Anxious Moments

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Passionflower helps relieve chronic mild anxiety.
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Ever get the feeling that instead of the Age of Aquarius, we live in the Age of Anxiety? You worry about the kids, the job, the relationship and how you’re going to pay the bills. Those concerns may be uniquely your own, but all of us have anxious moments that can displace our sense of calm. For an estimated 19 million Americans, however, anxiety can overtake daily life. For those who suffer from an anxiety disorder, feelings of worry, fear and even panic are constant companions. This continual state of emotional and physical turmoil prevents sufferers from living a happy, rewarding life.

The Faces of Anxiety

When it comes to anxiety, one size doesn’t fit all. Although post-traumatic stress disorder (PTSD) — a disorder that can affect people who have experienced war, natural disasters or other traumatic situations — may be the most severe form of anxiety, other types of anxiety can be just as life-disrupting. Obsessive behavior, phobias and panic attacks can leave sufferers feeling that they have no control over their lives.

Perhaps the most insidious form of anxiety is generalized anxiety disorder (GAD). People with GAD live in a state of constant tension and exaggerated worry over life’s everyday activities. Instead of counting their blessings, they focus on life’s “what ifs” and worst-case scenarios. As a result, these anxious feelings feed on themselves and can lead to headaches, irritability, fatigue, restlessness, concentration problems and gastrointestinal upset.

While no one has a firm handle on exactly what causes anxiety disorders, most researchers suspect imbalances in three brain chemicals — norepinephrine, serotonin and gamma-amino butyric acid (GABA).

Normally, stress triggers a spike in norepinephrine, causing the fight-or-flight response. While norepinephrine is a critical neurotransmitter that prepares the body’s response to stress, too much of it can bring on a panic attack.

Along with helping to regulate sleep, appetite and body temperature, serotonin also controls mood. Low levels of this chemical can lead to phobias and obsessive-compulsive behavior.

GABA is a natural calming agent, and low levels in the brain can allow thoughts and worries to run full-throttle day in and day out. Experts believe generalized anxiety disorder may result from a GABA deficiency.

Conventional medicine is often short-sighted when it comes to treating anxiety. Biofeedback and cognitive behavioral therapy can be very effective, but most doctors rely on anti-anxiety drugs, tranquilizers and antidepressants to tame symptoms. While these and other medications may offer relief to anxiety sufferers, their use can exact a hefty price. Potential side effects include drowsiness, decreased mental sharpness, nausea, tremors, disturbed sleep patterns, sexual problems and increased agitation. If you suffer from mild to moderate anxiety, you may be able to forego prescription drugs and find help with natural solutions.

Herbal Bliss

For thousands of years, people have been turning off anxious thoughts with herbs. Perhaps the best-known anti-anxiety herb is kava (Piper methysticum). South Pacific islanders traditionally have used kava to calm nerves and enhance sociability. And anxious Europeans have relied on kava for decades as a natural and non-addictive way to induce mental and physical relaxation, without the mental fog common to anti-anxiety drugs.

How well does it work? To find out, researchers at Ludwig-Maximillians University in Munich, Germany, divided 129 anxious patients into three groups. The first group took 400 mg of kava a day. The second group was given 10 mg of the anti-anxiety drug buspirone (Bu-Spar). And the third group received 100 mg daily of the antidepressant opipramol. After eight weeks, the researchers found that kava was just as effective as the pharmaceuticals for treating GAD.

These findings didn’t surprise Yadhu Singh, professor of pharmaceutical sciences at South Dakota State University, Brookings, who discovered that kava has a direct impact on both GABA and norepinephrine in the brain.

But kava recently came under attack after the herb was implicated in 35 cases of liver damage. As a result, the U.S. Food and Drug Administration issued a consumer advisory warning against its use — even though toxicological studies haven’t established a clear link. Nevertheless, many health-food stores no longer carry kava. Mark Blumenthal, founder and executive director of the American Botanical Council notes that if you have liver disease or drink alcohol on a regular basis, you should avoid using kava. Until kava’s safety is established conclusively, it’s also wise to limit daily use to 100 mg two or three times a day for no more than four weeks.

Passionflower (Passiflora incarnata) is another excellent herb that appears to help regulate the brain’s neurotransmitters. In one double-blind study published in the Journal of Clinical Pharmacy and Therapeutics, 32 people suffering from GAD were treated daily with either 45 drops of a liquid passionflower extract or 30 mg of oxazepam, a common anti-anxiety drug. After four weeks, all participants had experienced a significant decrease in anxiety. The difference was that those in the passionflower group had no problems at work, while 44 percent of those taking the oxazepam reported severely impaired job performance.

