We do not intend the information provided here to be used as a diagnostic tool. Do not use it to arrive at or exclude a diagnosis. Our intention in providing information about anxiety disorders is so you can recognize some of its features.

Do not use this as a substitute for professional evaluation or professional treatment.

If you have a problem, you should first consult a licensed mental health professional to assess the severity of the problem. Try to find a mental health professional who is sympathetic or at least not opposed to the concept of using alternative medicine for psychological-emotional ailments. Then, seek a licensed practitioner for the particular form of alternative therapy, e.g. herbalist, acupuncturist, naturopath, etc. Stay in consultation with the mental health professional to monitor your progress.

Traditional psychiatric treatment must be sought if anxiety is so severe that you are suicidal or dangerous to others or, your ability to function at home or work is severely impaired.

Use alternative medicine as a temporary aid to give you the symptomatic relief. As your symptoms are lessened and stress is reduced, learn the coping skills you need. Make appropriate emotional changes. Do not use alternative medicine in lieu of coping skills and emotional education. You must learn how your thoughts, feelings, attitudes, perceptions, and behaviors contribute to your psychological-emotional ailments.

Psychological techniques and self-help measures are alluded to, but not discussed in detail in order to keep this presentation brief. Refer to other books, tapes, and magazines to learn about how you can make use of such psychological techniques and self-help measures to benefit you.

Make your goal to reach the state of self-sufficiency and self-reliance, that is, that eventually, you will not need a traditional medicine specialist, alternative therapist, or a counseling professional. For example, you will have the necessary skills to handle your tendency for depression, anxiety, or addiction.

Signs and Symptoms of Chronic Anxiety

Herbs for Anxiety

Valerian, A natural Anxiety Pill

Guidelines for Using Alternative Medicine For Anxiety Problems

Signs and Symptoms of Chronic Anxiety

Anxiety, nervousness, persistent fear, and worry are terms that we use interchangeably for physical and mental tension and unease. The word "anxiety" is derived from the word, "Angst" which means anguish or pain. Anxiety is the mental anguish or mental pain. U.S. National Comorbidity Survey suggests that 15% of the population will suffer from an anxiety disorder at some point in their life. Many people suffer from mixed depression and anxiety. A generalized and pervasive anxiety is the most prevalent problem in the anxiety sufferers, also called as, "worry warts."

Conventional medicine may work well for the short-term and acute problem but it is not very effective for the long-term management of a chronic anxiety problem. Benzodiazepines (such as, valium or xanax) and other anxiety medication (such as the beta blockers) may be ineffectual for the long-term management of anxiety and habit forming in some cases. The treatment of choice for anxiety problem is psychological therapy, particularly cognitive-behavioral therapy. Cognitive-behavioral therapy involves teaching a person to challenge and change the anxiety producing thoughts and learn to quiet and calm the body of the physical symptoms of anxiety.

The generalized and pervasive anxiety is referred to as the "Generalized Anxiety Disorder," in the Diagnostic And Statistical Manual of Mental Disorder, fourth edition (DSM-IV).

Is there a pattern of anxiety and worrying? Pattern if it happens more days than not and have been present for at least six months.

A general pattern of excessive anxiety, worrying, or apprehension about a number of events or activities such as, work, school, health, family, etc.

Inability to control the anxiety, worrying, or apprehension.

Do you habitually experience the following?

Restlessness or feeling keyed up or on edge

being easily fatigued

difficulty concentrating or mind going blank

irritability

muscle tension

sleep disturbance (difficulty falling or staying asleep, or restless unsatisfying sleep)

The anxiety, worry, or physical symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

The major criterion for anxiety is this: Do you stay tense and are generally unable to relax?

Signs and symptoms of a Panic Attack

Note: If you have panic attacks, you need to work with a therapist, preferably a cognitive-behavioral therapist and find out if you need to take psychiatric medication on a temporary basis.

