This article is for informational purposes only. None of the information here should be taken as medical advice. If you suspect you may have an anxiety disorder, seek medical help. You may try the complementary approaches listed below if you and your doctor determine that they could be appropriate for you. Discuss the strategies listed here with your doctor.
Lifestyle
Cognitive-Behavioral Therapy
Cognitive-behavioral therapy can improve anxiety disorders such as generalized anxiety disorder, panic disorder, and social phobia, especially if combined with medication [1].
Different forms of behavioral therapy, such as in-person, internet-based, and self-guided, are a part of standard care for anxiety — consult with a healthcare professional about your options [2, 3].
Mindfulness
Research suggests that mindfulness is the only form of meditation that reliably improves anxiety [4].
Mindfulness meditation reduced stress and anxiety with similar effectiveness to cognitive-behavioral therapy in several studies [5].
Applied Relaxation
Applied relaxation techniques can reduce general anxiety, excessive worry, and tension. The improvements may be maintained for up to one year after initial treatment [6, 7, 8].
A study reported that computer-delivered applied relaxation can be as effective as therapist-guided applied relaxation in reducing emotional stress and improving relaxation [9].
Yoga
A large body of evidence supports the benefits of yoga in reducing anxiety [10, 11, 12, 13].
Exercise
People who exercise regularly experience lower levels of neuroticism, anxiety, and depression, while lack of regular physical activity has been associated with an increased risk of anxiety [14, 15].
Aerobic exercise may be most effective at reducing anxiety in both healthy people and those diagnosed with disorders such as generalized anxiety, panic disorder, and PTSD [16, 17, 18].
Heart Rate Variability Biofeedback Training
A lower heart rate variability from a normal “baseline” heart rate indicates a dominance of the “fight-or-flight” (sympathetic) nervous system, which is associated with increased stress and many forms of anxiety [19, 20].
A handful of studies have shown that heart rate variability biofeedback training can reduce overall anxiety and perceived stress [21, 22, 23, 24].
Cognitive Bias Modification
People with anxiety issues tend to preferentially pay attention to threatening information, interpret emotionally ambiguous information as threatening, and store and retrieve threatening information more often than positive or neutral information [25].
Cognitive bias modification is the practice of “re-training” the above biases. Limited research shows it may lower anxious behavior and decrease negative automatic thoughts [26, 27].
Massage
A review of 10 clinical trials concluded that massage may reduce anxiety associated with postoperative recovery [28].
Similarly, Swedish massage reduced anxiety in a small trial on ICU patients [29].
Massage seems to reduce anxiety and stress by lowering the levels of hormones that increase heart rate, breathing, and sweating (norepinephrine and ACTH) [30].
In a study of people with generalized anxiety disorder, massage was as effective as thermotherapy or relaxing room therapy in alleviating anxiety [31].
Tai Chi
Multiple studies have associated the practice of Tai Chi with improvements in overall well-being, including stress, anxiety, and depression [32, 33, 34].
Tai Chi may also help with anxiety from conditions such as coronary heart disease, cancer, COPD, and AIDS [35, 36, 37, 38].
Sunlight Exposure
Anxiety issues appear to follow a strong seasonal pattern, being the symptoms worse in winter compared to any other time of the year [39].
Sunlight exposure may reduce anxiety and depression, possibly by increasing serotonin levels and stimulating the growth and development of new neurons in the brain [40, 41].
Sunlight is the primary source of vitamin D, and the lack of sun exposure is the biggest risk factor for vitamin D deficiency. Most experts suggest you need 15-30 mins of daily sun exposure to produce sufficient vitamin D levels [42, 43].
In a small trial on people with generalized anxiety disorder, those who took supplementary vitamin D as an add-on to conventional medication experienced greater anxiety reduction [44].
Pet Therapy
Several, low-quality studies show that a single session of pet therapy can improve self-reported stress and anxiety [45].
In a clinical trial on patients with scleroderma, 20 weekly sessions of dog-assisted therapy reduced anxiety better than standard treatments alone [46].
Aromatherapy
Preliminary research in humans shows that aromatherapy may help reduce anxiety and tension [47].
