Written By: Dr. Lorianne R.
Edited and Reviewed By: Veronica
Triple checking that you turned off the oven; that wedding you were invited to is around the corner; your period will visit you in a few days; your mother-in-law might pop up unexpectedly or, your child has been coughing for three days in a row. Life is just uncertain and at times you may feel as though you are about to have a panic attack.
Anxiety seems to be something inevitable in the life of a woman, at various levels, and at different stages. And, of course, we share our problems with any woman that’s willing to listen, and everybody around us has an opinion on it, especially the women you didn’t ask for one (which causes even more anxiety)! The internet is spewing with natural remedies for anxiety, which doesn’t make it any easier to get relief.
I’ve had an experience that seems insignificant, but it’s deeply ingrained in my memory for some reason. I had just graduated from medical school, and big changes and decisions were happening in my life. My anxiety levels went to the roof, so my mom was worried about me. Her solution: acupuncture.
I was skeptical about natural remedies and oriental medicine, but she paid an appointment for me, and I must admit I was curious about it. I was there, and I was like: “This is it?!” It was really quick and not relaxing at all. And, as you would imagine, it didn’t help with my anxiety.
Want to know the Real Deal about Natural Remedies for Anxiety?
I am a one person sample, so don’t take my experience as evidence. But, before you invest your precious time and money in an acupuncture session, gadgets, or any remedy or technique to kill your nerves, it’s worth taking a closer look at that shiny list of “tips” and find out what science says about what actually works and what doesn’t.
Dr. J. Sarris1 and his team, made (hands down) the most complete and objective open source review on alternative methods to treat generalized anxiety disorder, social phobia, panic disorder, and posttraumatic stress disorder, among other conditions that present with anxiety symptoms.
Guided by the results of this review, today I will give you a verdict on the effectiveness of almost every tried way of calming anxiety by putting together a no BS analysis on what they found.
1. Let’s chat over a cup of tea!
Herbal teas have been used for centuries as medicinal drinks; but with so many other options today, is it still worth trying? And if so, which of the many available herbs is really effective?
From the works of Pittler and Ernst 2 on herbal treatments, Kava roots (Piper methysticum) seemed to show acceptable evidence of effectiveness in reducing anxiety, compared to other herbs. But Kava could damage the liver, as well as St John’s wort,B which had no real support by evidence and was not recommended by the authors.
They also mention a study 4 where patients used Ashwagandha (Withania somnifera) combined with diet, breathing techniques, and a multivitamin. This group was compared with patients that received psychotherapy, breathing techniques, and a placebo. At the end of the therapy, the anxiety levels of the group that received Ashwagandha were significantly lower than the group that had psychotherapy. But there’s something important that I noted about this research (and they pointed out that, too): the groups were not comparable.
Both had different combinations of treatments, making it difficult to say what caused the effect. If, for example, group A consisted of Ashwagandha and breathing techniques, and the B group had Placebo and breathing techniques, it would be easy to conclude that the Ashwagandha was the determinant factor. But if we have, like in this trial, factors W, X, Y, and Z in one group, and A, X, B, and C in the other, we can’t really compare because they are already so different.
Verdict: Meh. ?
Kava is the only herb that could have a real effect at being a natural remedy for anxiety, but it could be dangerous for your liver.
2. Massage: An all-time favorite for relaxation. Does it work?
I’ve always wanted to sit on one of those chairs at the mall and get a massage, but with more kids than hands and a germaphobe husband, I literally would have to escape home in the middle of the night and drive to the mall while everybody is sleeping to get one.
It might sound funny, but someone5 thought of doing a study on massage chairs, and the results proved they can be effective at reducing anxiety in sober alcoholics and addicts in recovery. The ones using the chairs were also under medications, and it would be worth knowing what drugs they were taking and if everybody was under the same prescription (which is very unlikely). With a total of 82 patients, there’s a small chance that one of the groups was favored by the medications they were taking.
