Herb Med 4 2011 - Nervous System Conditions

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Herbal Medicine 4 2011

NERVOUS SYSTEM DISEASES & CONDITIONS


CONTENTS:
Insomnia References:
 Mills & Bone. 2000. Principles and Practice of
Conditions with a Nervous System Phytotherapy (pp 207-219)
Component
 Winston, D. & Maimes, S. 2007. Adaptogens.
Case Studies  Kellie Limeburner: Clinical and study notes.
 Gerry Dendrinos: Clinical notes

NOTE: herbs listed below under each condition in bold underline are herbs you have
covered so far in Herbal Medicine 2 and 3.

See Herbal Medicine 3 Notes ‘Phytotherapy For the Nervous System’.

INSOMNIA

POSSIBLE CAUSES:
Overuse of stimulants Nightmares
Anxiety and worry Fe and B supplements at night
Depression Eating late
Pain Shift work
Environmental factors EMR (electromagnetic radiation)
(noise/light/allergies) Fear, anger or grief
Exercise before bed
Working late

* You need to work out what is causing the insomnia: the causes of insomnia can be
many and varied. What is the insomnia associated with and/ or symptomatic of?
Look at allergies and nutrient deficiencies;
Drug use (including medical);
Lifestyle habits;
Mental/ emotional factors – especially unresolved grief/ anger/ trauma/ anxiety/
depression.
You often need to look beyond just the physical level, and explore the types of stress(es)
present in a person’s life on constitutional, physical, emotional and mental levels. The
various herbs at our disposal have affinities with the types of stresses and events people
experience in their lives. Often the herb(s) needed to correct sleep patterns are not
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primary sedative or hypnotic nervines, which many people have already self-prescribed
before they come to see you and have found to be ineffective, or effective only briefly.
Often people find a herb or two (eg. Valerian, Passionflower) that helps them sleep, but
the effect is palliative only. You need to help them address the underlying cause.

Case example: Woman, single mother, who was waking every night between 1-3AM.
She followed a traditional southern European diet, which was balanced and healthy.
She went to bed early, but would wake between these hours every night. She had tried
a variety of the usual herbal nervines (Hypericum, Passiflora, Valerian, Scullcap,
Avena, Chamomile, Hops, Lavender) with temporary palliation, but no lasting effect.
Upon further questioning, she revealed that when she woke she felt anxious and
worried about her teenage sons who were starting to go out and come home late at
night. Further questioning revealed that deeper down she felt very resentful and angry
at these times towards her ex-husband who had left her in the situation of having to
parent two teenage boys alone – it was actually the tension and anxiousness created
by her anger and resentment that was her basic problem. She did very well on Rue
(Ruta graveolens – ‘the herb of grace’).

HERBAL TREATMENT:
Use herbs to re-establish a sleep pattern while treating the underlying causes.
Herbs given during the day for associated health problems and herbs given at night for
sleep (a Sleep Mix).

FORMULATION EXAMPLE:
Total 100mls
Sleep Mix:
Passiflora 40  5mls half an hour prior to bed, another 5mls every
Scutellaria 40 half hourly until asleep (up to three more doses)
Humulus 20  20mls max.

Insomnia Treatment Differentials:


 from Bergner (2001) [http://medherb.com/Therapeutics/therapeutics.htm]:

Category: Herbs:

To prevent anxieties when insomnia feared: Avena


Passiflora
Pulsatilla

With spasms, pain, nervous irritability, tachycardia: Piscidia (Jamaica Dogwood)


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Viscum (Mistletoe)

Frequent waking with nightmares: Cannabis (scheduled)

In atonic, debilitated states: Cypripedium (endangered –


use homeopathically 30C/
200C)
Epipactis
Valeriana

With muscular pain, agitation, “rheumatoid”: Cimicifuga (Black Cohosh)

