St john's wort at work: fiona’s story

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St john's wort at work: fiona’s story
ST JOHN'S WORT AT WORK: FIONA’S STORY
Fiona is a 60-year-old social worker and mother of three grown children who has been troubled by depression and mood fluctuations for years. Her depressive symptoms have often seemed more physical than emotional. During her depressions she would become fatigued, her arms and legs would feel heavy, her eyelids would begin to droop and she would feel 'rather sad and tired', wanting to sleep much of the time. To some extent these problems might have been related to a condition of adrenal failure, known as Addison's disease, from which Fiona suffers. The steroid replacement that is necessary to control her medical condition has been partly responsible for causing Fiona's mood swings. Because of these mood variations she has never been able to rely on her ability to cope and has chosen not to work at her profession.
Fiona had been on Prozac (20 mg per day) for six or seven years. Although she credits Prozac for lifting her out of her depression, it left her with a 'dazed view of the world'. Things did not feel 'quite real'. Her mind was not clear and she would forget things. Her reactions were delayed and it was hard to keep up with a conversation even though she had previously been an extrovert.
Fiona's GP wondered to what degree her problems with thinking were due to the Prozac, and brought her off the medication in order to find out. She soon became depressed again, at which time he started her on St John's Wort (500-750 mg per day). Within two weeks her mood picked up. Her thinking was clearer and she was able to read again. She rates the anti-depressant effect of the St John's Wort on a par with that of Prozac, but she feels that she is now 'part of the world again'. With her newfound clarity she has restarted therapy and is contacting old friends and having lunch with them. She has even initiated 'play groups for adults', where friends come over simply to do fun things like painting or throwing medicine balls around. These get-togethers remind her of the 'co-operative games of the 1960s'. T never got to play them then,' she observes, 'and I want to play them now.'
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