Natural Treatments for Anxiety

Written by Institute for Natural Medicine Staff

Contributors: American Association of Naturopathic Physicians (AANP)

Published February 17, 2022
Last Updated November 30, 2023

Forty million adults in America suffer from anxiety,¹ the most commonly diagnosed behavioral health condition in the country. Unique for every person, generalized anxiety disorder (GAD) often feels like excessive, uncontrollable worry about numerous situations and issues. Many people fret over health, family, money, and work. Chronic nervousness, agitation, a restless mind, muscle tension, racing heart, and sleep disturbance are common symptoms.

Anxiety has various causes and contributors, including genetic, biological, and environmental factors. Common first-line treatments often focus on prescription medication and therapy. While medication can provide symptom relief, these drugs may have limited effectiveness. Benzodiazepines can be highly addictive² and cause unwanted side effects. A growing body of research is uncovering dangers associated with commonly prescribed drug treatments,³ including selective serotonin reuptake inhibitors (SSRIs) such as Prozac and Lexapro, and benzodiazepines (Xanax and Ativan).

Identifying Anxiety’s Underlying Causes

Licensed naturopathic doctors (NDs) excel at treating anxiety because they focus on treating the whole person and addressing the condition’s underlying causes. NDs have a deep toolbox of evidence-based natural therapies, including clinical nutrition, botanical medicine, and behavioral interventions.

Initial appointments often last an hour or more and include a detailed family and medical history, as well as a discussion of diet, physical activity, environmental issues, sleep patterns, and psycho-emotional stressors. NDs explore underlying causes of anxiety, including neurological imbalances, digestive/microbiome dysfunction, and hypothalamic-pituitary-adrenal (HPA) axis dysfunction:

Genetic predisposition.⁴ An understanding of genetic markers and pathways contributes to a more precise and personalized approach to treatment. Single Nucleotide Polymorphisms (SNPs) are the most frequent type of mutation. NDs look at patterns in SNPs and see how they affect B vitamins, hormones, nutrients, and neurotransmitter production and breakdown. This information provides foundational support for treatment planning.
Neurological imbalance.⁵ The balance of chemicals in the brain helps control mood and can play an important role in anxiety. Your ND will look for imbalances in serotonin, gamma-aminobutyric acid (GABA), and norepinephrine.
Digestive/microbiome dysfunction.⁶ The microbiome or “good germs” that line your digestive tract play an important role in balancing the nervous, hormonal, and immune systems. Your ND may order a stool analysis test to evaluate the health of your GI tract. You can also expect a detailed discussion of your diet, and potential labs to identify food sensitives and nutritional deficiencies.
Dysfunction of the HPA axis.⁷ Your HPA axis is your body’s stress response system. In the face of chronic psychological stress, the adrenal glands excrete an abnormal amount of cortisol in an abnormal rhythm. This can be caused by a number of factors, including blood sugar imbalance, lack of sleep, caffeine, toxins, and allergens. Your ND may order lab testing if this condition is suspected.

Evidence-Based Natural Treatments for Anxiety

Naturopathic doctors provide highly individualized therapies. They are trained in the pharmacological treatments commonly prescribed by conventionally trained MDs, and in some states, have scope for prescription of pharmaceuticals when necessary. When medications are necessary, genetic testing can help determine which medications you will be responsive to with the least side effects. NDs lead with minimally invasive therapies that support the body to restore healthy function.

Improving Gut Health: Restoring the Microbiome

Research on the biology of stress, fear, anxiety-related behaviors, and the gut-brain connection supports the importance of a nutritional and diverse diet, and supplementation with probiotics. NDs have the expertise to balance the microbiome and address food sensitivities and leaky gut thanks to their rigorous training in clinical nutrition.

Nutritional and Botanical Supplements

NDs utilize a multitude of evidence-based nutritional and botanical supplements for their calming effects to help reduce the frequency, severity, and duration of generalized anxiety and panic disorders. These treatments are individualized and evaluated carefully for safety in every patient. Effective supplements include gamma-aminobutyric acid (or GABA),⁸ L-theanine,⁹ passionflower,¹⁰ Scutellaria lactiflora (skullcap),¹¹ hops,¹² Piper methysticum (kava),¹³ lavender,¹⁴ adaptogens such as Withamnia Somnifera (ashwagandha),¹⁵ lithium rotate,¹⁶ and magnesium.¹⁷

Managing Stress with Personalized Behavioral Treatments

Naturopathic doctors are trained to evaluate anxiety symptoms in the context of an individual’s lifestyle, behavior, and socio-cultural environment. By examining diet, stress level, sleep, physical activity, and more, NDs can prescribe the most effective, evidence-based behavioral treatments and mind-body medicine techniques. These include mindfulness, therapeutic exercise/yoga, biofeedback, progressive muscle relaxation, breath work, and meditation.

For some patients, addressing repressed or current trauma can play a significant role in anxiety treatment. Naturopathic doctors who specialize in mental health, such as those certified by the Psychiatric Association of Naturopathic Physicians, can offer energy-based therapies that focus on releasing trauma. These may include hypnotherapy, guided visualization, cranial sacral therapy, and other specialized modalities.

Optimizing Lifestyle Choices

Because of the extra time they spend getting to know you, NDs uniquely tailor recommendations to optimize lifestyle habits such as sleep, diet, exercise, and reduction of stimulants, all of which play contributing roles in anxiety.

