Anxiety is the most common mental illness in the United States, estimated to affect over 40 million adults, according to the Anxiety and Depression Association of America. In addition to pharmaceutical interventions, many other therapies can help people improve their neurophysiology and overall mental health.
Common symptoms of anxiety include:
- Restlessness, feeling on edge
- Easily fatigued
- Irritability, emotional instability
- Inability to control feelings of worry
- Excessive feelings of worry
- Insomnia, restless sleep, sleep issues
- Breathlessness, excessive sweating
- Desire to avoid things that trigger anxious feelings
Anxiety disorders diagnosable by health care professionals include generalized anxiety disorder (GAD), panic disorder, agoraphobia, social anxiety disorder, specific phobias, and other forms of anxiety.
We all know that good nutrition supports good physical and mental health. A nutritious diet supports optimal neurotransmitter production and hormone balance, and balanced blood sugar. All of these contribute to a more stable mood.
Common nutritional deficiencies are associated with feelings of anxiety. Several studies have associated insufficient vitamin D levels with anxiety and depression. One broad cross-sectional review of previous research, published in Physiological Research in 2015, found that low vitamin D levels “were found in men and women with depression as well as in age matched patients with anxiety disorders.” The 25-hydroxy vitamin D test is the most accurate diagnostic to determine vitamin D levels.
A study published in Metabolic Brain Disease in 2019 found that supplementation with vitamin D is an effective treatment for generalized anxiety disorder. Sun exposure is the best way to get vitamin D; dark-skinned people need considerably more sun exposure for their bodies to create the same amount of vitamin D as light-skinned people.
Deficiencies in essential elements such as zinc, magnesium, lithium, iron, calcium, and chromium have been associated with both depression and anxiety. Food sources rich in these essential elements include:
- Zinc: oysters, red meat, poultry, chickpeas
- Magnesium: pumpkin seeds, dairy products, dark chocolate
- Lithium: potatoes, tomatoes, cabbage, mineral water
- Iron: beef, bison, liver
- Calcium: cheese, yogurt, sardines, spinach
- Chromium: liver, beef, sardines
Iron is best tested via iron panel tests that include ferritin, a protein that stores iron. Many women with heavy menstrual cycles may be iron-deficient without being anemic. Thus, low iron levels are not always apparent on traditional blood panel screenings, such as a complete blood count (CBC).
However, most people have high iron levels because processed foods and breads are fortified with iron; they may also have high iron content in their well water or multivitamins, cook with cast iron, or eat a lot of much red meat. Iron can become problematic when levels get too high, so it is imperative to test iron levels before supplementation. A comprehensive iron panel includes total iron binding capacity, iron saturation, total iron, and ferritin.
Magnesium levels are best tested as magnesium within the red blood cells themselves (using the Magnesium RBC test); the other essential elements are more difficult to test for accurately. Ultimately, ensuring a diet rich in nutrition is paramount to support a healthy and stable mood.
Often, lifestyle basics make the biggest impact. In terms of anxiety, optimizing sleep and getting out in the sun can have a drastic impact on mental health.
In a 2014 study from the Netherlands that looked at patients with multiple sclerosis, those with higher levels of sun exposure were shown to have lower levels of depression and a better overall mood. We continue to learn about how the human body responds to the sun.
But sun does more than create vitamin D; it also impacts our circadian rhythms as light reaches the receptors in our eyes and relays this message to the brain. Light therapy has been used for decades to help improve seasonal affective disorder (SAD) symptoms in colder environments with less sun exposure.
Being in nature and being in the sun can help ease anxiety, and the American Heart Association advises spending time in nature to reduce stress. Light exposure first thing in the morning is also very helpful if you’re unable to get outside regularly; it sets your circadian rhythm and gets you set for the day. Numerous therapy lights on the market provide synthetic light therapy that is also shown to improve mood.
Additionally, poor sleep is associated with increased feelings of anxiety. While anxiety itself can perpetuate restlessness and insomnia, improving sleep quality and duration can make a drastic impact on mood. Make a sleep routine: Avoid screens before bed, use blackout curtains, and do things that soothe you in the hours before you head to bed.
Botanical and Nutraceutical Therapies
The Earth has provided us with medicinal plants that are natural anxiolytics—medications that reduce anxiety. Other herbs are naturally sedating or help increase levels of gamma-aminobutyric acid (GABA) in the body. GABA, an inhibitory neurotransmitter, blocks messages between the nerve cells and the brain or spinal cord, and reduces fear, stress, and anxiety.
The herbs commonly used for anxiety in my practice include passionflower, gotu kola, Siberian ginseng, valerian, blue skullcap, kava kava, and water hyssop. Many of these are commonly available as over-the-counter calming teas and anxiety aides. They may be prescribed in higher and targeted doses under the care of a clinically trained naturopathic doctor or herbalist to control moderate to severe symptoms of anxiety. Clinically, I find combinations of herbs in tincture form, extracted in alcohol or glycerin, to be most effective.
In addition to herbs, the amino acid L-theanine, readily available in natural food stores, is well tolerated and shown to be helpful in reducing feelings of anxiety and stress. It’s naturally found in green tea and helps increase levels of GABA.
Other Non-Pharmacologic Therapies
Traditional talk therapy is often utilized to help reduce feelings of anxiety; other therapies with promising results include cognitive behavioral therapy (CBT) and somatic experiencing. These therapies help people challenge both belief systems and memories that trigger anxious thought patterns and physical responses.
Additionally, instead of pharmaceutical interventions, transcranial magnetic stimulation (TMS) therapy is increasingly being used in psychiatric offices for appropriate candidates. TMS employs a magnetic field to induce a small electric current to certain areas of the brain associated with emotion. While most commonly used to treat depression, it’s also been shown effective in treating anxiety.
Medications can be immensely helpful when anxiety is at its worst, but it’s imperative to work with your doctor to investigate the factors contributing to anxiety, and how to correct them. Learning how to properly fuel your body and develop a resilient mind will lead you to greater vitality, joy, and happiness.
Please note that none of these therapies are a replacement for a qualified mental health therapist or health care provider.
This article was first published on Radiant Life Magazine.