The internet is full of supposedly “amazing,” “natural” cure-alls for anxiety. Unfortunately, a lot of these claims are over-hyped, and often not based on science! In this post, we’ll run through some of the supplements claimed to control anxiety, and review what the latest science says about each one.
Disclaimer: This post is not a recommendation or endorsement for any particular type of mental health treatment, either for anxiety disorders or otherwise. The only way to be sure you get effective treatment is to discuss your options with your personal doctor – and none of the complementary approaches described below should ever be used to replace what your doctor has prescribed or recommended. We have written this post for informational purposes only, and its goal is simply to inform our readers about the science behind some complementary approaches to alleviating anxiety, and what we currently know about how they might work.
What is Anxiety?
Anxiety disorders are a group of psychiatric disorders including social anxiety, generalized anxiety, panic disorder, PTSD, OCD, and phobias [1].
Common anxiety symptoms include inner turmoil, nervous behavior, and excessive rumination [2].
Flawed processing of threat is theorized to be the common underlying factor in contributing to anxiety disorders [3].
While it is certainly helpful to experience fear and vigilance in response to an actual threat, someone with anxiety will interpret non-threatening signals as threatening, thus maintaining an unnecessarily high state of worry and arousal [4].
Underlying this exaggerated fear response is a network of brain structures that function improperly in response to stimuli. The amygdala, which controls fight-or-flight threat response, is often overactive [5].
On the contrary, the prefrontal cortex, which inhibits the fear-generation of the amygdala, is underactive [6].
Impaired activity of the hippocampus, striatum, anterior cingulate cortex, and insula can also be involved in anxiety [7].
These neural “malfunctions” can be accompanied by disturbances in neurotransmitters (serotonin, norepinephrine, dopamine, GABA), neurotrophic factors (nerve growth factor, BDNF), the HPA axis, immune function, heart rate variability, and cognitive function [8].
Now that we know what we’re up against, here are some tools you can use to overcome anxiety.
Anxiety: Why Take A Complementary Approach?
While there are many pharmaceutical drugs that have been developed which can treat anxiety relatively safely and effectively, it is unfortunately also the case that these can often have negative side-effects in some people [9].
For these reasons, there’s a lot of people out there who are skeptical about jumping right into using medical drugs to control their anxiety, and who are curious about complementary approaches that might be more “natural”, or which don’t rely on psychiatric medications [10].
However, before we begin we want to stress that this post is not an endorsement for- or against any particular mode of treatment! Nor are the strategies outlined in this post intended to be used as a replacement for conventional medical care in any way.
If you are ever diagnosed with a mental health condition of any kind, the only way to decide what the best treatment for your specific case might be is to discuss it with your doctor. Only a fully-qualified medical professional fully understands all the different advantages and drawbacks associated with the many different possible modes of treatment – and they will work with you to come up with the safest and most effective approach for your individual needs.
With that in mind, in the rest of this post we’ll discuss some of the many non-drug-based treatments for anxiety and other related mood symptoms, and what science currently says about them.
Supplements That May Reduce Anxiety
In addition to some of the behavior- or lifestyle-based approaches discussed above, there are also many supplements, herbs, and other compounds that have been touted as having potential effects on anxiety.
However, keep in mind that the science behind these is still mostly preliminary, and none of these supplements have been officially approved for treating anxiety or other related psychological conditions. Therefore, none of these compounds should be used to replace any ongoing medical treatments that your doctor has recommended.
It’s also always a good idea to consult with your doctor before trying out any new supplements or other dietary changes, as there’s always the possibility that these compounds could have adverse interactions with other ongoing medications, pre-existing medical conditions, etc. Therefore, we don’t recommend “experimenting” with supplements on your own without at least discussing them with your doctor first!
With all that in mind, here’s what some of the latest science says about several supplements that might have potential anxiety-related effects.