The authors also go over a paper that compared therapeutic massage, thermotherapy, and relaxation-room therapy. All three methods showed a decrease in the anxiety scale in people with generalized anxiety disorder. They also concluded that the relaxation room is the cheapest method!
Another research team 6 compared aromatherapy massage (my favorite!) with psychotherapy in patients with cancer that suffered anxiety or depression. Although aromatherapy massage was preferred by patients (of course!), both psychotherapy and aromatherapy had a significant effect in reducing the symptoms.
This was for 39 patients, and it’s worth to note that they were receiving other treatments. It doesn’t specify if they were getting medications for anxiety and depression or only for cancer and other diseases that they might have; and even if we had that information, we would still need to know the specific medications, because there are many drugs that can interfere with mood even if they are not used as mood stabilizers. Also, I would give this study more credibility if the sample were at least 50 patients.
Verdict: Could work! ?
Massage and other relaxation techniques seem to have a significant effect on the reduction of anxiety but, to confirm this, there is a need for studies that don’t involve medications. Try it! It won’t hurt!
3. #Goals. Would a “New You” be free from anxiety?
Exercise, good sleep, reducing alcohol and caffeine, change of schedule, diets, electronic detox, getting more natural sunlight, stop smoking, and all those things that everybody seems to do only on Instagram. Don’t deny that you have at least one of them in your “long-term goals list.” They are lifestyle changes modifications. Imagine if you actually followed through with them, how much happier would you be?
4. What came first: Exercise or Happiness?
It’s the game of the chicken and the egg. Many papers have concluded that exercise improves emotional wellbeing and reduces anxiety.7 But there’s something that stands out: you will rarely see someone unmotivated and sad working out.
Sarris and his team1 had this same question and went further looking for trials that not only observed the differences between people that exercise and people that don’t, but that took patients with anxiety and made them exercise to see what happened.
Unfortunately, these research efforts were disappointing. All of them concluded that exercise was comparable to psychotherapy and medications, but they had many issues on their design, and the groups were very small, which means that those results can’t be taken seriously to get to a final conclusion.
Although nothing is conclusive on the extent of exercise influencing anxiety, there is strong evidence that it might be beneficial in the treatment of panic disorder. 8
How does exercise play a role in anxiety?
It is believed that exercise modifies the activity of serotonin, endorphins, and our fight or flight response. Exercise amplifies the effects of serotonin in the cortex, amygdala, locus coeruleus, and grey matter, all areas of the brain critical in our reactions to fear, anxiety, and control of our mood. Also, it has an anti-inflammatory effect and promotes the release of antioxidants that protect the brain from damage that can impact your mental health. 9,10,11
Verdict: Just do it! ?
It’s not clear if those who exercise lacked anxiety in the first place, or if exercise reduced their symptoms, but physical activity has so many benefits that you should hit the gym regardless.
It’s also important to note that exercising too frequently can have the opposite effect and cause anxiety that stems from exercise obsession29.
5. Binge Eating and Anxiety
Similar to exercise, diet and anxiety seem to be related in a two-way direction. Yes, healthy food is related to less anxiety, but we either eat more or don’t eat enough when we are nervous, and the studies analyzed found that we tend to choose unhealthy foods under states of anxiety. 1
However, the research showed evidence that fatty foods and highly palatable foods (i.e., “bingeable” food) can protect from anxiety. But the consequences of filling your body with bad fats are not worth the risk and can lead to major anxiety disorders in the long haul.12
See that DHA that’s added to your kids’ milk? This is a type of omega-3 (found in fish). It looks like if we don’t get enough of it, it’s more likely we will suffer anxiety, and low levels of this product are associated with higher social phobia.13 A study found a 20% reduction of anxiety when taking omega-3 supplements. 14
About other nutrients, it’s been reported that magnesium and zinc are proven anxiolytics in animals, but still need more research to be recommended for this use in humans. 1
Verdict: Eat fish! ?
Everything points to the fact that a diet won’t necessarily make you less anxious, but that you make worse nutritional decisions under stressful situations. However, omega-3 seems to have a more verified effect over anxiety than most of the alternative treatments.