From exhaustion following excitement: Pedicularis


Scutellaria

Wakefulness in chronic disorders: Scutellaria

With indigestion and epigastric fullness: Humulus


Matricaria

General, in asthenic (lacking in strength or vigour) Cypripedium (endangered –


individuals: use homeopathically 30C/
200C)
Hypericum
Symplocarpus
Valeriana

General, in sthenic (vital, strong, nervous energy) Avena


individuals:
Passiflora
Scutellaria
Verbena

Article:
Nervous - Nourishing the nerves - Specific medicines
 by Deborah Francis, R.N., N.D.
 Medical Herbalism 12(1)8-9 [http://medherb.com/Therapeutics/therapeutics.htm]
In these high stress times, herbal nervines, sedatives and adaptogens provide an important role in
clinical practice, both in the treatment of disease processes and in staying healthy. Specific
prescribing, individualized to the particular patient’s response to their life experience in an y given
moment, gives us tools for choosing among the wide array of herbs we have to prescribe for the
nervous system.
Nervines may generally be defined as that class of herbs that calm the nervous system. These herbs
may be very nourishing, as in the case of Avena sativa or trophorestorative, as with Hypericum
perforatum or Centella asiatica. A sedative is an herb with a stronger action on the nervous system
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and one that is more likely to induce drowsiness. This class of herbs is most useful in the treatment
of insomnia. Passiflora incarnata and Valeriana spp. are two examples of sedative herbs.
Adaptogens are herbs that help us deal with stress more effectively at a physiologic level. These
herbs often have a strengthening or tonic affect on the adrenal glands and immune system.
Examples include Glycerrhiza glabra and Eleutherococcus senticosus. Of course these categories
are not pure and there is lots of crossover.
Hypericum perforatum (St. Johns Wort)
Hypericum has a wide reputation as a regenerative nerve tonic for both psychiatric and neurologic
conditions. It is directly calming to the limbic system and, as numerous studies have shown, is a
powerful adjunct in mild to moderate depression.
Hypericum, named for the Greek Titan, Hyperion, God of the Sun, has a strong relationship with
the sun. In some sensitive persons or in very high doses taken internally, it is known to cause
photosensitivity reactions, yet it is used topically as a mild sunscreen and again for sunburn. Its
perforated leaves allow sun to shine through, just as the plant taken internally brings the sun into
those sad depressed places. Even the flowers are the color of the sun – a beautiful bright yellow.
Hypericum works well in alleviating the mild depression of seasonal affective disorder, through its
ability to increase our sensitivity to the sun.
Leaonurus cardiaca (Motherwort)
Leonurus is the herb to think of first when anxiety is accompanied by functional heart palpitations
due to stress and anxiety or liver toxicity. It is also a bitter digestive, antispasmodic, emmenogogue
and useful in hyperthyroidism where it both calms the nerves and protects the heart. Its common
name, motherwort, reflects its ability to connect us to Divine Mother, when used in medication.
Many writers call Leonurus the herb to mother mothers. It is also said to give courage and
strengthen the heart.
Avena sativa (Milky Oat Seed)
Rich in a wide array of nutrients, Avena is a wonderful nerve tonic gentle yet reliable. It is said that
Avena can bring focus to the scattered mind that jumps from one subject to the next (Boericke). It
also has a reputation for being helpful in breaking addictions to various drugs. Avena is specifically
indicated for nervous exhaustions or debility from protracted illness or overwork.
Crataegus spp. (Hawthorne)
Although not primarily considered a nervine, Crataegus can often act as a calming agent when
specific symptoms indicate. Such symptoms include tension or anxiety associated with a history of
grief, or feelings of betrayal and disappointment in relationships. Crataegus is particularly well
suited for those patients who have closed their hearts even partly or have built walls to protect
themselves or, conversely, for those overly sensitive patients whose anxiety stems from being too
open.
Melissa officinalis (Lemon Balm)
Melissa is a soothing nervine whose uplifting qualities make it mildly antidepressant as well. It is
carminative and antiviral. As it interferes with thyroid stimulating hormone (TSH) binding to
thyroid cells it is contraindicated in hypothyroidism, but may be a helpful adjunt in
hyperthyroidism, where the common symptoms of restlessness and agitation make it well indicated.
Scutellaria lateriflora (Skullcap)
Scutellaria is useful for insomnia and nervousness or anxiety where there is muscle spasm,
twitching, or tremors. It may also be helpful in functional heart palpitations, a form of muscle
spasm, or for insomnia from overwork, worry or long illness.