Possibly Effective
1) Kava (Piper methysticum)
Kava is a plant grown in the South Pacific islands, and which is generally consumed as tea or supplement.
Kava has been reported to improve anxiety, insomnia, depression, sleep quality, cognitive function, tension, and restlessness in studies of 141, 20, and 101 healthy human participants [11, 12, 13].
In animals, Kava’s anti-anxiety effects have been reported to be quite powerful, and possibly even comparable to the effects of benzodiazepines (a class of pharmaceutical drugs commonly used to treat anxiety disorders) [14].
A study that performed a comparison of many different herbal anti-anxiety remedies concluded that Kava may be more effective than most other herbal supplements in reducing anxiety [15].
Although its precise mechanisms aren’t known for sure yet, kava has been reported to increase the activity of the GABAA receptor [16], and may also inhibit the uptake of the neurotransmitter norepinephrine [17].
However, it should be noted that there have been reports linking kava with liver toxicity (11 liver failure cases leading to liver transplants, including 4 deaths). While the toxicity of kava alone is quite small, it may interact with other drugs or increase the toxicity of other substances [18, 19]. Therefore, it is best to consult with your doctor before trying out kava – especially if you have any known liver problems.
2) Lavender
According to several studies in humans, Lavender (Lavendula) improved anxiety and sleep quality in studies of 221, 77, 47, and 10 participants [20, 21, 22, 23].
Although its mechanisms aren’t fully clear yet, in animal studies, several components of lavender essential oil (linalool and borneol) were reported to slightly increase activity of the inhibitory neurotransmitter GABA, which may underlie some its purported anxiety-reducing effects [24, 25, 26].
3) Ginkgo Biloba
Ginkgo biloba is a medicinal plant widely used in Chinese medicine to counteract the effects of age-related cognitive decline, among other traditional uses [27].
According to one study in 107 humans, supplementation of 240 or 480 mg Ginkgo biloba daily for 4 weeks was reported to significantly reduce anxiety symptoms (as compared to an inactive placebo treatment) [28].
Ginkgo biloba extract has also been reported to reduce anxiety, depression, and dementia symptoms in elderly patients [29].
Early evidence from a few animal studies suggests that Ginkgo biloba may also show some anti-anxiety properties in rats, although the exact mechanisms behind this are still mostly unclear [30, 31].
4) Chamomile (Apigenin)
Apigenin is a flavonoid present in chamomile, celery, cilantro, licorice, Ginkgo biloba, and passion flower [32]. Among these foods and herbs, chamomile is believed to contain the highest levels of apigenin [33, 34, 35].
Chamomile extract was reported to reduce mild-to-moderate levels of anxiety, depression, and stress in two human studies of 57 and 61 participants each [36, 37].
When taken in standard supplementation doses, apigenin has been reported to reduce anxiety without causing unwanted sedation-like effects [38].
Although its mechanisms aren’t known for sure, some early evidence suggests that apigenin may act by enhancing GABA communication by binding to GABA receptors (similar to how benzodiazepines act). Some have reported that it may also inhibit NMDA receptors of the glutamate family [39, 40].
5) Lemon Balm
Lemon balm (Melissa officinalis) is traditionally consumed as a tea and has long been claimed to have calming properties. Although its exact biological mechanisms are not yet fully known, it contains many psychoactive chemicals [41], with rosmarinic acid as its most psychoactive compound [42].
According to several studies in human users, supplementation ranging from 300-1,600 mg of lemon balm extract was reported to improve anxiety, stress, insomnia, memory, mood, and cognitive processing in human studies of 20, 18, 20, and 20 participants [43, 44, 45, 46].
Some researchers have suggested that rosmarinic acid may increase levels of the inhibitory neurotransmitter GABA by blocking an enzyme that is a common target for anxiety treatment, which converts GABA to L-glutamate [47, 48].
6) Purple Passionflower
Purple passionflower (Passiflora incarnate) is a flowering vine native to the southeast United States.