The most effective essential oils used in aromatherapy for stress reduction are those of lavender and sweet orange [48, 49, 50, 51, 52].
Reflexology
A review of 10 clinical trials found that both foot and hand reflexology may reduce anxiety in people undergoing heart surgery [53].
Sauna
According to limited clinical evidence, far-infrared sauna can lower anxiety and improve emotional and psychological status [54, 55].
Art Therapy
Art therapy has been mainly investigated in cancer patients. Research suggests it may help improve cancer-related anxiety and depression [56, 57].
Art therapy seems to reduce anxiety by improving executive function [58].
Sexual Activity
Preliminary research in animals suggests that sexual activity counteracts the negative effects of chronic stress on brain function [59].
Diet
Tryptophan
Tryptophan deficiency has been associated with anxiety in healthy people [60, 61].
A study of patients with panic disorder associated tryptophan deficiency with increased anxiety and frequency of panic attacks [62].
Dietary tryptophan reduced anxiety in both healthy people and patients with social phobia [63, 64].
Similarly, tryptophan supplementation reduced anxiety in women with severe PMS and people on smoking-cessation therapy [65, 66].
Common foods that contain tryptophan include oats, bananas, dried prunes, milk, tuna, cheese, bread, chicken, turkey, peanuts, and chocolate [67].
Calorie Restriction
Calorie restriction and the resulting weight loss improved anxiety and mood in several trials on aging and overweight people [68, 69, 70].
A calorie-restricted, low-fat diet showed more favorable effects on mood and anxiety than a low carbohydrate diet without calorie restriction in a weight-loss study followed up for one year [71].
Reducing Gut Inflammation
Although this is a very recent line of research, some early evidence suggests a connection between gut inflammation and anxiety issues [72, 73, 74].
In a population-based study, 40% of people with food sensitivities who reported psychological issues showed improvement after implementing dietary changes [75].
Fennel
In a clinical trial of post-menopausal women, fennel slightly improved anxiety and depression [76].
Fennel extract improved PMS symptoms, including anxiety, in another trial [77].
Incorporating crushed fennel seeds and fennel essential oil in the diet reduced anxiety in mice [78, 79].
Reducing Meat and Fish Intake
Adopting a lactovegetarian diet (avoiding all animal products but dairy) reduced stress and improved mood in a preliminary clinical trial [80].
Another intervention with a low-fat vegan diet improved anxiety, mood, and work productivity [81].
Supplements
Kava
Kava has been reported to improve anxiety, insomnia, depression, sleep quality, cognitive function, tension, and restlessness better than most other herbal supplements in several clinical trials [82, 83, 84, 85].
Note that kava is banned in Europe, the UK, and Canada due to its potential for abuse and association with liver damage. Therefore, it is best to consult with your doctor before trying out kava – especially if you have any known liver problems [86, 87].
Lavender
An oral preparation with lavender oil improved anxiety and sleep quality in several human studies [88, 89, 90].
Research in animals suggests that two components of lavender essential oil (linalool and borneol) may reduce anxiety by increasing the activity of the inhibitory neurotransmitter GABA [91, 92, 93].
Ginkgo Biloba
Ginkgo biloba has been reported to reduce anxiety, depression, and dementia in human and animal studies [94, 95, 96, 97].
Chamomile (Apigenin)
Chamomile extract reduced mild-to-moderate levels of anxiety, depression, and stress without causing unwanted sedation-like effects in human studies [98, 99, 100].
Chamomile owes its anti-anxiety effects to the flavonoid apigenin, which is also found (although at lower levels) in celery, cilantro, licorice, Ginkgo biloba, and passion flower [101, 102, 103, 104].
Lemon Balm
Lemon balm (Melissa officinalis) is traditionally consumed as a tea and has long been claimed to have calming properties [105].
Lemon balm improved anxiety, stress, insomnia, memory, mood, and cognitive processing in human studies [106, 107, 108, 109].
Galphimia Glauca
A standardized Galphimia glauca extract improved generalized anxiety disorder symptoms as effectively as anti-anxiety drugs and with fewer adverse effects [110, 111, 112].
