Herbal supplements for stress relief

Between economic concerns and ongoing global conflict, the majority of Americans are at peak stress levels. Seventy-three percent of respondents to this year’s Stress in America survey, conducted annually by the Harris Poll on behalf of the American Psychological Association (APA), reported feeling overwhelmed by the number of crises facing the world right now, results the APA calls “alarming.”

Living in “sustained survival mode” for the past few years has definitely had an impact on our collective health, according to the survey results. Alcohol use is up,  physical activity is down, and we’re not sleeping well.

These effects make sense, given what we know about how mental stress can affect physical health. Elevated stress hormones, especially cortisol, can increase inflammation, reduce immunity, and raise the risk of high blood pressure, stroke, and heart attack. According to the National Institute of Mental Health, chronic stress can negatively impact every aspect of your health and contribute to a wide range of problems, including:

• Headaches
• Sleep problems
• Mood disturbances, such as sadness, anger, or irritability
• Heart disease
• High blood pressure
• Diabetes
• Anxiety
• Depression

Stress is a problem we clearly need to address, and there are numerous strategies that have been shown to be effective for relieving it, including eating a healthy diet, getting plenty of sleep, exercising regularly, talking to friends or a mental health professional, and engaging in relaxation techniques and meditation, to name just a few.

Another, often-disputed stress-relief tool at your disposal? Dietary supplements. While none are a magic pill that will make stress disappear entirely, certain supplements claim to help lower anxiety levels, tame sleep troubles, ease depression symptoms, and more. While these claims are often overhyped, there is some evidence that dietary supplements can be part of a holistic approach to reducing stress, along with a healthy diet and other lifestyle changes.

It’s important to note that the U.S. Food and Drug Administration (FDA) doesn’t regulate supplements in the same way that it does medications, so you should talk to your doctor before taking any product. Additionally, robust research on herbal supplements and stress is lacking. Some studies have had promising findings, but the sample sizes were too small to make any definitive conclusions. Other studies have looked at larger groups of people but left out populations that face a higher risk of stress symptoms like anxiety — for example, women and young adults. Ultimately, more large, long-term studies that include a variety of populations are needed before health experts can recommend herbal supplements for stress.

That said, here is the evidence currently available on seven products with the potential to help curb stress (and one you’ll probably want to pass up) as you start your journey toward a more relaxed (and healthier) you.

Is there an effective herbal treatment for anxiety?

Answer From Brent A. Bauer, M.D.

Several herbal remedies have been studied as a treatment for anxiety, but more research is needed to understand the risks and benefits. Here’s what we know — and don’t know:

• Kava. Kava appeared to be a promising treatment for anxiety, but reports of serious liver damage — even with short-term use — caused the Food and Drug Administration to issue warnings about the use of dietary supplements containing kava. While these initial reports of liver toxicity have been questioned, use extra caution and involve your doctor in the decision if you’re considering using products containing kava.
• Passion flower. A few small clinical trials suggest that passion flower might help with anxiety. In many commercial products, passion flower is combined with other herbs, making it difficult to distinguish the unique qualities of each herb. Passion flower is generally considered safe when taken as directed, but some studies found it can cause drowsiness, dizziness and confusion.
• Valerian. In some studies, people who used valerian reported less anxiety and stress. In other studies, people reported no benefit. Valerian is generally considered safe at recommended doses, but since long-term safety trials are lacking, don’t take it for more than a few weeks at a time, unless your doctor approves. It can cause some side effects such as headaches, dizziness and drowsiness.
• Chamomile. Limited data shows that short-term use of chamomile is generally considered safe and can be effective in reducing symptoms of anxiety. But chamomile can increase the risk of bleeding when used with blood-thinning drugs. Use of chamomile can cause allergic reactions in some people who are sensitive to the family of plants that includes chamomile. Other members of this family are ragweed, marigolds, daisies and chrysanthemums.
• Lavender. Some evidence suggests that oral lavender or aromatherapy with lavender can reduce anxiety; however, evidence is preliminary and limited. Oral lavender can cause constipation and headaches. It can also increase appetite, increase the sedative effect of other medications and supplements, and cause low blood pressure.
• Lemon balm. Preliminary research shows lemon balm can reduce some symptoms of anxiety, such as nervousness and excitability. Lemon balm is generally well-tolerated and considered safe for short-term use, but can cause nausea and abdominal pain.

Herbal supplements aren’t monitored by the FDA the same way medications are. Despite enhanced quality control regulations in place since 2010, the quality of some supplements may still be an issue. Remember, natural doesn’t always mean safe.