Discrete period of intense fear or discomfort, in which four (or more) of the following symptoms developed abruptly and reached a peak within 10 minutes:

palpitations, pounding heart, or accelerated heart rate

sweating

trembling or shaking

sensations of shortness of breath or smothering

feeling of choking

chest pain or discomfort

nausea or abdominal distress

feeling dizzy, unsteady, lightheaded, or faint

feeling like it’s happening to you in a dream or at a distance from you. Feelings of unreality or feeling detached from oneself)

fear of losing control or going crazy

fear of dying

numbness or tingling sensations

chills or hot flushes

If you have less than four symptoms of the above, you may be having limited- symptom panic attacks.

Herbs for Anxiety

Ginseng

In a study conducted in 1982, nurses who switched from a day to a night shift were tested to see how efficient they were and how they reacted psychologically as they struggled to adjust to their new routine. Some of them were given ginseng to help them maintain emotional balance; another group was not given anything. Those who took ginseng felt less moody and were emotionally steadier than those who did not take the herb.

Ashwagandha (also known as Indian ginseng)

In a 1990 study, Ashwagandha, an Ayurvedic medicine was given to people who had been diagnosed with anxiety disorders. Ashwaganda treatments improved the mental condition of most participants in only three months.

Zizyphi seed and lligustrum.

Chinese herbalists may use zizyphi seed and lligustrum for anxiety. Ligustrum is one of the herbs commonly used to support the adrenal glands when a person is under stress. Studies conducted in China showed that these herbs are successful anti-anxiety agents. In the same studies, both herbs proved even more potent when combined with licorice and the Chinese herbs poria and bunge root. This ancient Chinese combination is known as Suanzaorentang. A 1986 study showed that this treatment is almost as effective as the anti-anxiety drug diazepam (known commercially as Valium) in dealing with anxiety, weakness, irritability and insomnia. When taken three times a day, there herbal combination, unlike the drug, improved psychomotor skills and produced no side effects. In another 1986 study done in Europe, this same combination helped people whose anxiety attacks consisted of such symptoms as the heart palpitations, chest pains and shortness of breath.

Kava

In Polynesia, a drink made of the root of kava has traditionally been used to lift the spirits. Kava ceremonies are held to relax, rejoice, and celebrate important events. Kava is reported to make people feel relaxed and friendly. In one study, kava helped subjects to reduce both depression and high anxiety levels in about one week.

In a study conducted in Germany in which kava was given to women suffering from anxiety, depression and other symptoms associated with menopause, the symptoms were relieved, and the women reported an increase in their sense of well-being.

According to some German researchers kava has been as effective in treating some forms of anxiety as the powerful tranquilizers known as Benzodiazepines. And unlike this drug and others used for similar purposes, kava is not habit forming and does not reduce alertness. In fact, it improves alertness, vigilance and memory. Kava is available in tincture and pill form at natural food stores.

Lemon balm

Around AD 1000, the Persian herbalist Avicenna recommended lemon balm "to make the heart merry." In Europe, this herb was sipped in cordials.

Motherwort

Motherwort-- recognized today as a "heart herb" that also increases blood circulation in the brain-was recommended by the seventeenth-century herbalist Nicholas Culpeper to prevent melancholy. In modern times, it has been studied in Germany, where it is recognized as a mild sedative effective for treating anxiety and sleep disorders.

Modern herbalist report that both lemon balm and motherwort help alleviate depression, especially when combined with other antidepressant herbs. And aromatherapists commonly use the scent of lemon balm to treat depression.

GLA

To relieve depression and anxiety, capsules of GLA are also recommended. GLA is found in evening primrose, borage and black currant seed oils. In studies done at the London Children’s Hyperactive Clinic in England, evening primrose oil was shown to reduce depression and nightmares in children.

Valerian: A Natural Anxiety Pill

The root of valerian, a tall, fernlike plant has served for thousands of years as a mild sedative. From 1820 until 1942 valerian was listed in the US Pharmacopoeia as a tranquilizer. It’s widely used and approved in Europe as a mild hypnotic to induce sleep and relieve anxiety. More than 5 million units of valerian are sold in Germany and about 10 million in France every year. In the United Kingdom, valerian is also a popular and government-approved sleep aid. It is also approved in Belgium, Switzerland, and Italy as an over-the-counter medication for insomnia.