Regardless of the results, the benefits are so many that you should always keep a healthy diet.
6. Coffee Break Anxiety
Now, if you failed with diet and exercise, your next try will be to go with something (that seems) simpler: drinking less coffee.
Good thing I had to write about this; I knew something was off: I forgot my coffee!!
Now that I grabbed my mug, we can continue…
After so much talk and debate on if it’s good or if it’s bad if it will kill you or save your life, one thing is sure about it: Coffee is proven to increase anxiety, so much that a “caffeine challenge test” is used to produce panic attacks in patients as part of a therapy where they learn to control their symptoms. 15
Verdict: No-no ?
You must reduce or cut coffee from your life if you suffer anxiety.
7. Would quit smoking quit anxiety?
Smoking is related to anxiety in a way that it’s more common for people with anxiety to smoke than it is for people that don’t have it. Also, it’s less likely for someone with anxiety to try to quit smoking and the period of abstinence is more difficult for them if they do stop; but this doesn’t mean that they will have higher levels of anxiety when quitting. 16
The nicotine in cigarettes decreases the activity of dopamine, a crucial neurotransmitter in the regulation of anxiety. But this is not enough to conclude if quitting smoking will reduce anxiety. 17
Verdict: Quit! ?
You will have a hard time to quit smoking, and quitting doesn’t guarantee your anxiety will go away, but it will give you better health and avoid many future problems.
8. Does alcohol cause or relieve anxiety?
Approximately 50% of alcoholics also suffer anxiety, and alcohol abstinence is known to cause spikes of anxiety. But the relationship between anxiety and alcohol goes in an interesting way, where people use the substance to soothe their anxiety. 1
Verdict: Watch out! ?
If you suffer anxiety, you could be more prone to alcohol abuse. Be careful when drinking or avoid drinking at all.
9. “Sharp objects cause you anxiety? I have the right treatment for you…”
Back to acupuncture! I did a quick search on acupuncture, and I must admit that I was surprised by the overwhelming amount of research on the use of acupuncture for the treatment of different conditions, from gastritis to Parkinson’s, and even its application in neuroimaging.
The studies included in the review were poorly designed and, because of that, practically worthless to get the truth about the use of acupuncture in anxiety. The major problems were that the groups were too small and the patients suffered from other diseases besides anxiety. Getting to a conclusion from such research wouldn’t be the most honest approach. 1
But there is evidence that acupuncture has an effect in the substances in our brain that produce relaxation.18 Seeing that translated to real life use is what it’s lacking.
Verdict: Nah! ?
Acupuncture seems to work for other conditions. In theory, it could work for anxiety, but there’s no evidence that it does, and it didn’t work for me!
10. Meditation. Mindfulness. Mice.
On a more relaxing topic, Sarris’ review1 starts by mentioning the publications of Dr. Kabat-Zinn19, who is a pioneer in linking mindfulness and meditation to behavioral science, but I decided to disregard the results of any of his studies for two reasons: 1) They are relatively old; 2) there is a huge conflict of interest. Kabat-Zinn has a business on mindfulness courses and retreats (proof here), which are the base of his research, so, who’s not to say that his trials might have been designed to favor his business? Or there could be an innocent (but imminent) observer bias on them.
So I focused on the other publications that they analyzed, like the one by Lee and collaborators.20 They compared the 8-week meditation program of Kabat-Zinn vs. patient education on anxiety. It resulted that the group that took the 8-week meditation program had a vast improvement in comparison with the group that received education on anxiety instead.
But Koszycki and colleagues21 didn’t have the same results with the 8-week program. They found that psychotherapy was more effective according to the anxiety measurement tests. However, patients and physicians rated meditation better than psychotherapy, and long-term it had better results.
This also happened to Vollestad et al.22; their patients had a better response to meditation, too, and the results were carried on for up to 6 months. But it caught my attention that they compared the subjects that practiced meditation with a group of patients that was put on a waiting list for the 8-week program… Wouldn’t being on a waiting list potentially increase their anxiety?
