Herbal medicine for anxiety is truly a wonderful thing.
Those who suffer anxiety will agree that it comes with a multitude if symptoms – both physical and psychological (think heart palpitations, sweating, shaking, nausea, insomnia; as well as racing mind, inability to focus, persistent worrying, and irritability – just to name a few). Anxiety is real and debilitating.
There are a number of medications available for the treatment of anxiety – and in some people they work brilliantly (which is great – I completely acknowledge the powder of conventional medicine and appreciate that it can be lifesaving). However, for others they don’t seem to work at all OR their use is complicated by some pretty awful side effects. What’s more, many of the available anti-anxiety medications can be quite addictive – and while addressing some of the symptoms they don’t address the underlying driver or cause of your anxiety. AND despite the availability and use of these medicines, people are still suffering.
So what might the alternative be? This is where herbal medicine steps in, and really shines! Here, we can use herbs to provide relief from the symptoms of anxiety while working to determine and then provide remedy for some of the underlying drivers. We can personalise supportive remedies to your individual symptom picture. And what’s even more exciting is that the science confirms what has been known for many many years of traditional use – that herbal medicine for anxiety is as effective (if not more) than both placebo and conventional medications. Often these herbs are considered very gentle – but they are showing truely powerful effects.
* Please note, I do not ever recommend that you self prescribe. Nor do you need to take all of these herbs. It is important that you reach out to a qualified practitioner (either myself, your local naturopath or herbalist, or a naturopath or herbalist working within your local health food shop) so that we can personalise your prescription to your symptoms, and ensure there are no interactions with any medications you might be taking.
Chamomile (Matricaria chamomilla)
Oh sweet chamomile. With a strong affinity for the nervous system, chamomile is heaven-sent for anxiety, stress and nervousness. Its carminative and digestive properties lend it really well to IBS and anxiety induced digestive concerns. When combined with lemon balm it is truly a dream for a nervous tummy.
The research behind chamomile is pretty amazing. A 6 month, randomised controlled trial using a DSM-IV cohort with generalised anxiety disorder (GAD) found that chamomile significantly reduced symptoms. The reduction in symptoms was maintained for longer and relapse rates were less in participants using chamomile compared to placebo. It was well tolerated, with no adverse side effects (1).
Chamomile is really accessible and can be taken as a tea (loose leaf or in a bag, organic is highly recommended). At least 3 cups a day, infused for 10 minutes followed by a big squeeze of the tea bag is really effective. A cup of strong chamomile tea is lovely for easing digestion, calming the mind and encouraging sleep.
Gotu Kola (Centella asiatica)
Gotu Kola is a beautiful healing promoter – although not one that we think of immediately as an anxiolytic. It is wonderful for revitalising and restoring vitality, and is a go to “brain herb” with neuroprotective and neuro-regenerative properties (the leaves themselves are shaped like a brain). It is also a beautiful adaptogen and nervine – heavenly for calming the mind and supporting the stress response.
Studies have shown it to reduce anxiety by 26% after 2 months of use (2). It has also been shown to reduce the “startle response” within an hour of use! So if you’re an anxious type who literally jumps at their own shadow – gotu kola is your go to (3).
Lavender (Lavandula angustifolia)
Lavender is one of my absolute favourite plant medicines for anxiety and depression. Famous for its divine scent, it offers instant and enveloping calm to the nervous system. Its anxiolytic and light sedative properties are wonderful for quietening a busy mind and supporting restful sleep.
A recent meta-analysis (i.e. the highest levels of evidence) found lavender to be more effective than placebo for treating anxiety, and in quite small doses (4).
Lavender can be prescribed in a herbal tincture, but it is also highly effective as a tea or via diffusion of the essential oil.
Lemon Balm (Melissa officinalis)
Lemon balm is another favourite of mine. She has a gentle and nurturing energy, eliciting powerful effects. Lemon balm wears many hats and is a healing promoter in many circumstances of dis-ease. It is brilliant for sensitive, nervous tummies; and is a go to herb for IBS which is so often driven by stress and anxiety.
A 2018 study has shown it to be effective in reducing anxiety, stress and sleep issues (5).