Results from one early study in 18 patients with generalized anxiety disorder suggest that purple passionflower may help reduce anxiety similar to a benzodiazepine (a pharmaceutical medication often used to treat anxiety and other psychiatric disorders) [49].
In another study, purple passionflower supplementation before surgery was reported to reduce anxiety in 30 surgery patients [50].
Finally, another study reported that just a single 5,000mg dose of purple passion flower reduced heart rate after public speaking, while 500mg for 6 days was reported to reduce blood pressure during the public speaking exercise, according to a 30-person study (DB-RCT) [51].
Some early evidence from animal studies suggests that purple passionflower contains high amounts of GABA [52], and may influence hippocampal GABAA and GABAC pathways in mice [53]. However, more research will be needed to fully understand the underlying mechanisms behind these potential effects.
Insufficient Evidence
7) Cannabidiol (CBD)
Cannabidiol, or “CBD” for short, is one of the major bioactive compounds found in cannabis and hemp. However, it is non-psychoactive (unlike THC, the compound that makes you “high”), and is widely sold for personal use in the form of CBD oil.
However, note that CBD oil is derived from cannabis, which is a controlled substance in many countries and states. Because of this, its legal status may vary from place to place, and may even be illegal to buy or possess where you live. Therefore, make sure to verify the legality of CBD and similar products before seeking them out. (If you’re in doubt about whether you can legally access these products, don’t risk it – just check out one of the 20 other potential options throughout this post!)
According to some early studies in human users, cannabidiol was reported to reduce anxiety in studies of 40 healthy individuals, and 10 patients with social anxiety disorder [54, 55].
CBD was also reported to reduce anxiety and distress brought on by public speaking according to another study of 24 individuals with social anxiety disorder [56].
If you’re looking to purchase CBD, these CBD capsules are trusted by SelfDecode.
Mechanism
Although its mechanisms are still being discovered, some early research suggests that one way CBD may act to ease anxiety is by activating serotonin receptors [57, 58, 59].
CBD also binds to cannabinoid (CB1) receptors, which are frequently found in the hippocampus and amygdala – regions of the brain which are widely believed to be involved in emotional control [60].
Other studies have reported that CBD may reduce activity in the amygdala, and may increase prefrontal cortex activation – two brain structures commonly associated with anxiety [61].
Some other evidence suggests that activation of CB1 receptors may also influence GABA and glutamate systems, although the involvement of these specific mechanisms in some of the wider psychological effects of CBD is still being researched, and haven’t been fully confirmed yet [61].
8) Ashwagandha (Withania somnifera)
Ashwagandha is an Indian herb usually consumed as ashwagandha root extract.
Ashwagandha is considered an “adaptogen” – a non-toxic substance that may help correct imbalances in the hormonal and immune systems. Some early evidence suggests that ashwagandha may help restore biological functions disturbed by chronic stress [62].
Additionally, ashwagandha has been reported to reduce mood fluctuations and anxiety in 51 women with menopausal syndrome [63], and some researchers have even suggested that extracts of ashwagandha may be useful in treating anxiety disorders in conventional psychiatric practice [64].
According to a handful of animal studies, ashwagandha has been reported to exert some “anti-anxiety” effects similar to the pharmaceutical drug lorazepam [65]. Other studies report that it acts similar to a mood stabilizer when treating cases of anxiety and social-isolation-induced behavior [66, 67]. Finally, it has also been reported to alleviate the OCD-like symptoms in animals [68].
Mechanism
Although its mechanisms are still being actively studied, some early findings suggest that ashwagandha may decrease cortisol levels and levels of perceived stress according to a 64-person study (DB-RCT) [69].
Relatedly, some animal studies have reported that it may have stress-reducing effects [70], and has been claimed to improve stress tolerance in rats [71].
