause of the problem, without being intrusive. A person has to get involved in their own treatment and take part in the diagnosis," O'Flynn says.
The issue of involvement in your own health is vital for depression, says Dr Anthony Sharkey, of the Body Mind Consultancy, based at the Dublin Meditation Centre. "At the core of depression is `learned helplessness', when you think that no matter what you do, you are never going to be cured. Meditation, which is a tool for using your mind to work on your mind, provides an indirect benefit and gives hope. If you can direct your mind then, by implication, you can control other aspects of your life." Meditation is also effective in dealing with stress, McKenna says: "It is important to balance periods of high physical and mental activity with periods of complete inactivity as in silent meditation." Sharkey believes "any stress management course which does not have meditation at its core, is not worth it", and says meditation practice "helps a lot" with anxiety, has variable results with insomnia, and can be used to supplement other treatments for depression.
The foods we eat can also influence our emotional well-being and mood. Low serotonin levels have been associated with depression: consuming carbohydrates found in bread, cereals and pasta elevates serotonin levels, as does the intake of certain amino acids such as tryptophan and phenylalanine. Unlike doctors, who believe vitamin and mineral supplements are unnecessary if you eat a balanced diet, McKenna argues supplements are important "because the modern diet is rich in processed foods which are often devoid of essential nutrients and, in addition, fruits and vegetables that we consume are often grown in depleted soils". McKenna attributes his philosophy of natural healing to his childhood in rural Ireland and believes we need to retune to some of the old values and ways. "The Western world is very much about the head, about making money, about `progress'. My upbringing was very much about the opposite: it was about simplicity, about having time to converse and tell stories . . . The more we speak and write and live our lives from the head, the greater our anxiety will be and the more we shall need tranquillisers; the more we live from the heart, the more peace we shall know."
Alternatives to Tranquillisers by Dr John McKenna is published by Newleaf, price £6.99 in UK