Purple Passionflower
Purple passionflower showed similar effectiveness to benzodiazepines at reducing anxiety in a small trial on people with generalized anxiety disorder [113]
Purple passionflower supplementation has also been found to reduce anxiety from public speaking and surgical procedures [114, 115].
Cannabidiol (CBD)
CBD reduced anxiety from stressful situations such as public speaking and medical procedures in several trials on healthy people [116, 117, 118, 119].
More limited evidence suggests that CBD may help with anxiety from anxiety disorders, autism, and drug use [120, 121, 122, 123, 124, 125, 126, 127].
Note that CBD oil is derived from cannabis, which is a controlled substance in many countries and states. Therefore, make sure to verify the legality of CBD products where you live before seeking them out.
Ashwagandha
The Indian herb ashwagandha reduced mood fluctuations and anxiety in women with menopausal syndrome [128].
Some researchers have even suggested that extracts of ashwagandha may be useful in treating anxiety disorders in conventional psychiatric practice [129].
Early evidence in animals reported anti-anxiety, anti-OCD, and mood-stabilizing effects of this herb [130, 131, 132, 133, 134].
Probiotics
In a clinical trial, a probiotic supplement including Lactobacillus plantarum lowered IBS-related anxiety [135].
Similarly, probiotic capsules containing Lactobacillus rhamnosus and other bacteria strains reduced anxiety in another study on stressed workers [136].
The combination of Bifidobacterium longum and Lactobacillus helveticus taken daily for 30 days decreased anxiety, hostility, and levels of the stress-related hormone cortisol in healthy volunteers [137].
5-Hydroxytryptophan (5-HTP)
5-HTP is a naturally-occurring amino acid believed to curb anxiety by increasing overall serotonin levels in the brain [138].
In a small clinical trial, six weeks of supplementation with 5-HTP decreased anxiety from unreciprocated romanticism [139].
A single 5-HTP dose partially alleviated panic attacks in people suffering from panic disorder [140].
L-Theanine
L-theanine is an amino acid found in white, black, and green tea, and has been widely touted for its calming effects [141].
Taken after the performance of mental tasks, L-theanine alleviated symptoms of stress while also lowering heart rate and blood pressure [142, 143].
L-theanine supplementation also reduced anxiety in both schizophrenic patients and healthy individuals [144].
Fish Oil/Omega-3 Fatty Acids
Low levels of omega-3 fatty acids have been associated with increased levels of social anxiety [145].
Omega-3 supplementation reduced anxiety symptoms in clinical trials on healthy people and substance abusers [146, 147].
Fatty fish (such as mackerel, salmon, sardines, and herrings) is especially rich in omega-3 fatty acids [148].
Black Seed (Black Cumin)
Black seed supplements helped stabilize mood, decrease anxiety, and even improve cognitive function in a small clinical trial [149].
Research in both humans and animals suggests that black seed may help improve inflammation, blood pressure, and anxiety without notable side effects [150, 151, 152, 153].
Bacopa Monnieri
Supplementation with Bacopa monnieri reduced anxiety in three clinical trials [154, 155, 156].
Bacopa monnieri supplementation also reduced cortisol levels and overall stress in another study [157].
Note that Bacopa monnieri supplements should be taken with a meal because many of their components are fat-soluble—that is, they require dietary fats to be successfully absorbed by the body.
Echinacea
Different echinacea preparations reduced anxiety in both humans and rats [158, 159].
Echinacea extract worked best in people with high baseline anxiety levels and its adverse effects were rare and mild [160].
Rhodiola
Rhodiola rosea extract improved anxiety and mood in four clinical trials [161, 162, 163, 164].
Yohimbe
In a study of patients with social anxiety disorder, the active compound of yohimbe (yohimbine) decreased social anxiety and improved mood [165].
Several studies (both in animals and humans) have found that yohimbine may help fear extinction by increasing norepinephrine levels [166, 167, 168, 169].
However, yohimbine has been reported to trigger anxiety in people with panic disorder and PTSD [170, 171, 172, 173, 174, 175].