Lemon balm pairs beautifully with chamomile (my favourite combo for anxiety driven digestive disturbance). Both are very gentle and safe, and can be used as part of your home apothecary as a tea or infusion.
Kava (Piper methysticum)
Kava is a powerful anxiolytic that is steeped in controversy. It is native to the Pacific Islands where it has been used almost daily in sacred ceremonies for thousands of years. Historically there has been some concern around its safety, particularly with respect to liver health. Recently, a research group out of Australia tested a new and safer way of extracting and using Kava. This new water extraction was found to be very safe and effective, and is very well supported by the research (6).
Several studies using this new water extract of Kava have shown it to be as effective as a number of anxiolytic drugs in the treatment of generalised anxiety disorder, and more effective than placebo (6, 7, 8, 9). When comparing side effects with benzodiazepines, Kava has been shown to have no impairment in reaction time, nor any sedative effect (10).
Kava is really great in acute situations and panic or in known anxiety provoking situations like test anxiety, fear of flying or stage fright.
While Kava is very safe, I do recommend using Kava under the guidance of a practitioner.
Passionflower (Passiflora incarnata)
Passionflower is truly magical! The flower in and of itself is absolutely beautiful and has quite a hypnotic quality to it. Passionflower has an affinity for the nervous system and is great for anxiety, restlessness, heart palpitations, irritability, nervous tension and insomnia, as well as digestive complaints driven by stress and anxiety.
Studies have shown Passionflower to be equally as effective as benzodiazepine drugs without any of the common side effects associated with their use (specifically impaired job performance/cognition) (11). There are a number of studies that show a single dose of passionflower reduces anxiety prior to surgery without influencing sedation (12, 13).
Passionflower works very well on its own but is even more potent when used with other calming herbs. It elicits its effects quite quickly so is really wonderful for acute anxiety and panic disorder.
Valerian (Valeriana officinalis)
Valerian is a relaxing, light bringing herb for the nervous system. The roots of its Latin name, valare, means “to be strong, be well, be brave”. It is wonderful for anxiety, panic, insomnia and quietening a busy mind.
Studies have shown that in combination with St John’s Wort, it is more effective than a benzodiazepine in reducing symptoms of moderate anxiety (14). It has also been shown to significantly reduce symptoms of OCD compared to placebo (15). The most exciting thing about valerian is that it has been shown to demonstrate actual changes to brain activity – increasing alpha coherence (meaning one feels more alert yet relaxed) and decreasing theta coherence (so it does not sedate or induce that “cotton wool brain” that many patients on anti-anxiety medications experience)(16).
It is important to note that valerian doesn’t always work instantly (so you can’t really pop a valerian tablet as you might a sleeping tablet). It is most effective after 1-2 weeks of consistent use.
Withania (Withania somnifera)
Withania (or Ashwaganda) has become quite trendy, and for good reason – it is such a gentle yet potent plant. Traditionally withania is used as an adaptogen – meaning it helps one adapt to stress and nourishes the body systems most impacted by that stress. It has an affinity for wiry, frazzled types suffering burnout, depletion, low energy and exhaustion.
A systematic review of five clinical studies demonstrated that withania significantly reduced symptoms of anxiety and stress (17), making it a lovely herb for anxiety driven by external stressors and overwhelm.
Zizyphus (Zizyphus spinosa)
Zizyphus is another lovely herb for anxiety. Studies have shown it to have the same anxiolytic effect as diazepam without any side effects. In fact unlike diazepam, Zizyphus was shown to improve cognitive performance (i.e. no “cotton wool” brain, rather enhanced cognition)(18).
Zizyhhus is typically used for sleep and insomnia – so I find it particularly helpful in patients with difficulty sleeping due to an anxious, busy brain. It is also really helpful in calming heart palpitations and excessive sweating – so is wonderful for anxiety induced sweating and/or heart palpitations.
Oats (Avena sativa)
Oats is another favourite of mine (lets be honest, they’re all my favourite) for anxiety. Less anxiolytic directly, more like a warm hug for the nervous system. As a plant medicine, either the green tops or the seed are used – both having slightly different effects on the nervous system.
Oats are so gentle, and work wonders for the strung out, stressed and exhausted anxious type. They may also be helpful for those in which trauma is a contributing factor to anxiety.
