Also indexed as: Nervousness, Panic Attacks
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:
- Address your stress
- Reduce stress with meditation, counseling, and other methods
- Avoid caffeine
- If you are anxious, avoid stimulants such as caffeine
- 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
- Aim for better nutrition with a multivitamin
- Taking one a day may help reduce anxiety and feelings of
- Talk to your doctor
- Ask your healthcare provider about relieving anxiety symptoms with
lorazepam (Ativan), clonazepam (Klonopin), and alprazolam (Xanax)
These recommendations are not comprehensive and are not intended to replace
the advice of your doctor or pharmacist. Continue reading the full anxiety article for more
in-depth, fully-referenced information on medicines, vitamins, herbs, and dietary and
lifestyle changes that may be helpful.
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.
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What are the symptoms?
Physical symptoms of anxiety include fatigue,
insomnia, stomach problems, sweating, racing heart, rapid breathing, shortness of breath,
Dietary changes that may be helpful
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
Underlying medical conditions, such as excess hormone secretion from the thyroid or adrenal
glands, should be treated when present. Psychological counseling often accompanies drug
Vitamins that may be helpful
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.2 Inositol (18 grams per day) has also been shown
in a double-blind trial to be effective at relieving the symptoms of obsessive-compulsive
An isolated 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.4
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).5 The fish oil used in this
study provided 3 grams per day of omega-3 fatty acids and was given for three months.
Many years ago, magnesium was reported to
be relaxing for people with mild anxiety.6 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.
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.7 One study found that niacinamide (not niacin) helped people
get through withdrawal from benzodiazepines—a common problem.8 A reasonable
amount of niacinamide to take for anxiety, according to some doctors, is up to 500 mg four
times per day.
Are there any side effects or interactions?
Refer to the individual supplement for information about any side effects or interactions.
Herbs that may be helpful
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.9 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.10
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
Other nervines include oats (oat straw), hops, passion flower, American scullcap, wood betony, motherwort, pennyroyal, and linden.
Bacopa, a traditional herb used in
Ayurvedic medicine, has been shown to have anti-anxiety effects in animals.12 A
preliminary study reported that a syrup containing an extract of dried bacopa herb reduced
anxiety in people with anxiety neurosis.13 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.14
St. John’s wort has been reported in
one double-blind study to reduce anxiety.15
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.16 There are also
animal studies that suggest a benefit from chamomile for anxiety,17 but no human
studies support this belief. Often one cup of tea is taken three or more times per day.
Warning: Kava should only be taken with medical supervision. Kava is
not for sale in certain parts of the world.
Until recently, the preeminent botanical remedy for anxiety was kava, an herb from the South Pacific. It has been
extensively studied for this purpose.18 One 100 mg capsule standardized to 70%
kava-lactones is given three times per day in many studies. Preliminary19 and
double-blind trials20 21 have validated the effectiveness of kava for
people with anxiety, including menopausal
women.22 A previous study found kava to be just as effective as benzodiazepines over the course of six
weeks.23 The latest research shows that use of kava for up to six months is safe
and effective compared with placebo.24 Although kava rarely causes side effects at
the given amount, it may cause problems for some people if combined for more than a few days
Are there any side effects or interactions?
Refer to the individual herb for information about any side effects or interactions.
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Holistic approaches that may be helpful
Reducing exposure to stressful situations can help decrease anxiety. In some cases, meditation, counseling, or group therapy can
greatly facilitate this process.26
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.27 However, a trial of
acupuncture treatment for anxiety associated with quitting smoking did not provide any
evidence of benefit.28 A double-blind study of acupuncture for the treatment of
anxiety associated with dental procedures reported that acupuncture and placebo were equally
effective.29 Acupuncture remains unproven in the treatment of people with
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.30 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.
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