Anxiety disorders are the most common types of psychiatric disorder. The diagnosis is based largely on its symptoms. However, symptoms identical to those of an anxiety disorder, or an attack, can be caused by a medical condition (for example, an overactive thyroid gland) or by the use of drugs (for example, corticosteroids, amphetamines, cocaine, or excess caffeine).

What about a natural stress and anxiety treatment?
There are several supplements and herbs that may help reduce anxiety and stress. Please discuss with your health care provider before using these natural treatment options to make sure they are appropriate for you. Do not expect these anti-anxiety nutrients to be as powerful as Valium and Xanax, however their side effect profile is generally much safer. Stop or dramatically reduce all caffeine intake, particularly coffee, since caffeine can cause anxiety.

5-HTP pills reduces anxiety by increasing levels of serotonin. This supplement often works within hours, and some studies say hydroxytryptophan, a serotonin precursor, may be helpful in panic attacks. 5HTP is a good anxiety treatment for those whose depression is associated with anxiety, restlessness, or racing thoughts. 5-HTP supplement is also available over the counter usually at 50 mg or 100 mg. I suggest using low dosages of 50 mg a day for a few days and then take less or more depending on your response.
Passion flower helps to calm nerves and muscles and is a good treatment for those whose anxiety is mild or moderate.
Valerian is able to reduce anxiety as demonstrated in a few studies but results of studies have not been consistent.
Hops helps relax and induces sleep. Hops is a good option for nighttime use since it causes sleepiness.
Ashwagandha is an Ayurvedic herb with relaxation and mood balancing properties.
Tryptophan is an amino acid that helps form serotonin.

Kava is from the South Pacific islands and is a good nerve and muscle relaxer. Anti-anxiety effects usually noticed within a couple of hours. Kava is good for stress relief and also social anxiety. Kava should not be used more than three times a week and a full week off needs to be taken after every two weeks of use. Kava is not recommended for children or teenagers, only for adults who do not have liver problems or taking medicines that harm the liver.

Kava treatment in patients with anxiety.
Phytother Res. 2004 Apr.
In several clinical trials, mainly conducted with a dose of 300 mg kava extract per day, kava has been employed successfully for such treatment. Our study concludes that 150 mg kava extract  per day is an effective and safe treatment of non-psychotic anxiety disorder syndromesn.

Fish Oils help stabilize mood, takes several days of high doses to have an effect
St. John's Wort in low doses works within days. High doses of St-Johns wort can cause restlessness.
GABA - some people like the amino acid GABA although I personally have not noticed much of an effect from this neurotransmitter supplement based on limited experimentation. An amino acid that may be helpful in reducing tenseness is L-theanine.
We had an email from someone who mentioned that mucuna pruriens was helpful to him as a means to overcome social phobia. I would be interested to see if others have a similar reaction.
Skullcap herb

I have been looking into purchasing an anti- anxiety supplement due to my personal bouts. There seems to be a large number of anti-anxiety supplements on the market and was wondering if you have a particular recommendation. Also, there is one supplement that appears to combine three active herbs into one formulation with passion flower, ashwagandha and valerian root. Is it ok to combine these three ingredients?
   I suggest starting with low doses of one anti anxiety supplement at a time, learning full well on how each works by itself, and then mixing two together, learning about this combo, and then 3, etc.

I feel that I have depression and anxiety. Is this common? Also, my brother has OCD, any supplements for this condition?
   Yes, anxiety and depression often coexist. In this case, 5HTP works better than SAM-e since SAM-e can cause anxiety in high doses. See obsessive compulsive disorder for more information.

I have been on Lexapro for social / general anxiety at least 6 years. I had initially tried Paxil but it did not affect on anxiety and caused horrible anorgasmia. Lexapro has generally been great for anxiety but over the last few years libido loss, and mild anorgasmia have increased. I have begun looking into natural alternatives, and initially thought 5-htp had promise, but after reading your site, it appears that SSRI or herbal increases in seretonin will affect these. I have a new fiance and she has difficulty understanding why I cannot always climax with her. I decreased my Lexapro dosage and orgasms came a little easier but after some time so did the anxiety. Now she has to deal with either my unexplainable worries or delayed ejaculation. She chooses the former, but I really dislike the anxiety. I know you can't give me specific advice, but I was curious which natural anti-anxiety supplements I might research? Or combinations of Passion Rx or what not.
    5-HTP and kava reduce sex drive, but ashwagandha and passion flower do not, in fact ashwagandha also helps with sexual enhancement.