Motherwort (Leonurus cardiaca)
As its name suggests, motherwort exudes a maternal, nurturing energy. It has an affinity for the cardiovascular system and is very helpful in reducing anxiety driven heart palpitations and/or nervous tachycardia. It is also a supportive remedy for heartbreak, heartache, or loss; as well as distress driven by parent-child relationship tension.
One study has shown it to produce a moderate to significant improvement in patients with co-occuring anxiety and sleep disorders (19).
California poppy (Eschscholtzia californica)
Hailing from North America, California poppy offers up the zen vibes that its namesake evokes. It has anxiolytic, hypnotic and sedative qualities making it a wonderful herb for anxiety, panic and insomnia. It is a gentle plant, perfect for sensitive souls and highly strung nervous systems.
California poppy is helpful in reducing the build-up of tension or mental overload throughout the day which may then result in anxiety induced insomnia. When combined with magnesium, it has been found to be safe and effective in reducing mild to moderate anxiety (20).
Echinacea (Echinacea angustifolia, Echinacea purpurea)
Echinacea is everyones favourite immune supporting herb, and is often a go-to for colds, flus and the like. But it is also a beautiful adaptogen with anxiolytic potential.
One study has shown that echinacea significantly reduced anxiety within 3 days of treatment, and it’s anxiolytic effects remain for 2 weeks post treatment (21).
It is the perfect tonic for those who suffer immune depletion as a result of persistent stress and anxiety.
While naturopathic medicine is never about a “pill for every ill” (rather we look at supporting the body as a whole) – you can see that there are plant medicines for so many of the common symptoms of anxiety. So while you dive deep into uncovering the underlying causes of your anxiety, these beautiful plant medicines can work to bring inner peace and harmony.
If you are experiencing anxiety and would like some support, or would like to cultivate a little more calm in your day to day life please reach out. x
(1) Mao, J. J., Xie, S. X., Keefe, J. R., Sneller, I., Li, Q. S. & Amsterdam, J. D. (2016). Long-term chamomile (Matricaria chamomilla L.) treatment for generalised anxiety disorder: a randomised controlled trial. Phytomedicine, 23(14), 1735-1742.
(2) Jana, U., Sur, T. K., Maity, L. N., Debnath, P. K. & Bhattacharyya, D. (2010). A clinical study on the management of generalised anxiety disorder with Centella asiatica. Nepal Medical College Journal, 12(1), 8-11.
(3) Bradwejn, J., Zhou, Y., Kosycki, D. & Shlik, J. (2000). A double-blind, placebo-controlled study on the effects of gotu kola (Centella Asiatica) on acoustic startle response in healthy subjects. Journal of Clinical Psychopharmacology, 20(6), 680-684.
(4) Generoso, M. B., Soares, A., Tamar, I. T., Cordeiro, Q. & Shoizawa, P. (2017). Lavender oil preparation (silexan) for treating anxiety: an updated meta-analysis. Journal of Clinical Psychopharmachology, 37(1), 115-117.
(5) Haybar, H., David, A. Z., Haghighizadeh, M. H., Valizadeh, E., Mohaghegh, S. M. & Mohammadzadeh, A. (2018). The effects of Melissa officinalis supplementation on depression, anxiety, stress, and sleep disorder patients in patients with chronic stable angina. Clinical Nutrition ESPEN, 26, 47-52.
(6) Sarris . J., Stough. C., Teschke, R., Wahid, Z. T., Bousman, C., Murrary, G., Savage, K. M., Mouatt, P., Ng, C. & Schweitzer, I. (2013). Have for the treatment of generalised anxiety disorder RCT: analysis of adverse reactions, liver function, addiction, and sexual effects. Phytotherapy Research: PTR, 27(11), 1723-1728.
(7) Boerner, R. J., Sommer, H., Berger, W., Kuhn, U., Schmidt, U. & Mannel, M. (2003). Kava-kava extract LI 150 is as effective as opipramol and buspirone in generalised anxiety disorder: an 8 week randomised, double-blind milk-centre clinical trial in 129 out-patients. Phytomedicine: International Journal of Phytotherapy and Phytopharmachology, 10(4), 28-49.