For chronic mild anxiety, take 350 mg of passionflower three times a day. If you prefer getting your herbs in liquid form, Ray Sahelian, M.D., author of Mind Boosters (St. Martin’s Press, 2000), suggests taking 30 drops of passionflower extract in a few ounces of water or juice one to three times a day.

The herb valerian (Valeriana officinalis) has been shown to reduce tension and induce sleep, especially if you are suffering from both anxiety and depression. A clinical trial published in the journal Phytotherapy found that combining valerian with St. John’s wort (Hypericum perforatum) was significantly more effective for treating anxiety with depression than St. John’s wort alone. And if you suffer from insomnia, taking 300 to 500 mg of valerian an hour before bedtime not only makes it easier to fall asleep, it can help you get a more restful night’s sleep.

Skullcap (Scutellaria lateriflora), another mild herbal sedative, reduces anxiety in animal studies. However, there have been no human trials to confirm its effect in people. As with kava, there have been some reports of liver toxicity. Most herbalists recommend taking 1/3 to 3/4 of a teaspoon of skullcap in tincture form three times a day.

Mellow Out Naturally

Some vitamins also can help banish anxious feelings. Inositol and niacinamide are two that seem to be especially effective.

Inositol, found naturally in nuts, beans, wheat and cantaloupe, is part of the vitamin B complex and is one reason many nutritionists recommend boosting B vitamin intake for anxiety and stress. Inositol works by affecting nerve transmission and can help reduce panic attacks and obsessive-compulsive disorder (OCD). In one clinical trial of 20 patients suffering from panic disorder, Israeli scientists found that inositol reduced the frequency of attacks better than the pharmaceutical drug fluvoxamine — and with far fewer side effects. Inositol (1,800 mg a day) also has been shown in a double-blind trial to be effective at relieving the symptoms of OCD.

The other noteworthy anxiety-reducing vitamin, niacinamide, is found in brewer’s yeast, broccoli, eggs, fish and beef liver. Animal studies show that niacinamide has the same effect on the brain as tranquilizers used in conventional medicine. And according to David Williams, M.D., inositol can enhance the effects of niacinamide, so the two nutrients should be taken together. Niacinamide is almost always safe to take, though rare liver problems have occurred at amounts in excess of 1,000 mg daily.

Because studies show that people suffering from anxiety often have a GABA deficiency, many nutritionists recommend taking GABA as a supplement. The problem with this logic is that GABA doesn’t cross the blood-brain barrier very well so supplements may be ineffective. However, a new supplement, L-theanine, might be the answer to boosting GABA levels in the brain. A compound in green tea, L-theanine is a derivative of another neurotransmitter, glutamic acid. Readily absorbed by the brain, L-theanine calms anxiety by directly influencing both GABA and serotonin levels. And, unlike anti-anxiety drugs, L-theanine works quickly and doesn’t leave you feeling groggy. On the contrary, this green tea derivative actually improves concentration. In one small study, researchers found that anxious students taking 200 mg of L-theanine felt much less anxious and more focused within 40 minutes of taking the supplement. Patented under the name of Suntheanin, L-theanine has no reported side effects.

Living the Calm Life

When it comes to anxiety, herbal and nutritional remedies work better when combined with a healthy lifestyle. The first step is to ditch caffeine, a move that can calm anxious feelings significantly. Adopting a whole-foods diet low in sugar also can help ease anxiety, as can getting enough sleep.

Along with changing your diet, taking the time to practice some stress-busting techniques can help you gain serenity. A few minutes of deep breathing can elicit the relaxation response. Or try a soothing massage to help control angst. Meditation is another way to calm anxious feelings. According to a small study by psychiatrists at the University of Massachusetts Medical Center, mindfulness meditation can reduce the number and severity of panic attacks. More recently, researchers at the University of California, San Diego, found that daily meditation is an effective treatment for OCD. Although meditation appears simple in theory, it takes practice and patience. For best results, find a quiet place and set aside 15 to 20 minutes once or twice a day to develop your practice.

Even laughter can trigger physiological changes that reduce fearful feelings. According to humor expert Lee Berk, associate director for the Center for Neuroimmunology at California’s Loma Linda University, when fear strikes, it’s time to send in the clowns.

Kim Erickson is the author of Drop-Dead Gorgeous: Protecting Yourself from the Hidden Dangers of Cosmetics (Contemporary Books, 2002) and a frequent contributor to Herbs for Health.

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