Herbs and the Nervous sytem Flashcards

Question

What is the function of interneurons?

Answer 1

Interneurons are found only in the central nervous system where they connect one neuron to another.

Answer 2

neurons are not the most common type of cell in the nervous system. Another type of cell, glial cells (also called neuroglia), outnumber neurons by 10-50:1

Answer 3

Glial cells provide structural stability to neurons by wrapping themselves around them. They have a variety of other functions, including transferring nutrients from the blood to the neurons and creating myelin to support and insulate axons.

Answer 4

Communication between neurons occurs in the synapse between the axon of one neuron and the dendrite of another. One cell can have over 150,000 synapses so there can be a lot of communication going on in one tiny area (Silverthorn, 2004)! There are two types of synapses: the electrical synapse and the chemical synapse. Chemical synapses are much more common and use chemicals called neurotransmitters to carry information from one neuron to another. There are many neurotransmitters that our body uses to communicate including norepinephrine, dopamine, and serotonin. Electrical synapses are less common and are only used when extremely rapid conduction of a signal is necessary (Costanzo, 2010).

Answer 5

the spinal cord, which connects the brain to the rest of the body.

Answer 6

The capillaries of the CNS have a slightly different structure than the capillaries in the rest of the body. Weaving all throughout the brain, these capillaries are highly selective—they only allow certain substances to pass through their membranes. This web of selective capillaries is known as the blood-brain barrier and it is vital in isolating the brain from harmful substances that may be in the blood and sheltering the brain from toxins and from fluctuations in hormones, ions, and neurotransmitters.

Answer 7

Two important substances that do cross the blood-brain barrier are oxygen and glucose. Neurons consume oxygen at very high rates and the brain is responsible for about half of the body's glucose use (McCance et al., 2010)! Certain pharmaceutical medications and some herbal constituents are also able to cross the blood-brain barrier.

Answer 8

Basically, the RAS connects the seat of involuntary functions in the brain (the brainstem) to the seat of consciousness in the brain (the cerebral cortex). Besides processing arousal and sleep, the RAS filters the information that we receive from our external environment, giving us the ability to focus on one thing and be only mildly aware of other things around us. It also aids in coordination during any physical activity, including the seemingly simple act of walking.

Answer 9

While the RAS keeps our brain quiet while we sleep, our circadian rhythm is what actually initiates that sleepy feeling. Circadian rhythms are physical and mental changes that follow a 24-hour cycle and that are typically in response to the amount of light or darkness in our environment. All of this is controlled by our internal “clock,” which resides in a complex network of neurons in the hypothalamus of the brain. Circadian rhythms influence our sleep-wake cycle (because of the influence on melatonin secretion), the release of hormones, our body temperature, and insulin and cortisol release. Because they have such a wide-ranging influence on various body systems and functions, disruption to circadian rhythms can have significant effects on our health and wellness

Answer 10

For a human to feel an emotion, sensory stimuli must first be fed into the cerebral cortex, where a perception of that stimuli is created. Information about the stimuli is then passed on to the limbic system. Feedback from the limbic system back to the cerebral cortex creates awareness of the emotion and feedback to the hypothalamus and brainstem initiate voluntary, as well as involuntary responses, such as changes in heart rate, behavioral changes, and movement of the body (Silverthorn, 2004). Thus, an emotion is much more than a thought in the brain; it can affect all areas of the body.

Answer 11

The PNS has two divisions: the somatic motor system and the autonomic system. The somatic motor system contains neurons that control skeletal muscles (this is also known as the voluntary division of the PNS, because even though we don't normally think, “I am going to pick up my right leg now,” as we are walking, we can control these movements). The autonomic system, or the involuntary division, controls actions of smooth muscles, cardiac muscles, and many glands.

Answer 12

The autonomic nervous system is further divided into sympathetic and parasympathetic branches. These two branches work in tandem, each taking the lead depending on the situation.

Answer 13

The parasympathetic nervous system is activated when a person is resting and is often called the rest-and-digest mode of the nervous system. Pupils: constrict Saliva production: increases heart rate: reduces Bronchia: constricts Digestive organs activity and bloodflow: increase Pancreas activity: increase Gallbladder activity: increase urinary bladder: constricts genitals: stimulates errection

Answer 14

The sympathetic branch is dominant in stressful situations. When the sympathetic nervous system is dominant, one is in what is commonly referred to as fight-or-flight mode. Pupils: dilate Saliva production: decrease Heart rate: increase Bronchia: dilate Digestive organs activity and bloodflow: decrease Pancreas activity: decrease Gallbladder activity: decrease Adrenal madula: releases adrenalin/nordrenalin urinary bladder: relaxes genitals: stimulates orgasm.

Answer 15

the ENS is composed of millions of neurons in the wall of the gastrointestinal tract (Silverthorn, 2004). These neurons receive messages from the vagus nerve and are responsible for promoting secretion of digestive juices, permitting food to pass from one area of the digestive system to another, and controlling peristalsis.

Answer 16

The ENS, the nervous system located in the gastrointestinal tract, controls digestion with or without input from the CNS and influences our mood and emotions. Because emotional stimuli can share the same nervous system pathways as messages about digestion, emotions can also directly affect digestion. We feel the effects of the ENS when we experience nervousness as “butterflies in the stomach” or have diarrhea from anxiety. In fact, the ENS plays a key role in determining our mood and emotions. Thus, keeping the digestive system healthy is a great way to help avoid nervous system imbalance.

Answer 17

adaptogens

Answer 18

stress is any response to a perception that requires an adjustment/change in the body, and is necessary for staying alive. Our body is constantly experiencing stress as our interior and exterior environments fluctuate and the body works to maintain homeostasis

Answer 19

homeostasis, a state of physiological balance that allows our cells to remain stable despite external fluctuations and changes. It is when the body is unable to maintain that homeostasis that we start to notice the effects of stress on our physical body, especially the nervous system, and thus in our behavior, thoughts, and emotions.

Answer 20

When the nervous system interprets a situation as stressful, the sympathetic nervous system (SNS) is activated. When the SNS is activated, the neurotransmitters norepinephrine (also known as noradrenaline) and epinephrine (also known as adrenaline) are released by the adrenal medulla (tissue located in the core of the adrenal glands, the little glands that sit on top of each kidney). These hormones are what cause the fight-or-flight response The release of norepinephrine and epinephrine causes several shifts in the body: the heartbeat quickens, the breath quickens, blood pressure increases, glycogen (a form of stored energy) is pulled from storage and converted to glucose for energy, and the bronchioles of the lungs dilate. This all happens very quickly—minutes after we perceive a stressful situation Another section of the adrenal gland—the cortex, or the outer tissue of the adrenal gland—secretes different hormones in response to stress, including cortisol. Receptors for cortisol are in virtually every tissue of the body so stress is truly felt everywhere (Tsigos et al., 2016). Cortisol is responsible for many physiological changes that would be useful if we needed to fight or to run for our lives, but are not as useful when we are driving in traffic “stressing” about our to-do list. Cortisol frees up bits of protein from our muscles and other tissues to liberate amino acids so that the liver can continue to produce glucose and keep blood sugar elevated. This way, the brain and heart receive more sugar than the rest of the body, allowing for continued physical activity and focus In the first hour or so after cortisol is released, the immune system is stimulated (this is so that the body is prepared to resist trauma, infection, and hemorrhage). However, after that period of time, there is a decrease in immune activity and the body begins to not respond as well to immune challenges and makes fewer important immune cells such as macrophages and T-cells

Answer 21

1. Cortisol breaks down muscle protein to liberate amino acids. 2. Cortisol boosts prolactin levels, which antagonizes dopamine (our pleasure hormone). 3. Cortisol stimulates the immune system in the first hour or so after it is released, and later suppresses it 4. Cortisol decreases delta wave sleep patterns. 5. Cortisol reduces absorption of dietary calcium 6. Cortisol inhibits gonadotropinreleasing hormone, which results in a decrease in the secretion of sex hormones

Answer 22

Sex hormones, such as progesterone, estrogen, and testosterone, also decrease in response to cortisol (why would our body want to reproduce when we are assumed to be in a life-or-death situation?). The decrease in secretion of sex hormones is due to the inhibition of gonadotropin-releasing hormone (GnRH) by cortisol. GnRH is a sex hormone secreted by the hypothalamus and when it is inhibited by cortisol, it is not able to do its job of triggering the pituitary gland to produce and secrete other sex hormones (Breen et al., 2008).

Answer 23

When cortisol levels are high in the body, there is also a reduction in absorption of dietary calcium (potentially resulting in osteoporosis over the long term) and an increase in prolactin levels.

Answer 24

Prolactin antagonizes dopamine, our pleasure hormone—we don't feel as much pleasure while we are perceiving stress. For this reason, among others, chronic stress has been associated with depression (van Praag, 2005).

Answer 25

Deep sleep is also less likely to happen during times of stress because there is a decrease in delta wave sleep patterns with increased cortisol (Bush & Hudson, 2010) (we need to run or fight, not take a nap!). Because we are meant to be fighting or fleeing when we are in this state,

Answer 26

exercise clears cortisol from the body. If our body is not active (e.g., if we are watching a stressful movie while we sit leisurely on the couch) cortisol is cleared less quickly (Tsigos et al., 2016).

Answer 27

When stress becomes chronic (when the body is chronically exposed to stress hormones), our perception of “reality” can shift, causing us to be hyper-vigilant and thus perceive more stress, creating a cycle that feeds itself. Due to this feedback loop, chronic stress can cause anxiety, depression, weight loss or gain, fatigue, sleep disruption, insulin resistance, and hypertension. From chronic stress we may enter a state in which we are less able to maintain homeostasis in the body when the environment around us shifts

Answer 28

1. Improve resistance to and recovery from stressors; 2. are generally safe for most people; 3. have non-specific activity (instead of affecting one area of the body, they have a general effect on increasing resistance to stressors on the body as a whole).

Answer 29

Adaptogens work to maintain our reserves of energy, enhancing the process of recovery from chronic stress (and usually other conditions, as well), and many can “recharge” the body, bringing it back from depletion. Most adaptogens are also immunomodulating (they tonify and restore balance in the immune system) and antioxidant (they help to neutralize potentially damaging agents, such as free radicals, from the body and so are often considered beneficial in warding off cancer).

Answer 30

Asian Ginseng (Pinax ginseng) Ashwagandha – Withania somnifera (Solanaceae) – Root Codonopsis – Codonopsis pilosula (Campanulaceae) – Root Eleuthero – Eleutherococcus senticosus (Araliaceae) – Root Tulsi – Ocimum tenuiflorum (Lamiaceae) – Aerial parts

Answer 31

Red ginseng is white ginseng that has been steamed. Red ginseng is more warming and stimulating than white ginseng Red ginseng is more readibly available.

Answer 32

Adaptogen, antioxidant, hypoglycemic, hypolipidemic, immunomodulant, stimulant

Answer 33

Asian ginseng is an adaptogen specific for stress in the cardiovascular system and for individuals whose stress is affecting their heart or blood vessels.

Answer 34

Asian ginseng may decrease blood clotting in people taking warfarin. Asian ginseng may interfere with blood glucose regulation and people with diabetes should only take Asian ginseng under the guidance of a qualified healthcare practitioner (Gardner & McGuffin, 2013).

Answer 35

Adaptogen, anti-inflammatory, antioxidant, antispasmodic, hepatoprotective, hypolipidemic, immunomodulant, nervine, sedative, thyroid stimulant

Answer 36

ashwagandha means “that which has the smell of a horse, as it gives the vitality and sexual energy of a horse”

Answer 37

provides a boost in libido! It is best used as a long-term sexual tonic (ashwagandha does not often work acutely, to “get in the mood,” rather, it tends to work over the long-term for the person who’s libido suffers due to chronic stress) (Lad & Frawley, 1986). a good choice for those with exhaustion, anxiety, insomnia related to stress, cloudy thinking, and lack of energy

Answer 38

whereas many adaptogens are stimulating, ashwagandha is calming. In fact, the species name (somnifera) suggests its use as a sedative and indeed, for some, it can be useful as a sleep aid. However, for some individuals, especially those with a lot of nervous energy, ashwagandha can, and should, be taken in the morning—the sedating qualities of the plant will calm the nerves rather than send them back to bed.

Answer 39

Ashwagandha should not be used in pregnancy unless under the care of a qualified healthcare professional. Because ashwagandha can modify blood glucose levels, those with diabetes should be under the care of a qualified healthcare professional when taking ashwagandha (Gardner & McGuffin, 2013).

Answer 40

Codonopsis

Answer 41

Adaptogen, expectorant, hypoglycemic, immunomodulant

Answer 42

slightly warming and moistening

Answer 43

Codonopsis has a strong affinity for the digestive organs and strengthens both digestion and assimilation. Modern Western herbalists use codonopsis as an adaptogen when stress leads to digestive upset such as a lack of appetite, diarrhea, and/or bloating

Answer 44

In Chinese medicine, codonopsis is known as dang shen, and is regarded as an analog to Asian ginseng, though not as strong in its actions. Chinese medicine practitioners use codonopsis for Spleen and Lung qi deficiencies, fatigue, diarrhea, chronic cough, and organ prolapse

Answer 45

No known safety issues

Answer 46

Adaptogen, antioxidant, hypolipidemic, hypotensive, immunomodulant

Answer 47

It's primary function is to increase endurance. Best suited for those who are suffering from burnout and fatique but who needs to keep going. eleuthero is an adaptogen specifically “for those that work hard, play hard, and hardly sleep” (2007, p. 160). Eleuthero is commonly used to enhance physical performance and reduce fatigue and for most people, it does this without being overly stimulating. Germany’s Commission E approved eleuthero as “a tonic for invigoration and fortification in times of fatigue and debility or declining capacity for work and concentration, also during convalescence” (American Botanical Council, 2007, para. 5). Eleuthero is specifically indicated for exhaustion, irritability, insomnia, and mild depression and conditions such as angina, hypertension, hypotension, and various types of neuroses resulting from the stress response (Hoffmann, 2003). Eleuthero is also normalizing to the thyroid, so can be beneficial for those with hyperthyroid as well as hypothyroid conditions (Wood, 2008).

Answer 48

“The use of [eleuthero] typically generates no side effects, unlike traditional stimulants that possess addiction, tolerance and abuse potential, produce a negative effect on sleep structure, and cause...'come down' effects. Furthermore, [eleuthero] effectively increases mental performance and physical working capacity in humans”

Answer 49

Adaptogen, alterative, anticancer, antidepressant, antimicrobial, antioxidant, antispasmodic, cardiotonic, carminative, diaphoretic, emmenagogue, expectorant, galactagogue, immunomodulant, nervine, radioprotective

Answer 50

In Hindu mythology, tulsi is an incarnation of the goddess Tulasi—a goddess of protection. Tulsi plants are often planted at the door of one's dwelling to protect all who live there. Use tulsi as your own protector against stress, illness, anxiety, and sadness!

Answer 51

Tulis is best suited for stress that causes anxiety and which impairs cognition and memory. Tulsi is a nervine and anxiolytic, and has been shown to attenuate generalized anxiety and correlated stress and depression (Bhattacharyya et al., 2008). It is both a relaxing and stimulating nervine, promoting calm focus. It can help with cognitive performance and in cases of poor memory, attention deficit disorder (ADD), and attention deficit hyperactivity disorder (ADHD) because of its ability to enhance cerebral circulation, an action that may improve overall function (Winston & Maimes, 2007).