The herb valerian tranquilizes safely and gently without a risk of addiction, and is widely used and approved in other countries as an alternative. There’s evidence that it calms the brain. Reduce anxiety, induce sleep, relieve stress, and even relax muscles without a morning hangover or permanent harm.

Valerian has been compared to anxiety prescription drugs. Valerian affects the same nerve receptors as benzodiazepines. The most popular of these tranquilizers is Valium, which doctors have long prescribed to relieve symptoms of anxiety. The drug is also used to lessen the anxiety, agitation and tremors that occur during alcohol withdrawal. Valium is not derived from valerian. There is no connection between the two, except that their names sound similar.

The results of one study conducted in 1993 showed that valerian and hops are calming to the central nervous system and reduce depression and anxiety. In fact, the herbs were reported to work faster than the prescription drugs. Hops and valerian worked in only two weeks, as opposed to a longer period required for conventional drugs. The herbs also caused far fewer side effects.

Be aware that if you are used to strong prescription sedatives, Valerian will have a harder time taking effect.

Valerian may be used to get Off the Prescribed Anxiety Medication

Some anxiety pills such as, the xanax or valium can be highly addictive. Physicians in Germany commonly prescribe Valerian in place of Valium or Xanax for mild and moderate cases of anxiety. Some recommend fairly large doses, up to two teaspoons of the tincture at least twice a day. Some use this dosage of Valerian to get off antidepressants or anti-anxiety medication in just few weeks. Caution: For most people, a dosage of this size creates no problems, but for a few it leads to upset stomachs or headaches. If you are taking Valium, Xanax or other anti- anxiety or antidepressants prescribed drugs do not discontinue them without your doctor’s approval. No prescription drug should be discontinued or its dosage altered without consulting a doctor.

How is valerian able to conduct such a smooth withdrawal? Perhaps the answer is because the Valerian binds to the same receptor sites on brain cells as Xanax. When Xanax is no more in the system, the receptors "scream out for something to bind to. If there’s nothing there, the brain cell receptors "go nuts." But if you can slip in valerian, it’s enough to satisfy them so they calm down. Many doctors now use valerian to help ensure a safe and painless transition from Xanax.

Scientific Evidence For Valerian as a Sleeping Pill

Many anxiety sufferers experience sleeping problems. While you learn to handle your anxiety by psychological means which would also improve your sleep, you may find it helpful to take temporary help of Valerian as a sleep aid. European manufacturers of plant medicines have petitioned the FDA to allow claims for valerian as an over-the-counter nighttime sleeping "aid," defined as an agent that relaxes and mildly sedates.

More than 200 scientific studies on the pharmacology of valerian have been published in the scientific literature, mostly in Europe in the last thirty years.

Six controlled clinical trials in Europe show that valerian is particularly effective for sleep problems, as follows:

Shorten the time to fall asleep

Prolong sleep time

Increase deep sleep stages

Increase dreaming

Reduce nighttime awakenings

Improve the quality of sleep in both normal sleepers and insomniacs.

In an impressive study, 128 volunteers participated at the Nestle( Research Laboratories in Switzerland in the mid-1980s. For three nights at time they took either valerian extract or a sugar pill without knowing what they were taking. Valerian won out. Thirty-seven percent on valerian said they fell asleep faster, compared with 23 percent on placebo. Further, 43 percent said they slept better versus 25 percent on placebo. Even 45 percent of good sleepers said they "slept better then usual" on valerian. But habitually bad sleepers got the most benefit.

In another study, a double blind Swedish study, Valerian was the winner. Forty-four percent of poor sleepers said they had "perfect sleep" after taking a product with 400 milligrams of valerian. Eighty-nine percent said their sleep improved.

In another study, Valerian equaled the powerful drug Halcyon as a sleeping pill. A 1992 German study compared a combination valerian pill (160 milligrams of valerian and 80 milligrams lemon balm) with Halcion (0.125 milligrams triazolam) in twenty people, ages thirty to fifty. Over a period of nine nights, the valerian combination put subjects to sleep just as fast and produced the same sound sleep as Halcion. It was most effective in so-called bad sleepers. However, unlike the valerian takers, the Halcion users suffered hangovers and loss of concentration the next day.

