Natural Tools To Tame Anxiety

Second to fatigue, the most common concern that my patients have is anxiety. While it may seem like everyone has anxiety (and I would argue to some extent that is true and normal), about 1 in 5 Americans meet the criteria to be considered diagnosable with an anxiety disorder. 

While anxiety can present in different forms (generalized anxiety disorder, social anxiety disorder, phobias, OCD, etc), there is a lot of similarities around the root cause(s) of anxiety. 

From an evolutionary standpoint, anxiety is normal and expected. It makes sense to feel anxious from an unknown noise in the dark. Is it a predator? An animal or something less concerning, like the wind? Our brain reacts and creates anxiety as a way to protect ourselves, even though there might not be a real threat. 

You could even argue that things today are less stressful. We have electricity (thank goodness for refrigerators, freezers, heating, and air-conditioning), efficient transportation (you can traverse the country in a few hours by plane or a few days by car), and abundant supplies of food (grocery stores, fast food, and restaurants). 

The issue we run in to is that we have a lot more stimulation in our modern world. Our brains have not caught up to these dramatic advances in technology and society over the past few centuries to realize that the vast majority of what occurs during our day is non-threatening. 

In other words, that nasty email or social media comment, that driver who cut you off, or realizing you forgot to pay a bill this month, will still activate the parts of your brain that cause a physiological reaction and create anxiety to let you know to “be on the alert.”

This can be an issue since most of the time these smaller things are not worth going into alert-mode. A common theme of anxiety disorders is that they are an overreaction to normal day-to-day stimuli.

That being said there are some things that can predispose us to heightened levels of anxiety or having that exaggerated response. Adverse childhood experiences are potentially traumatic events, also (known as ACEs, such as abuse or violence that occurs during childhood. ACEs are associated with increased levels of mood disorders like anxiety and depression. And of course, to some extent, genetics and upbringing play a role (nature and nurture). 

But what I’d rather focus on is empowering you so you can tame your anxiety and have less disruptions throughout your day.

Nutrition

As always, we cannot ignore nutrition, especially when it comes to mental health conditions such as anxiety. There are two main areas to focus on when it comes to reducing anxiety.

First, is regulating blood sugar. All too frequently I find that people eat an overabundance of carbohydrates and often without any other macronutrient source. The issue this creates is a fast influx of sugar into your blood stream (yes, carbs are sugar, the terms are essentially interchangeable) followed by a crash as the sugar is metabolized. This up-and-down pattern of your blood sugar can drastically affect mood including anxiety. 

Some carbohydrates are more complex than others. For example, vegetables contain fiber, vitamins, and minerals compared to simple carbohydrates like candy or some other refined sugar source., However, not pairing carbohydrates with a source of protein and fat can still cause this up-and-down blood sugar pattern in individuals, especially those people who are more sensitive to blood sugar changes (most frequently women).

I often advise patients to keep having their healthy fruits or veggies for snacks but pair it with healthy fats and proteins like nuts, hummus, or cheese. While snacks are usually the most common time where unbalanced carbs can sneak in, make sure your meals aren’t falling into the same category, especially breakfast. That bowl of cereal with a bagel and a cup of orange juice does not pack the same nutritional and blood sugar balancing punch as scrambled eggs with sautéed veggies.

The other common issue I see with nutrition and anxiety is not being aware of your food sensitivities. If you’ve been reading my articles for a while, you might notice that this is a recurring theme. But that’s because there are a LOT of conditions associated with food sensitivities. I personally get anxious after consuming anything with gluten or caffeinated. Food sensitivities can be the source of a lot of problems, like anxiety depression, constipation, eczema, insomnia, and many other conditions. Figuring out what your food sensitivities are is always a great place to start. An elimination challenge is the simplest way to identify food sensitivities.

Lifestyle Tools

There are some key lifestyle tools that can have a large impact on reducing anxiety. I will often recommend counseling, especially if someone hasn’t tried it before. Counseling is a great way to help you recognize potential triggers of anxiety, identify maladaptive thought patterns, and provide tools and insight to help overcome or reduce anxiety. 

While it’s been more of a challenge to find a counselor since Covid, there are now various online models (such as Talkspace) that offer counseling sessions within a day or two. And I always say counseling is like dating; if you don’t find a person that’s a good fit for you, don’t be afraid to look for someone else.

If you’re already in counseling or have tried it in the past, there are still other lifestyle tools that can offer benefits. Mindfulness and meditation, when practiced regularly, can help reduce anxiety in the long-term. 