(8) Sarris, J., Kavanagh, D. J., Byrne, G., Bone, K. M., Adams, J. & Deed, G. (2009). The kava anxiety depression spectrum study (KADSS): a randomised, placebo-controlled crossover trial using an aqueous extract of Piper Methysticum. Psychopharmachology, 205(3), 399-407.
(9) Sarris, J., Stough, C., Brusman, C. A., Wahid, Z. T., Murray, G., Teschke, R., Savage, K. M., Dowell, A., Ng, C. & Schweitzer, I. (2013). Kava in the treatment of generalised anxiety disorder: a double-blind, randomised, placebo-controlled study. Journal of Clinical Psychopharmachology, 33(5), 643-648.
(10) Sarris, J., Laporte, E., Scholes, A., King, R., Pipingas, A., Schweitzer, I. & Stough, C. (2013). Does a medicinal dose of kava impair driving? A randomised, placebo-controlled, double-blind study. Traffic Injury Prevention, 14(1), 13-17.
(11) Akhondzadeh, S., Naghavi, H. R., Vazirian, M., Shayeganpour, A., Rashidi, H. & Khani, M. (2001). Passionflower in the treatment of generalised anxiety: a pilot double-blind randomised controlled trial with oxazepam. Journal of Clinical Pharmacy and Therapeutics, 26(5), 363-367.
(12) Movafegh, A., Alizadeh, R., Hajimohamadi, F., Esfehani, F. & Nejatfar, M. (2008). Preoperative oral Passiflora Incarnata reduces anxiety in ambulatory surgery patients: a double-blind, placebo-controlled study. Anaesthesia and Analgesia, 106(6), 1728-1732.
(13) Aslanargun, P., Cuvas, O., Dikmen, B., Aslan, E. & Yuksel, M. U. (2012). Passiflora Incarnata Linneaus as an anxiolytic before spinal anaesthesia. Journal of Anaesthesia, 26(1), 39-44.
(14) Bone, K. M. & Mills, S. Y. (2013). Principles and Practice of Phytotherapy: Modern Herbal Medicine 2nd Ed., Elsevier: UK, 2013.
(15) Pakseresht, S., Boostani, H. & Sayyah, M. (2011). Extract of valerian root (Valeriana Officinalis L.) vs. Placebo in treatment of obsessive compulsive disorder: a randomised double-blind study. Journal of Complimentary and Integrative Medicine, 11(8).
(16) Roh, D., Jung, J. H., Yoon, K. H., Lee, C. H., Kang, L. Y., Lee, S, Shin, K. & Kim, D. H. (2019). Valerian extract alters functional brain connectivity: a randomised double-blind placebo-controlled trial. Phytotherapy Research: PTR, 33(4), 939-948.
(17) Pratte, M. A., Nanavati, K. B., Young, V. & Morley, C. P. (2014). An alternative treatment for anxiety: a systematic review of human trial results reported for the Ayurvedic herb ashwagandha (Withania somnifera). Journal of Alternative and Complimentary Medicine, 20(12), 901-908.
(18) Chen, H. C., Hsieh, M. T. & Shibuya, T. K. (1986). Suanzaorentang versus diazepam: a controlled double-blind study in anxiety. International Journal of Clinical Pharmacology, Therapy and Toxicology, 24(12), 646-650.
(19) Shikov, A. N., Pozharitskaya, O. N., Makarov, V. G., Demchenko, D. V. & Shikh, E. V. (2011). Effects of Leonurus Cardiacs oil extract in patients with arterial hypertension accompanies in anxiety and sleep disorders. Phytotherapy Research: PTR, 25(4), 540-543.
(20) Hanus. M., Lafon. J. & Mathieu, M. (2004). Double-blind, randomised, placebo-controlled study to evaluate the efficacy and safety of a fixed combination containing two plant extracts (Crataegus oxyacantha and Eschscholtzia californica) and magnesium in mild-to-moderate anxiety disorders. Current Medical Research and Opinion, 20(1), 63‐71.
(21) Haller, J., Freund, T. F., Pelczer, K. G., Füredi, J., Krecsak, L. & Zámbori, J. (2013). The anxiolytic potential and psychotropic side effects of an echinacea preparation in laboratory animals and healthy volunteers. Phytotherapy Research: PTR, 27(1), 54-61.