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Alternatives for anxiety 

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I’ve been diagnosed with general anxiety disorder and would rather not take drugs. I’m looking into cognitive behavioral therapy, but can you suggest any other alternatives that could help? 

T.C., via email 

 It’s perfectly normal to feel anxious from time to time, especially with everything that’s going on in the world right now. But for some people, anxiety is a chronic problem that interferes with everyday life. Generalized anxiety disorder is diagnosed when worry is challenging to control on more days than not for at least six months, and is accompanied by three or more of the following symptoms: restlessness or feeling on edge, being easily tired, difficulty concentrating, irritability, muscle tension and sleep disturbances.1

The standard treatment is benzodiazepine drugs or antidepressants, which can come with serious side-effects such as dependency, sexual dysfunction and suicidal thoughts.2

Cognitive behavioral therapy (CBT), or talking therapy, can be an effective alternative,3 but there are lots of other drug-free options to consider. Here’s a roundup of what works. 

Strike a pose 

Practicing yoga twice a week for two months led to a marked reduction in anxiety levels in one study of women with anxiety disorders.5 Another trial, which found that yoga was more effective than walking for improving mood and anxiety in healthy people, suggests that the mind-body technique may work by boosting levels of the neurotransmitter GABA (gamma-aminobutyric acid) in the brain.6

Get moving 

Exercise is effective for relieving anxiety in people with anxiety disorders. A recent study found that both cardio and resistance training work well, but high-intensity training had a slight edge over low-intensity training.4

The key thing is to find a form of activity you enjoy so you’ll do it at least three times a week and stick with it.

Spice it up 

Curcumin, a compound in the spice turmeric, seems to be useful for anxiety symptoms when taken as a supplement, according to several trials.7 Curcumin also enhances synthesis of the omega-3 fatty acid docosahexaenoic acid (DHA), which is essential for brain function. And low levels of DHA are linked to anxiety.8

Look for a supplement containing black pepper extract to aid absorption, and take with a fatty meal. 

Suggested dosage: Try Pure Encapsulations Curcumin 500 and follow the label instructions 

Try other supplements 

Certain nutritional deficiencies have been linked to anxiety and other mental health conditions,9 so it’s a good idea see a naturopathic practitioner who can organize the right tests for you and recommend suitable supplements and dosages. But here are the nutritional supplements shown to be useful for anxiety in scientific studies. 

Magnesium. Taking supplements of this mineral improved symptoms of generalized anxiety disorder in one study.10 Magnesium supplements have also proven helpful for people with mild anxiety and anxiety associated with high blood pressure and premenstrual syndrome (PMS).11

Suggested dosage: 200 mg two to three times per day 

Omega-3. A pooled analysis of 19 trials found that a dosage of at least 2,000 mg/day of omega-3 fatty acids effectively reduced anxiety symptoms.12 

Suggested dosage: Try Wiley’s Finest Peak Omega-3 Liquid, which supplies over 2,000 mg of omega-3 (from fish oil) per teaspoon 

B vitamins. Taking multivitamin and mineral supplements, particularly those with high doses of B vitamins, can reduce anxiety and improve mood, a review of eight trials reported.13 A study of a B-complex supplement containing the active forms of vitamins B1, B2, B3, B5, B6, B12, folate and biotin significantly improved anxiety, depression and quality of life compared to a placebo.14

Suggested dosage: Try Max B-ND by Premier Research Labs, a similar product to the one used in the study above, and follow the label instructions 

Amino acids. Supplementing with L-lysine and L-arginine for a week reduced anxiety in healthy men and women exposed to stressful situations. Taking L-lysine alone has also been shown to reduce chronic anxiety in people with low dietary intake of the amino acid.15

Suggested dosage: 2.6 g/day each of L-lysine and L-arginine 

Probiotics. An imbalance in the gut microbiome has been linked to generalized anxiety disorder,16 so taking prebiotics and probiotics may be helpful. Research shows that taking probiotics can improve several psychological symptoms, especially anxiety.17

Suggested dosage: Choose a high-quality multistrain formula and follow the label instructions 

Vitamin D. Men and women with generalized anxiety disorder and vitamin D deficiency were given standard care with or without a high weekly dose of vitamin D for three months. Only those in the vitamin D group had a significant improvement in symptoms.18