9) Probiotics
The beneficial impact of probiotics on mental health is gaining prominence as early studies shed light on the significant influence of gut microbiota. “Psychobiotics” describe a class of probiotics that have been claimed to benefit those with psychiatric illness, by helping the body to produce and transport various important neurotransmitters [72].
Lactobacillus and Bifidobacterium are two types of bacteria that have been studied in the treatment of anxiety [73]. Lactobacillus and Bifidobacterium inhabit the gut, and have been reported to be involved in carbohydrate energy conversion [74, 75].
Lactobacillus Plantarum
According to one study, a probiotic supplement including L. plantarum lowered gut-related anxiety in a study (DB-RCT) of 84 IBS patients [76].
In one animal study, chronic L. plantarum intake reportedly increased dopamine and serotonin levels, and reduced anxiety-like behaviors in mice. It was also reported to reduce pro-inflammatory cytokines, as well as increase anti-inflammatory cytokine levels of mice subjected to early life stress [77, 78].
Lactobacillus Rhamnosus
A recent study reported that probiotic capsules containing L. rhamnosus and other bacteria strains reduced anxiety in a study (DB-RCT) of 70 people [79].
Similarly, a handful of animal studies have reported that treatment with L. rhamnosus may have reduced anxiety-like behaviors in mice [80, 81].
In another animal study, L. rhamnosus supplementation was reported to reduce anxiety and depressive behaviors, and may have even altered brain GABA gene activity in mice [82].
Lactobacillus Helveticus
In one recent animal study, L. helveticus supplementation was reported to decrease anxiety-related behaviors in rats [83, 84].
Relatedly, L. helveticus supplemented was reported to protect against the negative effect of a Western-style diet on anxious behavior in mice [85].
Lactobacillus Fermentum
According to one recent animal study, L. fermentum supplementation was reported to reduce anxiety-like behavior brought on by antibiotics in mice [86].
Bifidobacterium Longum
B. longum reportedly lessened anxiety-like behavior in mice with infectious colitis [87]. The authors of this study concluded that these effects appear to be mediated by the vagus nerve pathway [88].
In one human study, L. helveticus and B. longum taken daily for 30 days reportedly decreased anxiety, hostility, and levels of the stress-related hormone cortisol in 25 individuals [89].
10) 5-Hydroxytryptophan (5-HTP)
5-HTP is a naturally-occurring amino acid which the brain uses as one of the main “ingredients” (metabolic precursors) to produce the neurotransmitter serotonin, which is widely believed to be heavily involved in mood.
It is available over-the-counter as a dietary supplement, and is believed to help increase overall serotonin levels in the brain [90].
In one human study in 15 young adults with anxiety due to unreciprocated romanticism, six weeks of supplementation with 5-HTP was reported to decrease anxiety by increasing blood BDNF and serotonin levels [91].
Similarly, another human study reported that just a single 200-mg dose of 5-HTP was able to partially alleviate panic attacks in 24 patients with panic disorder [92].
Because this amino acid is one of the main precursors for making serotonin, 5-HTP is believed to exert its effects primarily by raising brain serotonin levels [90].
11) Theanine and Green Tea
L-theanine is an amino acid found in white, black, and green tea, and has been widely touted for its calming effects [93].
A few early studies back this up. For example, L-Theanine (taken after the performance of mental tasks) has been reported to alleviate symptoms of stress, while also lowering heart rate and blood pressure, in two studies of 12 and 14 participants each [94, 95].
Similarly, daily L-theanine supplementation was reported to reduce anxiety in one study (DB-RCT) of 20 schizophrenic patients, and reportedly had relaxation-promoting effects in 20 healthy individuals [96].
While the sample sizes in these studies are relatively small, these preliminary results are nonetheless promising, and will hopefully be followed up by more future studies in larger numbers of healthy human users.
Some early evidence from animal studies suggests that L-theanine may act by increasing brain levels of several important neurotransmitters, such as GABA, dopamine, and serotonin [97].
