Overview 

According to the Anxiety Disorders Association of America, approximately 40,000,000 adults over the age of 18 years are affected by an anxiety disorder in the US, or roughly 18.1% of the total population. In addition, experts estimate that nearly 15% of all US adults will suffer from some form of anxiety disorder at some point during their lives, the majority of them women. Left untreated, anxiety disorders can escalate in severity and greatly diminish the quality of life for the affected person, as well as impacting families and associates. Further, chronic anxiety has been linked to a higher risk of developing heart disease, depression and even suicidal tendencies. 

Types of Anxiety Disorders 

Generalized Anxiety Disorder (GAD) affects about 4,000,000 adults in the US, with women being 3.1% more likely to be impacted than men. Characterized by chronic worry and tension, GAD commonly occurs in combination with other emotional health issues. For instance, other symptoms may also be present, such as sleeplessness and difficulty concentrating. In order for a diagnosis to be made, the person must experience chronic worry and at least two associated symptoms for a period of six months or more.  

Obsessive-Compulsive Disorder (OCD) involves compulsive urges, persistent intrusion of unwanted thoughts, and repetitive motions or ritualistic tendencies (i.e., compulsive touching, muscle flicks, counting objects, etc.)  OCD typically first appears during childhood for about one-third of diagnosed adults, and tends to occur equally between men and women. 

Panic Disorder is described as experiencing sudden and recurring panic attacks with a variety of accompanying symptoms, which include heart palpitations, profuse sweating, trembling, a choking sensation, shortness of breath, dizziness, numbness or a tingling sensation of the hands or feet, or a fear of loss of control or even dying. While panic attacks tend to come on unexpectedly, sufferers often become aware of an impending incident due to these associated symptoms. According to the criteria set forth by the American Psychiatric Association, a person may be diagnosed with panic disorder if the attacks occur with frequency, experiences anxiety about future attacks, and if the person’s behavior changes as a result. Not surprisingly, depression often accompanies panic disorder. Women are twice as likely to develop this disorder than men. 

Phobias are unrealistic or unexplained fears of specific things, often to a highly exaggerated degree. An irrational fear of spiders, for example, is a common phobia shared by many individuals. 

Social Anxiety Disorder (SAD) is found equally among men and women and is characterized by a feeling of dread toward social events due to a fear of being ridiculed or singled out. People afflicted with this disorder often feel anxious about being watched or judged by others. SAD may also produce other physical symptoms, such as sweating, trembling, nausea and an intense fear of meeting or speaking with new people. 

Posttraumatic Stress Disorder (PTSD) can occur at any age and affect anyone who has witnessed or survived a traumatic event, such as a serious accident, violent crime, war-related shock or natural disaster. The person is sometimes troubled by recurring nightmares of the event, or even flashbacks while awake. If left untreated, PTSD can become quite debilitating, especially if an ordinary event or stimuli triggers hallucinations and the belief that the traumatic experience is happening again. Symptoms may take years to develop. For instance, sexual abuse in childhood increases the likelihood of this disorder occurring at some time in adulthood. 

Diagnosis and Treatment of Anxiety Disorders 

Health care professionals must rely on screening tools and experience to make a diagnosis of an anxiety disorder. Treatment typically consists of several modalities, depending on the nature and severity of the disorder. Common treatments include: 

Cognitive behavioral therapy (modification of thought processes)

Behavioral therapy (exposure therapy)

Massage

Meditation

Biofeedback

Medication with psychotherapy drugs 

Diet and lifestyle changes are also usually encouraged in conjunction with therapy or medication. For instance, some studies have shown that patients with depressive tendencies or anxiety disorders are often deficient in certain nutrients, such as folate and B vitamins. In addition, these subjects also have a tendency to have elevated levels of homocysteine, which diet and nutrient supplementation can help correct. 

Recommended Supplements in the Treatment of Anxiety 

Omega 3 

Omega-3 fatty acids, in particular eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), are necessary for optimal brain functioning, as well as other body mechanisms. Unfortunately, these fatty acids are usually deficient in the typical Western diet and supplementation is needed. Studies using human and animal models on the effects of EPA and DHA indicate that supplementation may help to offset depression and anxiety-related symptoms. 

Amino Acids 

L-tryptophan and L-tyrosine are important for brain neurotransmission and are required to produce sufficient levels of serotonin and norepinephrine. Several studies have shown that diets lacking in these amino acids often produce symptoms of anxiety. However, when L-tyrosine supplementation is introduced, an increase is brain levels of dopamine and norepinephrine results. Whereas L-lysine supplementation has been shown to help reduce cortisol levels, which can become elevated in response to emotional stress and anxiety. 

Theanine 

Theanine is an amino acid derived from green tea capable of crossing the brain-blood barrier, a membrane barricade designed to protect the brain from harmful chemicals entering via the bloodstream. Combined with the function of increasing production levels of serotonin and dopamine, theanine has a mild tranquilizing effect. In addition, this amino acid increases alpha brain waves in the brain. Theanine has also been noted for having a protective action on neurons. 

Herbs to Help Treat Anxiety 

Valerian 

This herb has a long history of use as a sleep aid and anxiety reducer. In fact, its effectiveness has been compared to diazepam (valium). Several studies have shown that valerian (sometimes combined with lemon balm) reduces the symptoms of anxiety as measured by the Hamilton anxiety scale, but without side effects often experienced with drugs. 

St. John’s Wort 

A few studies have shown that St. John’s Wort increases serotonin production in the brain, while others have suggested that this herb is as or more effective than antidepressant medications. While St. John’s Wort extract contains at least 10 pharmacologically active constituents, researchers are most interested in hypericin and pseudohypericin, which become active at alpha receptor sites and ultimately promote a sedative effect through increased serotonin release. 

Passion Flower 

Another botanical with a long history of being valued for its calming effects, passionflower continues to be recommended by traditional herbalists to help reduce anxiety. In a recent study involving 36 men and women diagnosed with GAD, passionflower was shown to significantly reduce symptoms of anxiety and stress compared to the conventional drug oxazepam. 

Safety Precautions 

EPA/DHA 

May increase the risk of bleeding if taken with warfarin (Coumadin). 

L-tryptophan 

Do not take in conjunction with type A monoamine oxidase inhibitors (MAOIs), serotonin 5-HT receptor agonists or antidepressant medications. 

Do not take if you have been diagnosed with carcinoid tumors or ischemic heart disease. 

L-tyrosine 

Do not take with non-selective monoamine oxidase (MAO) inhibitors. 

Should be avoided if you have hypertension or melanoma. 

Valerian 

May cause drowsiness. 

Do not take with alcohol or other sedatives. 

St. John’s Wort 

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