Anxiety is normal. It’s something we all have experience with—to one degree or another. Most people are anxious about something that hangs over them and follows them around like a personal rain cloud. Then there’s the deeper but still familiar anxiety many of us carry. The anxiety about our self-worth. The anxiety of performance, of social situations. This type can grip us in an uncomfortable, but hopefully not chronic, way.
But not all anxiety is run-of-the-mill—or manageable. People with Generalized Anxiety Disorder, for instance, might have trouble leaving the house, ordering a coffee from Starbucks, going to work. Anxious thoughts cycling through their brains often keep them up at night. When untreated, people with this level of anxiety can end up living in a state of perpetual fear.
The conventional approach is to take anti-anxiety meds, which can be genuinely life-saving for some people. Nonetheless, these can come with downsides that vary depending on an individual’s dosage and reactions—and the nature of the particular medication itself. Some meds result in few side effects, but others’ effects can be heavy. For instance, there are the benzodiazepines, highly-addictive tranquilizers with the potential for abuse. They make driving unsafe. They lower productivity. They sedate you. When necessary for the severity of the condition, these side effects may be worth it.
In other cases, a person might have more space to experiment and want to explore a different route.
In some cases, people choose to try natural anxiety aids. These are supplements, nutrients, and herbs that have been designed across millennia by nature (and maybe some input from green-thumbed healers). They might not always be enough for something as serious as a clinical anxiety disorder (please talk to your doctor before making any adjustment or addition to your medication), but at least some may be important complements to a prescribed regimen.
For those who want or need an alternative strategy for anxiety beyond meditative practices and general good health, these natural remedies may be worth a try.
First, the NUTRIENTS….
These are basic vitamins, minerals, and amino acids that your body needs to work. They are non-negotiable. You don’t have to get them through supplements—in fact, that should be a last resort after food—and I wouldn’t expect “drug-level” effects, but you do need to get them.
1. Long Chained Omega-3 Fatty Acids
Some human evolution experts maintain that the human brain wouldn’t be the human brain without steady and early access to coastal food resources—fish and shellfish rich in long chain omega-3s. If the long-chained omega-3s found in fatty fish and other sea creatures made our brains what they are today, it’s safe to assume that our brains work better when we eat them today. And if we’re talking about anxiety, that appears to be the case:
Studies in substance abusers find that supplementing with enough fish oil (and, yes, here’s what I use regularly) to raise serum levels of the long chain omega-3 fatty acid EPA reduces anxiety, while increases in DHA (the other long chain omega-3) reduce anger. Rising EPA levels after supplementation predicted the reduction in anxiety.
In healthy young medical students, omega-3 supplementation (2 grams EPA, 350 mg DHA) lowered inflammation and anxiety. Follow-up analyses revealed that reducing the serum omega-6:omega-3 ratio also reduced anxiety scores.
And in early pregnancy, high DHA levels predict low anxiety scores.
Magnesium deficiency is a risk factor for anxiety. The evidence, considered by some to be low quality, nonetheless suggests that supplementing with magnesium can reduce subjective anxiety. The mechanistic evidence is stronger, as magnesium is one of those minerals that plays a role in hundreds of very basic and essential physiological processes—including the generation of ATP, the body’s energy currency. Without adequate energy production, nothing works well. One’s mental health is no exception.
Magnesium supplementation reduces subjective anxiety (the only kind that matters) in the “mildly anxious” and in women with premenstrual syndrome.
Magnesium L-threonate, a form particularly good at getting into the brain, is worth trying for more immediate, noticeable effects.
Zinc deficiency is common in people with anxiety, including Chinese males and Americans. And although mainlining oyster smoothies probably won’t fix serious anxiety, a follow-up in the group of Americans with low zinc levels found that zinc supplementation did reduce anxiety levels.
4. Vitamin B6
Vitamin B6, or pyridoxine, helps regulate production of serotonin and GABA—two neurotransmitters that control depression and anxiety. In mice exposed to anxiety-producing situations, pyridoxine increases GABA, reduces glutamate, and reduces anxiety. In humans, correcting a magnesium deficiency with magnesium and vitamin B6 has a stronger effect on anxiety than magnesium alone. (Good to note: women on hormonal birth control may be depleted of vitamin B6 as well as other vitamins and minerals.)
