Adaptogens and Mental Health Conditions: Bipolar Disorder, Anxiety Disorders and Antidepressants
What the sources say about rhodiola, ginseng and ashwagandha with bipolar disorder, anxiety disorders and antidepressants, and why adaptogens never replace treatment. 988 information first.
Content last updated . This page has not been medically reviewed.
Safety first. Supplements can cause side effects and interact with medicines. Read mushroom safety and interactions before you use any mushroom product.
If you or someone you know is struggling or having thoughts of suicide, call or text the 988 Suicide & Crisis Lifeline at 988 (US), or chat at 988lifeline.org. In life-threatening situations, call 911. [1]
An adaptogen is not a replacement for treatment. This page is information only. Do not start, stop or change a prescribed medicine because of anything here; ask the prescriber or pharmacist. "Adaptogen" is a contested term from Soviet-era research, not a regulatory category, so each plant is treated on its own.
Why this group needs its own page
The National Institute of Mental Health describes bipolar disorder as a condition with clear shifts in mood, energy and activity, including periods of extremely "up," elated, irritable or energized behavior known as manic episodes. [1] It says bipolar disorder usually requires lifelong treatment, though an effective plan can help people manage symptoms. [1] Herbs that stimulate, sedate or change brain chemistry can matter more for people in these situations, and for people already on psychiatric medicines.What the sources found
| Plant | What the source found | Kind and strength of evidence |
|---|---|---|
| Asian ginseng (Panax ginseng, root) | NCCIH names insomnia as its most common side effect. [2] | Agency summary |
| Ginseng and mania | A report of two cases described new-onset mania linked to high-dose, long-term ginseng use; one 23-year-old man also used cannabis intermittently. [3] The authors said available data prevent a clear determination of causation, and symptoms fully remitted within days after ginseng was stopped with supportive treatment. [3] | Case reports; causation unclear |
| Rhodiola (Rhodiola rosea) | NCCIH says there is not enough reliable evidence to say whether rhodiola is useful for any health-related purpose. [4] It also says anyone with or at risk of depression should consult a provider. [4] | Insufficient evidence |
| Rhodiola with antidepressants | Memorial Sloan Kettering says concurrent use with a prescription antidepressant was reported to cause tachyarrhythmia (a fast, irregular heartbeat). [5] It also describes monoamine oxidase inhibition that may increase serotonin-related side effects; clinical relevance is yet to be determined. [5] | One case report; theoretical |
| Rhodiola with stimulants | MSK says the same enzyme action may enhance the hypertensive effect of stimulants; clinical relevance is yet to be determined. [5] | Theoretical |
| Ashwagandha (Withania somnifera) | NCCIH says evidence is unclear about its effects on anxiety. [6] It names possible interactions with sedatives and anti-seizure medicines. [6] MSK says people who take benzodiazepines, anticonvulsants or barbiturates should likely avoid it, based on preclinical sedative properties. [7] | Agency summary; preclinical |
| Ashwagandha and thyroid | MSK associates ashwagandha supplements with thyrotoxicosis in case reports, which resolved after stopping. [7] | Case reports |
A comparison that the sources draw
NCCIH says St. John's wort taken with certain antidepressants or other drugs that affect serotonin may lead to increased serotonin-related side effects, which can be serious. [8] St. John's wort is not an adaptogen, and the evidence for it is different; it is mentioned because it is the best-documented herb for this kind of interaction. See St. John's wort interactions and serotonin syndrome signs.Frequently asked questions
Can I use rhodiola with an antidepressant?
Ask a prescriber or pharmacist first. NCCIH says anyone with or at risk of depression should consult a provider, and Memorial Sloan Kettering reports a case of fast irregular heartbeat with concurrent use. [4][5]
Can ginseng trigger mania?
Case reports describe mania linked to high-dose, long-term ginseng use, but the authors said causation cannot be clearly determined. [3] People with bipolar disorder should ask their psychiatrist.
Is ashwagandha safe with anxiety medicine?
NCCIH names possible interactions with sedatives and anti-seizure medicines, and evidence for anxiety is unclear. [6] Ask a pharmacist.
Can an adaptogen replace my medicine?
No source we read supports that. Do not stop a prescribed medicine on your own; ask the prescriber.
What if I feel much worse after starting one?
Contact a clinician. If you have thoughts of suicide, call or text 988. [1]
More details: evidence, limits and cautions
The details behind this page: cautions, limits of the evidence and where sources disagree. Open any note to read it.
Limits and uncertainty
Who should ask first
- Anyone with bipolar disorder, a history of mania or psychosis, or difficulty sleeping: ask the psychiatrist or pharmacist before trying any of these plants.
- Anyone taking SSRIs, SNRIs, MAOIs, lithium, antipsychotics, benzodiazepines, anti-seizure medicines or stimulants: ask a pharmacist. See supplements and antidepressants.
- Anyone whose mood, anxiety or thinking changes after starting a supplement: the FDA lists marked mood, cognitive or behavioral changes and thoughts of suicide among serious reactions to report. [9]
Related reading: mental health conditions and supplements, rhodiola side effects and interactions, adaptogens versus prescription treatments and mental health crisis information.
References
- National Institute of Mental Health. Bipolar Disorder. Read 2026-10-23.
- NCCIH. Asian Ginseng: Usefulness and Safety. Last updated February 2025. Read 2026-10-23.
- Manic psychosis associated with ginseng: a report of two cases and discussion of the literature. 2015. Read 2026-10-23.
- NCCIH. Rhodiola: Usefulness and Safety. Last updated April 2025. Read 2026-10-23.
- Memorial Sloan Kettering Cancer Center. Rhodiola (About Herbs). Read 2026-10-23.
- NCCIH. Ashwagandha: Usefulness and Safety. Last updated March 2023. Read 2026-10-23.
- Memorial Sloan Kettering Cancer Center. Ashwagandha (About Herbs). Read 2026-10-23.
- NCCIH. St. John's Wort: Usefulness and Safety. Read 2026-10-23.
- U.S. Food and Drug Administration. How to Report a Problem with Dietary Supplements. Content current as of 03/13/2025. Read 2026-10-23.