Mood and Sleep Disorders
Mood disorders, such as depression and anxiety, are those which persistently affect a person’s emotional state (mood) and adversely influence their daily life. Anxiety and depression are often concurrent with impaired sleep and cognitive function. These conditions may be triggered by a variety of factors including nutritional, psychological, biochemical, emotional, environmental, social and spiritual. Genetic tendencies and brain disease are also factors. While most of us experience some degree of anxiety, depression or insomnia in our lives, for some these are chronic and even debilitating conditions. Cognitive, mood and sleep disorders affect many people, adversely influencing their ability to lead vibrant, healthy lives and to respond appropriately to
the many challenges of life.
In 2012, according to the National Institute of Mental Health (NIMH), major depression is one of the most common mental disorders in the United States,1 with incidence of about 6.9% of adults. Women are 70% more likely to experience depression. Findings show that eleven percent of Americans, aged 12 years and over, take antidepressant medication. Twenty-three percent of women age 40 to 49 take antidepressants, more than in other age groups.
According to the NIMH, 40 million adults, or about 18.1%, of adults in America, suffer from some type of anxiety. This is almost three times the incidence of depression. Women are 60% more likely than men to experience some form of anxiety. Anxiety disorders are common in Western countries, ranging between 13.6% and 28.8% of the population. Three out of four people with chronic anxiety experience one or more other mental disorders during their lifetime. Many suffer with generalized anxiety disorder, which includes chronic worriers or those who experience low level chronic anxiety with an inability to relax. Additionally, people with chronic anxiety experience trouble with their sleep cycle or ability to experience a deep, restorative sleep. Inadequate sleep adversely affects mood, anxiety and the ability to function well at work and socially. This is reported to be an issue for one third of Americans.
Healing Response and Restorative Sleep
It is essential to initiate the healing response and restore vital function to resolve impaired or prolonged stress response. Evoking the healing response facilitates restorative processes at all levels. This includes addressing physiological, nutritional, emotional/mental, spiritual and lifestyle issues. Sleep disturbance is consistently a risk factor for development of and recovery from mental/emotional disorders. It is a clinical factor in chronic arousal conditions such as PTSD (post-traumatic stress disorder), attention disorders, dementia, Alzheimer’s, anxiety and depression. Lack of sleep or other interruption of the normal, restorative sleep cycle furthers the maladaptive stress response. It triggers mood disorders including
anxiety, depression, and disrupts cognitive function.
We spend an average of about 30% of our lives sleeping and if our normal, personal circadian rhythm and sleep cycle is disrupted, a myriad array of health issues can ensue. Our metabolism, hormonal levels, cellular healing and repair, nervous system response and other functions perform in a specific chronobiological rhythm. Cortisol levels tend to rise in the early morning and dip in the evening before sleep. Our body typically cools during the very early morning hours and warms as we prepare to get up. Night shift workers or those whose work shifts are constantly changing from day to night shifts are found to be at greater risk for immune system issues and even certain kinds of cancer because with a disrupted sleep pattern, natural physiological processes cannot function optimally.
Foundational to any healing process is the ability to sleep well, which is also a key indicator of physical, cognitive and mental health. Sleep, of course, has a profoundly restorative function. Sleep is characterized by quiescence and reduced responsiveness. It has a restorative effect that optimizes neurocognitive, emotional and physiological functions during our waking time. Additionally, researchers find that sleep has transformative effects – promoting lasting changes in the brain, enhancing brain function and exerting a positive influence of learning and memory.8 Studies find that cognitive and emotional memories of events are processed and organized during sleep. Sleep is a state of rest but not of inactivity. There is a lot of neurological activity with neurons firing during the nighttime as the brain and nervous system work to integrate our experiences. Researchers find that sleep is a highly-organized, cyclic process with specific states and transitions. Both sleep and wakefulness are regulated by interacting homeostatic and circadian processes.
Adaptogens are the elite class of herbs essential for restoring the foundation of well-being, normalizing unction and fueling the vital and reserve energy so the body has the ability to heal
and repair. Adaptogens, group of unique botanicals, are particularly suited to addressing the multitude of issues due to exhaustion and depletion of reserves from a prolonged stress response. They engage he body’s healing response by normalizing function, enhancing repair mechanisms and promoting restorative sleep.
Normalizing function (whether hypo- or hyper-) involves mechanisms such as lowering corticosteroid levels, which allows the neuroendocrine
system to return to a balanced rhythm of activity and repose.
When a person is in a state of exhaustion, they literally have no energy, from the cellular level p, with which to engage in the healing process. They are too exhausted to relax, just as tired
little children get wired and won’t sleep. As the person’s energy reserves are restored and their stress response calms, they re able to return to a normal rhythm of activity and relaxation.
Nighttime sleep is when the body does restorative and healing work at the cellular, organ, energetic and other levels of the system.
