Probably the most common use of biofeedback is to treat stress and stress-related conditions, including anxiety, insomnia, high blood pressure, fibromyalgia, muscle pain, migraine headaches, and tension headaches.
Several studies indicate that massage combined with aromatherapy may be helpful for relieving anxiety.36
One study evaluated this combination therapy for treating anxiety and/or depression in people undergoing treatment for cancer.40 The treatment did appear to provide some short-term benefits.
In a 2008 review of 27 studies, for example, researchers concluded that relaxation therapies (including Jacobson's progressive relaxation, autogenic training, applied relaxation, and meditation) were effective against anxiety. (Although, not all of the studies were randomized, controlled trials.)66
In a randomized trial involving 68 patients with generalized anxiety disorder, ten sessions of therapeutic massage, thermotherapy (application of heat), or relaxation were all found to be beneficial at reducing anxiety, though none was superior to the others.67
Acupuncture is most often used in conjunction with Chinese herbs to treat many chronic diseases and the same is true of its effectiveness in the treatment of anxiety.
Selenium is a trace mineral that our bodies use to produce glutathione peroxidase. Glutathione peroxidase is part of the body's antioxidant defense system; it works with vitamin E to protect cell membranes from damage caused by dangerous, naturally occurring substances known as free radicals.
Selenium is required for a well-functioning immune system.24
Lysine is an essential amino acid, one that you need to get from food. Some evidence suggests that supplemental lysine may be able to help some conditions including herpes infections and anxiety.
Though no formal research has been done on the use of gamma orzyanol for anxiety, it has been approved in Japan for several conditions, including menopausal symptoms, mild anxiety, stomach upset, and high cholesterol.
Arginine is an amino acid found in many foods, including dairy products, meat, poultry, and fish. It plays a role in several important mechanisms in the body, including cell division, wound healing, removal of ammonia from the body, immunity to illness, and the secretion of important hormones.
The body also uses arginine to make nitric oxide (NO), a substance that relaxes blood vessels and also exerts numerous other effects in the body. Based on this, arginine has been proposed as a treatment for various cardiovascular diseases, including congestive heart failure and intermittent claudication, as well as impotence, female sexual dysfunction, interstitial cystitis, and many other conditions. Arginine's potential effects on immunity have also created an interest in using it as part of an "immune cocktail" given to severely ill hospitalized patients and also for preventing colds.
In a double-blind, placebo-controlled study, 36 people with generalized anxiety disorder were given either valerian extract, valium, or placebo for a period of 4 weeks.16 The study failed to find statistically significant differences between the groups, presumably due to its small size. However, a careful analysis of the results hints, at least, that valerian was helpful.
In addition, a preliminary double-blind study found that valerian may produce calming effects in stressful situations.28 Again, though, this study was too small to provide definitive results. Another study evaluated the anxiety-relieving effects of a combination containing valerian and lemon balm taken in various doses; some benefits were seen with doses of 600 mg or 1200 mg three times daily, but the highest dose (1800 mg three times daily) actually appeared to increase anxiety symptoms during stressful situations. Furthermore, people taking the herbal treatment at any dose showed slightly decreased cognitive function as compared to those given placebo.
According to most contemporary herbalists, suma is best understood as an adaptogen, a substance that supposedly helps one adapt to stress and fight infection (see the article on ginseng for a more in-depth discussion about adaptogens). In the US, suma is considered a general strengthener of the body.
The herb sage has a long history of use in food and medicine. In Mediterranean cultures it was used internally to treat excessive menstrual bleeding, increase fertility, aid memory, reduce symptoms of arthritis, and reduce breast engorgement during weaning. It was used topically for treatment of wounds, sprains, and muscle injuries, and as a gargle for sore throat, hoarseness, and cough.
A 4-week, double-blind study of 36 individuals with anxiety (specifically, generalized anxiety disorder) compared the herb passionflower to the standard drug oxazepam.35 Oxazepam worked more quickly, but by the end of the 4-week trial, both treatments proved equally effective. Furthermore, passionflower showed a comparative advantage in terms of side-effects: use of oxazepam was associated with more impairment of job performance. And, in a placebo-controlled trial involving 60 surgical patients, passionflower significantly reduced anxiety up to 90 minutes prior to surgery.64 The only other supporting evidence for passionflower comes from animal studies.45
As its Latin name cardiaca suggests, motherwort has traditionally been used to treat heart conditions. The ancient Greeks and Romans employed motherwort to treat heart palpitations as well as depression, which they considered a problem of the heart. Centuries later, Europeans would believe motherwort helpful for "infirmities of the heart" but also considered the herb to have strengthening and stimulating effects on the uterus, using it to bring on a delayed menstrual period, as an aid during labor, and to relax a woman's womb after childbirth. Chinese medicine also uses it for the stimulating effects it can have on the uterus.