Answer 52

In Ayurveda, tulsi is used to kindle the digestive fire, clear mucus from the lungs or head, and strengthen the immune system. It is indicated for cold, congested, stuck conditions, which may be helped by the gently stimulating and moving effects of the volatile oils. It is considered balancing to all doshas, though may aggravate pitta dosha in excess (McIntyre & Boudin, 2012).

Answer 53

Tulsi may interfere with blood glucose regulation and people with diabetes should only take tulsi under the guidance of a qualified healthcare practitioner (Gardner & McGuffin, 2013).

Answer 54

Warming and drying

Answer 55

Tulsi affects reduces the production of cortisol via the HPA axis and at the same time increases the production of dopamine and seratonin

Answer 56

Nervines are essentially plants that "calm the nerves" and most nervines contain volatile oils, which, in part, are responsible for their nervine effect.

Answer 57

Most volatile oils are nervine, carminitive, antispasmodic and anti-inflamatory. In addition to releasing tension in the nervious system, they also sooth and relax the smooth muscle of the vascular and digestive system as well as that of other organs, relieving spasms and making us more feel relaxed and at ease. Volatile oils also act on our sense of smell, which is directly connected to the limbic system of the brain, which governs emotion and memory. When we catch the scent of an aromatic plant, nerve endings are stimulated to send impulses to the limbic system and to structures that manage stress in our internal organs; All and all, this balanced state in our internal organs are reflected in our emotions.

Answer 58

Lemon balm – Melissa officinalis (Lamiaceae) – Aerial parts Lavender – Lavandula spp. (Lamiaceae) – Flower bud Catnip – Nepeta cataria (Lamiaceae) – Aerial parts Skullcap – Scutellaria lateriflora (Lamiaceae) – Aerial parts

Answer 59

Antidepressant, antioxidant, antispasmodic, antiviral, carminative, diaphoretic, nervine, radioprotective

Answer 60

Cooling and drying

Answer 61

Lemon balm is calming an uplifting and is indicated for the relief of stress, depression and anxiety, especially where when the aforementioned causes dyspepsia or affects the cardiovascular system, such as high blood pressure or arythmia

Answer 62

GRAS Lemon balm is generally regarded as safe.

Answer 63

Analgesic, antibacterial, antidepressant, antispasmodic, carminative, circulatory stimulant, diaphoretic, nervine

Answer 64

Cooling and drying

Answer 65

nervine tonic for nervous system complaints such as anxiety, depression, insomnia, nervous debility or exhaustion, and headache.As a carminative and antispasmodic (Hoffmann, 2003), lavender relaxes spasms in the digestive tract associated with tension and anxiety and eases flatulence

Answer 66

GRAS- Lavender is generally regarded as safe.

Answer 67

Analgesic, anticatarrhal, antispasmodic, aperient, bitter, carminative, diaphoretic, emmenagogue, nervine, sedative

Answer 68

Mild tranquilizer used to ease nervous tension.

Answer 69

Catnip should be avoided in pregnancy

Answer 70

Nepeta cataria (Lamiaceae)

Answer 71

aerial parts

Answer 72

Skullcap – Scutellaria lateriflora (Lamiaceae)

Answer 73

Aerial parts

Answer 74

Analgesic, antispasmodic, bitter, hypotensive, nervine

Answer 75

Cooling and drying

Answer 76

One of the best herbs for the mind that just won't quiet down, a clinical trial of skullcap showed “noteworthy anxiolytic effects” in healthy subjects (Wolfson & Hoffmann, 2003). Skullcap is a great herb to turn to when there is a feeling of stuckness resulting from a constant state of stress that leaves one tense, exhausted, and suffering from heart palpitations (Rose, 2007). Skullcap is also indicated for people needing to release control, or as herbalist David Winston describes, those who are likely to “fly off the handle” when under stress and then feel hopeless and out of control as a result (Rose, 2007). David Hoffmann (2003) calls skullcap “perhaps the most relevant nervine available to us in the Western materia medica. It effectively soothes nervous tension while renewing and revivifying the central nervous system” (p. 582). In a nod to its uplifting, nervine effects, herbalist Kiva Rose has renamed the plant with the much lovelier moniker “blisswort.” In general, skullcap is considered a nerve trophorestorative, meaning it restores balance to the nervous system by nourishing and rebuilding nerves. Holmes (2006) describes it as a nervous system restorative “for debilitating effects due to longstanding unproductive stress, whether caused by disease or excessive lifestyle” (p. 509). Some individuals experience skullcap as a sedative, while others say that too much can make them feel jittery. Both effects are uncommon. Skullcap can be used fresh or dried for tea and tincture, though some herbalists recommend a fresh plant tincture as the most potent preparation of skullcap.

Answer 77

Avoid during pregnancy Avoid when taking sedatives (potentiates) Skullcap products in the marketplace have a history of adulteration with germander, a hepatotoxic plant, so it is important to source skullcap from a reputable, trustworthy source. Overdose of adulterated skullcap tincture resulted in stupor, confusion, giddiness, and twitching of limbs. Holmes (2006) warns that skullcap root should be avoided during pregnancy. Skullcap may potentiate sedative medications (Hoffmann, 2003).

Answer 78

Linden – Tilia spp. (Malvaceae)

Answer 79

Flower and bract

Answer 80

Anodyne, antifungal, antispasmodic, antitussive, carminative, diaphoretic, diuretic, expectorant, hepatoprotective, hypotensive, nervine

Answer 81

Cooling and moistening

Answer 82

Linden has been used widely for its calming and anxiolytic effects. Bathwater infused with linden has been used traditionally to ease anxiousness, irritability, and restlessness and to foster a calm and relaxed state for adults and children alike. Internally, an infusion of linden flowers is used in many cultures for people of all ages as a soothing nervine or gentle sedative for quelling anxiety, hyperactivity, and insomnia (King et al., 1898). As an infusion, linden has an agreeable aroma and flavor, owing to its aromatic volatile oils, and it combines well with other herbs in tea blends. Linden has an affinity for the heart. It has a traditional reputation for cardiovascular and circulatory disorders, such as atherosclerosis, hypertension, and swollen ankles, and is sometimes combined with hawthorn for this purpose (Hoffmann, 1998; World Health Organization, 2010). Its relaxing effects and circulatory benefits can ease nervous headaches, sinus headaches, and migraines (Hoffmann, 1998; World Health Organization, 2010)

Answer 83

Linden should be taken separately from iron supplements and iron-rich food, as it may reduce iron absorption (Gardner & McGuffin, 2013).

Answer 84

Chamomile – Matricaria chamomilla (Asteraceae)

Answer 85

Anti-inflammatory, antimicrobial, antispasmodic, bitter, carminative, nervine

Answer 86

Cooling and drying

Answer 87

Chamomile makes a soothing tea or tincture helpful for easing anxiety and tension. One clinical trial reported a significant anxiolytic effect in patients with mild to moderate generalized anxiety disorder who were given chamomile (Amsterdam et al., 2009). Another study a few years later by the same researchers found that chamomile "may provide clinically meaningful antidepressant activity" (Amsterdam et al., 2012). Chamomile may also help ease premenstrual syndrome (PMS) symptoms. A randomized, double-blind study reported a significant reduction in emotional symptoms after taking 100 mg of chamomile three times a day (Sharifi et al., 2014). Due to its anti-inflammatory properties and cooling nature, chamomile is especially beneficial for those who experience anger and inflammation when under stress. A classic digestive herb due to its bitter, carminative, antispasmodic actions, chamomile also benefits those who experience gastrointestinal upset under stress.

Answer 88

Those with allergic sensitivity to Asteraceae (daisy) family plants may experience sensitivity to chamomile. Chamomile has also been shown to potentially reduce iron absorption in humans when taken at the same time (Bone & Mills, 2013).

Answer 89

Some individuals feel the effects of stress in their heart as heart palpitations or a rapid heart rate. Linden (Tilia spp.) bract and flower, motherwort (Leonurus cardiaca) aerial parts, or hawthorn (Crataegus spp.) berry, leaf, and/or flower could be added to an anti-stress formula for this individual.

Answer 90

The digestive system of some individuals is affected by stress and manifests as “butterflies,” nausea, diarrhea, or indigestion. Chamomile (Matricaria chamomilla) flower, tulsi (Ocimum tenuiflorum) aerial parts, or lemon balm (Melissa officinalis) aerial parts could be added to an anti-stress formula for this individual.

Answer 91

Some individuals hold stress in their muscles, resulting in tension in various places in the body. Skullcap (Scutellaria lateriflora) aerial parts or blue vervain (Verbena hastata) aerial parts could be added to an anti-stress formula for this individual.

Answer 92

majja dhatu

Answer 93

vata dosha

Answer 94

The concept of movement applies to our thoughts and nerve impulses. Wherever movement exists, vata is present. In fact, the ancient ayurvedic rishis, or sages, likened our nerve impulses to a wind moving through the body (Frawley, 2000).

Answer 95

An excess of Vata or disturbance of the nervous system.

Answer 96

vata vyadhi (meaning vata disorder)

Answer 97

Broadly speaking, nervous system imbalances are the result of either a blockage of the nerve impulses or weakened and depleted nerve tissue.

Answer 98

Blockage of the nerve impulses can be due to an excess of any of the three doshas: vata, pitta, or kapha, as well as accumulation of ama (undigested food or experiences).

Answer 99

Wasting or weakening of the nerve tissue is usually due to vata or pitta excesses. Vata dosha, which is cold, light, dry, and mobile, has a way of depleting any bodily tissue that it invades. Also, vata tends to move into empty spaces. So, areas of the mind and body that are left porous by deficiency or loss become easy hosts for vata dosha. Pitta dosha, with its strong and potentially destructive heat, has a way of causing depletion by burning tissue up (Frawley, 2000).

Answer 100

Prana vayu is located in the head and centered in the brain. Prana vayu draws energy into the body through the five senses (Halpern, 2012). Prana vayu is also the motivating force behind the acts of inhalation, swallowing, sneezing, spitting, and belching, which are incidentally actions centered in the head, throat, and upper chest region (Frawley, 2000). Udana vayu, located in the chest and centered in the throat, governs all upward and outward moving actions of the body. It is the upward and outward wind. Udana vayu is also connected to our muscle tissue, and a healthy udana vayu expresses as strong memory, strength, and ability to carry out our will in the world (Frawley, 2000). It may be worth noting that in order for muscles to move, nerve impulses are required. Vyana vayu is centered in the heart and governs the circulatory system as well as the movements of the joints and muscles. Vyana vayu is referred to as the diffusive or pervasive air, largely due to its involvement in circulation (Frawley, 2000). Samana vayu is based in the small intestine and governs the nerve activity that is involved in digestion (Frawley, 2000). Digestion isn’t just an interplay of microbiota, enzymes, and acids. The enteric nervous system pervades the gut (Enders, 2015) and is the house of samana vayu. apana vayu is the downward moving air. Its center is the colon and is responsible for all processes of elimination, such as menstruation, urination, ejaculation, and excretion (Frawley, 2000).

Answer 101

food that is warm, moist and heavy.

Answer 102

a lifestyle that is grounding and calming.

Answer 103

If there is a disturbance to the nervous system and vata is deemed the culprit (which is usually the case), it is helpful to pinpoint which vata subdosha is disturbed. Also, any time the movements of the body are imbalanced, the nervous system is involved, and hence vata is as well. Recommendations for pacifying vata can be fine-tuned based upon the particular type of vata disturbance and what aspects of the nervous system are affected.

Answer 104

Though the nervous system is not clearly described in Chinese medicine, qi plays an important role in maintaining balanced energy for vital physical and mental functioning. qi is commonly translated as energy or vital energy, but most scholars are dissatisfied with this translation because qi does not correlate with our typical Western definition of energy; nor is energy a complete definition (Deadman, 2007; Maciocia, 2015).

Answer 105

Qi is one the Three Treasures of Chinese medicine: qi (vital energy), jing (essence), and shen (spirit). In this context, qi is one aspect of the Three Treasures, which together, in balance and harmony, determine the wellbeing of our body, mind, emotions, and spirit.

Answer 106

The balance of pre- and postnatal qi is a central concept in Chinese medicine. Our prenatal qi can be thought of as our genetics and basic constitutional makeup and is stored in the Kidney. Postnatal qi is formed by the Spleen from the food we eat. If our prenatal qi is weak, we can improve our health through dietary and lifestyle changes that promote our postnatal qi.

Answer 107

Qi is a force that moves things. So just as qi moves air, it moves blood, fluid, and nerve impulses through the body. qi itself, as a substance, is formed from the combination of good food and pure air and travels through the meridian systems of the body to nourish every cell, tissue, and organ.

Answer 108

Gu qi (Grain qi) is known as the earthly qi we derive from food. Zong qi (Gathering qi) is derived from the combination of the pure qi of food (from the Spleen) and the pure qi of air (in the Lung). This refined form of qi nourishes the Heart and Lung, promotes blood circulation to the extremities, and has numerous other vital functions. Zhen qi (True qi) originates from the Lung and the zong qi and is the qi that circulates through the meridians. Zheng qi (Upright, or True, qi) ensures harmonious physiological function. It denotes what is correct or upright in both a physiological and ethical context. It plays a role in defending the body from pathogenic factors. Wei qi (Protective qi) is derived from a portion of the food we eat. It is a coarse form of qi that circulates around the exterior of the body, in the more superficial layers of the skin. It is in charge of the opening and closing of the pores and helps protect from invasion of pathogenic factors, such as wind and cold. Wei qi is a form of zhen qi. Ying qi (Nutritive qi) flows with the blood in the blood vessels and flows through the meridians to nourish all internal organs (Dawes, 2004; Deadman, 2007; Dharmananda, 2018; Maciocia, 2015).

Answer 109

linden (Tilia spp.) bract and flower skullcap (Scutellaria lateriflora) aerial parts lemon balm (Melissa officinalis) aerial parts chamomile (Matricaria chamomilla) flower catnip (Nepeta cataria) aerial parts (0.01 oz) lavender (Lavandula officinalis) bud

Answer 110

Asian ginseng – Panax ginseng (Araliaceae) – Root Ashwagandha – Withania somnifera (Solanaceae) – Root Codonopsis – Codonopsis pilosula (Campanulaceae) – Root Eleuthero – Eleutherococcus senticosus (Araliaceae) – Root Tulsi – Ocimum tenuiflorum (Lamiaceae) – Aerial parts

Answer 111

Primary headaches have no underlying cause and are a "disease in themselves", while secondary headaches are caused by underlying health conditions and are a "symptom of another disease".

Answer 112

Tension headaches

Answer 113

pain that is mild to moderate in intensity. bilateral doesn't worsen with physical activity or ADLs pressing/tightening quality, but not pulsating Nausea is absent unless the headaches become chronic, at which point pericranial tenderness may also be experienced slightly sensitive to light and sound

Answer 114

Primary headaches

Answer 115

Many researchers currently suggest that there are imbalances in central pain processing as well as a lower threshold for pain sensitivity in individuals who experience tension headaches (Loder & Rizzoli, 2008). Tension-type headaches are also hypothesized to be caused by genetics, environmental factors, tenderness of pericranial muscles, mechanical disorders of the spine or neck, co-existing mood disorders, or changes in neurotransmitters (Kaniecki, 2015; Rizzoli & Mullally, 2018; Siva Krishna et al., 2012). In addition, there are certain individual triggers that can bring on a tension headache. These contributing factors may include stress, arthritis, anxiety, depression, body posture, eye strain, fatigue, skipping meals, head or neck injury, jaw-clenching or teeth-grinding, medications (including some that are specific to headaches), hormonal shifts, chronic overwork, sleep imbalance, and the use of stimulants (Siva Krishna et al., 2012).

