It’s normal to feel anxious, worried and fearful from time to time due to the complicated lives we live. Anxiety is a natural part of life, and it helps us cope with the stresses we encounter. But if anxiety occurs more than just occasionally, it can become harmful to our emotional well-being and overall health. Prolonged feelings of anxiety can be a sign that we have too much stress, which translates into negative effects on the body and the nervous system and may lead to chronic disease.1 Anxiety disorders are the most common mental illness in the United States, affecting 40 million adults ages 18 and older.2  

How does this happen? There are many causes of anxiety, but daily stress is a major contributor. There is certainly no shortage of stress these days, whether it’s from busy lifestyles, poor diet, or toxins and chemicals in the environment and food. Two main areas of concern are time management (overscheduling) and relationship issues (marital, extended family and work-related).3

The body processes stress through the brain, specifically the hypothalamus-pituitary-adrenal (HPA) axis and the nervous system. Physiological responses are initiated and create downstream effects, i.e., anxiety, mood changes, focus, memory, energy levels and sleep disturbances. If we remain in a sympathetic nervous system “fight or flight” mode for too long, we become hypervigilant and our parasympathetic processes are hindered. Because parasympathetic activities involve “rest and digest,” the ability to relax, absorb nutrients and sleep soundly suffers. The release of higher levels of cortisol through HPA axis activation also increases the time patients remain in an agitated, anxious and alarmed state. 

TARGETED THERAPIES FOR REDUCING ANXIETY

Evidence shows certain strategies will support the brain and nervous system to reduce anxiety naturally and improve feelings of well-being. Unsurprisingly, supervised stress management programs are shown to offer the greatest compliance and better overall results than unsupervised, self-guided programs.3 When comparing multiple lifestyle interventions, relaxation techniques and physical exercise were found to be the most practical and most effective, respectively.4 Along with lifestyle techniques, nutrient supplementation can be helpful to support calming neurotransmitters and relaxation for reparative sleep. 

1. LIFESTYLE RECOMMENDATIONS FOR ANXIETY

Learning to calm the mind and body is an extremely important skill to decrease the effects of stress. Relaxation exercises are an easy and inexpensive way to produce a physiologic relaxation response to stress. In essence, this activates the parasympathetic nervous system and allows the body to create a balance with the sympathetic portion of the autonomic nervous system. Parasympathetic activities include reading a book, taking a relaxing bath or simply sleeping. 

2. PRIORITIZING MENTAL HEALTH TO MANAGE ANXIETY

Prioritizing stress-reducing lifestyle habits is key to managing anxiety. Consider these recommendations for your patients:

  • Schedule downtime. Organize your day and allow time for interruptions and unplanned demands on your time.
  • Eat in a relaxed environment. The parasympathetic nervous system largely controls digestion. Good digestion is important for good health, so eat slowly and avoid a noisy or stressful environment.
  • Learn to say “no.” You can’t do everything yourself so delegate, train and depend on others to do some of the work.
  • Choose an enjoyable hobby. As children, we found joy in activities. Take note of what you find relaxing and fun and makes you laugh. It could be activities such as gardening, playing in a sports league, or spending time with a small group of friends.
3. NUTRIENT SUPPLEMENTATION FOR ANXIETY

Stress can deplete the body of critical nutrients and disrupt the balance of chemicals that maintain mood. Nutritional and botanical supplementation is important to help support the stress response and mood balance. Vitamins and minerals such as vitamins C and B6, zinc, magnesium and pantothenic acid (B5) are crucial to maintain health and manufacture stress response hormones and chemicals. 

Gamma-aminobutyric acid (GABA) is the most abundant inhibitory neurotransmitter for calming and mood balance.5 It, along with the amino acid L-theanine, help the nervous system promote relaxation by increasing alpha brain wave activity. Both also decrease beta brain wave activity, which is responsible for scattered thoughts. 