If you’re considering taking any herbal supplement as a treatment for anxiety, talk to your doctor first, especially if you take other medications. The interaction of some herbal supplements and certain medications can cause serious side effects.

Some herbal supplements taken for anxiety can cause you to feel sleepy, so they may not be safe to take when driving or doing dangerous tasks. Your doctor can help you understand possible risks and benefits if you choose to try an herbal supplement.

If your anxiety is interfering with daily activities, talk with your doctor. More-serious forms of anxiety generally need medical treatment or psychological counseling (psychotherapy) for symptoms to improve.

 

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1. Natural medicines in the clinical management of anxiety. Natural Medicines. https://naturalmedicines.therapeuticresearch.com. Accessed Feb. 13, 2018.
2. Kava. Natural Medicines. https://naturalmedicines.therapeuticresearch.com. Accessed Feb. 13, 2018.
3. Passion flower. Natural Medicines. https://naturalmedicines.therapeuticresearch.com. Accessed Feb. 13, 2018.
4. Valerian. Natural Medicines. https://naturalmedicines.therapeuticresearch.com. Accessed Feb. 13, 2018.
5. German chamomile. Natural Medicines. https://naturalmedicines.therapeuticresearch.com. Accessed Feb. 13, 2018.
6. Lavender. Natural Medicines. https://naturalmedicines.therapeuticresearch.com. Accessed Feb. 13, 2018.
7. Lemon balm. Natural Medicines. https://naturalmedicines.therapeuticresearch.com. Accessed Feb. 13, 2018.
8. FDA issues consumer advisory for dietary supplements containing kava. National Institutes of Health Office of Dietary Supplements. https://ods.od.nih.gov/Health_Information/kava.aspx. Accessed Feb. 13, 2018.
9. Bystritsky A. Complementary and alternative treatments for anxiety symptoms and disorders: Herbs and medications. https://www.uptodate.com/contents/search. Accessed Feb. 13, 2018.
10. Mixing medications and dietary supplements can endanger your health. U.S. Food and Drug Administration. https://www.fda.gov/ForConsumers/ConsumerUpdates/ucm420349.htm. Accessed Feb. 13, 2018.
11. Dietary supplements: What you need to know. U.S. Food and Drug Administration. https://www.fda.gov/Food/DietarySupplements/UsingDietarySupplements/ucm109760.htm. Accessed Feb. 13, 2018.
12. Using dietary supplements wisely. National Center for Complementary and Integrative Health. https://nccih.nih.gov/health/supplements/wiseuse.htm. Accessed Feb. 13, 2018.
13. Bauer BA (expert opinion). Mayo Clinic, Rochester, Minn. Feb. 16, 2018.

See more Expert Answers

Some medications for anxiety relief, such as beta-blockers or benzodiazepines, can have uncomfortable side effects. So, at times, people with anxiety consider herbal remedies as alternatives to prescription drugs. Examples include chamomile, valerian, and more.

Talking with a doctor before reducing or stopping prescription medication or starting an herbal supplement is important. Many medications derived from ingredients in herbs can be potent, cause side effects, and interact with other medications.

Here, we describe nine herbs and supplements that could help alleviate anxiety.

How do herbs for anxiety work?

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Different herbs can affect the body in different ways.

For example, some ashwagandha can reduce levels of the stress hormone cortisol in the blood. Long-term exposure to high circulating cortisol levels can increase a person’s risk of developing anxiety.

Other herbs can aid relaxation by altering signal processing in the brain. For example, valerian root extracts may modulate gamma-aminobutyric acid receptors in the brain, which may promote relaxation and reduce anxious feelings. So, many claim that valerian root can also assist in treating sleep conditions such as insomnia.

1. Ashwagandha

Ashwagandha or Withania somnifera is among a group of herbs called “adaptogens.”

Adaptogens affect systems and hormones that regulate a person’s stress response. Ashwagandha has a long history of use in traditional Indian, or Ayurvedic, medication.

A small 2019 study investigated the efficacy of ashwagandha for stress and anxiety.

The 8-week study involved 58 participants with perceived stress. Each participant randomly received one of three treatments: Ashwagandha extract at doses of either 250 milligrams (mg) per day, 600 mg per day, or a placebo.

The participants who took ashwagandha showed less cortisol than those in the placebo group. They also experienced improved sleep quality.

Participants who took 600 mg of ashwagandha reported significantly reduced stress levels. However, participants who took the lower dose of ashwagandha did not report a stress reduction.