Suggested dosage: Home testing kits for vitamin D are available via the Vitamin D Society (www.vitamindsociety.org) and Better You (www.betteryou.com), along with a personalized supplementation plan based on your results (or see your doctor)

Get help from herbs 

Passionflower (Passiflora incarnata). This herb was just as effective as the anti-anxiety drug oxazepam for generalized anxiety disorder in one study.19 

Suggested dosage: 45 drops/day liquid extract 

Chamomile (Matricaria recutita). Famous for its calming properties, chamomile was significantly better than a placebo at reducing symptoms in patients with chronic anxiety.20  

Suggested dosage: 220-1,000 mg/day chamomile extract, depending on the severity of symptoms 

Learn to relax 

Relaxation techniques including Jacobson’s progressive relaxation, autogenic training, applied relaxation and meditation can all significantly reduce anxiety.21 Meditation appears to be the most effective22 and is simple to learn. Check out meditation apps like Headspace and Calm, or look to YouTube for free meditation guides and exercises.  

Eat well 

Evidence suggests that the following dietary strategies may be helpful for anxiety. 

DON’T eat inflammatory foods like sweets and cakes, refined grains, red and processed meat and processed foods in general.24

DO fill up on prebiotic and probiotic foods to promote a healthy gut microbiome.25 Prebiotic foods include garlic, artichokes, onions, leeks, asparagus and bananas, while probiotics are found in kefir, kimchi, natto, sauerkraut and yogurt.  

DON’T consume artificial sweeteners like aspartame, which have been linked to anxiety.26

DO eat fatty fish, such as mackerel, sardines and salmon, as it’s rich in anti-anxiety omega-3 fatty acids.27

DON’T have too much caffeine, which can exacerbate anxiety symptoms.28 Watch out for it in tea, soda, energy drinks, cocoa products and medication as well as coffee. 

Try tapping 

Emotional Freedom Technique (EFT) or ‘tapping’ is known to boost mental wellbeing. The self-help technique involves tapping on specific points of the body in sequence, while focusing on a negative emotion. One study reported a 40 percent reduction in symptoms of anxiety after volunteers took part in a 4-day EFT workshop.23

To find out more about EFT and how to access free tapping meditations, visit www.thetappingsolution.com.

 

References

1 

Diagnostic and Statistical Manual of Mental Disorders, 5th ed. American Psychiatric Association, 2013

2 

Addict Behav, 1999; 24: 537–41; Psychiatr Ann, 1998; 28:89–97; Eur Arch Psychiatry Clin Neurosci, 2008; 258 Suppl 3: 3–23

3 

J Clin Psychol, 2019; 75(7): 1188–202

4 

J Affect Disord, 2022; 297: 26–34

5 

Complement Ther Clin Pract, 2009; 15(2): 102–4

6 

J Altern Complement Med, 2010; 16(11): 1145–52

7 

Crit Rev Food Sci Nutr, 2020; 60(15): 2643–53; Phytother Res, 2020; 34(4): 896–903; Chin J Integr Med, 2015; 21(5): 332–8

8 

Biochim Biophys Acta, 2015; 1852(5): 951–61

9 

Indian J Psychiatry, 2008; 50(2): 77–82

10

PLoS One, 2017; 12(6): e0180067

11 

Nutrients, 2017; 9(5): 429

12

JAMA Netw Open, 2018; 1(5): e182327

13

Psychosom Med, 2013; 75(2): 144–53

14

ISRN Psychiatry, 2013; 2013: 621453

15

Biomed Res, 2007; 28(2): 85–90

16

J Psychiatr Res, 2018; 104: 130–6

17

J Gastrointestin Liver Dis, 2020; 29(1): 77–83; Nutr Neurosci, 2020; 23(3): 237–50

18

Metab Brain Dis, 2019; 34(6): 1781–6

19

J Clin Pharm Ther, 2001; 26(5): 363-7

20

J Clin Psychopharmacol, 2009; 29(4): 378–82

21

BMC Psychiatry, 2008; 8: 41

22

Psychol Med, 2019; 49(13): 2118–33

23

J Evid Based Integr Med, 2019; 24: 2515690X18823691

24

Clin Nutr, 2018; 37(5): 1485–91

25

Front Psychiatry, 2021; 12: 598119

26

Nutr Neurosci, 2018; 21(5): 306–16

27

Front Psychiatry, 2021; 12: 598119

28 

Arch Gen Psychiatry, 1992; 49(11): 867–9

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