5-hydroxytryptophan (5-HTP) is an amino acid that plays an important role in the production of serotonin, a neurotransmitter associated with the feeling of wellbeing. In addition to supporting a positive mood, studies have shown serotonin encourages more restful sleep and supports healthy appetite regulation. 

Adaptogens are botanicals that enhance stress resilience by improving the body’s response to stress and decreasing its negative effects.6 They also improve mental and physical performance, increase energy and exhibit anti-anxiolytic effects. Adaptogens perform these tasks without any negative side effects. 

  • 5-HTP
  • Ashwaghandha7
  • Eleuthero8
  • GABA
  • L-theanine
  • Magnesium
  • Pantothenic acid
  • Rhodiola9,10,11
  • Vitamin B6
  • Vitamin C
  • Zinc
THE BOTTOM LINE

Managing anxiety is a process, but with targeted, natural therapies, you can help your patients overcome anxiety. A great method for patient compliance that I implemented into my practice was to offer options for patients to choose from. The more they like an activity or method, the greater the chance they will stick with it and use that technique for the rest of their lives! 

 

Stacey Smith, DC earned her doctorate in chiropractic from the National University of Health Sciences (NUHS) in Lombard, Illinois in 2004. She obtained two bachelor of science degrees, biochemistry from Michigan State University and human biology from NUHS. She worked alongside her chiropractic parents and brother in a family practice in Michigan for 16 years and focused on lifestyle and physical medicine. She continues her education of integrative evaluation and treatment practices through functional medicine coursework.

 

 

 

REFERENCES
  1. The Role of Stress and the HPA Axis in Chronic Disease Management, 2nd edition. Guilliams, T. ISBN: 978-0-9856158-7-1 
  2. Anxiety and Depression Association of America. https://adaa.org/understanding-anxiety/facts-statistics
  3. Textbook of Natural Medicine, 4th edition. Pizzorno, J, Murray, M. ISBN: 978-1-4377-2333-5
  4. Bellarosa C, Chen PY. The effectiveness and practicality of occupational stress management interventions: a survey of subject matter expert opinions. J Occup Health Psychol. 1997;2:247-262.
  5. Abdoua AM, Higashiguchia S, Horiea K, et al. Relaxation and immunity enhancement effects of gamma-aminobutyric acid (GABA) administration in humans. BioFactors. 2006;26:201-208.
  6. Daley, J. Adaptogens. J Complement Med. 2009;8(1):36:38.
  7. Auddy B, Hazra J, Mitra A, et al. A standardized Withania somnifera extract significantly reduces stress-related parameters in chronically stressed humans: a double-blind, randomized, placebo-controlled study. JANA. 2008;11:50-56.
  8. Davydov M, Krikorian AD. Eleutherococcus senticosus (Rupr. & Maxim.) Maxim. (Araliaceae) as an adaptogen: a closer look. J Ethnopharmacol. 2000;72:345-393.
  9. Hallstrom C, Fulder S, Carruthers M. Effect of ginseng on the performance of nurses on night duty. Comp Med East West. 1982;6:277-282.
  10. Darbinyan V, Kteyan A, Panossian A, et al. Rhodiola rosea in stress induced fatigue—a double blind cross-over study of a standardized extract SHR-5 with a repeated low-dose regimen on the mental performance of healthy physicians during night duty. Phytomedicine. 2000;7:365-371.
  11. Spasov AA, Wikman GK, Mandrikov VB, et al. A double-blind, placebo-controlled pilot study of the stimulating and adaptogenic effect of Rhodiola rosea SHR-5 extract on the fatigue of students caused by stress during an examination period with a repeated low-dose regimen. Phytomedicine. 2000;7:85-89.
  12. Olsson EM, von Scheele B, Panossian AG. A randomised, double-blind, placebocontrolled, parallel-group study of the standardised extract shr-5 of the roots of Rhodiola rosea in the treatment of subjects with stress-related fatigue. Planta Med. 2009;75:105-112.
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