There are several reasons why meditation (which includes mindfulness) might work. It’s a form of psychological training that focuses on acceptance of reality and minimizing the perception that we have on how much events can impact our lives, by controlling the reactions of the body to what happens in the environment.
Mindfulness has been thought to be useful in exposure therapy.23 For example, I have a terrible phobia to mice. My husband thinks that I need to be exposed to them so I ditch the fear. Well, that didn’t work well when he surprised me with a mouse he caught!
The theory is that with meditation I could start tolerating mice up to the point where thinking about it won’t cause me anxiety, by starting with looking at pictures of a mouse and gradually escalating it to touch a real mouse (yikes!). Maybe I should try it because there is evidence that meditation and mindfulness can change our brains.
Whoa! Wait! Meditation can do what?!
Yes, I am as surprised as you are. Lazar’s team24 took a series of MRI pictures from the brains of people that practiced mindfulness regularly. They found that they had more gray matter in their prefrontal cortex, the area of the brain that determines our level of attention; and not only that, but this happened mainly in older people, which suggests that meditation can keep (perhaps make!) your brain younger.
Other studies found that meditation increases the amount of oxygen that goes to your brain and the levels of neurotransmitters (all those substances that regulate your mood and make you happy).25
As far as yoga and tai-chi concerns, some researchers concluded that yoga has a significant effect on calming anxiety; but the samples were small, the participants didn’t stick for long enough to practicing yoga, and they were mixed with other diagnoses. In the case of tai-chi, they didn’t find research to be conclusive, but a promising practice that could potentially have a positive effect on anxiety treatment.1
Verdict: It works! ?
Mindfulness works when it comes to reducing anxiety, and it has the potential of transforming you into a superhuman (in the future… someday!).
11. Do Weighted Blankets Work For Anxiety?
Literature about the use of weighted blankets as a treatment for anxiety is limited. But I found an interesting case26 of a patient with ADHD, dyslexia, and bipolar disorder that also suffered anxiety. The use of deep touch pressure (the principle behind the design of weighted blankets) helped the patient to cope with overwhelming events that were happening in her life. This could be an indicator that weighted blankets might work for anxiety in bipolar disorder and other conditions.
Also, our very own Veronica, discusses a scientific publication of on dental anxiety and weighted blankets. You can read the details that she masterfully translated into simple terms for you here. The study was performed under very controlled conditions, and it showed objectively that weighted blankets can reduce anxiety about dental appointments.
Other therapies and devices use the same mechanism of weighted blankets. Therapeutic body wraps are a form of hydrotherapy that might have a deep touch pressure component as well. It consists of wrapping the person on wet and dry sheets intermittently, and with different water temperatures. This technique is traditionally used in Swiss mental institutions on patients with different psychiatric conditions. Through an observation of this practice, Opsommer et al27 concluded that the body wraps might be related to less use of medications for the control of anxiety and other drugs for mental health.
Although therapeutic body wraps combine a series of therapies in one, it would be worth analyzing how much of their effect could be due to deep touch pressure.
Talking about other forms of deep touch pressure, Grandin’s hug machine28 is a deep pressure device that was tried in children with autism. They concluded that “deep pressure may have a calming effect” in children with autism and high anxiety levels.
They used a rating scale based on the parents input, which could be affected by a biased observation of the caregivers, but this was compensated by using a registry of galvanic skin response, which is sort of an EKG for the skin.
An important detail that I didn’t find information about, is the location where the kids were using this device. The environment can play a significant part on the effects of a therapy. If performed at home, it’s prone to give better results or, in households with family drama, the outcomes could be worse. If all the kids go to the same place to receive the daily therapy, the results will be more standardized.
Verdict: Not so fast! ?
Although there is not enough updated information on the topic, this only means that more research needs to be done to know if weighted blankets are useful in the treatment of anxiety.