For a beginner, meditation can be intimidating. Trying to quiet your mind full of thoughts and just sit is extremely difficult and to move towards that stage of meditation practice requires exactly that: practice. Thankfully, there are other forms of meditation that still offer benefits. 

My favorite place to start are apps like Insight Timer or Headspace. They have several guided meditations that walk you through specific thoughts or mantras to focus on, tensing and relaxing specific body parts, and breathing techniques. These guides offer a great introduction on how to quiet your mind. 

The best part is you don’t need to reach the extremes of practicing an hour a day to see benefits. I encourage my patients to start with just a few minutes a day and build it into your routine. Consistency is better than 30 minutes once every two weeks. 

The main thing that meditation teaches you over time is that you are not your thoughts, therefore, you are not your anxiety. Elizabeth Gilbert has a great analogy in her book, Big Magic: Creative Living Beyond Fear, if we think of your mind as a car. It is ok to acknowledge that fear and anxiety is in your car and to thank them for doing their job of trying to keep you safe, but you are the one driving the car, whereas fear and anxiety should be kept in the back seat. They are along for the ride but you are ultimately in control.

Similar to meditation and mindfulness are breathing practices. I highly recommend the book Breath: The New Science of a Lost Art by James Nestor. He outlines all the benefits of breathing, what can go wrong when we don’t breathe properly, and a few different techniques to practice breathing. 

The simple act of breathing and focusing on your breath can offer some anxiety relief. When you make your exhale longer than your inhale, it actually helps to lower your heart rate, which you can feel instantly. 

Go ahead and try it: Find your pulse on your wrist and breathe in for 4 seconds, pause, and then breathe out for 5 (or 6) seconds. Repeat for 10 breath cycles and notice how your pulse changes. Such a simple and easy mindfulness technique that has immediate benefits!

The last lifestyle tool that can sometimes be overlooked is exercise. Studies have shown that exercise alleviates anxiety as well as has a host of other health benefits. Just like with meditation, start small. Go for a walk for 5 minutes or do 10 minutes of yoga on YouTube. Whatever you can do to get your body moving helps.

Supplements and Herbs

Hands down my favorite supplement for anxiety is a vitamin called inositol. It helps to calm anxious thoughts which can plague you day and night. Since it’s a calming vitamin, I usually recommend patients take it at night to help with sleep, but it can be taken any time of day.

The preferred form is myo-inositol and I usually dose it as a powder since it’s easier to increase if you need a higher dose. Standard dosages start at 2-4 grams but can be increased as high as 16 grams, if needed. While it’s usually tolerated fairly well, for some people inositol can cause mild gas and bloating and I wouldn’t increase beyond 4 grams if you have hypoglycemia, as it lowers insulin levels.

Another great supplement for anxiety, though it usually does not have as dramatic effect as inositol, is magnesium. Magnesium is needed for over 300 chemical reactions in our body and is used by basically every cell. Magnesium also acts as a muscle relaxant, which makes it a good option if you notice you tense your muscles with anxiety. While there are numerous forms of magnesium, I usually recommend magnesium glycinate as it is well-tolerated and easily absorbed. 

If something stronger is needed, herbs are a great option. Two herbs that I rely on frequently for anxiety are Scutellaria (Scutellaria lateriflora) and Passionflower (Passiflora incarnata). They both help to reduce anxiety and are mildly sedating. With any nutritional, supplement, herb or lifestyle recommendation, always consult your healthcare provider first. 

Other considerations

While it’s true that things like nutritional issues can cause anxiety-like symptoms, there are other common conditions that can also be responsible. With anxiety, I always evaluate for thyroid function and iron status, as both of these conditions can also cause with anxiety-like symptoms. 

But there can also be genetic causes that can be influenced by supplements or nutrition. For example, MTHFR is a gene that helps us utilize folate. It is estimated that about half the population have a mutation in this gene that makes them incapable of metabolizing the synthetic form, folic acid.  One of the symptoms of this can be anxiety. However, these same individuals may also feel anxious from taking the absorbable form, methylated folate, which is generally the recommended treatment. 

Knowing whether you have the gene mutation or not can be eye-opening as to whether you need to be more vigilant about avoiding folic acid and being cautious about dosing with methylated folate itself. 

This article just scratches the surface when it comes to all the potential treatments of anxiety, but at least you now know that from a naturopathic perspective, we have a plethora of options. Sometimes that feeling of empowerment can help get anxiety into the backseat so you can take the wheel for a while.