Anxiety (Holistic)

About This Condition

Take control of anxiety and get on with life. Some anxiety is normal—but it shouldn’t interfere with your ability to function. According to research or other evidence, the following self-care steps may be helpful.
  • Aim for better nutrition with a multivitamin

    Taking one a day may help reduce anxiety and feelings of stress.

  • Try valerian and passion flower

    Calm the nervous system by taking an herbal combination of valerian (100 to 200 mg) and passion flower (45 to 90 mg) three times a day.

  • Try fish oils

    Take 3 grams per day of omega-3 fatty acids from fish oil for anxiety symptoms if you are experiencing substance abuse.

  • Try inositol for panic attacks

    Take 4 grams three times daily to help control panic attacks.

  • Get a checkup

    See your healthcare provider to make sure your symptoms are not related to a medical problem.

These recommendations are not comprehensive and are not intended to replace the advice of your doctor or pharmacist. Continue reading for more in-depth, fully referenced information.
  • Address your stress

    Reduce stress with meditation, counseling, and other methods.

  • Avoid caffeine

    If you are anxious, avoid stimulants such as caffeine.

These recommendations are not comprehensive and are not intended to replace the advice of your doctor or pharmacist. Continue reading for more in-depth, fully referenced information.

About

About This Condition

Anxiety describes any feeling of worry or dread, usually about events that might potentially happen. Some anxiety about stressful events is normal. However, in some people, anxiety interferes with the ability to function.

Some people who think they are anxious may actually be depressed. Because of all these factors, it is important for people who are anxious to seek expert medical care. Natural therapies can be one part of the approach to helping relieve mild to moderate anxiety.

Symptoms

Physical symptoms of anxiety include fatigue, insomnia, stomach problems, sweating, racing heart, rapid breathing, shortness of breath, and irritability.

Holistic Options

Reducing exposure to stressful situations can help decrease anxiety. In some cases, meditation, counseling, or group therapy can greatly facilitate this process.1

Acupuncture has been the subject of limited research as a therapy for anxiety. In an uncontrolled study, eight patients suffering from anxiety were treated with acupuncture three times per week for eight sessions. Six of the eight patients achieved good to moderate improvement.2 However, a trial of acupuncture treatment for anxiety associated with quitting smoking did not provide any evidence of benefit.3 A double-blind study of acupuncture for the treatment of anxiety associated with dental procedures reported that acupuncture and placebo were equally effective.4 Acupuncture remains unproven in the treatment of people with anxiety.

A form of counseling known as Cognitive-Behavioral Therapy (CBT) has been shown to be superior to placebo for managing the symptoms of panic disorder.5 In a controlled trial, six months of CBT produced a response rate of 39.5%, compared to only 13% in the placebo group. When combined with the tricyclic antidepressant drug imipramine (Tofranil®), response rates were even higher (57.1%). For long-term management of panic disorder, imipramine produced a superior quality of response, but CBT had more durability and was better tolerated.

Eating Right

The right diet is the key to managing many diseases and to improving general quality of life. For this condition, scientific research has found benefit in the following healthy eating tips.

RecommendationWhy
Cut the caffeine
People with anxiety appear to be especially affected by caffeine, so steer clear of all sources, including coffee, tea, chocolate, caffeinated sodas, and caffeine-containing medications.

All sources of caffeine should be avoided, including coffee, tea, chocolate, caffeinated sodas, and caffeine-containing medications. People with high levels of anxiety appear to be more susceptible to the actions of caffeine.

Supplements

What Are Star Ratings?
SupplementWhy
2 Stars
Chamomile
Refer to label instructions
Chamomile is an old folk remedy for anxiety, particularly anxiety that causes insomnia. Animal studies support this idea, due possibly to the herb’s calming compounds.

An old folk remedy for anxiety, particularly when it causes insomnia, is chamomile tea. There is evidence from test tube studies that chamomile contains compounds with a calming action. There are also animal studies that suggest a benefit from chamomile for anxiety, but no human studies support this belief. In an eight-week double-blind trial, treatment with a chamomile extract improved anxiety by an average of 50% in people suffering from chronic anxiety. This improvement was significantly greater than the improvement in the placebo group. The amount of chamomile extract used was 220 mg per day of a product standardized to contain 1.2% apigenin. After one week this was increased to 440 mg per day. For people whose anxiety did not improve sufficiently, the amount of extract was increased progressively, to a maximum of 1,100 mg per day by the fifth week of the study. Traditionally, one cup of tea is taken three or more times per day to treat anxiety.

2 Stars
Fish Oil
3 grams per day
In a double-blind trial, fish oil was significantly more effective than a placebo in improving anxiety levels for substance abusers.
In a double-blind trial, fish oil was significantly more effective than a placebo in improving anxiety levels in a group of substance abusers (alcohol, cocaine, and/or heroin). The fish oil used in this study provided 3 grams per day of omega-3 fatty acids and was given for three months.
2 Stars
Inositol
4 to 6 grams three times per day
Inositol has been used to help people with anxiety who have panic attacks.