12) Black Seed (Black Cumin)
Black seed (black cumin, Nigella sativa) is a flowering plant native to south and southwest Asia.
Black seed supplements were reported to help stabilize mood, decrease anxiety, and even improve cognitive function in one early study of 24 healthy adolescent males [98].
Black seed oil has also been reported to potentially improve inflammation, blood pressure, and anxiety, without notable side effects, according to several studies in both animals and humans [99, 100, 101, 102].
Thymoquinone, a major component of Nigella sativa, was reported to increase the activity of the inhibitory neurotransmitter GABA in mice, which may underlie some of black seed’s claimed effects [103].
13) Bacopa monnieri
Bacopa monnieri is an herb generally taken in capsule or powder form. It should be taken with a meal because many of its components are fat-soluble—that is, they require dietary fats to be successfully absorbed by the body.
According to one early human study (DB-RCT), supplementation with 300mg of bacopa monniera for 12 weeks was reported to reduce anxiety compared to placebo [104].
Bacopa supplementation has also been reported to reduce cortisol levels and overall stress in another study of 17 healthy humans [105].
According to one animal study, bacopa was also reported to reduce mixed anxiety-depressive disorder in mice [106].
Although its mechanisms are not yet fully known and probably quite complex, some early results from studies in rats suggest that bacopa may act by increasing levels of the major neurotransmitters norepinephrine, serotonin, and dopamine, and may also help normalize blood corticosterone levels previously compromised by stress [107].
14) Magnesium
Magnesium supplementation has been reported to improve anxiety and anxiety-related disorders when taken with other vitamins, minerals, and herbal extracts [108].
A few case studies have reported improvements in depression, anxiety, and sleep within one week of starting magnesium supplementation [109]. However, these results were only based on a few individual human users, and more large-scale trials in healthy human participants will be needed to confirm these effects.
According to some researchers, magnesium’s potential anti-anxiety effects may be due to its ability to reduce the activity of the HPA axis (a major brain system involved in stress regulation) [110] as well as inhibiting NMDA receptors [110].
15) Fish Oil / Omega-3 Fatty Acids
Low levels of omega-3 fatty acids have been associated with increased levels of social anxiety in a 49-person study [111].
In one study of 34 healthy human participants, omega-3 supplementation of 2.5 grams/day was reported to reduce anxiety symptoms, as well as decrease levels of interleukin-6 (a major proinflammatory cytokine) [112].
Similarly, according to another study), supplementation with 3 grams of omega-3 was reported to reduce anxiety in 11 substance abusers [113].
In one study on rats, DHA (an omega-3 fatty acid) was reported to reduce levels of TNF-a, IL-6, and nitric oxide synthase, which may suggest that at least some of its effects may be due to reduced inflammation – although follow-up studies in humans will be needed to confirm this [114].
On the other hand, other animal studies have reported that EPA (another omega-3 fatty acid) may help increase hippocampal neurogenesis, which suggests that there are other important mechanisms to be discovered in addition to some of the potential anti-inflammatory effects [115].
16) Gotu Kola
Gotu kola (Centella asiatica) is a plant found in the South Asian wetlands, and which has been traditionally used as a culinary vegetable and medicinal herb.
In one placebo-controlled study, Gotu kola was reported to suppress the startle response in 40 healthy adults [116].
Gotu kola – and its main component, asiatic acid – have been reported to reduce anxiety-related behavior in a few rat studies [117, 118].
Some early evidence from a study in rats suggests that Gotu kola may act by activating glutamic acid carboxylase, an enzyme that increases GABA levels in the brain [119].
17) Skullcap Herbs
Skullcap herbs include American (Scutellaria lateriflora) and Chinese (Scutellaria baicalensis) skullcap herbs. They contain bioactive flavonoids, which are believed to act as potent antioxidants with numerous purported health benefits [120].
According to one small-scale study in humans, American skullcap was reported to decrease anxiety in 19 adults (when compared to placebo) [121].