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Humulus lupulus (Hops)
Volatile oil content makes Humulus a good herb to include in a dream pillow for insomnia. Taken
internally, the presence of bitters give it some digestive stimulating and cholegogue powers and
make it useful for headaches from digestive upset. Its nervine qualities are specifically indicated for
the overly intellectualized type of worrier. It is also antispasmodic, as are many of the nervine
herbs.
Agrimonia eupatoria (Agrimony)
The flower essence of Agrimony is indicated for people who suffer from terrible inner turmoil, yet
put on a cheerful face. Small doses herbally can have a similarly calming effect when indicated. It is
commonly known as an astringent. Its near relative, Potentilla anserina may have similar
indications, but seems, in my experience, to impart a sense of empowerment and centeredness as
well.
Piper methysticum (Kava Kava)
Used traditionally as a sacred ceremonial herb in the South Sea Islands, Piper methysticum is said to
invoke the higher states of consciousness and increase openness in social gatherings or important
meetings. Experience in clinic reveals that Piper has an ability to lift one out of a deep chaotic
emotional state of either anxiety or depression to a place of clearer vision and centeredness. It not
only calms but actually lifts the patient to a different place. It is specifically indicated for patients
who have done their inner work, taken the “dark of night of the soul” journey, as it were, yet cannot
break free of the angst.
Piper can induce a mild feeling of peace and euphoria. Part of its ability to uplift may be linked to
the fact that it moves thinking from a linear processing of information to a greater sense of being
and understanding where there is more capacity to flow and let be. This plant seems to encourage us
to relax into other, more expansive parts of our brain, while still maintain and even sharpening our
ability to stay focused.
Piper methysticum can be toxic in prolonged or high dosage. Symptoms of such toxicity include
yellow, dry, rough skin and increased liver enzymes, all reversed when the herb is discontinued.
Very large doses can cause dilated pupils and unsteady gait.
Cimicifuga racemosa (Black Cohosh)
Specific indications for Cimicifuga include a deep dark depression, a sensation of a black cloud that
sometimes descends suddenly out of nowhere and a feeling of wildness in the mind with an inability
to focus. This wildness of the mind and inability to focus may bring on or accompany acute or
chronic anxiety. It is anti-inflammatory, antispasmodic, antirheumatic, and antihypertensive as well
as being regulatory to female reproductive organs. It may be used as a pelvic decongestant for both
men and women.
Artemesia tridentate (Sagebrush)
Sagebrush is most specifically indicated when depression or anxiety is associated with a sense of
being caught in either or patterns, or when the patients are feeling split off and isolated from parts
of themselves or from others. Sagebrush is invaluable for those patients who feel that certain
objects, most commonly electronic equipment are the source of demonic voices or bugging devices.
This is a common perception in people experiencing a schizophrenic state. The use of sagebrush
smoke, when the plant is burned as a smudge and passed over the offending objects on a regular
basis can be an enormous help in clearing this problem. Inhalation of volatile oils given off in the
smoke directly affects the limbic system via olfactory nerve pathways, which in turn has a
significant impact on the emotions.