Yoga practice does more than increase flexibility, strength and muscle tone. Yoga improves concentration and motivation and lessens stress.

Supplements that could aggravate this condition
SAM-e is used for depression. In high doses, SAM-e may increase anxiety and restlessness. There are several herbs with stimulant properties that may also induce jitteriness or restlessness, including tongkat ali herb and ginseng herb. Avoid the amino acids tyrosine and phenylalanine.

This natural relaxation aid was formulated to be used in the evening in order to provide natural help for tension and stress relief after a difficult day. Good Night Rx also helps ease your tension before you go to sleep and this product helps those with occasional sleepless nights. Good Night Rx can help you relax and provide a deeper sleep than you would otherwise.

Are there any herbs or supplements that are good for anxiety reduction that do not affect the heart?
   The herbs or supplements listed above are not known to cause heart problems if used in low dosages.

I've been to various psychiatrists in the past for anxiety / depression issues and I tried taking the mainstream antidepressants with little improvement. In fact, they often times would make my condition worse. I don't always have high anxiety but when I do, it gets to be a nuisance. Of all the products listed on your site, which do you personally feel might help a person such as myself? I'm not asking for dosages, etc. just a personal opinion of your own, for what you feel offers the best symptom relief.
   It's difficult to say since some people like 5htp, others respond better to passionflower, tryptophan, kava, and others. It is difficult to know which supplement and in what dosage a person will respond to without trying it for a week or two. Some people like to alternate them.

Symptoms and signs
Patients with generalized anxiety disorder experience worry and a number of physical and psychological symptoms. Anxiety disorder is frequently difficult to diagnose because of the variety of presentations and the common occurrence of other medical or psychiatric conditions. The lifetime prevalence is approximately 4 to 6 percent in the general population and is more common in women than in men. It is often chronic, and patients with this disorder are more likely to be seen by family physicians than by psychiatrists. Anxiety and depression often coexist.

An anxiety attack leads to several symptoms that include: rapid heart beat, pounding heart or palpitations, sweating, shaking visibly or inside, choking sensations or lump in throat, shortness of breath, chest pain or discomfort, nausea, bloating, or abdominal discomfort, dizziness or unsteadiness. Other anxiety attack symptoms include fear of losing control or a feeling of going crazy, chills and sweats, and numbness in extremities. 

Medication
The medications used in anxiety  treatment have changed over the last few years. A lot of the anxiety treatment medications that were used caused a number of problems including psychological dependence such as withdrawal symptoms including anxiety, irritability, anorexia nervosa, confusion and nausea. These are also the symptoms that the medications are meant to relieve. These days treatment usually involves either anxiolytics (anti- anxiety medication) or the more modern antidepressant medications. This is understandable as depression and anxiety are closely linked. Common anxiety medication options include SSRIs drugs such as Prozac, benzodiazepines such as Xanax, beta blockers such as propranolol, and tricyclic antidepressants. The benzodiazepines are used for short-term treatment, but because of the frequently chronic nature of generalized anxiety disorder, they may, in some people, need to be continued for months to years. Buspirone and antidepressants are also used for the pharmacologic management of patients with GAD.

Medication withdrawal
What supplements or any other courses of actions would you recommend for long term use benzo tapering / withdrawal, to ease the ill effects?

I have recently begun the process of tapering from clonazapam. Has any of your research has addressed the use of supplements to facilitate withdrawal from anti-depressant and anti-anxiety medications?
   One can gradually reduce the drug and gradually increase the dosage of an anti-anxiety supplement. Each person is unique and hence no definite dosages or particular supplements can be suggested with any certainty. It may be a process of trial and error along with medical supervision.

Children
Panic disorders, phobias and other childhood anxiety disorder conditions should be treated during childhood so that they won't be carried over into adulthood. Children usually grow out of such fears or can be treated for them through a variety of means, including play therapy or cognitive behavioral treatment, the best-known treatment for anxiety disorders in children and adolescents.

Social phobia
Do you have any supplements for phobia especially social phobia? if not will you be releasing any new product for phobias in future?
   We don't have any supplements for phobia or social phobia at this time, we will look into it, but it is possible that some of the supplements used for anxiety may be helpful for phobia.