Answer 116

Tension headaches occur either episodically or chronically. Almost everyone gets infrequent episodic-type tension headaches at some point in their life (Rizzoli & Mullally, 2018)—these are generally self-managed and do not require any medical attention (Kaniecki, 2015). Frequent episodic and chronic tension headaches, on the other hand, can be very debilitating and indicate the need for intervention (Kaniecki, 2015; Loder & Rizzoli, 2008).

Answer 117

Generally, the causes of tension headaches are so varied that the same approach might not work for everyone. Generally a person should try to identify their triggers and work to avoid or desensitize them. Manual bodywork: Schultz’s autogenic training, cervical spine kinesiotherapy, and posture-correction training are all bodywork techniques that have shown efficacy in avoiding headaches and a decrease in headache pain (Álvarez-Melcón et al., 2018). Relaxation techniques: Biofeedback training, in particular, has been demonstrated to control body responses to pain, slow heart rate and breathing, and reduce muscular tension (Freitag, 2013; Lodor & Rizzoli, 2008; Rizzoli & Mullally, 2018). A good night’s sleep: One study demonstrated that headaches occurring overnight or upon waking represented sleep disturbance in 55% of the study participants, and when those varied causes of sleep disturbance were treated, 100% of headache symptoms in the participants improved, with a 65% rate of full recovery (Paiva et al., 1997). Regular exercise: Regular exercise may aid in overall pain management for tension headaches (Kaniecki, 2015) and is very often reported to be of benefit to headache sufferers, but studies—particularly randomized, controlled trials—remain scant (Jensen, 2001). However, individuals with tension-type headaches have been found to have lower levels of physical activity than those without (Krøll et al., 2017). Isotonic exercises, wherein the muscles are toned by bearing weight in a range of motion (e.g., weight lifting), along with other physical therapy treatments, was found to be beneficial for tension headache (Hammill et al., 1996). Tai chi has also been studied in relation to tension headache and has been found to reduce the impact of headaches and to improve other aspects of mental and physical health at the same time (Abbott et al., 2007). Psychological approaches: Cognitive-behavioral therapy and mindfulness-based stress reduction (MBSR) have been used successfully to manage stress triggers that worsen or initiate tension headaches (Holyroyd, 2002; Kaniecki, 2015; Omidi & Zargar, 2015).

Answer 118

The role of nutrition in tension headache is not well understood, although simply not eating at regular times may be a factor (Spierings et al., 2001); fasting and low blood sugar have also been found to impact the frequency of headaches (Woolhouse, 2005). Individual dietary triggers can certainly precipitate headaches and it may take some close consideration to isolate and then manage these triggers. Keeping a diet history or journal may help in identifying triggers and determining a personal meal plan to avoid them (Woolhouse, 2005). Tension headache triggers may include chocolate, cheese and other dairy products, flavor additives (such as monosodium glutamate (MSG)), red wine, beans, nuts, nitrates in processed meats, and caffeine (Siva Krishna et al., 2012). Regulating blood sugar and hydration is key

Answer 119

Herbal tension headache support often focuses on ameliorating stress, muscular tension, liver congestion, and digestive issues.

Answer 120

Herbs that may help to avoid and ease symptoms of tension headaches include: chamomile (Matricaria chamomilla) flower, oat (Avena sativa) milky tops, mugwort (Artemisia vulgaris) aerial parts, lemon balm (Melissa officinalis) aerial parts, skullcap (Scutellaria lateriflora) aerial parts, wood betony (Betonica officinalis) aerial parts, linden (Tilia spp.) bract and flower, vervain (Verbena officinalis or V. hastata) aerial parts, meadowsweet (Filipendula ulmaria) aerial parts.

Answer 121

Herbs that may help to avoid and ease symptoms of tension headaches include: lemon balm (Melissa officinalis) aerial parts, chamomile (Matricaria chamomilla) flower, linden (Tilia spp.) bract and flower, skullcap (Scutellaria lateriflora) aerial parts oat (Avena sativa) milky tops, mugwort (Artemisia vulgaris) aerial parts, , wood betony (Betonica officinalis) aerial parts, vervain (Verbena officinalis or V. hastata) aerial parts, meadowsweet (Filipendula ulmaria) aerial parts.

Answer 122

peppermint (Mentha x piperita), lavender (Lavandula spp.), rosemary (Rosmarinus officinalis) essential oils

Answer 123

Nervine trophorestoratives, also known as nervine tonics, can be used to support the nervous system and address the stress trigger of tension headaches, especially when that stress is chronic. Herbs such as oat (Avena sativa) milky tops can help to rebuild the nervous system over time and have been traditionally used especially for those who are chronically stressed and fatigued. Milky oats influences the stress response by affecting the hypothalamus-pituitary-adrenal (HPA) axis and while oat pairs well with many herbs, it may combine especially well with nervine relaxants (see below) to bring the nervous system back into balance (Holmes, 2006). Another Tropho restorative is Lemon Balm

Answer 124

If an individual is aware of their own muscular tension and foresees an upcoming stressful event that may cause increased tension and increase their chances of getting a headache, they can start using antispasmodic anxiolytics proactively (Hoffmann, 2003).

Answer 125

tension headache sufferers may have a heightened sensitivity to pain. Many anodyne herbs, also known as analgesics, which address pain, often simultaneously have an antispasmodic or relaxing effect and help to reduce tension (Bone & Mills, 2013).

Answer 126

Examples include white willow (Salix alba) bark, California poppy (Eschscholzia californica) whole plant, corydalis (Corydalis yanhusuo) rhizome, Jamaican dogwood (Piscidia piscipula) bark, butterbur (Petasites hybridus) rhizome, feverfew (Tanacetum parthenium) leaf.

Answer 127

If the underlying triggers for tension headaches are not clear and/or diet is suspected, traditional herbal strategies often begin by using bitter and hepatic herbs to assist with liver support, digestion, and elimination (Bone & Mills, 2013; Hoffmann, 2003). The liver is a key organ in the stress response, but also in maintaining blood sugar levels, which, as discussed above, may impact the frequency of tension headaches. The stress response, one of the primary triggers in tension headache, is also connected to digestive wellbeing; some neurotransmitters—which may be involved in stress, anxiety, and depression—are produced within the gastrointestinal tract, thus addressing the health of the gut-brain axis, discussed in Unit 3, is a valuable consideration. Elimination is also an important concern, as impaired evacuation can lead to a build-up of waste products in the body. Thus, bitters with an aperient or laxative action might theoretically also serve in situations where headaches coincide with constipation. While the connections between tension headache and constipation have not been fully explored, a recent study involving children and adolescents suggests that constipation may play a role as a primary headache trigger and that resolving the issue may especially benefit those with tension-type headaches (Park et al., 2015).

Answer 128

Thymoleptic herbs include vervain (Verbena officinalis or V. hastata) aerial parts, lemon balm (Melissa officinalis) aerial parts, oat (Avena sativa) milky seed, St. John’s wort (Hypericum perforatum) aerial parts schisandra (Schisandra chinensis) berry.

Answer 129

Research suggests that depression may co-occur with tension headaches (Bendtsen, 2009; Waldie et al., 2015) and pharmaceutical treatment for tension headaches sometimes includes antidepressant drugs (Freitag, 2013). Many herbs known as thymoleptics or anti-depressants help to lift the mood and these herbs may also be nervine tonics, adaptogens, or antispasmodics that can be adopted in personalized tension headache formulas.

Answer 130

If a tension headache has a relationship with the menstrual cycle, then hormone-regulating herbs may be valuable. See more on this below, under herbal support for avoiding migraine headaches.

Answer 131

The first or worst headache of one’s life; A headache triggered by cough, by exertion, or during intercourse; A headache with change in personality, mental status, or consciousness level; A stiff neck or other signs of meningitis; A new, severe headache during pregnancy or postpartum; Being over 50 years of age; and Visual disturbances

Answer 132

Tension headaches don’t manifest with moderate or severe nausea, vomiting or with the aura that comes with some migraines sensitivities to odors, light, or sound are either absent or very minor during tension headaches.

Answer 133

Encouraging relaxation and easing pain are the primary goals during an acute tension headache. Thus, herbs that can provide both nervine relaxant, antispasmodic, anti-inflammatory, and anodyne actions can be swift allies. Many herbs with these actions may also aid sleep, a fantastic tool for calming tension headaches! See above for herbal examples in the anodyne and antispasmodic categories.

Answer 134

Vervain – Verbena officinalis or V. hastata (Verbenaceae)

Answer 135

Aerial parts

Answer 136

Anti-inflammatory, antispasmodic, anxiolytic, bitter, diaphoretic, diuretic, emmenagogue, galactagogue, hepatic, immunostimulant, liver stimulant, mild sedative, nervine tonic, vulnerary

Answer 137

It has been traditionally used as a general tonic and nervine trophorestorative for both chronic and acute conditions (Bone & Mills, 2013). One symptomology in which herbal practitioners may employ it is in cases of constrained qi, which is generally caused by an accumulation of stress and results in some form of pain along with depression, chronic stress, and fatigue (Holmes, 2007). This use, combined with vervain’s hepatic nature (Hoffmann, 2003) may help ease headache pain and avoid stress and digestive/liver headache triggers. Historically, vervain was used externally, applied to the head to ease pain, in the late Renaissance (Mazzei et al., 2018; Parkinson, 1640) and through the early 20th century in Europe. The Eclectic physicians of the early 20th century used vervain as a specific for the head (Tobyn et al., 2016) and sometimes favored the root over the aerial portions. Vervain has also been traditionally used for epilepsy (Barker, 2001) and herbalist Matthew Wood (2009) offers that vervain is indicated for spasms and epileptic seizures beginning in the neck; this is an area of the body considered sensitive in both tension headaches and in migraines (Migraine Research Foundation, 2018). Among modern Western herbalists, vervain is used as a nervine relaxant (Tobyn et al., 2016). Many herbalists use the European species (Verbena officinalis) and the American species (V. hastata) interchangeably, although some practitioners hold the opinion that V. hastata is more diaphoretic while V. officinalis is a stronger nervine restorative (Holmes, 2007).

Answer 138

Vervain is contraindicated during pregnancy, particularly early pregnancy, because of its emmenagogue action (Brinker, 2010). The herb is also emetic in high doses (Holmes, 2007).

Answer 139

Jamaican dogwood – Piscidia piscipula (Fabaceae)

Answer 140

Bark or root bark

Answer 141

Anodyne, antispasmodic, antitussive, hypnotic, hypotensive, nervine, sedative

Answer 142

Jamaican dogwood, which was introduced to Western medicine in the mid-19th century, is a powerful sedative traditionally suited to painful conditions and neuralgia through its analgesic and relaxant actions. The bark and root bark have traditionally been used among herbal practitioners for painful headaches (Barnes et al., 2007; Hoffmann, 2003) and although small doses are sometimes reported to trigger headaches, it was specifically indicated for migraines by the Eclectic physicians (Felter, 1922; Felter & Lloyd, 1905). Jamaican dogwood has also long been used for insomnia, painful spasms such as dysmenorrhea, rheumatism, and anxiety and agitation (Felter & Lloyd, 1905; Holmes, 2006). Jamaican dogwood is sometimes considered specific for insomnia caused by pain and nervous tension (Hoffmann, 1998) and can be used when headaches make it difficult to sleep. It has also been used as a specific for seizures in children and for uncontrollable coughing (Holmes, 2006). There are no pertinent research studies to date with a specific focus on Jamaican dogwood and its chemical constituents have also not received in-depth investigation.

Answer 143

Do not use in pregnancy, during lactation, or with pharmaceutical medications, particularly sedatives or analgesics, as it may potentiate their effects (Brinker, 2010; Hoffmann, 2003). Do not use with children or elders or in depression because of its neuromuscular depressant effect and speculatively not for cardiac insufficiency due to possible lowering of blood pressure in animal studies (note that human studies with Jamaican dogwood have rarely been conducted) (Brinker, 2010). Some herbalists advise against using Jamaican dogwood continuously, especially on its own, due to its potency and possible side effects, such as nausea, headache, and indigestion

Answer 144

Valerian – Valeriana officinalis (Caprifoliaceae)

Answer 145

Antiepileptic, antispasmodic, carminative, emmenagogue, hypnotic, hypotensive, nervine relaxant, sedative

Answer 146

Warming, with cooling potential, and drying

Answer 147

Specific for pain with tension, valerian root is commonly used for tension, especially those headaches that co-occur with skeletal muscle spasms and anxiety. Apart from headaches, valerian root is used for a range of nervous symptoms and herbalists commonly turn to it for tremors, heart palpitations, anxiety, nervous sleeplessness, and for support of attention deficit hyperactivity disorder (ADHD) (National Institutes of Health, n.d.). In one modern study, valerian was compared with oxazepam (a benzodiazepine medication) and was found to be equally as effective for insomnia, anxiety, and improved wellbeing, but with significantly fewer adverse side effects (Dorn, 2000). The relaxant, hypnotic, and sedative actions of valerian are in part due to its valepotriate and sesquiterpene content. These constituents help ease psychological tension while promoting a deep and nourishing state of sleep. Valerian is considered a strong relaxing nervine with an affinity for the digestive, musculoskeletal, and cardiovascular systems, making it especially useful when nervous system tension affects any of these systems (Hoffmann, 2003; Holmes, 2006).

Answer 148

Many herbalists assert that although it is a root, valerian should not be decocted, but rather steeped gently at a relatively low temperature to avoid destroying the volatile oils that are believed to be most effective. Herbalist David Hoffmann (2003) even suggests a cold infusion, using 1 cup of cold water to two teaspoons root, steeped for 8-10 hours. Mark Pedersen (2010) says that valerian is best extracted using alcohol or extracts fixed in oil because the active principles are so highly volatile, but Michael T. Murray (1995) recommends it as an aqueous extract, because valeric acid, which is one of the constituents found to have sedative effects, is water soluble.

Answer 149

Valerian may potentiate the effect of sedatives. A characteristic paradoxical reaction has been documented in a few people where an unpleasant stimulation response occurs instead of a relaxation response (Hoffmann, 2003).

Answer 150

``` 2 g (0.07 oz) lemon balm (Melissa officinalis) aerial parts or linden (Tilia spp.) bract and flower 2 g (0.07 oz) chamomile (Matricaria chamomilla) flower 1 g (0.04 oz) vervain (Verbena officinalis or V. hastata) aerial parts or passionflower (Passiflora incarnata) aerial parts, skullcap (Scutellaria lateriflora) aerial parts, or hops (Humulus lupulus) strobile, if drinking before sleep 1 g (0.04 oz) meadowsweet (Filipendula ulmaria) flower or aerial parts ```

Answer 151

Pulsating pain of moderate to severe intensity; Pain that is usually unilateral in location, but bilateral in children and adolescents; Worsening of symptoms during or after routine physical activity; Nausea, moderate to severe; Vomiting; Photophobia or phonophobia; and/or Aura—a complex of neurological symptoms that will often manifest prior to the headache itself, but can also begin after the pain has begun (migraines without aura are often connected to the menstrual cycle) (Headache Classification Committee of the International Headache Society, 2013).

Answer 152

``` Premonitory symptoms include: fatigue, concentration difficulties, stiff neck, sensitivity to sound and/or light, nausea, blurred vision, yawning, pallor ```

Answer 153

While the cause of migraines remains unknown, there are several hypotheses. The Vascular Hypothesis: The hypothesis that was prevalent from the 1930s until recently was that migraines are a vascular disorder. More recently, epidemiological studies raise the question of an association with disorders of vasculature (whether coronary, cerebral, retinal, dermal, or peripheral) (Bone & Mills, 2013) The Episodic Hypothesis migraines have recently come to be seen as an episodic condition (not unlike epilepsy) in which waves of brain function suddenly change, translating brain cell excitability into inflammation (Bone & Mills, 2013). The Hypoperfusion Hypothesis: The vascular hypothesis still has supporters, but several studies have confirmed via imaging that vasodilation is not a prerequisite for a migraine and that cortical hypoperfusion (decreased blood flow through the cerebral cortex) is much more characteristic of a migraine attack (Bone & Mills, 2013). Other possible causes Other hypotheses about migraine triggers involve lack of magnesium, blood platelet disorders, serotonin levels, diet, low blood sugar, stress, nervous system imbalances, hormone fluctuation, changes in light/technology use, changes in lifestyle, and changes in climate/weather (Chhater et al., 2018). Recent research also shows a possible connection between changes in the gut microbiome and migraines (Dai et al., 2017).