Advantages of taking Valerian as compared to prescription drugs:

Does not produce morning "hangovers"

Does not reduce concentration

Does not impair physical performance.

Does not interact with alcohol to accentuate impairment.

A 1995 German Study found no interaction between alcohol and valerian that lessened concentration, and impaired physical performance in driving a car. It is not to say that one should consume alcohol since alcohol is not good for anxiety sufferers.

It is reported that one can take Valerian when you are awake and active, as well as when you are going to sleep which makes it much more desirable. Valerian is beneficial if you want to reduce mild to moderate anxiety and or stress during the day.

Chemical information:

The mechanism of valerian in the brain appears similar to that of the benzodiazepine drugs-Halcion and Valium. These tend to sedate by stimulating activity of the nerve transmitter GABA (gamma-aminobutyric acid), which dampens the brain’s arousal system. In animals, valerian does the same thing, triggering release of GABA from the brain cortex. In mice, valerian prolongs sleep.

Research at the Institute of Pharmaceutical Biology in Barburg, Germany, showed that sedating constituents in valerian can bind to the same receptor sites on brain cells as barbiturates and benzodiazepines. In fact, valerian bounced benzodiazepines off the receptor sites of animal brain cells.

Perhaps valerenic acid and valepotriates, chemicals unique to valerian, sedate the brain cells responsible for arousal. Valerenic acid is a prime constituent in European products and is often combined with other mildly sedating herbs, such as lemon balm, passionflower, and chamomile. More that 120 active chemicals have been detected in valerian. Perhaps a combination of valerian’s compounds work together to produce the sedative effect.

Usage:

To relax and reduce tension level

To sleep better,

To calm down in stressful situations such as, public speaking, test, flying, etc.

To ease the symptoms of withdrawing from Xanax, Valium, and other benzodiazepines.

To serve as a substitute for anti-anxiety drugs if you take them for moderate anxiety and insomnia.

Dosage:

Start out with a low dose and, if needed, work up to a higher dose.

For use as a sleeping pill, often the recommended dosage is 300 to 500 milligrams of a standardized valerian extract about an hour before bedtime. Cut that dose in half when taking valerian as a mild tranquilizer to quiet anxiety during the day. One hundred fifty to 300 milligrams translate into one-half to one teaspoonful as a fluid extract, and one to one and a half teaspoons as a tincture. You should notice effects within thirty to forty-five minutes.

Side Effects:

Side effects at recommended doses are minor. Most common is occasional stomach upset. However, in large doses valerian could cause headache, restlessness, nausea, and morning grogginess. (If you are sleepy or groggy the next morning, the dosage may be too high for you; simply reduce the amount you are taking. Valerian, unlike prescription sleeping pills, is not addictive or a cause of any mental disturbances. There are no reports in animals or humans of serious poisoning or death from overdoses of valerian. However, some clinicians have noted that some individuals have an idiosyncratic (highly individualized response and not generally expected) response to valerian; they become more excited and revved up instead of relaxed and calm.

Valerian, at an overdose of 20 grams (20,000 milligrams) is not acutely poisonous. The Food and Drug Administration lists valerian as GRAS (Generally Recognized As Safe).

Use valerian for mild to moderate anxiety and sleep problems only. If you have serious anxiety or insomnia or have been diagnosed with or treated for psychiatric problems, or are taking other psychiatric drugs of any kind, consult your doctor before using valerian.

Because of the possibility of withdrawal symptoms, switching from prescription drugs to valerian should be done under the supervision of a doctor. Valerian is not advised for pregnant or lactating women, children under age two, or in combination with other over-the-counter or prescription tranquilizers or sedatives.

Most of the European research has been done on standardized valerian products. To get this research-grade valerian, look for labels indicating water-soluble extracts "standardized" for valerenic acid content (0.8 percent valerenic acid).

Guidelines for Using Alternative Medicine for Anxiety Problems

Start with a medical check-up first. A physical-chemical problem such as, blood sugar problem (hypoglycemia) or thyroid deficiency can cause symptoms that are identical with anxiety or depression symptoms.