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As a tea, Artemesia tridentata is used by native peoples for fevers, colds and flu, as well as
indigestion. Like its close relative Artemesia absinthium (wormwood), sagebrush is antiparasitic.  
Lavendula officinalis (Lavender)
Another plant high in essential oils, lavender is very soothing to the nervous system, and may be
used in a dream pillow for treatment of insomnia. Its folkloric association with the elderly suggests
it to be a specific for the insomnia of elders and indeed I have seen a simple sock filled with
lavender flowers and kept on the pillow at night do wonders in some case of insomnia in the elderly
where valerian and Passiflora had failed utterly. Taken internally, lavender acts as a digestive
stimulant and may be a helpful adjunct in the prevention and treatment of migraine or toxic
headache. In these cases it combines well with feverfew and ginger.
Matricaria chamomilla (Chamomile)
Chamomile is an excellent nervine when the patient is oversensitive, touchy and irritable. It is often
given to children who are prone to tantrums or irritable adults, whose oversensitive nature causes
them to be impatient and intolerant. It is a wonderful gastrointestinal remedy where it helps
stimulate digestive function as well as alleviate symptoms of spasm and inflammation.
Eschscholzia californica (California Poppy)
The California poppy, with its bright yellow and orange flowers and soft green, easy flowing leaves
and petals, is well indicated when what is needed is to relax into the moment, and flow, rather than
resist. It is a nice antispasmodic as well as a good nervine and is safe even for small children, as it
does not contain any of the strong alkaloids found in its relative the Opium poppy.
The sight of this plant blooming brightly is invariably and uplifting experience, suggesting it might
be a good adjunct in depression, particularly in those cases where the patent has struggled and feels
powerless in the face of life challenges that need to be accepted and embraced.
Passiflora incarnata (Passionflower)
Passiflora works most effectively for those heartful overworked worriers by bringing a gentle
healing to the nervous system that soothes the spirit. It is also helpful where functional heart
palpitations are part of the picture and stress is due to cares of the heart, as opposed to hops whose
worry is more intellectual in nature. In insomnia it works partially as a mild sedative but more as a
gentle nervine, healing the overwrought nervous system. Passiflora’s cure for insomnia is like a
wise gentle grandmother rocking us into a deep peaceful sleep.
Valeriana officinalis (Valerian)
Valerian is often the first herb folks turn to for treating insomnia. Studies from modern scientific
research have shown that valerian reduces the time it takes to fall asleep. Its bitter qualities and
volatile oils stimulate and tonify the digestive system causing, in some cases, the reverse effect of
overstimulation and wakefulness. Unlike the gentle Passiflora, valerian seems to act like a strong
warrior ordering us to sleep. The two work well together.
 
Some other nervine-type herbs to consider in insomnia include:
Zizyphus – anxiety, depression, insomnia, sweating.
Lavender – ‘emotional stagnation’/ ‘stagnant depression’, wher a person has had a
traumatic experience that becomes the focus of his or her life, with constant repetitive
thinking around this event, and the person is unable to move on (Winston & Maimes
2007, 227-8)
 Rosemary, Holy Basil and Damiana all help to resolve this type of depression.

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Albizia julibrissin (Mimosa Tree) – anxiety and depression (see Michael Tierra)
Damiana

Adaptogens to assist sleep: (Winston & Maimes 2007)


Stress can disrupt circadian rhythm-mediated secretion of cortisol, which responds to the
light-dark cycle. Cortisol plays a role in synchronising activity, eating patterns and sleep
patterns. Adaptogens regulate the production of cortisol and therefore help the body adapt
to stress. When the body is more relaxed this promotes deeper and more rejuvenating
sleep.
The following adaptogens aid the body in sleeping:
American Ginseng – helps with insomnia that is associated with chronic fatigue
syndrome
Withania – a calming adaptogen and traditionally used for insomnia and nervous
conditions
Siberian Ginseng – improves sleep quality and prevents night-time waking
Jiaogulan (Gynostemma pentaphyllum) – a calming adaptogen indicated for anxious
or agitated people with unstable hypertension, stress headaches and anxiety-induced
insomnia
Rhaponticum
Rhodiola – used to regulate sleep disorders and improve sleep quality
Schisandra – reported to relieve insomnia and dream-disrupted sleep.

CONDITIONS WITH NERVOUS SYSTEM COMPONENT:

Irritable Bowel Syndrome (IBS):


Digestive – dietary intake and fibre
NS – stress

Migraines:
Circulatory
Muscle tension
NS – stress and exhaustion
Digestive – dietary, especially allergy, sluggish liver and bowel (recirculating toxicity).