Some evidence from animal studies suggests that Chinese skullcap supplementation may help reduce stress-induced anxious behaviors and blood corticosterone levels, which may point towards some of the underlying mechanisms behind its effects [122].
Although there are many different interesting compounds in these herbs, wogonin – which is believed to be the primary active flavonoid in Chinese skullcap – was reported to reduce anxiety-like behavior and enhances GABAA receptor activity in mice [123].
18) Hops
”Hops” (Humulus lupulus) are most commonly known for their role as a flavoring and preserving ingredient of beer. However, some early evidence suggests that hops may have some sedative properties.
For example, non-alcoholic beer (still containing hops like regular beer) consumed with dinner for 14 days was reported to reduce anxiety and improve sleep in two human studies of 17 and 16 participants each [124, 125]. In the 16-person study, overnight serotonin levels were also reduced in the treatment group, suggesting a possible role of hops in the serotonin-melatonin pathway, which is vital to the circadian rhythm [126].
Although the mechanisms are mostly unknown, one preliminary study in cells reported that adding a small amount of beer to frog egg cells elicited a strong GABAA response, and that adding a small amount of hops strengthened GABAA receptor transmission [127]. Nonetheless, more research in living animals and human users will be needed to further clarify the reasons for hops’ potential effects.
19) Valerian
Valerian (Valeriana officinalis) is a flowering plant historically used in perfumes, and which is often supplemented in the form of tea or an extract of the root.
According to one preliminary human study, valerian supplementation (500mg twice daily for 60 days) was reported to reduce anxiety, stress, and depression in a study of 33 healthy individuals [128].
Although more human studies (with larger sample sizes) will be needed to confirm these effects, some animal studies have also reported that valerian may potentially reduce anxiety-like behaviors [129, 130].
Some researchers have suggested that the anti-anxiety effects of valerian may be due to its ability to increase the strength of GABAA signaling, although this research is still in a very early stage [130].
Animal & Cell Research (Lacking Evidence)
No clinical evidence supports the approaches listed below to combat anxiety. Below is a summary of the existing animal and cell-based research, which should guide further investigational efforts. However, the studies listed below should not be interpreted as supportive of any health benefit.
20) Magnolia Bark
Magnolia bark (Magnolia officinalis) has a long history of use in traditional Chinese medicine. Its active compounds include honokiol and magnolol, located in the bark of the tree [131].
Although human studies are currently lacking, both honokiol and magnolol have been reported to reduce depression and anxiety in animals [132, 133, 134]. Some researchers have proposed that these effects may be due to the activation of GABAA receptors [135, 133].
However, more research will be needed to know if the effects and mechanisms are similar in healthy human users as well, so these early results from animal studies should be taken with a grain of salt.
Possibly Ineffective
21) Inositol
Inositol is a sugar alcohol structurally similar to glucose. It can be synthesized in a lab, but is also found naturally in many foods [136].
Inositol has 50% of the sweetness of table sugar, and some people even use its powder forms as a sweetener. It is also commonly taken as a supplement in pre-made capsules.
According to a few early human studies, daily inositol supplementation was reported to help reduce panic disorder, anxiety, and OCD symptoms in both children and adults [137, 138, 139].
Similarly, supplementation with 18 grams/day of inositol reportedly reduced anxiety and panic attack symptoms in 20 patients [140], as well as lowered anxiety and depression in people with binge eating disorder or bulimia [141].
However, other studies have found no benefit of inositol supplementation for people with anxiety disorders [142].
Further Reading
Takeaway
Anxiety disorders are a group of mental illnesses that cause a disproportionate fear response to non-threatening signals. People with anxiety disorders typically have irregular levels of many neurotransmitters.
Many supplements have been studied for their potential to reduce anxiety. Among those with the best results so far are kava, lavender, ginkgo, chamomile, lemon balm, and purple passionflower.