Linden flowers have a pleasant, tangy taste, and for this reason the tree is sometimes called “lime flower.” Besides use in beverages and liqueurs, linden flower has a long history of medicinal use for such conditions as colds and flus, digestive distress, anxiety, migraine headaches, and insomnia. The wood of the linden tree has been used for liver problems, kidney stones, and gout.
Commonly called by its Latin first name, Melissa, lemon balm is a native of southern Europe, often planted in gardens to attract bees. Its leaves give off a delicate lemon odor when bruised.
Medical authorities of ancient Greece and Rome mentioned topical lemon balm as a treatment for wounds. The herb was, and in some cases still is, used orally as a treatment for generalized anxiety, influenza, insomnia, depression, panic disorder and nervous stomach.
There have been at least 11 placebo-controlled studies of kava, involving a total of more than 700 people.13,16,18,38,39,41-43, 55 Most found kava helpful for anxiety symptoms.
One of the best of these was a 6-month, double-blind study that tested kava's effectiveness in 100 people with various forms of anxiety.13 Over the course of the trial, they were evaluated with a list of questions called the Hamilton Anxiety Scale (HAM-A). The HAM-A assigns a total score based on such symptoms as restlessness, nervousness, heart palpitations, stomach discomfort, dizziness, and chest pain. Lower scores indicate reduced anxiety. Participants who were given kava showed significantly improved scores beginning at 8 weeks and continuing throughout the duration of the treatment.
This study is notable for the long delay before kava was effective. Previous studies had shown a good response in one week.14,15,16 The reason for this discrepancy is unclear.
Several double-blind, placebo-controlled studies have specifically tested kava for the treatment of the anxiety that often occurs during menopause.15,16, 38 In one study, 40 women were given either kava plus standard hormone therapy or hormone therapy alone for a period of 6 months. The results showed that women given kava experienced greater improvement in symptoms than those given hormone therapy alone.
However, not all studies have been positive. One double-blind, placebo-controlled study failed to find kava effective for people with generalized anxiety disorder (GAD).39 Another study failed to find kava more effective than placebo for people with both anxiety and insomnia.55
Besides these placebo-controlled studies, one 6-month, double-blind study compared kava against two standard anxiety drugs (oxazepam and bromazepam) in 174 people with anxiety symptoms.18 Improvement in HAM-A scores was about the same in all groups. Another study found kava equally effective as the drugs buspirone and opipramol.^44 ^
A 5-week, double-blind, placebo-controlled trial studied 40 people who had been taking standard anti-anxiety drugs (benzodiazepines) for an average duration of 20 months.17 Participants were gradually tapered off their medications and switched to kava or placebo. Individuals taking kava showed some improvement in anxiety symptoms. This would appear to indicate that kava can successfully be substituted for benzodiazepine drugs. However, participants who were switched from benzodiazepines to placebo showed little to no increase in anxiety, suggesting perhaps that they didn't really need medication after all! Thus, the results of this study are hard to interpret.
Note: This trial involved close medical supervision and very gradual tapering of benzodiazepine dosages. Do not discontinue anti-anxiety medications without supervision. Withdrawal symptoms can be life-threatening.
One study purported to find evidence that kava helps reduce reactions to stressful situations.19 Although, the results mean little because the study lacked a placebo group.
One small, double-blind study found evidence that a proprietary combination of hops and valerian extract is more effective as a sleep aid than placebo; the results of this trial also hint that hops plus valerian is more effective than valerian alone, but this possible finding did not reach statistical significance.9
Germany's Commission E authorizes the use of hops for "discomfort due to restlessness or anxiety and sleep disturbances." However, scientists have had difficulty proving that hops causes sedation.2 Because its sedative effect is mild at most, the herb is often combined with other natural treatments for anxiety and insomnia, such as valerian.
The name "hawthorn" is derived from "hedgethorn," reflecting this spiny tree's use as a living fence in much of Europe. Besides protecting estates from trespassers, hawthorn has also been used medicinally since ancient times. Roman physicians used hawthorn as a heart drug in the first century AD, but most of the literature from that period focuses on its symbolic use for religious rites and political ceremonies.
During the Middle Ages, hawthorn was used for the treatment of dropsy, a condition we now call congestive heart failure. It was also used for treating other heart ailments as well as for sore throat.
One substantial double-blind study purportedly found that a standardized Galphimia extract is as effective as the standard medication lorazepam.58 However, this study failed to use a placebo group.
Two distinct plants are known as chamomile and are used interchangeably: German and Roman chamomile. Although distantly related botanically, they both look like miniature daisies and are traditionally thought to possess similar medicinal benefits.
Over a million cups of chamomile tea are drunk daily, testifying to its good taste, at least. Chamomile was used by early Egyptian physicians for fevers, and by ancient Greeks, Romans, and Indians for headaches and disorders of the kidneys, liver, and bladder.
The modern use of chamomile dates back to 1921, when a German firm introduced a topical form. This cream became a popular treatment for a wide variety of skin disorders, including eczema, bedsores, skin inflammation caused by radiation therapy, and contact dermatitis (eg, poison ivy).