Eczema:
Digestive – allergies
NS – stress and anxiety

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Herpes Simplex: (Cold Sores and Genital Herpes)
Immune – run down
NS – stress and anxiety
Hypericum can be good for these conditions as an antiviral (enveloped viruses) and
nervine. In conjunction with Astragalus, Turnera, Withania and Glycyrrhiza.
Many members of the Lamiaceae (Mint) family are especially effective here – esp.
Lemon Balm (Melissa) and Peppermint (Mentha spp.)
Olive Leaf has a highly beneficial effect with herpes simplex.
Balm of Gilead (Populus candicans): works especially well topically. Goes well with
Olive Leaf.

Hypertension:
Circulatory
NS- stress and anxiety
Digestive – Liver and bowel
Urinary - renal

ACTIONS: HERBS:
Avena sativa (Oats Seed)
Hypericum perforatum (St John’s Wort)
Tonic Nervines/ Adaptogens
Withania somnifera (Ashwaghanda)
Glycyrrhiza glabra (Liquorice)
Scutellaria lateriflora (Sculcap)
Verbena officinalis (Vervain)
Centella asiatica (Gotu Kola)
Urticaria dioica (Nettle)
Withania somnifera (Fe)
Kava (Piper methysticum)
Brahmi (Bacopa monnieri)
Salvia officinalis (Sage)

Urticaria dioica (Nettle)


Nutritives
Avena sativa (Oats Seed)
Withania somnifera (iron)

Melissa officinalis (Lemon Balm)


Thymoleptics Hypericum perforatum (St John’s Wort)

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Ginkgo biloba (Ginkgo)
Circulatory Stimulants
Zingiber officinale (Ginger)
Capsicum minimum (Cayenne)
Bitters (to improve digestion, but do not Gentiana lutea (Gentian)
overcool)
Taraxacum officinale (Dandelion)
*Stimulating Nervines Centaury
(in small quantities very short term if at
all, depends on level of vitality)

OTHER TREATMENTS:
Counselling
Exercise
Decrease caffeine, OH and Sugar
Very nutritive diet
Diet high in live/vital fresh food.
Encourage enjoyable activities, hobbies etc.
Help them get involved with other people, helping others, bringing them out of
themselves.
Support groups

Nervous System Case Studies:

Case 1
Female 24, currently unemployed. Lost her job 12 months ago after a car accident left her
unable to work.

She suffered whiplash injuries and episodes of post traumatic stress. Her neck pain has
diminished and her initial panic attacks have subsided. She no longer feels anxious but
said that now she just feels “numb”. She is not on any medication.

She sleeps a lot throughout the day and will spend most nights awake watching late night
TV. She eats at night and has put on considerable weight. Approx 20kg over the 12
months. She constantly feels “tired and empty”. She describes her digestion as sluggish
and that she suffers regularly with constipation and bloating. She said she feels “very
heavy”. She has developed moderate acne and complains of being “cold and that her
joints ache”.

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Her diet is appalling, mostly snack food and take-away eaten late at night. She may only
eat once on most days. She said she knows that life is passing her by but she feels
“emotionally paralysed”.

Case 2
Male, 59, presents with chronic insomnia. He has recently finished work with the public
service and is trying to adjust to retirement. (12 mths ago).

He is thoroughly enjoying his freedom and has become much more active, playing lots of
golf and jogging. He is very fit for his age and finds his lack of energy due to lack of sleep
very frustrating.

He has always suffered with mild insomnia but since retirement it has become far worse.
He feels this may be due to a change in routine.

He wakes feeling very tired and sluggish and it takes him half the day to get going. He
then finds that he is very active in the afternoons and is often awake and energetic late at
night.

He is tired physically when he goes to bed but cannot shut down mentally. He says he has
no major worries, just that he just thinks about silly things of no importance.

When he does finally fall asleep he sleeps soundly for about four hours then wakes again.
His diet is very good and due to his regular exercise he is at an acceptable weight for his
age. He will have three glasses of wine most nights ( he says it helps him sleep) and he
often eats dinner very late.

http://www.elwoodindiana.org/content/daily-snapshot-insomnia

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