While I recommend that you start with a medical check-up first, let me also suggest that if physicians don’t find anything medically wrong, you should promptly consult a mental health professional, preferably, a member of Anxiety Disorder Association of America, or someone who specializes in anxiety disorders. Why? Because I have had many patients who had been to emergency rooms of hospitals time and time again for chest X-rays, EKGs, and other tests and doctors have not found any medical reason. Patients panic more because no one knows what is wrong with them. Having spent several thousand dollars and experiencing more fear and aggravation, they finally find out that what was wrong with them was an undiagnosed anxiety problem. Don’t let that happen to you.

At times, anxiety is a bye-product of disorders such as, social phobia, agoraphobia, other phobias, post-traumatic disorder, obsessive-compulsive disorder, acute stress disorder, or other disorders. A professional evaluation can correctly diagnose the problem before you start any treatment.

You must learn to challenge and change your anxiety producing thoughts and behaviors that maintain and induce anxiety.

Instead of avoiding situations that make you anxious, face them in baby steps, one step at a time. Take help of a mental health professional how to break down a fearful situation into graduated, smaller increments, which is called, "anxiety hierarchy desensitization."

Learn belly breathing and muscle relaxation techniques

Learn visualization technique to manage your anxiety for an approaching event. .

Use self-affirmations. Change your negative self-talk to positive and self-affirming talk.

Our herb of choice for anxiety is Valerian, which is also beneficial for insomnia. Use the herb if you have chronic and generalized anxiety

Use the herb for stress-related anxiety, that is, when anxiety accompanies the stress you are dealing with.

Use the herb if your medical problem have made you anxious. Physicians generally prescribe traditional antidepressants or anti-anxiety pills for their medical patients who become depressed and/or anxious. Some drugs may have negative interaction with medications that you are already taking for your medical problem.

Consult your physician. Herbs generally have less side effects and cautions. Psychological techniques and self-help techniques have no chemicals in them.

If you are having panic attacks, combine alternative medicine with cognitive-behavior therapy and learn how to bring panic symptoms in control.

Recurrent panic attacks which have gone on unabated without relief, sometime, bring on agoraphobia (fear of going out, driving, being alone, etc.) or cause depression. Be watchful of any such development.

American Psychiatric Association (1994) Diagnostic Statistical Manual of Mental Disorders (fourth edition) revised (DSM-IV). Washington, D.C. American Psychiatric Association.

Bourne, Edmund J. ( 1990) The Anxiety & Phobia Workbook. New Harbinger Publications, Inc. Oakland, CA

Burns, David (199-) Ten Days to Self Esteem, William Morrow & Company, INC. New York, N.Y.

Burns, David D. (980) Feeling Good: The New Mood Therapy, William Marrow & Company, INC New York, N.Y.

Copeland, Mary Ellen ( 1992) The Depression Workbook, New Harbinger Publications, Inc. Oakland, CA

Davis, Martha (1989) Relaxation and Stress Reduction Workbook Guide New Harbinger Publications, INC. Oakland, CA

Davis, Martha, Eshelman E.R. & McKay, Matthew (1989) Relaxation and Stress Reduction Workbook New Harbinger Publications Inc. Oakland, CA

Dumont, Raeann (1996) The Sky is Falling, W.W. Norton & Company, New York, NY.

Foa, Edna B. & Wilson, Reid (1991) Stop Obsessing, Bantam Books, New York, NY

Greenberger, Dennis & Padensky, Christine A. (1995) Mind Over Mood, Guilford Publications Inc. New York, NY

Looper, Stan H & Scott, Cynthia M. ( 1993) When Anxiety Attacks, Swan Publishing Company Alvin, Texas

Markway, Barbara A. Carmin, Cheryl N. Pollard, Alec & Flynn, Teresa ( 1992) Dying of Embarrassment, New Harbinger Publications, INC Oakland, CA

McKay, Matthew & Fanning Patrick ( 1991 ) Prisoners of Belief, New Harbinger Publications, INC. Oakland, CA

Ross, Jerilyn (1994), Triumph Over Fear, Bantam Brooks, New York, N.Y.

"Panic Disorder: Stories of Hope" a video by Modern Talking Picture Service. Contact National Institute of mental Health. Call (800) 64-PANIC or (301) 443-4536

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