Inositol has been used to help people with anxiety who have panic attacks. Up to 4 grams three times per day was reported to control such attacks in a double-blind trial. Inositol (18 grams per day) has also been shown in a double-blind trial to be effective at relieving the symptoms of obsessive-compulsive disorder.

2 Stars
Lavender
Refer to label instructions
In a double-blind trial, a proprietary lavender oil preparation (silexan) provided significant symptom relief to people with generalized anxiety disorder.
In a double-blind trial, individuals with anxiety (generalized anxiety disorder) received 80 mg per day of a proprietary lavender oil preparation (silexan, 80 mg once a day) or a low dose of an anti-anxiety drug (lorazepam, 0.5 mg once a day) for 6 weeks. Significant improvement was seen in both groups, and the degree of improvement was similar in both treatment groups. In another double-blind trial, Silexan also improved anxiety in people who were suffering from a combination of anxiety and depression.
2 Stars
Multivitamin
Follow label instructions
A double-blind trial found that supplementing with a multivitamin-mineral supplement significantly reduced anxiety and perceived stress.

A double-blind trial found that supplementation with a multivitamin-mineral supplement for four weeks led to significant reductions in anxiety and perceived stress compared to placebo.

2 Stars
Passion Flower and Valerian
100 to 200 mg valerian and 45 to 90 mg passion flower three times a day
A combination of passion flower and valerian has been shown to reduce symptoms in people suffering from anxiety.

Several plants, known as “nervines” (nerve tonics), are used in traditional herbal medicine for people with anxiety, with few reports of toxicity. Most nervines have not been rigorously investigated by scientific means to confirm their efficacy. However, one study found that a combination of the nervines valerian and passion flower reduced symptoms in people suffering from anxiety. In a double-blind study, 45 drops per day of an extract of passion flower taken for four weeks was as effective as 30 mg per day of oxazepam (Serax), a medication used for anxiety.

2 Stars
Rhodiola
170 mg of a standardized extract twice per day
Taking rhodiola has been shown to significantly improve anxiety symptoms.

In a preliminary study, supplementation with rhodiola (Rhodiola rosea) significantly improved measures of anxiety in people suffering from generalized anxiety disorder. The amount used was 170 mg of a standardized extract taken twice a day for ten weeks.

2 Stars
St. John’s Wort
Refer to label instructions
St. John’s wort has been reported in one double-blind study to reduce anxiety.

Caution: It is likely that there are many drug interactions with St. John's wort that have not yet been identified. St. John's wort stimulates a drug-metabolizing enzyme (cytochrome P450 3A4) that metabolizes at least 50% of the drugs on the market. Therefore, it could potentially cause a number of drug interactions that have not yet been reported. People taking any medication should consult with a doctor or pharmacist before taking St. John's wort.

St. John’s wort has been reported in one double-blind study to reduce anxiety.

1 Star
American Scullcap
Refer to label instructions
American scullcap is one of a group of “nerve tonic” (nervine) herbs used in traditional herbal medicine for people with anxiety, with few reports of toxicity.

Other nervines include oats (oat straw), hops, passion flower, American scullcap, wood betony, motherwort, pennyroyal, and linden.

1 Star
Bacopa
Refer to label instructions
Bacopa, a traditional herb used in Ayurvedic medicine, has been shown to have anti-anxiety effects.

Bacopa, a traditional herb used in Ayurvedic medicine, has been shown to have anti-anxiety effects in animals. A preliminary study reported that a syrup containing an extract of dried bacopa herb reduced anxiety in people with anxiety neurosis. A double-blind trial in healthy adults found that 300 mg per day of a standardized bacopa extract reduced general feelings of anxiety, as assessed by a questionnaire.

1 Star
Hops
Refer to label instructions
Hops is one of a group of “nerve tonic” (nervine) herbs used in traditional herbal medicine for people with anxiety, with few reports of toxicity.

Other nervines include oats (oat straw), hops, passion flower, American scullcap, wood betony, motherwort, pennyroyal, and linden.

1 Star
Linden
Refer to label instructions
Linden is one of a group of “nerve tonic” (nervine) herbs used in traditional herbal medicine for people with anxiety, with few reports of toxicity.

Other nervines include oats (oat straw), hops, passion flower, American scullcap, wood betony, motherwort, pennyroyal, and linden.