Answer 154

Menstrual migraines (migraines that occur just before or during menstruation) are a common occurrence and may be due to a drop in estrogen levels. Menopause may also affect migraines, resulting in regression, progression, or no change in occurrence (Bone & Mills, 2013).

Answer 155

Acupuncture: Acupuncture may help reduce the frequency of migraine headaches (Da Silva, 2015; Li et al., 2012; Linde et al., 2009; Rizzoli & Mullally, 2018). Sleep disorders: Migraines are associated with several sleep disorders; some links have been confirmed by studies and others remain uncertain (Cevoli et al., 2012). Gental exercise: Migraine sufferers have a tendency to be less physically active than non-migraine sufferers (Krøll et al., 2017). While there may be a fear among migraine-sufferers of triggering an attack via physical activity, combining low-impact workouts such as tai chi and yoga while being mindful of not over-exerting muscles in the neck and staying hydrated can improve quality of life (Kisan et al., 2014; Migraine Research Foundation, 2018). Biofeedback and CBT: Other useful strategies include biofeedback (Andrasik, 2010), massage and relaxation (Chaibi et al., 2011), and cognitive behavioral therapy, which has shown mixed results in the scientific literature (Harris et al., 2015).

Answer 156

In some individuals, food sensitivities can trigger migraines. Cheese, chocolate, and red wine have long been recognized as primary culprits (Peatfield, 1995), but eggs, milk, other stimulants such as coffee, other types of alcohol, and citrus may also trigger migraine headaches (Bone & Mills, 2013). A double-blind, controlled trial demonstrated that 93% of children with severe migraines recovered on an elimination diet (Woolhouse, 2005). Otherwise, a diet that supports the nervous system (see aforementioned dietary considerations for avoiding tension headaches) may also be of assistance in combating stress, which can aggravate migraines. The American Academy of Neurology/The American Headache Society guidelines for preventing migraine also suggest supplementation of magnesium, riboflavin, and coenzyme Q10 (Mauskop, 2013; Rhee & Harris, 2018). Because magnesium plays a role in skeletal and smooth muscle relaxation as well as serotonin and neurotransmitter production/regulation, it seems to offer promise for migraine sufferers (Peikert, 1996; Teigen & Boes, 2015; Woolhouse, 2005). Riboflavin wards off headaches through its neuroprotective properties (Schoenen et al., 1998; Woolhouse, 2005) and coenzyme Q10's anti-inflammatory action and its role in metabolism are useful in counteracting the migraine process (Dahri et al., 2018). Migraine sufferers often also suffer from celiac disease, in which case a gluten-free diet is beneficial (Gabrielli et al., 2003; Roche Herrero et al., 2001). A noticeable number of individuals (about 40%) with migraines test positive for Helicobacter pylori (a type of bacteria that grows in the digestive tract and attacks the stomach lining) and when the organism is removed there is significant improvement in migraine frequency (Gasbarrini et al., 1998; Su et al., 2014). On a related note, adding fermented foods or probiotic supplements to the diet may help shift the gut microbiota in a positive way. Research supports the use of probiotics as a potential therapeutic strategy in migraines. As Dai et al. (2017) point out, the strong association between migraines and celiac disease (and other inflammatory and gastrointestinal disorders like intestinal bowel disease) supports the idea of bidirectional modulation of gut microbiota and brain function, and may also share underlying mechanisms such as increased intestinal epithelial permeability and inflammation.

Answer 157

nervine tonic, sedative, antispasmodic, antiepileptic, and anodyne herbs and supporting the liver with hepatics Antispasmodics and Nervine Relaxants: ``` Antispasmodic herbs help relax the body and nervine relaxants can help ward off the impact of stress, particularly when it is a primary factor in triggering a migraine. Some herbalists suggest that antispasmodic and nervine herbs that also influence the circulatory system, such as chamomile (Matricaria chamomilla) flower, hawthorn (Crataegus spp.) aerial parts, and cramp bark (Viburnum opulus) bark, may be particularly important herbs for avoiding migraines, providing relaxation, and addressing spasm (Bone & Mills, 2013). Both butterbur (Petasites hybridus) rhizome and feverfew (Tanacetum parthenium) aerial parts fit into the antispasmodic category. Other antispasmodic nervine relaxants include rosemary (Rosmarinus officinalis) aerial parts (Barker, 2001) lavender (Lavandula spp.) bud, and vervain (Verbena officinalis or V. hastata) aerial parts. ``` Antiepileptics: As many understand migraines as an episodic condition with changing waves of brain function similar to epilepsy, herbs with antiepileptic action may be of use (Bone & Mills, 2013). Two common examples are mugwort (Artemisia vulgaris) aerial parts, which has been used traditionally both for epilepsy and headache (see more in monograph below), and butterbur (Petasites hybridus) rhizome. Vervain (Verbena officinalis or V. hastata) aerial parts have also been used for epilepsy (Barker, 2001) and it is interesting to note that herbalist Matthew Wood indicates vervain for spasms and epileptic seizures beginning in the neck (Wood, 2009), as this is an area of the body considered sensitive in migraines (Migraine Research Foundation, 2018) as well as tension headache.Many antiepileptic herbs also fall into the antispasmodic category and include kava (Piper methysticum) root, ashwagandha (Withania somnifera) root, bacopa (Bacopa monnieri) leaf, cramp bark (Viburnum opulus) bark, feverfew (Tanacetum parthenium) aerial parts, black cohosh (Actaea racemosa) root, hops (Humulus lupulus) strobile, Jamaican dogwood (Piscidia erythrina) bark, lavender (Lavandula spp.) bud, linden (Tilia spp.) bract and flower, passionflower (Passiflora incarnata) aerial parts, and valerian (Valeriana officinalis) root (Bone & Mills, 2013; Holmes, 2006). Anti-inflammatories and Circulatory Stimulants: Because a pro-inflammatory cascade may be involved in migraines, anti-inflammatory herbs are indicated (Bone & Mills, 2013). Circulatory stimulant herbs, especially those that are also anti-inflammatory, are also useful because migraine is sometimes associated with vascular endothelial dysfunction as well as impaired vascular reactivity (the responsiveness of blood vessels to specific stimuli, which allows for adjustments in blood flow and vasodilation) (Bone & Mills, 2013). Primary herbal examples of anti-inflammatory circulatory stimulants include turmeric (Curcuma longa) rhizome, ginger (Zingiber officinale) rhizome, and ginkgo (Ginkgo biloba) leaf (Bone & Mills, 2013).Ginger possesses anti-inflammatory, anodyne, and circulatory stimulant actions and it may inhibit thromboxane (a vasoconstrictor compound in the body) in the case of migraines (Bone & Mills, 2013). In a double-blind, randomized, clinical trial of 100 individuals, ginger was deemed similar in efficacy to sumatriptan (a pharmaceutical used to treat migraines); 2 hours after taking ginger, headache severity declined, and with less side effects than sumatriptan (Maghbooli et al., 2014). Ginger is also used as an essential oil by aromatherapists to address migraines (Keville & Green, 2012).Ginkgo is an anti-platelet-activating factor (PAF) (PAF is a strong inflammatory agent in the body that helps platelets in the blood adhere, leading to clotting). It therefore may be of specific use because cortical hypoperfusion (decreased blood flow through the cerebral cortex) is implicated in migraines (Bone & Mills, 2013). In a study of ginkgolide B (a constituent of ginkgo), aura symptoms were ameliorated and in some of the study’s participants the migraine pain phase disappeared (Allais et al., 2013). Hormone Modulants: Migraines that are associated with menstruation are sometimes addressed with hormone modulating herbs, such as black cohosh (Actaea racemosa) root, shatavari (Asparagus racemosus) root, and tribulus (Tribulus terrestris) fruit (Bone & Mills, 2013).When migraines tend to occur premenstrually, chaste tree (Vitex agnus-castus) fruit may be indicated. A study of 100 menstruating individuals concluded that taking a chaste tree extract (40 mg/day) for 3 months resulted in reduction of migraine frequency in 99% of participants (Ambrosini et al., 2013).A formula of black cohosh with extracts of dong quai (Angelica sinensis) and soy isoflavones also reduced the severity and frequency of menstrual-linked migraines in a randomized, double-blind trial (Burke et al., 2002). Bitters and Hepatics: Many herbal practitioners focus on a connection between liver function and migraines, particularly in France (Bone & Mills, 2013). If migraines are triggered by certain foods or if digestive problems coincide with migraines, herbs are used to support liver function and simultaneously improve digestion (Bone & Mills, 2013; Hoffmann, 2003). For this reason, hepatics such as turmeric (Curcuma longa) rhizome, schisandra (Schisandra chinensis) berry, and artichoke (Cynara scolymus) leaf may be added to a migraine formula (Bone & Mills, 2013). Recent research is now looking in-depth at the health of other body systems, including the digestive and hepatic system, and their connection to migraines and headaches in general (Martami et al., 2018). Nervine Trophorestoratives/Tonics Herbal nervous system tonics may help to keep the stress trigger of migraines at bay (see aforementioned herbal support for avoiding tension headaches). St. John’s wort (Hypericum perforatum) aerial parts, in particular, has been studied for its effect on serotonin, a factor in migraines, and was demonstrated to reduce the frequency and intensity of migraine attacks in combination with the pharmaceutical drug valproate (Mirzaei et al., 2012).

Answer 158

Butterbur (Petasites hybridus) rhizome and feverfew (Tanacetum parthenium) aerial parts are the two herbs most extensively studied in relation to migraines. Butterbur’s prophylactic role has been confirmed (Grossman & Schmidramsl, 2000; Pringsheim et al., 2012; Utterback et al., 2014) and it is widely used in Europe to lessen the occurrence of migraines, particularly for migraines associated with indigestion and tension (Barker, 2001). Butterbur contains liver-toxic pyrrolizidine alkaloids, however, which must first be removed before consumption. Butterbur is antispasmodic, anodyne, and antiepileptic and thus fits many of the general parameters for migraine strategies. Feverfew is an official herb in Europe (approved for use by current European legislation), used by both herbal and orthodox medical practitioners, and has undergone extensive scientific review (Bone & Mills, 2013; Hoffmann, 2003). Feverfew works prophylactically as long as it possesses proper levels of its most applicable constituent, parthenolide, and if one is willing to take the herb for about four to six months before seeing improvement (Bone & Mills, 2013) (see more in the feverfew monograph below).

Answer 159

pyrrolizidine alkaloids

Answer 160

When a migraine attack becomes unavoidable, there is a general herbal focus on hypnotics and antispasmodic sedatives, anti-inflammatories, and anodynes. a general formula might include herbs such as willow (Salix alba) bark, feverfew (Tanacetum parthenium) aerial parts, ginger (Zingiber officinale) rhizome, or corydalis (Corydalis spp.) root in high doses (Bone & Mills, 2013), Antiemetics: Nausea and/or vomiting may accompany some migraines and herbs that are antiemetic may be of use in these situations. Antiemetics include black horehound (Ballota nigra) aerial parts, peppermint (Mentha x piperita) aerial parts, and ginger (Zingiber officinale) rhizome (Barker, 2001). Anodynes: The pain of an acute migraine attack can be intense and easing the pain is a primary goal of support. In a prospective study, white willow (Salix alba) bark combined with feverfew (Tanacetum parthenium) aerial parts reduced the duration and pain intensity of migraines (Shrivastava et al., 2006). Valerian (Valeriana officinalis) root, when combined with pharmaceutical drugs in migraine treatment, reduced duration, frequency, and intensity of attacks (Mirzaee et al., 2015). Other anodynes that may be useful during an acute migraine attack include passionflower (Passiflora incarnata) aerial parts, meadowsweet (Filipendula ulmaria) aerial parts, wood betony (Stachys betonica) aerial parts, and Jamaican dogwood (Piscidia piscipula) bark. Anti-inflammatories and Circulatory Stimulants: Anti-inflammatory circulatory stimulants, such as garlic (Allium sativum) bulb, ginkgo (Ginkgo biloba) leaf, and turmeric (Curcuma longa) rhizome may be of use due to the vascular aspects of migraine headaches (Bone & Mills, 2013). Ginger (Zingiber officinale) rhizome is traditionally used as an abortive for acute migraine and in a recent double-blind, placebo-controlled, randomized study, it was found to induce a clinically positive response in terms of pain severity, functional status, and migraine symptoms (Martins et al., 2018). Nervine Sedatives: Stronger nervine relaxants may be called for during a migraine to help with severe pain and spasm as well as to promote rest and sleep. Examples include hops (Humulus lupulus) strobile, passionflower (Passiflora incarnata) aerial parts, valerian (Valeriana officinalis) root, California poppy (Eschscholzia californica) whole plant, and Jamaican dogwood (Piscidia piscipula) bark.

Answer 161

Ginkgo – Ginkgo biloba (Ginkgoaceae)

Answer 162

Antioxidant, anxiolytic, circulatory stimulant, decongestant, neuroprotective, nervine restorative

Answer 163

Gingko is neuroprotective and is now largely employed for imbalances involving stagnant cerebral blood flow, including a host of issues that are supported by clinical trials: headache, depression, cognitive difficulties, fatigue, vertigo, tinnitus, and dementia (Bone & Mills, 2013). Because it is an anti-PAF and a cerebral stimulant, ginkgo may be considered for the avoidance of migraine headaches because cortical hypoperfusion (decreased blood flow in the brain) tends to occur during a migraine (Bone & Mills, 2013). Its anxiolytic actions also make ginkgo a candidate for avoiding stress responses that trigger migraines, although these actions do not appear to have been formally studied in the context of headaches. Ginkgo has been found to reduce the severity of physical and psychological symptoms of premenstrual tension in a randomized, single-blind, placebo-controlled trial (Ozgoli et al., 2009), which may speculatively make it useful in headaches triggered by hormones and the menstrual cycle.

Answer 164

Ginkgo has demonstrated some cumulative toxicity and long-term use may result in a variety of effects, including diarrhea, appetite loss, dizziness, fatigue, headache, gastric discomfort, chest discomfort, or constipation, and some herbalists do not use it long-term or for over two to three consecutive months (Holmes, 2007). That being said, there is no formal restriction on long-term use (Bone & Mills, 2013). Ginkgo is an anticoagulant and may impact the blood; use with caution with pharmaceutical drugs, especially monoamine oxidase inhibitors and blood thinners (e.g., Warfarin) and stop use up to a week before surgery as ginkgo may contribute to hemorrhage (Brinker, 2010), although most reports have been overstated (Bone & Mills, 2013). Due to potential adverse reactions to ginkgolic acid, use of galenical tinctures (where only the main active constituent(s) are extracted) or fluid extracts (1:1 preparations, which are more concentrated than tinctures) may not be recommended (Bone & Mills, 2013).