If you would like to verify all the facts that I mention in this post and learn more about alternative methods to relieve anxiety, you can read the publications of Dr. J. Sarria and colleagues and other research studies mentioned on this article in the links below.
- Sarris, J., Moylan, S., Camfield, D. A., Pase, M. P., Mischoulon, D., Berk, M., Jacka, F. N., … & Schweitzer, I. (2012). Complementary medicine, exercise, meditation, diet, and lifestyle modification for anxiety disorders: a review of current evidence. Evidence-based complementary and alternative medicine : eCAM, 2012, 809653.
- Pittler, M.H., & Ernst, E. (2003). Kava extract for treating anxiety. Cochrane Database of Systematic Reviews,(1).
- Woelk, H. (2000). Comparison of St John’s wort and imipramine for treating depression: randomised controlled trial, 321(7260), 536-9.
- Cooley, K., Szczurko, O., Perri, D., Mills, E. J., Bernhardt, B., Zhou, Q., & Seely, D. (2009). Naturopathic care for anxiety: a randomized controlled trial ISRCTN78958974. PloS one, 4(8), e6628. doi:10.1371/journal.pone.0006628
- Black, S., Jacques, K., Webber, A., Spurr, K., Carey, E., Hebb, A., & Gilbert, R. (2010) Chair Massage for Treating Anxiety in Patients Withdrawing from Psychoactive Drugs The Journal of Alternative and Complementary Medicine, 16(9), 979-987
- Serfaty, M., Wilkinson, S., Freeman, C., Mannix, K., & King, M. (2011). The ToT Study: helping with Touch or Talk (ToT): a pilot randomised controlled trial to examine the clinical effectiveness of aromatherapy massage versus cognitive behaviour therapy for emotional distress in patients in cancer/palliative care. Psychooncology, 21(5), 563–569.
- Deslandes, A., Moraes, H., Ferreira, C., Veiga, H., Silveira, H., Mouta, R., … & Laks, J. (2009). Exercise and Mental Health: Many Reasons to Move. Neuropsychobiology, 59, 191-198.
- Goodwin, R. D. (2003). Association between physical activity and mental disorders among adults in the United States . Prev Med, 36(6), 698-703.
- Cotman, C.W. & Berchtold, N. C. Exercise: a behavioral intervention to enhance brain health and plasticity (2002). Trends Neurosci, 25(6), 295-30.
- Lowry, C.A., Johnson, P.L., Hay-Schmidt, A., Mikkelsen, J., & Shekhar A. (2005). Modulation of anxiety circuits by serotonergic systems. Stress, 8(4), 233-246.
- Maes, M., Kubera, M., Obuchowiczwa, E., Goehler, L., & Brzeszcz, J. (2011). Depression’s multiple comorbidities explained by (neuro)inflammatory and oxidative & nitrosative stress pathways. Neuro Endocrinol Lett., 32(1), 7-24.
- Finger, B.C., Dinan, T.G., & Cryan, J.F. (2011). High-fat diet selectively protects against the effects of chronic social stress in the mouse. Neuroscience, 29(192), 351-60.
- Green, P., Hermesh, H., Monselise, A., Marom, S., Presburger, G., & Weizman, A. (2006). Red cell membrane omega-3 fatty acids are decreased in nondepressed patients with social anxiety disorder. Eur Neuropsychopharmacol, 16(2), 107-13.
- Kiecolt-Glaser, J. K., Belury, M. A., Andridge, R., Malarkey, W. B., & Glaser, R. (2011). Omega-3 supplementation lowers inflammation and anxiety in medical students: a randomized controlled trial. Brain, behavior, and immunity, 25(8), 1725-34.
- Charney, D.S., Heninger, G.R., & Jatlow, P.I. (1985). Increased anxiogenic effects of caffeine in panic disorders. Arch Gen Psychiatry, 42(3), 233-43.
- Johnson, K. A., Stewart, S., Rosenfield, D., Steeves, D., & Zvolensky, M. J. (2011). Prospective evaluation of the effects of anxiety sensitivity and state anxiety in predicting acute nicotine withdrawal symptoms during smoking cessation. Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors, 26(2), 289-297.
