Psychiatry and psychotherapy offer many options for the treatment of anxiety, but the most effective treatment plans often combine pharmacology, therapy, and unique complementary treatments that work for the patient's needs. Some individuals may prefer to avoid drug-based treatments entirely during pregnancy or for any other number of reasons. Several complementary and alternative treatments are described in more detail below.
There is significant variation in the yoga styles that are practiced in the United States: some types can be intense and strenuous whereas others are relaxed and gentle. In America, the most frequently practiced type is hatha yoga, which incorporates the following elements: asanas (physical poses), controlled breathing done simultaneously with these poses, and periods of meditation or relaxation. Stress produces anxiety through psychological and physical arousal that increases heart rate, respiration, and blood pressure; by contrast, the calm, controlled breathing in combination with relief of muscle tension and quieting of the mind that are characteristic of yoga can reverse these instinctual responses to stress and, by extension, reduce anxiety.
The practice of yoga for the treatment of anxiety – like the use of exercise – is, increasingly, being affirmed by medical research. A 2005 study conducted in Germany found a 30% decrease in self-reported anxiety (as well as a 50% decrease in depression) among participants who took 2 yoga classes weekly for a period of 3 months. In the same year, researchers examined 113 patients at a psychiatric hospital in New Hampshire. After only a single class, the participants had less anxiety, anger, fatigue, tension, and other negative feelings. In a sample of war veterans with post-traumatic stress disorder (PTSD) in Australia, the participants' anxiety scores dropped significantly after a period of only 6 weeks, and the benefits were still present when they were evaluated again 6 months later.
Done for religious purposes or medical benefits in the United States, meditation involves invoking a state of consciousness or alertness of the mind through (depending on the style) breathing, focus, mantras (repeated words or phrases) prayer, and/or control of one's thoughts or guided thought activities. Two common types include Transcendental Meditation (TM) and mindfulness meditation. Meditating can calm the fight-or-flight instinctual response to stress that propels the sympathetic nervous system into physical changes like increased respiration and heart rate as well as narrowing of the blood vessels. Although studies have had different results based on the specific population under consideration, there seems to be strong support for meditation as a treatment for anxiety. Another benefit of this option, as with yoga, is the absence of any severe side effects that may be associated with pharmacological interventions.
Estimates from the National Institutes of Health indicate that nearly 20 million Americans meditated during 2007. Meditation is best practiced in a quiet place while assuming a comfortable position (sitting, standing, lying down, etc.). You may want to focus on a word, object, or concept and consciously relax your muscles and steady your breathing. Ask your doctor for additional information or contact a meditation group in your community to learn more about meditation and its benefits.
Herbs and Supplements
- Omega 3
In 2011, researchers at Ohio State University published results about the use of Omega-3 to treat anxiety in the journal Brain, Behavior and Immunity. In a sample of 68 medical students, those who were taking the omega-3 supplement had, compared to the placebo group, a 20% reduction in level of anxiety. In addition, the researchers took blood samples from the participants and discovered a 14% reduction in IL-6 (a type of cytokine, which is a compound that is responsible for promoting inflammation and has been associated with depression). Although the researchers emphasized that further research would be necessary before a blanket recommendation on the use of omega-3 could be made to the general public, the results offer a promising potential supplement or alternative for those suffering from anxiety.
- Kava Kava
Kava Kava (or simply “Kava") is the more common name for the Piper methysticum plant, the roots of which are ground to make a beverage that, in the Pacific Islands, has a social status comparable to that enjoyed by alcohol in the United States. Some (but not all) of the clinical research related to the use of kava kava to treat anxiety has suggested that it can be used effectively. One study found a significant improvement in participants' level of anxiety after a week of kava kava use. Another publication, which reviewed seven related studies, found that kava kava had a substantially greater effect compared to placebo. Yet another study compared kava kava to Valium (diazepam) in terms of brain wave activity; the results suggested that there were a number of similarities between the two in terms of the mechanisms behind each substance's ability to reduce anxiety. In 2004, Thompson, Ruch, and Hasenohrl found that use of kava kava could improve both cognitive function and mood when taken at a dose of 300 mg; these results were considered notable because many benzodiazepines commonly used to treat anxiety produce the negative side effect of decreased cognitive performance. Although kava kava received an evidence rating of “A" from the American Academy of Family Physicians, if you are considering using kava kava as a supplement or alternative to other treatments, you should do so under the direction of a physician. Additional research on the long-term outcomes of kava and kava-containing product use prompted the Food and Drug Administration to release an advisory in 2002 that such use has been found to be associated with liver failure. Although it has not yet been clarified whether the kava itself was implicated in these cases of liver failure, it is best to err on the side of caution when introducing any new substance into your regimen and consult your doctor.
- St. John's Wort
The name of the plant from which St. John's wort is derived is Hypericum perforatum. The primary contemporary use of this supplement is an alternative or complementary treatment for depression. Although there is some conflicting evidence, a substantial body of research seems to suggest that St. John's wort is an effective treatment for mild to moderate depression; however, the evidence for its use in treating anxiety is mixed and does not clearly indicate that it would be effective for this purpose. Because using this supplement in conjunction with certain other medications and substance can result in serious interactions, you should consult your doctor and pharmacist before taking it for any purpose.
- Valerian Root
A perennial plant, Valeriana officinalis and its roots have been used for medicinal purposes as well as perfumes for centuries. Historically, the purported anxiolytic (anxiety-reducing) effects of valerian root have not been sufficiently confirmed by scientific research. As of 2007, only two studies had been conducted, one of which used valerian in combination with St. John's wort. The other study compared valerian to Valium and placebo; the results showed no significant differences between any treatment, which may have been the result of the sample size or other methodological differences. The American Academy of Family Physicians, therefore, is unable to make clear recommendations for its use as a complementary treatment for anxiety and anxiety disorders.
- Rhodiola Rosea
Grown in regions with cold climates, the Rhodiola Rosea plant and, specifically, extract from its roots have been used to treat a number of different conditions including depression, fatigue, and anxiety. The scientific evidence to support the use of this plant has primarily focused on depression. Still, a small pilot study with ten participants with generalized anxiety disorder (GAD) that was conducted at UCLA in 2008 found substantial improvement in symptoms after ten weeks of 340 mg doses of Rhodiola Rosea extract daily. Although the exact mechanisms of the compounds in R. Rosea are not clear (for example, it appears to reduce the stress hormone cortisol), a number of scholars have been encouraged by its potential for treating psychiatric and other disorders. As with any substance, consult your health care provider prior to use.
When a patient receives cranial electrostimulation (CES), electrodes are placed on the patient's earlobes and low-intensity electrical pulses are emitted with the goal of stimulating the regions of the brain involved in the production of certain hormones and neurotransmitters. The devices used for CES (cranial electrotherapy stimulators) have been approved by the Food and Drug Administration for the treatment of depression, anxiety, and insomnia; they are classified as Class III devices. CES is not the same as “shock therapy," which uses a much, much stronger electrical current to achieve its effects and is not commonly used in the treatment of anxiety. In 1995, Klawansky and colleagues performed a meta-analysis on the use of cranial electrostimulation in the treatment of a number of conditions. For anxiety, the researchers reported that there was a statistically significant improvement in anxiety symptoms of those who were receiving CES compared to the group who had been exposed to a sham treatment. If you are interested in adding or switching to this type of treatment, ask your psychiatrist for more information.
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Date of original publication: April 09, 2013
Updated: December 06, 2016