NDs may evaluate and utilize additional strategies and therapies for different types of anxiety disorders, including anxiety in perimenopausal women, post-traumatic stress disorder (PTSD), obsessive-compulsive disorder, and panic disorder.

A service for consumers from the American Association of Naturopathic Physicians (AANP) and the Institute for Natural Medicine (INM). The AANP and INM would like to acknowledge Moira Fitzpatrick PhD, ND, FICPP, CHT, for her contributions to the content of this FAQ.

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Footnotes

1
Anxiety Disorders – Facts & Statistics. Anxiety and Depression Association of America. Accessed February 17, 2022. https://adaa.org/understanding-anxiety/facts-statistics
2
Tan KR, Brown M, Labouèbe G, et al. Neural bases for addictive properties of benzodiazepines. Nature. 2010;463(7282):769-774. https://doi.org/10.1038/nature08758
3
Ferguson JM. SSRI Antidepressant medications: adverse effects and tolerability. Prim Care Companion J Clin Psychiatry. 2001;3(1):22-27. https://doi.org/10.4088/pcc.v03n0105
4
Gottschalk MG, Domschke K. Genetics of generalized anxiety disorder and related traits. Dialogues Clin Neurosci. 2017;19(2):159-168. https://doi.org/10.31887/DCNS.2017.19.2/kdomschke
5
Martin EI, Ressler KJ, Binder E, Nemeroff CB. The neurobiology of anxiety disorders: brain imaging, genetics, and psychoneuroendocrinology. Psychiatr Clin North Am. 2009;32(3):549-575. https://doi.org/10.1016/j.psc.2009.05.004
6
Foster JA, Neufeld McVey KA. Gut-brain axis: how the microbiome influences anxiety and depression. Trends Neurosci. 2013;36(5):305-312. https://doi.org/10.1016/j.tins.2013.01.005
7
Ma D, Serbin LA, Stack DM. How children’s anxiety symptoms impact the functioning of the hypothalamus–pituitary–adrenal axis over time: A cross-lagged panel approach using hierarchical linear modeling. Development and Psychopathology. 2019;31(1):309-323. https://doi.org/10.1017/S0954579417001870
8
Lydiard RB. The role of GABA in anxiety disorders. J Clin Psychiatry. 2003;64 Suppl 3:21-27.
9
Lu K, Gray MA, Oliver C, et al. The acute effects of L-theanine in comparison with alprazolam on anticipatory anxiety in humans. Hum Psychopharmacol. 2004;19(7):457-465. https://doi.org/10.1002/hup.611
10
Akhondzadeh S, Naghavi HR, Vazirian M, Shayeganpour A, Rashidi H, Khani M. Passionflower in the treatment of generalized anxiety: a pilot double-blind randomized controlled trial with oxazepam. J Clin Pharm Ther. 2001;26(5):363-367. https://doi.org/10.1046/j.1365-2710.2001.00367.x
11
Sarris J, Panossian A, Schweitzer I, Stough C, Scholey A. Herbal medicine for depression, anxiety and insomnia: a review of psychopharmacology and clinical evidence. Eur Neuropsychopharmacol. 2011;21(12):841-860. https://doi.org/10.1016/j.euroneuro.2011.04.002
12
Kyrou I, Christou A, Panagiotakos D, et al. Effects of a hops (Humulus lupulus L.) dry extract supplement on self-reported depression, anxiety and stress levels in apparently healthy young adults: a randomized, placebo-controlled, double-blind, crossover pilot study. Hormones (Athens). 2017;16(2):171-180. https://doi.org/10.14310/horm.2002.1738
13
Sarris J. Herbal medicines in the treatment of psychiatric disorders: 10-year updated review. Phytother Res. 2018;32(7):1147-1162. https://doi.org/10.1002/ptr.6055
14
Woelk H, Schläfke S. A multi-center, double-blind, randomised study of the lavender oil preparation silexan in comparison to lorazepam for generalized anxiety disorder. Phytomedicine. 2010;17(2):94-99. https://doi.org/10.1016/j.phymed.2009.10.006
15
Cooley K, Szczurko O, Perri D, et al. Naturopathic care for anxiety: a randomized controlled trial ISRCTN78958974. PLoS One. 2009;4(8):e6628. Published 2009 Aug 31. https://doi.org/10.1371/journal.pone.0006628
16
Szklarska D, Rzymski P. Is lithium a micronutrient? from biological activity and epidemiological observation to food fortification. Biol Trace Elem Res. 2019;189(1):18-27. https://doi.org/10.1007/s12011-018-1455-2
17
Sartori SB, Whittle N, Hetzenauer A, Singewald N. Magnesium deficiency induces anxiety and HPA axis dysregulation: modulation by therapeutic drug treatment. Neuropharmacology. 2012;62(1):304-312. https://doi.org/10.1016/j.neuropharm.2011.07.027

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The Institute for Natural Medicine, a non-profit 501(c)(3) organization. INM’s mission is to transform health care in the United States by increasing public awareness of natural medicine and access to naturopathic doctors. Naturopathic medicine, with its person-centered principles and practices, has the potential to reverse the tide of chronic illness overwhelming healthcare systems and to empower people to achieve and maintain optimal lifelong health. INM strives to fulfil this mission through the following initiatives:

Education – Reveal the unique benefits and outcomes of evidence-based natural medicine
Access – Connect patients to licensed naturopathic doctors
Research – Expand quality research on this complex and comprehensive system of medicine

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Natural Treatments for Anxiety

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Identifying Anxiety’s Underlying Causes

Evidence-Based Natural Treatments for Anxiety