Answer 165

Mugwort – Artemisia vulgaris (Asteraceae)

Answer 166

Aerial parts

Answer 167

Anti-inflammatory, antimicrobial, bitter, cholagogue, emmenagogue, thymoleptic, vermifuge

Answer 168

Cooling and drying

Answer 169

Mugwort is traditionally associated with womb health because the herb addresses a variety of uterine imbalances, particularly those associated with menstruation. This connection, combined with its use for head pains, makes mugwort theoretically useful in tension or migraine headaches where a menstrual trigger has been identified. One of the earliest connections between migraine and mugwort may have an Arabic origin and can be found in the 15th century Herbal Livre des Simples Medicines (also known as the Secreta Salernitana), wherein mugwort was combined with hot opiates for migraine (Tobyn et al., 2016). Mugwort is also found in Italian folk remedies for headache (Mazzei et al., 2018). It is a well known bitter herb with application for liver congestion; bitters and liver herbs have long been employed by herbalists in addressing headaches, where they help to ease digestive triggers (Bone & Mills, 2013). Mugwort is also used for muscle spasms, seizures, and epilepsy (for which the root of the herb was traditionally used)—all clues that indicate that mugwort may be an ally for migraine sufferers (Holmes, 2007). Despite its traditional use, there is currently no clinical research connecting mugwort to migraines or headaches; however, modern herbalists commonly use mugwort in herbal formulas for both.

Answer 170

Mugwort is not for use during pregnancy due to its emmenagogue nature (Brinker, 2010). Mugwort is considered to possess cumulative toxicity due to its thujone content and should not be used long-term or at high doses. It may also dry milk during lactation (Holmes, 2007).

Answer 171

Feverfew – Tanacetum parthenium (Asteraceae) –

Answer 172

Analgesic, anti-inflammatory, antimicrobial, antispasmodic, aperient, bitter, carminative, decongestant, diaphoretic, emmenagogue, febrifuge, vermifuge

Answer 173

Cooling and drying

Answer 174

As a heat-clearing relaxant, feverfew is also analgesic and anti-inflammatory (Holmes, 2006), which is in part why it has been used for headaches, neuralgia, and fibromyalgia. With respect to its reputation in migraine therapy, it appears that feverfew inhibits granule secretion from platelets and is highly and uniquely anti-inflammatory due partially to the presence of parthenolide, a sesquiterpene lactone (Bone & Mills, 2013). Scientific research on feverfew’s prowess in conquering migraines began relatively early and on a large scale. In the 1970s, newspapers in England were reporting the story of a Welsh woman who was nibbling three fresh feverfew leaves each day and thus rid herself of migraine headaches over a timeframe of several months (Bone & Mills, 2013; Mabey, 1988). Highly successful clinical studies followed, along with popularity in the United Kingdom.The clinical trial of migraine specialist Dr. Stewart Johnson subsequently confirmed that feverfew was useful in the prevention of migraines, in reducing the length and severity of attacks, and in removing the nausea associated with some migraine episodes (Bone & Mills, 2013). While feverfew rapidly became the “migraine herb” in the public eye, herbalists have taken time to point out how their practices employ feverfew for only certain types of headaches or migraines. Rosemary Gladstar, who likes to tincture feverfew with lavender, emphasizes that feverfew works on migraines over time—usually at least one to three months and when used preventatively rather than curatively (Gladstar, 2001). Meanwhile, herbalist David Winston (2003) asserts that feverfew best addresses yang migraines, or those of a specifically vasodilative nature. Furthermore, herbalist Michael Tierra (1998) records that the effectiveness in terms of migraines is probably only for those migraines marked by “genuine excess heat conformation” (p. 159).

Answer 175

Those with allergic sensitivity to Asteraceae (daisy) family plants may experience sensitivity to feverfew. Feverfew should not be used in pregnancy. Individuals discontinuing the use of feverfew should lower the dose gradually, over a 1 month period, to avoid “post-feverfew syndrome,” something that has been reported in 10% of long-term feverfew users that involves symptoms of aches, pains, stiffness, anxiety, and sleep disturbance (Gardner & McGuffin, 2013).

Answer 176

Aromatherapy has much to offer during a migraine or tension headache. A blend of essential oils can be prepared rapidly or a larger quantity assembled in advance to assist in tending to migraines in a timely fashion. It may be applied as soon as warning symptoms appear. Note that a particular blend of eucalyptus and peppermint essential oils may specifically aid in migraine (Keville & Green, 2012) as may the use of lavender essential oil (Sasannejad et al., 2012). ``` Ingredients 12 drops essential oil(s) of choice: experiment with peppermint (Mentha x piperita), eucalyptus (Eucalyptus radiata), lavender (Lavandula angustifolia), sweet marjoram (Origanum majorana), ginger (Zingiber officinale), and rosemary (Rosmarinus officinalis) 30 mL (1 fl oz) organic vegetable carrier oil of choice (olive, sunflower, almond, coconut) ``` Directions Mix 12 drops total of essential oil(s) of choice into the vegetable carrier oil in a 30 mL glass bottle. Rub a drop or two of the oil blend into temples and the back of the neck when sensing an impending migraine or during a migraine attack. The oil blend may also be incorporated into a cool or cold compress. For that you’ll need some cold water and a clean washcloth. Apply the oil blend to the neck, temples, or forehead. Then cover over with a cloth that has been immersed in water and keep away from eyes.

Answer 177

Aromatherapy has much to offer during a migraine or tension headache. A blend of essential oils can be prepared rapidly or a larger quantity assembled in advance to assist in tending to migraines in a timely fashion. It may be applied as soon as warning symptoms appear. Note that a particular blend of eucalyptus and peppermint essential oils may specifically aid in migraine (Keville & Green, 2012) as may the use of lavender essential oil (Sasannejad et al., 2012). ``` Ingredients 12 drops essential oil(s) of choice: experiment with peppermint (Mentha x piperita), eucalyptus (Eucalyptus radiata), lavender (Lavandula angustifolia), sweet marjoram (Origanum majorana), ginger (Zingiber officinale), and rosemary (Rosmarinus officinalis) 30 mL (1 fl oz) organic vegetable carrier oil of choice (olive, sunflower, almond, coconut) ``` Directions Mix 12 drops total of essential oil(s) of choice into the vegetable carrier oil in a 30 mL glass bottle. Rub a drop or two of the oil blend into temples and the back of the neck when sensing an impending migraine or during a migraine attack. The oil blend may also be incorporated into a cool or cold compress. For that you’ll need some cold water and a clean washcloth. Apply the oil blend to the neck, temples, or forehead. Then cover over with a cloth that has been immersed in water and keep away from eyes.

Answer 178

during sleep that the body performs the essential work of repairing tissues, restoring energy, and releasing metabolic waste products

Answer 179

human growth hormone (HGH), an important hormone which is released from the pituitary gland in pulses during the sleep cycle. In children and adolescents, HGH spurs tissue growth, but it continues to play a critical, if different, role in adulthood. HGH is a master regulator of proteins and fat metabolism, stimulating the growth and regeneration of organ, muscle, and other tissue cells throughout the body in adulthood (Vijayakumar et al., 2011). Growth hormone supports the breakdown of fat stores and the maintenance of blood sugar balance, providing the energy we need to thrive.

Answer 180

Sleep is also required to minimize neuronal damage from the free radicals that we accumulate during the day. Sleep is the time when our bodies can continue all body processes without the added stress of being awake and going about our daily routine. If this necessary process of sleep is cut short, we may awaken less able to concentrate, make decisions, or engage fully in work or social activities.

Answer 181

Four to six cycles of REM and non-REM sleep occur during an average sleep cycle and follow one after the other in predictable 90 to 110 minute intervals

Answer 182

It is during this stage that the hippocampus (the center of emotion and memory in the brain) “downloads” its daily learning and short-term memories to the “long-term secure vault” of the cerebral cortex in short, electrical bursts called spindles (Walker, 2017). As we age, this process is increasingly interrupted, which explains some of the cognitive decline and memory loss that accompany aging.

Answer 183

rhythms that influence our sleep, as well as body temperature, hormone release, appetite, digestive function, and more!

Answer 184

Hypothalamus

Answer 185

Human beings’ circadian rhythm is synchronized to light. When light enters the eyes, a signal is sent through the optic nerve to the suprachiasmatic nucleus (SCN), a group of specialized neurons located in the hypothalamus at the base of the brain. Each of the many thousands of SCN cells functions as a tiny biological clock, synchronized with the rhythms of the cells surrounding it. Exposure to light on a 24-hour cycle sets the rhythms that influence our sleep, as well as body temperature, hormone release, appetite, digestive function, and more!

Answer 186

Major imbalances in circadian rhythm are seen in sleep disorders as well as chronic diseases and mental illness of various types

Answer 187

Sleep-onset insomnia, in which there is difficulty falling asleep, Sleep-maintenance insomnia, in which one wakes during the night and has trouble falling back to sleep, Sleep-offset insomnia, in which one wakes too early, Non-restorative sleep, in which, even after sleeping, one is still not rested (Bone & Mills, 2013, p. 279).

Answer 188

we can't fall asleep because we are mulling over an important decision we have to make, or have trouble sleeping soundly through the night because we are excited or anxious about some event the next day. This type of insomnia is called primary insomnia. Primary insomnia is usually transient, lasting a few days at most, and is related to acute situations such as stress, jet lag, disrupted sleep schedules, etc. Primary insomnia may result in daytime fatigue or sleepiness, irritability, depression, anxiety, difficulty with focus, increased accidents/errors, tension headaches, and decreased creativity (Buysse, 2013).

Answer 189

Secondary insomnia is associated with more chronic factors and sleeping may be difficult most nights and/or for an extended period. Factors associated with secondary insomnia include drug or alcohol abuse, chronic pain, chronic depression, obesity, sleep apnea, depression, restless leg syndrome, headaches, hot flashes, acid reflux, asthma, and urinary issues.

Answer 190

Drugs known to result in insomnia include antidepressants, thyroid hormones, beta-blockers, calcium channel blockers, amphetamines, steroids, and of course, caffeine

Answer 191

Mental: impaired cognitive function(memory, concentration, attention, reasoning, and learning capacity, decreased reaction time) and hallucinations, Emotional: depression or other mood disorders, reduced resistance to stressors, physical:tremors,,poor immune function, heightened pain perception, increased vulnerability to the effects of alcohol, and increased risk of hypertension, diabetes, obesity, and cardiovascular disease

Answer 192

anxiety, chronic pain, and drug or alcohol use are more closely associated with sleep-onset insomnia, .

Answer 193

sleep-maintenance insomnia may be related to depression, sleep apnea, changes in blood glucose levels, and fibromyalgia (Bone & Mills, 2013).

Answer 194

adaptogens

Answer 195

Ashwagandha (Withania somnifera) is an adaptogen that is specifically indicated for insomnia. Ashwagandha helps calm the over-stimulated nervous system, is neuroprotective when sleep deprivation threatens cell health, and it also helps to maintain healthy rhythms of sleep and wakefulness (Kuhn & Winston, 2008).

Answer 196

Ayurvedic tradition has given us the centuries-old nighttime tradition of blending ashwagandha into warm milk with cinnamon (Cinnamomum spp.), cardamom (Elettaria cardamomum), nutmeg (Myristica fragrans), and/or ginger (Zingiber officinale) to prepare the mind for rest (Frawley & Lad, 1993).

Answer 197

Non-restorative sleep and morning fatigue may be caused by overall depletion and exhaustion. Along with directly addressing sleep, it may be helpful to also address underlying causes and symptoms of insomnia—consider supporting sluggishness and depletion with lymphatic herbs such as calendula (Calendula officinalis) flower and red clover (Trifolium pratense) aerial parts and nourishing herbs such as oat (Avena sativa) milky tops (Hartman, 2007).

Answer 198

For all types of insomnia, relaxing nervines like lemon balm (Melissa officinalis) aerial parts, chamomile (Matricaria chamomilla) flower, passionflower (Passiflora incarnata) aerial parts, catnip (Nepeta cataria) aerial parts, skullcap (Scutellaria lateriflora) aerial parts, and lavender (Lavandula spp.) bud may be helpful.

Answer 199

Muscular tension can make it challenging to relax the body enough to fall asleep and may contribute to sleep-onset insomnia. Antispasmodic herbs such as skullcap (Scutellaria lateriflora) aerial parts and valerian (Valeriana officinalis) root are indicated for such cases.

Answer 200

Sedating herbs such as valerian (Valeriana officinalis) root and hops (Humulus lupulus) strobile may be necessary for situational (primary) insomnia and especially in cases of the sleep-onset type. Sedatives should be avoided in chronic insomnia—the focus should instead be on finding the underlying cause of insomnia so that one is not chronically dependant on sedative herbs. Sedatives should also be avoided if an individual is experiencing depression.

Answer 201

Passionflower – Passiflora incarnata (Passifloraceae) –

Answer 202

Aerial parts

Answer 203

Analgesic, antidepressant, antispasmodic, anxiolytic, hypotensive, nervine, sedative

Answer 204

Cooling and drying

Answer 205

Passionflower can help with both sleep-onset and sleep-maintenance insomnia. It can be particularly beneficial when circular thinking threatens a good night’s sleep, as we turn the day’s events over and over in our minds. Passionflower is often used in combination with other herbs, such as valerian (Valeriana officinalis) root, skullcap (Scutellaria lateriflora) aerial parts, and hops (Humulus lupulus) strobile, depending on the individual (Blankespoor, n.d.). While passionflower has been used by indigenous healers and other traditional herbalists for generations to support relaxation and counter anxiety, modern researchers are just beginning to understand its pharmacology. Recent studies point to a number of mechanisms that are responsible for its relaxing and anxiolytic effects, including modulation of the gamma-aminobutyric acid (GABA) system, which is involved in both anxiety and depressive disorders (Appel et al., 2011). The Eclectics frequently mentioned passionflower as safe and effective for insomnia, wakefulness, or restlessness in persons of all ages, from infants to the elderly (Ellingwood, 1919; Felter, 1922; Felter & Lloyd, 1898). Its efficacy in supporting sleep has been confirmed by modern research, as well. One clinical study reported that in healthy adults with primary insomnia, a cup of passionflower tea before bedtime yields subjective sleep quality benefits (Ngan & Conduit, 2011). However, due to passionflower's bitter taste, it may be best taken as a tincture, or mixed with more pleasant tasting herbs.

Answer 206

California poppy – Eschscholzia californica (Papaveraceae)

Answer 207

Whole plant

Answer 208

Analgesic, anti-inflammatory, antispasmodic, anxiolytic, nervine, sedative

Answer 209

A non-narcotic relative of the opium poppy (Papaver somniferum), California poppy is commonly used to improve sleep. It is specifically indicated for improving sleep latency, or for shallow sleep and early morning waking (Masé, 2008). Research has demonstrated that California poppy does improve sleep latency and quality (Bruneton, 1995). It can also be helpful for those who experience nighttime restlessness and sleep disrupted by pain or inflammation. Herbalist Kiva Rose suggests external as well as internal use of the tincture when the pain of sciatica affects sleep (Rose, n.d.). Many practitioners use California poppy in lower doses, combined in formulations with other nervine herbs (Abascal & Yarnell, 2004). In a clinical trial with over 250 patients, researchers studied the efficacy of a French formula (Sympathyl™), containing California poppy, hawthorn flower (Crataegus laevigata), and magnesium, for treating mild to moderate anxiety. Participants taking the California poppy formulation had significantly improved anxiety symptoms after 3 months compared to those taking placebo (Hanus et al., 2003), indicating that California poppy may be useful for insomnia related to anxiety. Because California poppy is so cooling, it may be best for those with cool constitutions to avoid it or combine it with warming herbs.