Melatonin/Blocking Blue Light at Night
Melatonin is an important hormone that controls the sleep-wake cycle. Light at night, especially blue light, suppresses melatonin production [176, 177].
Melatonin given prior to a surgical procedure reduced anxiety as effectively as midazolam in multiple studies on both adults and children [178, 179, 180, 181].
Magnolia Bark
Magnolia bark has a long history of use in traditional Chinese medicine. Its active compounds honokiol and magnolol (combined with soy isoflavones and Lactobacillus probiotics in some cases) have been reported to reduce depression and anxiety in human and animal studies [182, 183, 184, 185, 186, 187, 188].
Gotu Kola
Gotu kola suppressed the startle response (a largely unconscious defensive response to a sudden threat) in a small trial on healthy adults [189].
Gotu kola – and its main component, asiatic acid – reduced anxiety-related behavior and increased brain GABA levels in animal studies [190, 191, 192].
Skullcap
American skullcap (Scutellaria lateriflora) decreased anxiety in a small clinical trial on healthy people [193].
Chinese skullcap (Scutellaria baicalensis) reduced stress-induced anxious behaviors and blood corticosterone levels in animal studies [194, 195].
Turmeric (Curcumin)
In a preliminary clinical trial on obese people with anxiety and depression, curcumin supplementation reduced anxiety levels and improved mood [196].
Curcumin was more effective in formulations increasing its ability to cross the blood-brain barrier [197, 198].
Hops
Non-alcoholic beer (still containing hops like regular beer) consumed with dinner for 14 days reduced anxiety and improved sleep in two small human studies [199, 200].
L-Arginine and L-Lysine
In 2 clinical trials, supplementation with L-lysine and L-arginine (~3 grams each) reduced anxiety and modified stress hormone levels in response to stressful situations [201, 202].
Vitamin C
Two small trials on healthy people showed that vitamin C supplementation can reduce anxiety [203, 204].
Food sources of vitamin C include fruits and vegetables such as citrus fruits, peppers, berries, and broccoli [205].
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 study on healthy individuals, valerian supplementation reduced anxiety, stress, and depression [206].
Animal studies have also reported that valerian may reduce anxiety-like behaviors [207, 208].
Saffron
Saffron supplementation improved anxiety and depression symptoms in two small clinical trials [209, 210].
Saffron extract reduced anxiety-like behaviors and increased sleeping time in mice [211].
Hawthorn
Multi-herbal formulations with hawthorn reduced anxiety in two clinical trials. However, they included other ingredients with anti-anxiety properties that could have contributed to the effects observed [212, 213].
Hawthorn extract alone relaxed stressed mice and improved their sleep [214, 215].
Sceletium Tortuosum
Sceletium tortuosum extract decreased anxiety-related activity in a brain region involved in the processing of emotions (the amygdala) [216].
In rats, Sceletium tortuosum extract decreased stress-induced behaviors and cortisone levels [217].
Caralluma Fimbriata
Preliminary clinical research shows that supplementation with Caralluma fimbriata may improve stress and anxiety in people with generalized anxiety disorder [218].
In mice, Caralluma fimbriata extract reduced anxiety and improved object recognition and spatial memory [219].
Motherwort
Motherwort oil extract improved anxiety, depression, and blood pressure in a small trial on people with hypertension [220].
Vitamin D
In a small trial on people with generalized anxiety disorder, those who took supplementary vitamin D as an add-on to conventional medication experienced greater anxiety reduction [44].
In addition to taking supplements, you can increase your blood vitamin D levels through a healthy exposure to sunlight and eating food sources of this vitamin such as fatty fish, liver, egg yolks, and dairy [221].
Magnesium
Anecdotal evidence reports that magnesium supplementation can improve anxiety and anxiety-related disorders when taken with other minerals, vitamins, and herbal extracts [222, 223].
In a clinical trial, magnesium was more effective at reducing stress when combined with vitamin B6 [224].
Food sources of this mineral include green leafy vegetables, legumes, nuts, seeds, and whole grains [225].
