What are natural remedies for anxiety?

Natural Remedies for Anxiety: Evidence-Based Approaches

Cognitive Behavioral Therapy (CBT), mindfulness-based interventions, yoga, and regular exercise are the most effective natural approaches for managing anxiety, with strong evidence supporting their use as first-line non-pharmacological treatments. 1

Mind-Body Practices

Mindfulness-Based Interventions

• Mindfulness-based interventions have demonstrated significant effectiveness for anxiety management and are recommended as a first-line approach for moderate anxiety symptoms 1
• These techniques help individuals recognize and manage stress symptoms through focused attention and awareness of present moment experiences 1
• Self-help materials based on mindfulness principles can be effective for mild to moderate anxiety symptoms, with moderate to large effect sizes 1

Yoga

• Yoga shows significant benefits for anxiety reduction with moderate strength of recommendation 2
• Two systematic reviews focusing on yoga reported significant effects for anxiety with standardized mean differences of -1.35 and -0.98 2
• Only minor adverse events have been reported with yoga practice, making it a safe intervention 2
• Regular practice (3-5 times weekly) appears more effective than less frequent practice 3

Tai Chi and Qigong

• Tai chi and qigong may help reduce anxiety symptoms with a weak to moderate strength of recommendation 2
• A 2021 systematic review of five RCTs with 439 patients concluded there was a significant benefit of qigong on anxiety measures (SMD, –0.71) 2
• These movement-based practices combine physical activity with mindfulness, potentially addressing both physical and psychological aspects of anxiety 2

Physical Activity

Regular Exercise

• High-energy exercise (weekly expenditure of at least 17.5 kcal per kg) and frequent aerobic exercise (at least 3-5 times weekly) demonstrate superior anxiety reduction compared to less frequent or lower-energy exercise 3
• Both aerobic and non-aerobic exercise appear to reduce anxiety symptoms effectively 4
• Exercise has shown effectiveness as an adjunctive treatment for anxiety disorders, though it may be less effective than antidepressant medication as a standalone treatment 4
• The American College of Sports Medicine recommends structured physical activity for moderate to large reductions in anxiety symptoms 1

Relaxation Techniques

Progressive Muscle Relaxation

• Relaxation training through techniques such as progressive muscle relaxation and guided imagery is recommended to help recognize and manage stress symptoms 1
• These techniques can be integrated into daily routines for tackling anxiety and controlling panic symptoms 1
• Regular practice of relaxation techniques helps develop skills for managing physiological symptoms of anxiety 1

Reflexology

• Some evidence suggests reflexology may provide small benefits for anxiety reduction 2
• Three RCTs demonstrated reduction of anxiety in participants, though effect sizes were small and may have been below clinically meaningful differences in some cases 2
• Given the low likelihood of harm, reflexology may offer a small net benefit for anxiety symptoms 2

Nutritional and Herbal Supplements

Evidence-Based Supplements

• Strong evidence exists for the use of herbal supplements containing extracts of passionflower or kava and combinations of L-lysine and L-arginine as treatments for anxiety symptoms 5
• Magnesium-containing supplements may hold promise, but more research is needed 5
• Lavender oil extract (Silexan) has shown effectiveness for subsyndromal anxiety in primary care settings 6

Supplements with Insufficient Evidence

• St. John's wort monotherapy has insufficient evidence for use as an effective anxiolytic treatment 5
• Melatonin has shown no significant impact on anxiety in available studies 2
• Probiotics, chamomile tea, and various ginseng extracts have shown inconsistent results in clinical trials 2

Implementation Approach

For Mild Anxiety

• Begin with self-help materials based on CBT principles, which can be used at home with minimal therapist support (approximately 3 hours total over 3-4 months) 1
• Incorporate daily relaxation techniques and regular physical activity 1
• Practice recognizing symptoms of stress and implementing stress-management techniques regularly 1

For Moderate Anxiety

• Individual or group therapy with CBT, behavioral activation, or structured psychosocial interventions is recommended 1
• Combine with regular exercise (3-5 times weekly) and mindfulness practices 3, 1
• Consider evidence-based supplements as adjunctive treatments 5

Common Pitfalls and Considerations

• Screening for more severe symptoms is important, as moderate to severe anxiety may require more intensive intervention or referral to specialized care 1
• Consistency in practice is essential—both exercise and mindfulness techniques require regular implementation to be effective 3
• While natural approaches can be effective, they should not delay appropriate treatment for severe anxiety that significantly impacts quality of life 1
• Some supplements may interact with medications or have side effects, though reported side effects are generally mild to moderate 5