Answer 210

California poppy is said to exhibit a dose-dependent effect, such that lower doses are predominantly anxiolytic and higher doses have a sedative effect (Romm, 2009), while excessive use may lead to a hangover-like effect (Mars, 2001).

Answer 211

Contraindicated in pregnancy due to alkaloid content (Mills & Bone, 2005). California poppy may have additive effects when combined with other sedatives (Hoffmann, 2003

Answer 212

Hops – Humulus lupulus (Cannabaceae)

Answer 213

Analgesic, bitter, hypotensive, nervine, sedative

Answer 214

Cooling and drying

Answer 215

A cousin of Cannabis and distant cousin of nettle, hops is best known for its sedative properties. Farm hands working in hop fields often reported feeling excessively sleepy after handling the plant’s catkins, which led to hops’ reputation as a sedative. Lupulin, the golden resin found in hop strobiles, is thought to be responsible for this effect. Hops is often combined with other herbs, probably due to its intense bitter flavor. There are some herbs that are relaxing and stimulating, which help one ease into sleep by quieting the mind from anxious restless thoughts, but do not promote the deeper sleep cycles. Hops may be one of these, and may be better combined with herbs that also promote deep sleep. Herbalist Cascade Anderson Geller emphasized the importance of choosing dried hops preparations when the sedative quality only is desired, reporting that fresh preparations can be stimulating (Hobbs, 1997). Hops may be particularly useful for insomnia during menopause due to its phytoestrogenic qualities (Milligan et al., 1999). In a clinical trial on the efficacy of a hops and valerian (Valeriana officinalis) root combination, 2 mL of the combination tincture was given to individuals with insomnia before bed, which yielded positive results (Dimpfel & Suter, 2008). Other studies found similar results with the same herbal combination (Koetter et al., 2007; Morin et al., 2005).

Answer 216

GRAS because hops is depressive it is best avoided in depression (Kress, 2005). Due to estrogenic effects, hops is not to be used in cases of estrogenic dependent disorders (Duke, 2002). The sedative action of hops may potentiate the effects of alcohol or other sedatives

Answer 217

Kapha time, 6 am-10 am and 6 pm-10 pm: Since kapha dosha is characterized by steadiness, compassion, and social connection, it is a good time of day for conflict resolution, as well as a good time to connect with others. Kapha time is also helpful in creating healthful routines that will last. Pitta time, 10 am-2 pm and 10 pm-2 am: Agni (digestive fire) is hottest in midday during pitta time. For this reason, Ayurvedic principles recommend eating lunch, the largest meal of the day, during pitta time at midday. Also, since pitta is defined as “that which digests,” it is best to go to bed before 10 pm (before pitta time hits full stride). Since pittas like to have something to chew on, it is common to become hungry or to start mulling over work and to-do lists if one is still awake during the pitta hours of night. For this reason, it is best to avoid the problem entirely and simply be asleep by 10 pm. Vata time, 2 am-6 am and 2 pm-6 pm: As mentioned earlier, the vata time of day is great for meditation and subtle practices. Since vata’s assets include expansiveness and creativity, art-making, reflection, and creative pursuits in general are all great activities during the vata time of day.

Answer 218

Kapha time. As activities performed during Kapha hours have a better chance of taking root and becoming habbit or routine.

Answer 219

Vata time. As vata governs the mind.

Answer 220

05:00-07:00 Large Intestine Physical level: constipation, diarrhea, abdominal pain, sore throat, tooth ache, runny nose, nose bleeds, finger numbness, tinnitus, deafness Emotional & mental level: guilt, defensiveness, feeling stuck, difficulties in letting go of situations/ places/ people Balancing Activity: Wake Up & Drink Water!This is the best time to drink a lot of water, have your first bowel movement, and go for a brisk walk, according to TCM Body Clock. It is the worst time to have caffeine, because it’s a diuretic and your body needs a lot of water for healthy intestine and colon. Drink a large glass of warm water with lemon instead. 06:45 Sharpest Blood Pressure Rise

Answer 221

07:00-09:00 Stomach Physical level: no appetite in the morning, stomach pain, fluid retention & swelling, vomiting, nose bleeding, sore throat, bleeding gums, facial paralysis, lack of appetite, constant hunger, constipation Emotional & mental level: despair, disgust, problems with healthy eating habits Balancing Activity: Eat warm Breakfast! Make sure to eat fibers, proteins, and low GI-carbs. Breakfast should be the largest meal of the day, according to Chinese Body Clock – so don’t eat too much in the evening and go to bed at 10 pm to stimulate your morning appetite. 07:30 Melatonin Secretion Ceases 08:30 Colon Activated – Evacuation Likely

Answer 222

09:00-11:00 Spleen Physical level: sweet craving, tiredness, bloating, sluggishness, poor appetite, lack of thirst, vomiting, diarrhea, weakness, anemia, yellow skin/ eyes, allergies, problems with spleen/ pancreas Emotional & mental level: difficulties concentrating, jealousy, worry, low self esteem, disappointments Balancing Activity: Work & Be Active! Do your most mentally taxing work. The spleen is associated with mental powers, supports metabolism, and is responsible for converting nutrients into energy. This is why it’s so important to eat a healthy breakfast, according to TCM Body Clock. 10:00 Alertness Peaks

Answer 223

09:00-11:00 Spleen Physical level: sweet craving, tiredness, bloating, sluggishness, poor appetite, lack of thirst, vomiting, diarrhea, weakness, anemia, yellow skin/ eyes, allergies, problems with spleen/ pancreas Emotional & mental level: difficulties concentrating, jealousy, worry, low self esteem, disappointments Balancing Activity: Work & Be Active! Do your most mentally taxing work. The spleen is associated with mental powers, supports metabolism, and is responsible for converting nutrients into energy. This is why it’s so important to eat a healthy breakfast, according to TCM Body Clock. 10:00 Alertness Peaks

Answer 224

11:00-13:00 Heart Physical level: heart problems, abnormal heartbeat, thirst, bitter taste in mouth, yellow skin/ eyes, red complexion, incoherent speech Emotional & mental level: frightfully sad, restlessness, lack of passion/ inspiration/ joy, uncontrollable crying/ laughter, mental confusion, poor memory/ concentration, bipolar disorder Balancing Activity: Eat Lunch & Socialize! The lunch should be balanced, nutritious, warm, filling, and not too big. According to the Chinese Meridian Clock, this is the time to enjoy conversations, connect with people, and to cooperate. Reach out to people, be of service, and find your passion. Studies show that most heart-related incidents occur during this time frame, so don’t overwork your heart between 11am-1pm. 11:00-13:00 Greater Risk of Heart-Related Incidents

Answer 225

13:00-15:00 Small Intestine Physical level: energy crash, pain in the lower abdomen, stiff neck, hearing problems, yellow eyes, sore throat, swollen chin/ face, facial paralysis, pain in shoulder/ arm/ elbow Emotional & mental level: insecure, gullible, vulnerable, feeling of abandonment Balancing activity: Solve Your Problems & Get Organized! This is the best time for problem solving, sorting out issues & problems, and for getting organized, according to the TCM Body Clock. If you experience an energy crash between 1-3 pm and reach for caffeine/ sugar, it can be a result of skipping meals or eating unhealthy, so make sure to eat healthy at regular times. 14:30 Coordination Peaks

Answer 226

15:00-17:00 Bladder Physical level: headaches, pain in the neck/ back/ along the back of the leg, problem with bladder, eye problems, night blindness, color blindness, red/ swelling/ itching eyes, facial paralysis Emotional & mental level: timidity, irritation Balancing Activity: Work, Study & Drink Tea! This is the best time for efficient work, and to have your afternoon tea, according to the Chinese Body Clock. To detox your body,drink a lot of water between 3-5 pm, since toxins are passed in urine. 15:30 Fastest Reaction Time

Answer 227

17:00-19:00 Kidneys Physical level: tired, poor circulation, cold limbs, incontinence, night time urination, night sweats, dry throat, asthma, constipation, diarrhea, poor appetite, dizziness, tinnitus, lowering of the libido, weak back/ knees Emotional & mental level: anxious, fear, terror, poor memory, insomnia, stressed out Balancing Activity: Eat Dinner & Restore Your Energy! This is the best time to have dinner, but not too much, and to restore your energy, according to the TCM Clock. Your kidneys store your energy reserves, and if feel tired during these hours, ask yourself what thoughts and actions you spend your energy reserves on. You are only responsible for your own life, and no one ease’s. Take care of yourself, put yourself first & love yourself more! 17:00 Cardiovascular Efficiency & Muscle Strength Peaks 18:30 Blood Pressure Peaks

Answer 228

19:00-21:00 Pericardium Physical level: heart & chest pain, abnormal heartbeat, red face, armpit swelling, elbow spasm Emotional & mental level: mental & emotional problems, unresponsive, inability to express emotions, depleted, hurt, extreme joy, mania Balancing Activity: Socialize, Flirt & Have Sex!The pericardium is responsible for the circulation, and associated with the brain & reproductive organs. This is the best time for socializing, flirting, having sex, getting pregnant, soaking the feet in hot water, and massaging the arch of both feet, according to the Chinese Body Clock! Avoid big evening meals between 7-9pm. 19:00 Body Temperature Peaks

Answer 229

21:00-23:00 Triple Warmer Physical level: stiff neck, water retention, urinary difficulties, incontinence, problems with ears/ eyes/ chest/ throat, tinnitus, abdominal swelling, swelling of cheek, diseases of the thyroid and adrenal glands, pain in the shoulder/ arm Emotional & mental level: confusion, hopelessness, paranoia Balancing Activity: Relax & Chill Out! Triple Warmer is associated with the thyroid & adrenals, is responsible for energy transfer, and controls temperature & metabolism. This is the best time to chill out, according to the TCM Body Clock. Don’t think too deeply. Relax and read for a while instead. Avoid eating after 9 pm. 21:00 Melatonin Secretion Commences

Answer 230

23:00-01:00 Gallbladder Physical level: migraine, headaches, dizziness, nausea, frequent sighing, bitterness in the mouth, gall bladder problems, yellow skin/ eyes, ear diseases, pain in jaw/ outer corner of the eyes, hip problems Emotional & mental level: resentment, bitterness, indecisiveness, mental illness Balancing Activity: Sleep & Regenerate… Now it’s time to sleep and regenerate, according to the Chinese Body Clock. If you have gallbladder stones, it is most likely to experience pain during these hours. You may want to consider gallbladder flush & liver detox to cleanse these organs. 22:30 Colon Deactivated – Evacuation Suppressed

Answer 231

01:00-03:00 Liver Physical level: blurred vision, low back pain, PMS, pain in the lower abdomen, hernia, diarrhea, constipation, nausea, red face/ eyes, vomiting, breast tenderness, painful/ irregular menstruation, liver problems Emotional & mental level: rage, irritability, frustration, depression Balancing Activity: Deep Resting & Dreaming…If you often wake up during these hours, it’s because the liver is overwhelmed by the detoxing process, according to the TCM Body Clock. Too much alcohol, prescription drugs, or poor diet can cause liver stagnation. You may want to consider a healthier life style. It can also be a good idea to cleanse your liver. 02:00 Deepest Sleep

Answer 232

03:00-05:00 Lungs Physical level: Cough, respiratory problems, shortness of breath, asthma, sore throat, catching colds easily, stuffy/ runny nose, sweating, pale, weak voice, shoulder/ back pain Emotional & mental level: grief, sadness Balancing Activity: Sleep Soundly…If you cough between 3-5 am, it’s because your lungs are expelling toxins during these hours, according to Chinese Meridian Body Clock. If this happens often, it’s an indication that you need to make some changes in your diet / lifestyle. 04:30 Lowest Body Temperature

Answer 233

major depressive disorder is the leading cause of disability among Americans ages 15 to 44

Answer 234

Symptoms of anxiety include feelings of fear, worried thoughts, and somatic manifestations such as stomach pain, palpitations, breathlessness, hyperventilation, headache, dry mouth, restless legs, hot flushes, nausea, and dizziness

Answer 235

``` Lifestyle and relationship changes, World events, Environmental factors or phobia, Shortage of oxygen, Genetics, Trauma, Dietary deficiencies, Withdrawal or usage of substances, Side effects of medications, and Other health conditions. In addition, scientific studies link anxiety to imbalances in hormone levels and nervous system function (Cunningham et al., 2009; Parcells, 2010; Pigott, 1999), so not only does anxiety affect the endocrine and nervous systems, imbalance in these systems may bring on anxiety, creating a vicious cycle. ```

Answer 236

Anxiety disorders are widely classified into five categories, listed below. Generalized anxiety disorder (GAD), Obsessive-compulsive disorder (OCD), Panic disorder, Post-traumatic stress disorder (PTSD), and Phobias (including social phobia, or social anxiety disorder).

Answer 237

Anxiety is both a basic human emotion and a normal response to stress, trauma, fear, and many other factors. Anxiety can be acute or chronic and manifests in varied combinations of physical and emotional/mental symptoms. Upon experiencing the sensation of anxiety, physiological changes occur in the body that are associated with the autonomic nervous system (ANS) (Freeman & Freeman, 2012); just like stress, anxiety is grounded in the fight-or-flight response of the ANS. In anxiety disorders, the hypothalamus-pituitary-adrenal (HPA) axis or the central nervous system (CNS) neurotransmitter levels may be out of balance (Alramadhan et al., 2012).

Answer 238

Consider the root cause: Lifestyle considerations must take into account the root causes of anxiety and the symptoms and triggers of anxiety so that solutions can be tailored to an individual’s unique presentation. Stimulant use: Some lifestyle factors, such as stimulant use, should be considered very carefully when addressing anxiety. Individuals may be using stimulants and other drugs to cope with anxiety and withdrawal from them may pose risks to the individual (Bone & Mills, 2013). Slowing down and Grounding: Simply slowing down (not always an easy task!) and making time for enjoyable and calming activities can help to manage anxiety. Spending time in nature and practicing yoga, meditation, and other meditative practices may help individuals feel more centered. Some meditative practices have been demonstrated to reduce anxiety symptoms in randomized, controlled trials (Chen et al., 2012). Exercise: Exercise—both aerobic and non-aerobic—also helps to ease anxiety (Jayakody et al., 2014). Getting a good night's sleep is also crucial to wellbeing Sleep: sleep disturbance as a contributing factor to anxiety and anxiety disorders is commonly acknowledged if not fully investigated or understood (Mellman, 2006).

Answer 239

manage blood sugar levels Stay hydrated Avoid stimulants Microbiome: Because some neurotransmitter receptors are also located within the gastrointestinal (GI) tract and some neurotransmitters, including serotonin, are produced within the GI system (Mittal et al., 2017), addressing the health of the gut-brain axis is a key consideration in managing anxiety. Micronutrients, expecially VitD and Magnesium: Nutrient deficiencies, such as zinc, iron, calcium, chromium, magnesium, selenium, fatty acids, vitamins D and C, and specific amino acids may also contribute to anxiety (Alramadhan et al., 2012; Młyniec et al., 2014). A group of researchers analyzed the prevalence and severity of symptoms of anxiety and depression in over 16,000 participants in a prevention program focused on lifestyle modifications and nutritional supplementation. Their analysis of the data revealed an association between significant improvement in symptoms and both vitamin D status and strenuous physical activity (Kimball et al., 2018). A literature review of studies that investigated the role of magnesium in neurological disorders concluded that magnesium shows good potential to produce positive outcomes when used for anxiety disorders as well as depression, migraines, and chronic pain (Kirkland et al., 2018).

Answer 240

stress, anxiety, mood, sleep disturbances, and tension.

Answer 241

``` Nervine tonic, Nervine relaxant, Nervine stimulant, Hypnotic, Antispasmodic, Adaptogen, Analgesic Antidepressant (Hoffmann, 2003). ```

Answer 242

Nervine tonics work by generally tonifying and nourishing the nervous system (Hoffmann, 2003). You may also come across nervine tonics referred to as trophorestoratives or just plain “nervines.” They do not exert immediate calming effects, but rather are restorative to the nervous system over time. Nervine tonics are indicated for general nervous exhaustion, anxiety, chronic stress, neurasthenia, convalescent states, neuralgia, depressive states, and insomnia. As nervine tonics tend to be slow-acting, they are not ideal for acute situations because they work more gradually to restore balance. The primary example here is oat (Avena sativa) milky tops, but others include St. John’s wort (Hypericum perforatum) aerial parts, schisandra (Schisandra chinensis) berry, skullcap (Scutellaria lateriflora) aerial parts, damiana (Turnera diffusa) leaf, ashwagandha (Withania somnifera) root, and gotu kola (Centella asiatica) leaf, among others. Nervine tonics have a tendency to be mild and may be taken long-term and as required (Bone & Mills, 2013).