Adaptogenic herbs were first researched and designated as such by Russian scientists. They were looking for on-toxic herbs to enhance physical stamina, performance and endurance in Russian
athletes, cosmonauts and factory workers during prolonged stress, workload and athletic performance. They searched amongst botanical compounds with long histories of safe use in humans as an alternative to pharmaceutical compounds that have adverse side-effects offering short-term benefits with long-term adverse effects on well being. The simplest definition of adaptogens is any compound that (1) acts in a nonspecific manner to strengthen physiological adaptation, (2) exerts a normalizing action upon physiological responses, and (3) has a restorative effect on the organ and energy systems, enhancing optimal function – all with no side effects and while bringing the system as a whole back into its natural state of harmony.
This approach to healing has been utilized for thousands of years by ancient medicines, such as Ayurvedic and Chinese, along with the more modern Vitalist herbal tradition. Each of these traditions recognizes that there is a vital life force or energy that drives the neuroendocrine, cellular and other systems of the body. This vital life force is known in ancient traditions around the world as Prana (Ayurveda), Qi (Chinese Medicine), Ki (Kiatsu in Japan) and a multitude of other names. In these age-old medical traditions, specific herbs are recognized, classified and used according to their ability to nourish and support this vital life force in its very specific manifestations, and in relation to specific organ systems and functions.
Supportive, Adjunct Compounds and Formulations
Supportive herbs, nutrients and natural compounds are used to focus therapeutic support in a particular area, such as cardiovascular or neurocognitive. These play a supportive and/or adjunct role in the overall therapeutic treatment. Often nutritive or other natural compounds enhance formulations through their calming, supportive or nourishing functions. B-complex vitamins support a multitude of metabolic pathways and enhance healthy neurotransmitter function. Herbs high in flavonoids and other such compounds provide raw materials for healing and repair in
cells, vascular tissue and organ function and can provide anti-inflammatory and anti-oxidative benefits. Carnitine supports mitochondrial function and energy metabolism at the cellular
For cognitive and mood issues, many nervine herbs both nourish and calm the nervous system. Which of the hundreds of nervine herbs is chosen depends on the person and their needs. There is also a host of nutritional, herbal and other natural compounds to consider. Many of these are discussed later in this paper. Combination botanical formulas provide foundational support. Such formulas combine adaptogenic herbs with organ- and system-specific botanicals and nutrients. When higher doses of individual nutrients are desired, these can be integrated into the overall program tailored for the individual. For example, glycine is a key nutrient to modulate anxiety. It can be especially beneficial when taken at night before bed, often combined with the glycinate form of magnesium. Therapeutic dose of glycine for this purpose is usually between 150mg to 300mg before bed. A formula containing glycine combined with supportive herbs and
nutrients can enhance beneficial results. If additional amounts of glycine are desired, it can be used singly to meet the desired dosage.
A formula containing a number of compounds can provide a synergistic blend that is greater than one compound given alone, even at a higher dose. But individual response can differ, and some may benefit with additional amounts of specific compounds or botanicals. This is one way that protocols can be tailored for specific needs.
Glycine is a nonessential amino acid and neurotransmsitter that is metabolized in the brain. It inhibits release of norepinephrine and exerts a calming influence. For this reason is found to
modulate anxiety. Receptors for glycine are found throughout the vertebral central nervous system, in the brain stem and in the spinal cord and throughout the tissues. Highest concentrations of glycine are found in the thalamus, amygdala, substantia nigra and other areas.25 GABA receptors, melatonin, serotonin and dopamine play a big part in controlling mood, circadian rhythm, sleep duration and depth. Glycine is a precursor to GABA.
Nervines are a broad group of herbs that help calm and restore balance to the nervous system. Some nervine herbs are nutritive and restorative, such as Milky Oats (Avena sativa), which is also
a restorative tonic for the adrenal axis. Others calm the nervous system on a spectrum from gently calming to strongly sedating. Gently calming nerviness such as Passion Flower (Passiflora incarnata), Lemon Balm (Melissa officinalis) and Chamomile (Anthemis nobilis), are excellent for children and for sensitive adults. More strongly sedating nerviness, such as Kava Root (Piper methysticum) are useful to dampen an over-reactive nervous system.
Since adaptogenic botanicals work in a non-specific manner, they work on the system as a whole while modulating the neuroendocrine and immune system function and response. Adaptogenic botanicals enhance a resilient stress response and the capacity to achieve the best therapeutic benefits from any integrative protocol. Use of botanical and nutritional medicines to support and balance hormonal and neurotransmitter responses and to calm and nourish the nervous system offer a foundational approach to any integrative program. This is central to address issues such as cognitive health, mood and a restorative sleep cycle to enhance optimal well-being.
Donald R. Yance Jr., RH (AHG), CN and
Suzanne E. Sky, L.Ac., MTOM