How do you feel about the usage of St. John's Wort for depression? Will it affect my cancer treatment?

St. John's wort (hypericum perforatum) has been in the news a lot lately as a herbal remedy for depression. It is used frequently in Europe, particularly in Germany, where it is taken much more frequently than conventional antidepressants, such as Prozac. St. John's wort seems to be more effective for mild to moderate depressive symptoms; more severe depression probably requires "stronger" medicine. The effective dosage is 300 milligrams, three time per day, and, similarly to conventional antidepressants, St. John's wort may take several weeks to work fully. Side effects are rare; the most important precaution is to be careful to avoid extensive direct sunlight. There should not be any difficulty combining St. John's wort with cancer treatments.

Before trying an herbal remedy for depression, please speak with your physician. In people with cancer, the diagnosis of depression can be tricky. Obviously, sadness and worry are expected and normal. Depression, on the other hand, is a real medical illness and is treatable. While an herbal remedy may be reasonable for some, conventional antidepressant medication is generally well tolerated and very effective. And don't forget talk therapy. Counseling, whether individual or in a support group, is a crucial part of coping well for many people with cancer.

I'm frustrated with my support group. There is one lady in particular who always uses up most of our time talking about her own problems. What should I do?

Thanks for your question. While cancer support groups are designed to be helpful and supportive, problems such as yours do arise. All kinds of people get cancer, and all kinds of people join support groups. In any group of individuals, personality and style issues can interfere with the group's functioning well.

I'm guessing that you might feel uncomfortable bringing up this issue in the group. After all, this is not a psychotherapy group where you are supposed to talk about your feelings about other group members. This group is supposed to be for talking about cancer.

Still, I urge you to try to bring up your feelings in the group. Conversations about how the group is going, about what the group is and is not doing well, are crucial as the group continues. Open discussion between group members, while not always easy, can be very important. Some of the most productive sessions in groups I've led involve discussion of issues that seem not to be about cancer at all. Support groups are about living with cancer, and living involves relationships with others. Bringing this issue up in group may help open the discussion to important aspects about other relationships. While difficulties like this often seem like "one more stress", and you may be tempted to talk with other group members or the group leader outside of the group, or even to stop going, I urge you to bring the issue to the next group meeting. Good Luck!