Answer 243

Nervine relaxants (also called nervine sedatives) are ideally taken acutely during times of stress or confusion (Hoffmann, 2003) as they help promote physical relaxation more immediately than other nervines. Their relaxant action illustrates the mind-body connection: as the tension in the body relaxes, so does the tension in the mind, improving emotional wellbeing. Some primary examples of nervine relaxants include hops (Humulus lupulus) strobile, skullcap (Scutellaria lateriflora) aerial parts, linden (Tilia spp.) bract and flower, lemon balm (Melissa officinalis) aerial parts, kava (Piper methysticum) root, lavender (Lavandula spp.) bud, and chamomile (Matricaria chamomilla) flower.

Answer 244

Nervine antispasmodics are quite closely related to nervine relaxants as they are also used to relax tension in the body, but their primary action is to ease muscle spasms. By its very nature, anxiety is tension. On a physical level, tension causes tightening in the body that can result in muscle spasms, which can manifest as tension headaches, digestive upset, sleeplessness, and spasmodic dysmenorrhea. Examples of nervine antispasmodics include lavender (Lavandula spp.) bud, valerian (Valeriana officinalis) root, passionflower (Passiflora incarnata) aerial parts, and skullcap (Scutellaria lateriflora) aerial parts, which are all helpful when sleep is also disrupted. Chamomile (Matricaria chamomilla) flower and catnip (Nepeta cataria) aerial parts can be helpful for situations in which the anxious tension is manifesting in the digestive system as intestinal spasm.

Answer 245

Nervine hypnotics (also known as sedatives) foster deep states of relaxation and are thus ideal for short-term use in more acute situations such as insomnia and acute mild-to-moderate anxiety or panic. Strong hypnotics often contain alkaloids that encourage sleep, but can be powerful and should not be used during daytime activities. They should only be used in conjunction with other holistic approaches to avoid forming a reliance on the herb. They are contraindicated in cases of depression or in insomnia characterized by increased restlessness during early hours of the morning (Bone & Mills, 2013). Examples of commonly used herbal hypnotics include California poppy (Eschscholzia californica) whole plant, passionflower (Passiflora incarnata) aerial parts, Jamaican dogwood (Piscidia spp.) bark, valerian (Valeriana officinalis) root, wild lettuce (Lactuca virosa) aerial parts, and kava (Piper methysticum) root. They are generally taken at bedtime.

Answer 246

Nervine stimulants stimulate the nervous system and are rarely indicated in the stressful daily life of modern times, especially in cases of anxiety, as the nervous system is already stimulated. Some strong stimulants, such as coffee (Coffea spp.) bean, may even interfere with the balance of the nervous system and worsen anxiety (Hoffmann, 2003). More mild nervine stimulant herbs include herbs with aromatic principles such as rosemary (Rosmarinus officinalis) aerial parts (Hoffmann, 2003) and may be indicated when anxiety manifests alongside depression. Other nervine stimulants include green tea (Camellia sinensis) leaf, cacao (Theobroma cacao) fruit, and yerba mate (Ilex paraguariensis) leaf. At certain doses, some herbs commonly classified as adaptogens such as Asian ginseng (Panax ginseng) root, rhodiola (Rhodiola rosea) root, and eleuthero (Eleutherococcus senticosus) root are also considered nervine stimulants.

Answer 247

Adaptogens have a strong affinity for the nervous system and often also exhibit a nervine action. Adaptogens aid the body in adapting to stress, particularly chronic stress, and because of the relationship between stress and anxiety, adaptogens are often employed in anxiety states. In particular, adaptogens can help calm reactions during the fight-or-flight response, prevent and/or delay exhaustion, and offer protection from the long-term effects of stress (Hoffmann, 2003). Adaptogens have been studied scientifically for addressing not only stress, but also anxiety. In a pilot study on the use of rhodiola (Rhodiola rosea) root for GAD, researchers found significant improvement in GAD symptoms in participants who received 340 mg of rhodiola extract for 10 weeks (Bystritsky et al., 2008). Ashwagandha (Withania somnifera) root, another adaptogenic herb, has been investigated for its use in adult stress and anxiety in a double-blind, placebo-controlled study. Participants took one 300 mg capsule of ashwagandha root extract twice a day for 60 days, after which researchers reported fewer symptoms of anxiety and stress and reduced serum cortisol levels (Chandrasekhar et al., 2012). Other adaptogenic herbs include tulsi (Ocimum tenuiflorum), Asian ginseng (Panax ginseng), eleuthero (Eleutherococcus senticosus), and schisandra (Schisandra chinensis).

Answer 248

Analgesics, also known as anodynes, are herbs that help ease the pain that may accompany anxiety, such as headaches, intestinal upset, or neuralgia. Many analgesic herbs are also hypnotic, such as California poppy (Eschscholzia californica) whole plant, corydalis (Corydalis yanhusuo) root, Jamaican dogwood (Piscidia spp.) bark, kava (Piper methysticum) root, turmeric (Curcuma longa) rhizome, and valerian (Valeriana officinalis) root. Analgesics may be quite powerful and should be used with significant caution. Many are contraindicated in depression, psychosis, liver or kidney disease, neurological disease, children, or during simultaneous prescriptions of analgesics (Bone & Mills, 2013).

Answer 249

Antidepressant nervines may also be of assistance when addressing some types of anxiety—anxiety can lead to depression and vice versa (Alramadhan et al., 2012). Anxiety can also generally bring with it a whirl of negative emotions that can sink the spirits. Many herbs demonstrate a thymoleptic (favorably mood-modifying) action or are traditionally credited with exerting an “uplifting” action on the mind and spirit and may be useful for mild depression, low self-confidence, or a general “down in the dumps” feeling. Alkaloids or volatile oils, which have an impact on neuroendocrine function, are often credited with producing this uplifting herbal action (Holmes, 2006). Antidepressant nervines include lemon balm (Melissa officinalis) aerial parts, blue vervain (Verbena hastata) aerial parts, oat (Avena sativa) milky tops, St. John’s wort (Hypericum perforatum) aerial parts, rhodiola (Rhodiola rosea) root, and schisandra (Schisandra chinensis) berry, many of which are also nervous system trophorestoratives and work over the long-term to lift the mood. More stimulating herbs that are also thymoleptic (and don’t contain caffeine) include rosemary (Rosmarinus officinalis) aerial parts, basil (Ocimum basilicum) aerial parts, and tulsi (Ocimum tenuiflorum) aerial parts, all of which can be used in concert with other antidepressant nervines. In cases where anxiety symptoms include depression and mood swings, anger, or irritability, antidepressant herbs with a strong affinity for the liver, due to the liver’s role in modulating hormones and blood sugar, should be considered such as St. John’s wort (Hypericum perforatum) aerial parts, lemon balm (Melissa officinalis) aerial parts, and wormwood (Artemisia absinthium) aerial parts (Holmes, 2006).

Answer 250

A discussion of herbs to support anxiety wouldn’t be complete without mentioning anxiolytics! Anxiolytics help to decrease anxiety while stabilizing the mood and buffering reactions to stress. Although many types of nervines naturally possess this action, anxiolytics are most commonly nervine antispasmodics and nervine relaxants. Of herbs with strong anxiolytic action, kava (Piper methysticum) root has been one of the most widely studied—it binds to gamma aminobutyric acid (GABA), opiate, and dopamine receptors and has shown very positive results in studies on mild anxiety and anxiety disorders (Almaradhan et al., 2012; Sarris et al., 2013), though a recent review of the scientific literature on clinical trials of kava for GAD reports that, although promising, the current evidence is not sufficient to confirm the effects of kava in GAD (Ooi et al., 2018). Other examples include bacopa (Bacopa monnieri) aerial parts, valerian (Valeriana officinalis) root, ashwagandha (Withania somnifera) root, hawthorn (Crataegus spp.) berry, leaf, and flower, and ginkgo (Ginkgo biloba) leaf, the last of which is specifically employed for anxiety in traditional Chinese medicine (Lei et al., 2015).

Answer 251

Feelings of sadness or depressed mood, Loss of interest or withdrawal from usually enjoyable activities, Appetite changes, Changes in weight, Sleep troubles (too much or too little), Fatigue, Feelings of guilt or worthlessness, Increase in slowed movements and speech or in “purposeless physical activity” such as pacing or hand-wringing, Confusion or difficulty thinking, concentrating, or making decisions, and/or Thoughts of suicide or death (American Psychiatric Association, 2018). An individual may be considered to be experiencing a major depressive episode or in need of psychiatric help if they’ve experienced symptoms for at least a two-week period (American Psychiatric Association, 2018).

Answer 252

Major depression: depressive symptoms experienced for more than 2 weeks. Persistent depressive disorder (formerly known as dysthymia): a period of 2 or more years in which depressive states alternate with non-depressive episodes. Bipolar disorder (also known as manic-depressive illness): symptoms of mania (elation) alternate with symptoms of depression. Seasonal depression (formerly known as seasonal-affective disorder (SAD)): depressive symptoms experienced during winter months. Peripartum depression (formerly known as postpartum depression): symptoms of depression occur during pregnancy or post-childbirth, and make it difficult for the parent to care for themself and/or the child. Premenstrual dysregulation disorder: depressive symptoms appear premenstrually. Disruptive mood dysregulation disorder: a fairly new disorder commonly affecting children and featuring severe outbursts of temper at least three times a week.

Answer 253

BIO: Genetic (hereditary predisposition), Inflammation, Biochemical (brain chemical imbalance) ``` PSYCHO: Personality traits (low self-esteem, low stress threshold, pessimism), ``` SOCIAL: Environmental (exposure to poverty, abuse, neglect, or violence),

Answer 254

The monoamine hypothesis suggests that the etiology of depression is low levels of serotonin, norepinephrine, and/or dopamine in the central nervous system Lack of support in the research: there is a dearth of data to support this hypothesis and the pathophysiology of depression is still unknown (Brogan, 2016; Hirschfeld, 2000; Lacasse & Leo, 2005). Neuroanatomist Jonathan Leo and professor of social work Jeffrey Lacasse further note that modern neuroscience research “has failed to confirm any serotonergic lesion in any mental disorder, and has in fact provided significant counterevidence to the explanation of a simple neurotransmitter deficiency,” instead, neuroscience has “shown that the brain is vastly complex and poorly understood” (Lacasse & Leo, 2005, p. 1212). Lifestyle: our modern lifestyles may increase our “susceptibility to inflammatory dysregulation and chronic stress, both of which increase the amount of proinflammatory cytokines in peripheral blood, leading to low mood and sickness behaviour” (Rantala et al., 2018). Gut/Brain axis: The growing field of psychoneuroimmunology is exploring the involvement of the bidirectional gut-brain axis and its relationship to brain inflammation and the “pathogenesis of a number of disorders in which inflammation is implicated, such as mood disorder” (Petra et al., 2015, p. 984) Multifactorial triggers: Some scientists suggest that depression’s causes are multifactorial and may involve any number of triggers such as infection, stress, social isolation, trauma, postpartum challenges, seasonal changes, and chemical toxicants, among others (Rantala et al., 2018).

Answer 255

Adequate exercise: Lack of physical activity is a risk factor for the development of depressive symptoms (Galper et al., 2006). Adequate sleep: Depression has been linked to disruption of circadian rhythms and there is a causal link between insomnia and depression (McClung, 2011; Roth & Roehrs, 2003). Adequate relaxation: The idea of achieving balance between work, rest, and play needs further research, but individuals involved in increased recreation in a social group demonstrated better mental health and overall resiliency (Street et al., 2007). Listening to enjoyable music has also been shown, over time, to reduce depression (Chan et al., 2011). Some studies have demonstrated that among those who practice relaxation techniques and self-rated their depression, their depressive moods were shown to be reduced (Jorm et al., 2008). Social interactions: Positive and supportive relationships have been found to benefit overall health, but particularly psychological wellbeing (Ibarra-Rovillard & Kuiper, 2011). Mindfulness & meditation techniques: Mindfulness and meditation have been demonstrated to create a range of changes in the brain that improve mood symptoms (Sarris et al., 2014). Reduction of recreational substances: Alcohol is demonstrated to provoke anxiety, particularly in acute usage, and heavy use at a young age may predict depressive disorders later in life (Brook et al., 2002). Importantly, a few studies have shown that depressed moods are lifted quickly after the cessation of alcohol use (Davidson, 1995; Liappas et al., 2002; Schuckit, 1994). Cigarette use also increases the risk for anxiety and depression. Importantly, while caffeine increases risk of anxiety, the data suggests that coffee consumption may actually be preventative against depression (but note that high usage can increase insomnia, which in turn can trigger depression) (Broderick & Benjamin, 2004). Environment: Exposure to green spaces and to nature has demonstrated a range of health benefits (Sarris et al., 2014). Pollution, on the other hand, can have a negative impact on the CNS (Genc et al., 2012).

Answer 256

Microbiome health: The gut-brain connection is gaining attention in scientific inquiry, and is sometimes considered the “missing piece” of the depression puzzle (Evrensel & Ceylan, 2015) as recent research reveals that there is a possible association between depression and imbalances in the gut microbiome (Aizawa et al., 2016). An increase in pathogenic bacteria in the gastrointestinal tract or a decrease in beneficial bacteria may also contribute to inflammation, another contributing factor to depression (Inserra et al., 2018; Park et al., 2018). Thus, the health of the microbiome is foundational for balanced mood. Healthy diet + iron and selenium A whole foods diet that provides essential fatty acids, protein, and micronutrients (with B vitamins, magnesium, zinc, vitamin C, and flavonoids in particular) is generally deemed important for optimal neurochemical functioning (Sarris et al., 2014). Avoiding excessive carbohydrate intake, addressing iron and selenium levels, and considering amino acids may also help ameliorate depression for some individuals (Sathyanarayana Rao et al., 2008). In some Asian traditions, depression is linked to the liver and a diet that includes liver-supportive foods, such as seaweed and apple cider vinegar, may also be helpful (Pitchford, 2002). Comorbid anxiety: As anxiety may be associated with depression, one might also follow additional dietary suggestions for anxiety to further support the nervous system, namely: keeping hydrated (Pross et al., 2014), attending to blood sugar balance (Aucoin & Bhardwai, 2016), and avoiding certain stimulants such as sugar and alcohol.