- Volkow, N. D., Fowler, J. S., Wang, G. J., Baler, R., & Telang, F. (2008). Imaging dopamine’s role in drug abuse and addiction. Neuropharmacology, 56(1), 3-8.
- Wang, S.M.,Kain, Z.N., & White, P. (2008) Acupuncture analgesia: I. The scientific basis. Anesth Analg., 106(2), 602-10.
- Kabat-Zinn, J. (1982). An outpatient program in behavioral medicine for chronic pain patients based on the practice of mindfulness meditation: theoretical considerations and preliminary results. Gen Hosp Psychiatry., 4(1), 33-47.
- Lee, S.H., Ahn, S.C., Lee, Y.J., Choi, T.K., Yook, K.H., & Suh, S.Y. (2007). Effectiveness of a meditation-based stress management program as an adjunct to pharmacotherapy in patients with anxiety disorder. J Psychosom Res., 62(2), 189-95.
- Koszycki, D., Benger, M., Shlik, J., & Bradwejn, J. (2007). Randomized trial of a meditation-based stress reduction program and cognitive behavior therapy in generalized social anxiety disorder. Behav. Res Ther., 45(10), 2518-26.
- Vøllestad, J., Sivertsen, B., & Nielsen, G.H. (2011). Mindfulness-based stress reduction for patients with anxiety disorders: evaluation in a randomized controlled trial. Behav Res Ther., 49(4), 281-8.
- Roemer, L., Orsillo, S. M., & Salters-Pedneault, K. (2008). Efficacy of an acceptance-based behavior therapy for generalized anxiety disorder: evaluation in a randomized controlled trial. Journal of consulting and clinical psychology, 76(6), 1083-9.
- Lazar, S. W., Kerr, C. E., Wasserman, R. H., Gray, J. R., Greve, D. N., Treadway, M. T., McGarvey, … & Fischl, B. (2005). Meditation experience is associated with increased cortical thickness. Neuroreport, 16(17), 1893-7.
- Yu, X., Fumoto, M., Nakatani, Y., Sekiyama, T., Kikuchi, H., Seki, Y., … & Arita H. (2011). Activation of the anterior prefrontal cortex and serotonergic system is associated with improvements in mood and EEG changes induced by Zen meditation practice in novices.
Int J Psychophysiol., 80(2), 103-11.
- Sylvia, L. G., Shesler, L. W., Peckham, A. D., Grandin, T., & Kahn, D. A. (2014). Adjunctive Deep Touch Pressure for Comorbid Anxiety in Bipolar Disorder: Mediated by Control of Sensory Input? [Abstract]. Journal of Psychiatric Practice, 20(1), 71-77.
- Opsommer, E., Dubois, J., Bangerter, G., Panchaud, R., Martin, D., & Skuza, K. (2016).Therapeutic Body Wraps in Swiss public adult acute inpatient wards. A retrospective descriptive cohort study. J Psychiatr Ment Health Nurs., 23(3-4), 207-16.
- Edelson, S.M., Edelson, M.G., Kerr, D.C., & Grandin, T. (1999). Behavioral and physiological effects of deep pressure on children with autism: a pilot study evaluating the efficacy of Grandin’s Hug Machine. Am J Occup Ther, 53(2), 145-52.
- O’Brien V., Hamilton, S., Losinger, C., Bocan, D., Pieszak, K., & Stritzinger, K. (2015). Body satisfaction differences among low, medium, and high levels of exercise in a sample of recreational runners
About The Author
Dr. Lorianne R. is an International Medical Graduate with Harvard training on Clinical Research, and an advocate for evidence-based online medical information. She has worked in research projects for innovation in diabetes and cardiovascular disease and has a particular interest in Women’s Health. Her free time is spent annoying her husband, carrying her baby, trying to decipher what her toddler says, and having philosophical discussions with her 4-year old.