The best sources of vitamin B6 are turkey, beef, liver, pistachios, and tuna.
Now, the NATURAL INTERVENTIONS….
These aren’t essential nutrients. Rather, they’re plant compounds with pharmacological effects and, in most cases, hundreds of years of traditional usage for dampening, inhibiting, or resolving anxiety.
Kanna comes from a succulent plant native to South Africa. The story goes that an anthropologist noticed elderly San Bushmen nibbling on a particular type of succulent plant while displaying incredible cognitive ability and remaining calm, cool, and collected. The fact that they weren’t dealing with daily commutes, traffic jams, annoying bosses, and mounting bills probably had something to do with it, but it turns out that the succulent plant wasn’t hurting the cause.
Kanna has been shown to dampen the subcortical threat response, which is normally heightened in anxious states. It also increased well-being and resistance to stress in health adults who took it in a safety study.
Theanine, an amino acid found in green tea and available as a supplement, isn’t going to obliterate your nerves before a big performance. One study showed that it (along with the benzodiazepine Xanax) reduced resting state anxiety but not experimentally-induced anxiety. Then again, neither did Xanax.
Theanine is instead a mild anxiolytic. If you get anxiety from caffeine, take 200 mg of theanine with your coffee. It will smooth out the experience, reduce/remove the anxiety, and leave the stimulation.
Kava is a plant native to the South Pacific. Traditionally, its roots were chewed fresh with the resultant liquid often spit into communal bowls for consumption, pounded to release the moisture, or sun-dried, ground, and steeped in water to make an intoxicating, relaxing mild sedative. Nowadays, the active kavalactones are also extracted and pressed into capsules.
I don’t use kava, but I have tried it a couple times in the past. For what it’s worth, I don’t have anxiety issues but it did seem to pair well with caffeine (similar to theanine).
8. Rhodiola Rosea
Rhodiola rosea is a longtime favorite adaptogen of mine. It hails from the barren wastes of Siberia, where for millennia people from all over the ancient world coveted it. There’s something about the harsh environment of the northern tundra that made rhodiola rosea incredibly resilient—and bestows upon those who consume it a similar type of mental resilience.
A 2015 study sought to determine the impact of rhodiola on self-reported anxiety, stress, cognition, and a host of other mental parameters. Eighty subjects were divided into either a twice-daily commercial formula (containing 200 mg rhodiola) group or a control group. Compared to the controls, the rhodiola group showed notable improvements in mood and significant reductions in anxiety, stress, anger, confusion and depression after 14 days.
Rhodiola rosea, along with theanine, features prominently in my anti-stress (and anti-anxiety) supplement Adaptogenic Calm. (If you’re interested, here’s a video of me talking about how I use it.)
There’s a great lavender farm on the island of Maui. One of the favorite memories from that trip is strolling through the fields of lavender, brushing against the leaves and flowers, just basking in the relaxing scent that permeated the entire property. A very low-stress environment, to be sure.
One study gave lavender oil capsules to major depressive disorder patients suffering from anxiety who were already taking antidepressants. Not only did adding the lavender reduce anxiety, it also improved sleep.
Perhaps the most impressive study is this one, where generalized anxiety disorder patients either received lavender oil or a benzodiazepine anti-anxiety drug. Patients receiving the lavender had the same beneficial effects as the benzo patients without the sedation.
Lavender oil aromatherapy also seems to reduce anxiety, at least in cancer patients. One weakness of aromatherapy research is the difficulty of giving a “placebo smell.” Essential oil scents are quite distinct.
10. CBD Oil
As I wrote a couple weeks ago, CBD is the non-psychoactive cannabinoid found in cannabis.
Most recently, a large case series (big bunch of case studies done at once) was performed giving CBD to anxiety patients who had trouble sleeping. Almost 80% had improvements in anxiety and 66% had improvements in sleep (although the sleep improvements fluctuated over time).
In a five-year-old girl with PTSD (a category of patient that just shouldn’t exist) in whom pharmaceutical anxiety medications did not work, CBD oil provided lasting relief from anxiety.
What do you folks like for anxiety? What’s worked? What hasn’t? What did I miss?
Thanks for reading, everyone. Take care.