Answer 257

Herbs can be supportive when depression is mild to moderate or transient (grief and loss); herbs are generally not appropriate for major depressive disorders or periods and should only be taken under the care of a qualified healthcare professional when taking antidepressant pharmaceuticals.

Answer 258

Nervine Tonics (Trophorestoratives) Nervine tonics were previously discussed above with regard to anxiety. Many of these herbs can act to enhance neural and cerebral functions (Holmes, 2006) and are useful for long-term support for depression as they benefit the nervous system in general. Examples include oat (Avena sativa) milky tops, lemon balm (Melissa officinalis) aerial parts, skullcap (Scutellaria lateriflora) aerial parts, St. John’s wort (Hypericum perforatum) aerial parts, and schisandra (Schisandra chinensis) berry (Holmes, 2006). Nervine Relaxants and Antispasmodics Nervine relaxants and antispasmodics were also discussed previously and can be used for depression. Only mild nervine relaxants and antispasmodics should be used in depression and should only be used short-term—these are given at low doses to avoid aggravating depressive symptoms and creating further imbalance in the nervous system (Hoffmann, 2003). Examples include skullcap (Scutellaria lateriflora) aerial parts and lemon balm (Melissa officinalis) aerial parts. Bitters and Hepatoprotectives Attention to the digestive system and the liver may be especially beneficial with respect to depression considering the gut-brain connection and the role that the liver plays in processing hormones. In fact, the liver is the key organ addressed in depression in Chinese medicine, in which it is associated with emotions such as anger, irritability, and hopelessness. In Chinese medicine, bitter herbs are given to address what is termed “liver depression”—congestion of the liver combined with indigestion (Holmes, 2006). Bitter hepatoprotectives commonly used in depression include wormwood (Artemisia absinthium) aerial parts and mugwort (Artemisia vulgaris) aerial parts (Holmes, 2016). Artemisia absinthium, in particular, has been demonstrated to improve mood in Crohn's disease patients (Krebs et al., 2010). Nervine Stimulants As discussed previously, nervine stimulants should be used with care in anxiety, but may be indicated for depression. If used correctly, nervine stimulants can act to “diffuse” depression and provide a short-term lift in mood and energy. These must be used with great caution, however, to avoid worsening the imbalance in the nervous system (Holmes, 2006). Bitter metabolic stimulants, such as angelica (Angelica archangelica) root and orange (Citrus spp.) peel, may work in a similar way and are a safer option (Hoffmann, 2003). Studies on coffee (Coffea spp.) bean show that it may decrease the risk of depression (Wang et al., 2015). Milder stimulants—for example, rosemary (Rosmarinus officinalis) aerial parts, basil (Ocimum basilicum) aerial parts, and tulsi (Ocimum tenuiflorum) aerial parts can be more safely used along with liver restoratives. Adaptogens Adaptogens may be used long-term to support the adrenal glands and when stress accompanies depression (Hoffmann, 2003). Many adaptogenic herbs are also antidepressant or nervine, including schisandra (Schisandra chinensis) berry, Asian ginseng (Panax ginseng) root, ashwagandha (Withania somnifera) root, eleuthero (Eleutherococcus senticosus) root, rhodiola (Rhodiola rosea) root, and tulsi (Ocimum tenuiflorum) aerial parts (Winston & Maimes, 2007). Note that some of these (e.g., rhodiola, Asian ginseng, and schisandra) can be stimulating and so may need to be used with care, while some (e.g., eleuthero and ashwagandha) may be slow to exert changes. Antidepressants As discussed above, some herbs have a thymoleptic action and are traditionally credited with exerting an “uplifting” effect on the mind and spirit (Holmes, 2006). Antidepressant herbs include lemon balm (Melissa officinalis) aerial parts, blue vervain (Verbena hastata) aerial parts, oat (Avena sativa) milky tops, wormwood (Artemisia absinthium) aerial parts, mugwort (Artemisia vulgaris) aerial parts, St. John’s wort (Hypericum perforatum) aerial parts, and schisandra (Schisandra chinensis) berry, many of which are also nervous system trophorestoratives and work over time. Anxiolytics Because anxiety can lead to depression and vice versa (Alramadhan et al., 2012), anxiolytic herbs may be useful for certain types of depression. Skullcap (Scutellaria lateriflora), in particular, has been demonstrated to be useful as an anxiolytic for anxious individuals with co-morbid depression (Brock et al., 2008). Heart tonics with anxiolytic properties that have been traditionally used to uplift the spirits should also be considered for depression, especially in times of grief. Examples include rose (Rosa spp.) petal, hawthorn (Crataegus spp.) berry, leaf, and flower, and heartsease (Viola tricolor) aerial parts. Herbs for the energetic heart will be discussed in more detail in Unit 6.

Answer 259

Antidepressant, adaptogen, anxiolytic, cardiotonic, chemoprotective, restorative

Answer 260

Cooling and drying

Answer 261

Rhodiola is an adaptogen used for both chronic and acute conditions brought on or exacerbated by stress, whereby it aids in the maintenance of homeostasis. Rhodiola may be particularly useful for neurasthenia presenting with confusion, sleep troubles, and both chronic and seasonal depression (Holmes, 2007). Because it is a cooling adaptogen, it does not cause overstimulation as quickly as some warmer adaptogens (Winston & Maimes, 2007), which can be a concern when addressing depression co-occurring with anxiety. Research has demonstrated that rhodiola works as an adaptogen by affecting the central nervous and endocrine systems and lowers cortisol levels through its influence on the HPA axis (Panossian et al., 2010). Its ability to modulate neurotransmitters may explain why rhodiola is used for acute anxiety states (Holmes, 2007), and it has been found useful for major depression in clinical trials (Mao et al., 2015). Note that pharmaceutical antidepressants also work to inhibit neurotransmitters. For those with anxiety or depression that involves cardiac strain or impact on sexual drive, rhodiola may be of use due to its cardiac-restorative and hormone-modulating actions (Holmes, 2007). Rhodiola has been found to affect enzymes that regulate the neurotransmitter acetylcholine, which is important in the treatment of neurodegenerative diseases, such as Alzheimer’s disease (Al Noor Ahmed, 2015).

Answer 262

Rhodiola is a nervine stimulant, albeit a cooling one, so should be used with caution in conditions of excitement or agitation, particularly the manic phase of bipolar disorder (Holmes, 2007). Due to rhodiola’s involvement in modulating neurotransmitter levels, it should be used with caution in those taking prescription antidepressants such as monoamine oxidase inhibitors (MAOIs) or selective serotonin reuptake inhibitors (SSRIs) (Ulbricht et al., 2011).

Answer 263

St. John’s wort – Hypericum perforatum (Hypericaceae)

Answer 264

St. John’s wort – Hypericum perforatum (Hypericaceae)

Answer 265

Analgesic, antidepressant, anti-inflammatory, antimicrobial, antispasmodic, anxiolytic, astringent, emmenagogue, nervous trophorestorative, nervine relaxant, vulnerary

Answer 266

Cooling to warming and drying

Answer 267

As a relaxing nervine and anxiolytic with both external and internal uses, St. John’s wort is particularly suited to easing anxiety and tension in both mind and body. It is widely known for its use in mild to moderate depression and is approved by Germany’s Commission E for depressive moods and anxiety (American Botanical Council, 1990). Clinical trials show its efficacy in easing mild to moderate depression, but its use along with standard drug treatment for severe depression is controversial due to herb-drug interactions (Bone & Mills, 2013). St. John’s wort has been used since antiquity for melancholia (Winston & Maimes, 2007) and repelling evil influences (Wood, 2008), a relict way of referring to mental health disorders. Yet its current position as the go-to herb for depression is relatively recent, beginning around the time of the Eclectic physicians who took note of its use in homeopathy for the nerves (Wood, 2008). It is generally agreed that St. John’s wort must be taken for a number of weeks before changes in depression are noted. Herbalist David Winston suggests that its use in ancient Greece for black bile mirrors a type of depression characterized by a sour stomach and sour disposition (i.e., depression associated with imbalance in the liver and digestive systems)—he cites Mr. Scrooge from A Christmas Carol as a constitutional example (Winston & Maimes, 2007). He also asserts its pairing with lemon balm (Melissa officinalis) for addressing SAD (Winston & Maimes, 2007) resulting from lower sunlight exposure in the winter months. While popularly pigeonholed as “the depression herb,” St. John’s wort is rather more subtle and multifaceted in its applications. It may enhance cognition and act as a neuroprotective (Bone & Mills, 2013). St. John’s wort is analgesic and has an affinity for the nerves, helping to restore nerves damaged by physical injury. It is an excellent topical application for wounds, bruises, inflammation, muscle pain, sciatica, and sprains. It also works particularly well on viral skin conditions, such as herpes (Holmes, 2006).

Answer 268

Safety: St. John’s wort should not be used in pregnancy due to its emmenagogue properties. It is also not recommended during lactation or prior to surgery (it may interact with some anesthetic drugs) (Brinker, 2010). St. John’s wort may increase skin photosensitivity. Extended use should be avoided—there is a link between St. John’s wort use and cataract development (Holmes, 2006). It also interacts with a number of drugs, particularly blood thinners and antidepressants, by inducing CYP450 drug-metabolizing enzymes and P-glycoprotein, a drug-transporter protein, and should generally be avoided while taking any pharmaceutical drug (Brinker, 2010; Gardner & McGuffin, 2013).

Answer 269

Mimosa – Albizia julibrissin (Fabaceae)

Answer 270

Bark, flower

Answer 271

Analgesic, antidepressant, anti-inflammatory, anxiolytic, diuretic, sedative

Answer 272

Traditionally recognized as the “happiness herb” in China, its name he huan pi means “collective happiness bark” (Winston & Maimes, 2007). Mimosa has recently received the moniker “herbal Prozac” amongst some Chinese practitioners, but has a reputation that goes back to the 2nd century CE for its tonic, supportive, and calming properties (Tierra, 2015). In Chinese medicine, mimosa is used for Shen imbalance, Heart and Liver channels disorders, and grief (Liu et al., 2004). The flowers, specifically, are indicated for insomnia and poor memory arising from constrained emotions with stomach or chest oppression (Liu et al., 2004). The bark is also used for insomnia, but additionally for depression, stress, irritability, forgetfulness due to emotional distress, and pain and swelling (Liu et al., 2004). Mimosa has not been widely studied as a stand-alone herb, but has potential applicability for depression, anxiety, and insomnia (Sarris et al., 2011). In Western herbalism, mimosa is used for grief, deep sadness, and broken hearts in combination with hawthorn (Crataegus spp.) and rose (Rosa spp.) and may benefit individuals with PTSD (Winston & Maimes, 2007). Herbalist Michael Tierra has found mimosa more supportive for anxiety and depression than St. John’s wort (Hypericum perforatum) and advocates a wider use for it, particularly because mimosa is thought to support many aspects of neurotransmitter regulation and secretion (Tierra, 2015).

Answer 273

Mimosa is contraindicated during pregnancy due to its blood-moving properties (Tierra, 2015). No drug interactions are known, but it should be used cautiously with pharmaceutical antidepressants (Winston & Maimes, 2007).

Answer 274

Schisandra – Schisandra chinensis (Schisandraceae) –

Answer 275

Fruit (berry)

Answer 276

Adaptogen, antidepressant, antioxidant, anti-inflammatory, antiviral, astringent, anxiolytic, emmenagogue, expectorant, hepatic, nervine tonic, nervine stimulant

Answer 277

Schisandra is both a unique nervine adaptogen and a strong hepatoprotective herb. The berry exerts a mild stimulant action upon the central nervous system and, at the same time, calms the stress response, especially when palpitations or asthma appear as a result of stress (Winston & Maimes, 2007). Schisandra may be particularly useful in depression because it protects the liver and addresses neuroendocrine deficiency and neurasthenia. As an adaptogen, schisandra moderates the stress response by affecting the HPA axis (Winston & Maimes, 2007) and can balance immune function as well as neural and endocrine function (Holmes, 2007). Schisandra is also used to control excessive discharge, be that diarrhea, copious urination or sweat, vaginal discharge, or premature ejaculation. In Chinese medicine, it is used to ease breathing difficulties linked to kidney imbalance, such as asthma, and for Shen disturbances that result in nightmares, heart palpitations, or anxiety (Winston & Maimes, 2007). A recent 2018 paper suggests that with its anti-inflammatory and antioxidant properties and ability to regulate neurotransmitters, schisandra is a promising herb for future study on its protective role in neurological diseases, such as depression and neurodegenerative diseases (Zhang et al., 2018).

Answer 278

Schisandra is contraindicated in pregnancy because of its uterine stimulant action. In Chinese medicine it is contraindicated for individuals with acute viral or bacterial infections, such as the flu, colds, bronchitis, or pneumonia, and in the early stages of skin rashes (Holmes, 2007; Winston & Maimes, 2007). Schisandra may interfere with opiates, warfarin, and any drugs metabolized by CYP3A, CYP1A2, and CYP3A4 enzymes, counteracting their effectiveness or removing them from the system more quickly than intended (Gardner & McGuffin, 2013).

Answer 279

Oat – Avena sativa (Poaceae)

Answer 280

Grain in milky stage, straw

Answer 281

Analgesic, antidepressant, antispasmodic, anxiolytic, hypolipidemic, hypotensive, nervine relaxant, nervine tonic, nutritive

Answer 282

Warming and moistening

Answer 283

Milky oats is considered a nervine tonic par excellence due to its remarkable nutritive quality and overall gentle effectiveness. Its use in herbalism harkens back to the Eclectic physicians of the early 20th century, who considered oats an important remedy for nervous exhaustion and weakness of the heart (Felter, 1922). Milky oats is taken long-term for chronic conditions—it is particularly suited for chronic stress, anxiety and nervousness, insomnia, neurasthenia, mental confusion, and exhaustion. Indications include frazzled emotions, chronic upset, shattered nerves, and exhaustion (mcdonald, n.d.; Winston & Maimes, 2007). The sweet taste of milky oats indicates its nutritive, nourishing quality, and it is indeed rich in minerals and trace nutrients (European Medicines Agency, 2008). Milky oats is also a broad trophorestorative that is supportive to the nervous, musculoskeletal, and endocrine systems and sometimes overlooked in its application as a cardiac trophorestorative (Holmes, 2007), nourishing, strengthening, and moisturizing tissues throughout the body. Milky oats affects the HPA axis and while it pairs well with many herbs, it works particularly well combined with other nervine relaxants (Holmes, 2007). There is a notable dearth of scientific research on milky oats, but it has shown promise in ameliorating cognitive difficulties such as poor concentration (Berry et al., 2011; Wong et al., 2012; Wong et al., 2013).

Answer 284

No issues reported with the exception of caution for those with celiac disease or known sensitivities to oats. In terms of personal constitution, it may be too sweet and damp for individuals with moist constitutions and may cause diarrhea in such individuals (Wood, 2008).

Herbs and the Nervous sytem Flashcards

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