In another small 2019 study, 60 participants with mild anxiety received 240 mg of ashwagandha or a placebo for 60 days. Those taking the herb showed a significant reduction in some measures of anxiety but not in others.

People can take ashwagandha as a tablet or in liquid tincture form.

2. Chamomile

Chamomile is a flowering herb similar in appearance to a daisy. People can use two types of chamomile medicinally: Roman chamomile and German chamomile.

Some people use chamomile in the following forms to help relieve stress and anxiety:

• tea
• extract
• tablet
• skin cream

A small 2016 clinical trial investigated the efficacy and safety of chamomile as a long-term treatment for generalized anxiety disorder (GAD).

All 93 participants received 1,500 mg of chamomile daily for 12 weeks. Some continued taking chamomile for 26 weeks, while the remainder switched to a placebo.

Researchers observed that those participants who continued taking chamomile were no less likely to experience a relapse of GAD symptoms than those switching to placebo. However, when relapse did occur, the symptoms were less severe.

Some people may experience allergic reactions to chamomile. It may interact with certain drugs, including the blood thinner warfarin and the antirejection drug cyclosporine.

It is important for anyone taking any type of medication to check with their doctor before consuming chamomile teas or supplements.

3. Valerian

Valerian, or Valeriana officinalis, is a plant native to Europe and Asia. For centuries, people have used the root to help treat sleep problems, anxiety, and depression.

To date, there have only been a few high quality studies on the effects of valerian. The National Center for Complementary and Integrative Health (NCCIH) states that there is insufficient evidence to determine whether valerian can alleviate anxiety or depression.

Studies suggest that valerian is generally safe. However, the NCCIH notes that there is no information on the long-term use or safety of valerian in the following groups:

• pregnant people
• parents who are nursing
• children under 3 years old

4. Lavender

Lavender is a flowering plant belonging to the mint family. Many people use lavender to help calm their nerves and alleviate anxiety.

People may use lavender to make teas or utilize it as an essential oil

Lavender essential oil (LEO) contains chemicals called terpenes. A 2017 review article suggested that two of these terpenes, linalool and linalyl acetate, may have a calming effect on chemical receptors in the brain.

The review suggested LEO may be an effective short-term treatment for anxiety disorders. However, studies on the long-term effects of LEO are lacking.

5. Galphimia glauca

Galphimia glauca is a plant species native to Mexico. People traditionally used it as a tranquilizer to reduce anxiety.

According to a 2018 review, the evidence for G. glauca as a treatment for anxiety is promising. However, medical companies have not exploited its potential due to a lack of available plant material.

6. Passionflower

Passionflower or Passiflora is a family of plants with around 550 different species. Some studies show that a particular species, P. incarnata, may be effective in treating restlessness, nervousness, and anxiety.

People can take P. incarnata in tablet form or as a liquid tincture.

7. Kava kava

Kava kava, or simply kava, is a shrub that is native to the islands of the Pacific Ocean. Its scientific name is Piper methysticum.

Kava may help reduce stress and anxious feelings. However, there are reported cases of products containing kava causing severe liver damage. People must always consult a medical professional before taking kava.

8. Cannabidiol

Cannabidiol (CBD) is one of the active ingredients of the cannabis plant.

A study from 2019 suggested that CBD may have a calming effect on the central nervous system.

The researchers concluded that CBD might be beneficial for people with anxiety-related disorders. However, clinical trials are necessary to confirm these results.

Although the Food and Drug Administration (FDA) does not currently approve the use of CBD, this natural chemical is widely available in the following forms:

• tablet
• liquid extract
• vape liquid
• topical cream

Safety considerations 

Many herbs can interact with over-the-counter and prescription medications. Some can increase or reduce the effects of certain drugs, potentially causing serious health effects.

People taking medication must consult their doctor or pharmacist before starting herbal supplements.

They must also be aware that herbal remedies can take longer to start working than prescription medications.

If a person needs more advice about an herbal product, they can consult a qualified herbalist about brand, strength, and quantity.

The FDA does not monitor herbal remedies, so there are potential safety concerns for herbs that have mislabeling or contamination with heavy metals.

Summary

People have been using herbs for thousands of years to treat many health conditions. Scientific studies indicate that certain herbs may help to alleviate the symptoms of anxiety.

As with prescription medications, some herbal products can cause side effects. Herbal products may also take longer to begin working. People must consider these factors when weighing up the pros and cons of a particular treatment.

There can be serious interactions between certain herbs and medications. A person who is taking any medication must consult their doctor before they begin taking herbal products.

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