1 Star
L-Tryptophan
Refer to label instructions
Research suggests a connection between anxiety and serotonin deficiency and that its precursur L-tryptophan may help reduce anxiety in people with social anxiety disorder and neurosis.
Animal research suggests that the brain chemical serotonin is involved in the mechanisms underlying anxiety, and double-blind studies have reported that creating deficiencies of L-tryptophan, a precursor of serotonin, worsens symptoms in people with anxiety disorders. A small double-blind trial tested a food bar containing 250 mg of L-tryptophan plus carbohydrate compared with a placebo bar containing only carbohydrate in a people diagnosed with social anxiety disorder. The bars were consumed one hour before doing a task designed to provoke anxiety, and anxiety was measured with two tests of heart rate changes and by ratings of anxiety by the participants. Only one of the two heart rate measures showed the L-tryptophan bar was more effective, and only slightly lower anxiety was reported when L-tryptophan was consumed. A double blind study in China reported that 3 grams per day of L-tryptophan improved symptoms, including anxiety, in a group of people diagnosed with “neurosis.” More research is needed to evaluate L-tryptophan as a treatment for anxiety disorders.
1 Star
Magnesium
Refer to label instructions
Many years ago, magnesium was reported to be relaxing for people with mild anxiety. Some doctors recommend soaking in a hot bathtub containing magnesium sulfate crystals (Epsom salts).

Many years ago, magnesium was reported to be relaxing for people with mild anxiety. Typically, 200 to 300 mg of magnesium are taken two to three times per day. Some doctors recommend soaking in a hot tub containing 1–2 cups of magnesium sulfate crystals (Epsom salts) for 15 to 20 minutes, though support for this approach remains anecdotal.

1 Star
Motherwort
Refer to label instructions
Motherwort is one of a group of “nerve tonic” (nervine) herbs used in traditional herbal medicine for people with anxiety, with few reports of toxicity.

Other nervines include oats (oat straw), hops, passion flower, American scullcap, wood betony, motherwort, pennyroyal, and linden.

1 Star
Oats
Refer to label instructions
Oats are part a group of “nerve tonic” (nervine) herbs used in traditional herbal medicine for people with anxiety, with few reports of toxicity.

Other nervines include oats (oat straw), hops, passion flower, American scullcap, wood betony, motherwort, pennyroyal, and linden.

1 Star
Pennyroyal
Refer to label instructions
Pennyroyal is one of a group of “nerve tonic” (nervine) herbs used in traditional herbal medicine for people with anxiety, with few reports of toxicity.

Other nervines include oats (oat straw), hops, passion flower, American scullcap, wood betony, motherwort, pennyroyal, and linden.

1 Star
Vitamin B3 (Niacin)
Refer to label instructions
Niacinamide (a form of vitamin B3) has been shown in animals to work in the brain in ways similar to anxiety medications. One study found that niacinamide helped people get through withdrawal from benzodiazepines—a common problem.

Niacinamide (a form of vitamin B3) has been shown in animals to work in the brain in ways similar to drugs such as benzodiazepines (Valium-type drugs), which are used to treat anxiety. One study found that niacinamide (not niacin) helped people get through withdrawal from benzodiazepines—a common problem. A reasonable amount of niacinamide to take for anxiety, according to some doctors, is up to 500 mg four times per day.

1 Star
Vitamin B-Complex
Refer to label instructions
Double-blind research suggests that supplementing with vitamin B-complex multivitamin may reduce feelings of anxiety, perceived stress, and tiredness.
In one double-blind study, 80 healthy male volunteers (aged 18 to 42 years) were randomly assigned to receive a daily multivitamin-mineral formula or placebo for 28 days. The multi contained the following: thiamine (15 mg), riboflavin (15 mg), niacin (50 mg), pantothenic acid (23 mg), vitamin B6 (10 mg), biotin (150 mcg), folic acid (400 mcg), vitamin B12 (10 mcg), vitamin C (500 mg), calcium (100 mg), magnesium (100 mg), and zinc (10 mg). Compared with the placebo group, the multivitamin group experienced consistent and statistically significant reductions in anxiety and perceived stress, as determined by questionnaires measuring psychological state. This group also tended to rate themselves as less tired and better able to concentrate.
1 Star
Wood Betony
Refer to label instructions
Wood betony is one of a group of “nerve tonic” (nervine) herbs used in traditional herbal medicine for people with anxiety, with few reports of toxicity.

Other nervines include oats (oat straw), hops, passion flower, American scullcap, wood betony, motherwort, pennyroyal, and linden.

References

1. Miller JJ, Fletcher K, Kabat-Zinn J, et al. Three-year follow-up and clinical implications of a mindfulness meditation-based stress reduction intervention in the treatment of anxiety disorders. Gen Hosp Psychiatry 1995;17:192-200.

2. Lo CW, Chung QY. The sedative effect of acupuncture. Am J Chin Med 1979;7:253-8.

3. Lamontagne Y, Annable L. Acupuncture and anxiety. Can J Psych 1979;24:584-5.

4. Taub HA, Mitchell JN, Stuber FE, et al. Analgesia for operative dentistry: a comparison of acupuncture and placebo. Oral Surg Oral Med Oral Pathol 1979;48:205-10.

5. Barlow DH, Gorman JM, Shear MK, Woods SW. Cognitive-behavioral therapy, imipramine, or their combination for panic disorder. A randomized controlled trial. JAMA 2000;283:2529-36.

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