Botanical Support For Anxiety

In my post last week, I discussed at length the use of kava (Piper mythesticum) for the treatment of anxiety. Kava is one of my favorite herbs—not only for its beneficial effects on the nervous system, but also because it appears to have unique anti-cancer properties. However, as with any herb, I recommend using it in combination with other herbs and nutrients. In my practice, I’ve found that combining herbs and nutrients enables me to create formulas that are far more effective than relying on a single herb. This is the traditional manner of practicing herbalism, and it is as much an art as it is a science.

Passion Flower

Stress, anxiety, and depression are common afflictions for those of us living in modern society, and the consequences of these emotional states affects not only our emotions, but also our bodies. Emotional distress causes a cascade of hormonal events that negatively influence the cardiovascular, immune, digestive, and reproductive systems, as well as the brain and nervous system. For this reason, I always begin with lifestyle recommendations to provide a foundation for stabilizing and strengthening the nervous system (for specific suggestions, see my post from last week).

Adaptogenic formulas are an essential part of my recommendations. This special class of botanicals, which includes herbs such as eleuthero (Eleutherococcus senticosus), ginseng (Panax ginseng), rhodiola (Rhodiola rosea), schizandra (Schizandra chinensis), and ashwagandha (Withania somnifera), provide foundational support that bolsters resistance to stress and encourages a sense of wellbeing. Adaptogens have been used in traditional medicine for thousands of years (they were often used as “longevity tonics”), and decades of modern research studies show that they gently regulate the neuroendocrine system, increasing adaptability to emotional and physical stressors.

In addition, I prescribe botanical formulas that provide a broad spectrum of support for the nervous system. In traditional herbal medicine we call these herbs “nervines.”  Nervines support and relax the nervous system while nourishing and strengthening it. They fortify the “Vital Spirit” and gently support the Kidney and Liver Networks as well (for more information, read the ETMS appendix of my book, Adaptogens in Medical Herbalism).  Whereas pharmaceutical drugs such as benzodiazepines and antidepressants merely sedate the nervous system, my goal is to:

  • Promote relaxation without drowsiness
  • Reduce nervousness (mental and physical)
  • Aid in sleep
  • Sustain calm energy and assist in stress management
  • Strengthen the nervous system
  • Calm the spirit

An additional benefit of botanical medicines is that there is no risk of harmful side effects or addiction, which is most definitely not true of pharmaceutical drugs. In choosing herbs and nutrients that are beneficial for stress, anxiety, and depression, I select those that have synergistic and tonic-like effects on the neurotransmitter, nervous and endocrine systems. This includes acting as GABA receptor agonists and/or boosting GABA levels. GABA (g-aminobutyric acid) is an inhibitory neurotransmitter that reduces nerve impulse transmission between neurons; low levels of GABA in the central nervous system are associated with anxiety, depression and insomnia. Other beneficial effects of botanicals include modulation of the stress hormone norephinephrine, and enhancing levels of serotonin (sometimes referred to as the “feel good” hormone).

One of the great benefits of botanical medicine is that plants have pleiotropic effects—which means that they have multiple benefits. So for example, when we’re treating anxiety and stress, we can at the same time be enhancing immunity, or bolstering cardiovascular health, or strengthening the body’s defenses against cancer. Herbs are complex in that they bathe cells with hundreds of compounds, some of which may have very specific and direct ways in which they work, while others are non-specific and play a supportive role. Herbal nervines are unique in that they quiet down the sympathetic nervous system while enhancing the parasympathetic nervous system. Not only does this help us to feel more relaxed, but it also may prevent illness and enable us to live a healthier and longer life. In addition to kava, which I discussed at length in last week’s post, the following are a few of my favorite botanicals for nervous system support:

Passionflower (Passiflora incarnata)

Passiflora was traditionally used in Eclectic medicine for stress, nervousness, and insomnia. Research shows that the plant contains many important health-promoting compounds including apigenin, luteolin, chlorogenic acid and chrysin.

Animal and human studies have demonstrated that passiflora preparations have antispasmodic, sedative, anxiolytic (anxiety relieving) and blood pressure normalizing activity. In a 2008 study using passiflora for pre-surgical anxiety, researchers noted a significant reduction in anxiety.[1] The constituent chrysin has been extensively studied, and has been shown to bind to benzodiazepine receptor sites in the brain, thus creating a mild relaxing effect. For the same reason, chrysin appears to aid in withdrawal from benzodiazepine addiction.[2],[3],[4]

Chrysin has also been shown to have a variety of other potent and beneficial effects, including a potential role in drug metabolism and the chemoprevention of carcinogenesis.[5] Laboratory studies indicate that chrysin inhibits the secretion of lysosomal enzymes and arachidonic acid, as well as the degranulation of mast cells, thereby reducing inflammation.[6] And chrysin’s aromatase inhibiting ability contributes to cancer suppressing action in breast and other estrogen-driven cancers.[7]

Ziziphus (Ziziphus spinosa)

In traditional Chinese Medicine (TCM), zizyphus (Ziziphus spinosa) seed is one of the primary herbs in formulas for treating insomnia and for “calming the spirit.” Zizyphus (jujube) seeds contain jujubosides, unique triterpenes that have a calming effect. Classified as a nutritive sedative, jujube soothes the mind, relaxes muscles, nourishes the blood, spleen and liver, helps to conserve energy, and acts as an analgesic. Laboratory studies have demonstrated the effectiveness of jujube in reducing pain and increasing pain tolerance, further substantiating its use as an analgesic.

In a study of 295 volunteers with mild to moderate sleep difficulties, a combination of Ziziphus spinosa seed and Magnolia officinalis bark was provided as a sleep aid. Participants completed a questionnaire to self-report tolerance and efficacy following a minimum of two weeks of treatment with one capsule one hour before bedtime. More than 80 percent of the subjects found that the herbal combination helped them to relax, assisted in restful sleep, and reduced fatigue due to lack of sleep.[8]

Skullcap (Scutellaria lateriflora)

Skullcap (Scutellaria lateriflora), a member of the mint family, was used by both Native American Indians and the Eclectic physicians to ease anxiety and stress.

In the Eclectic herbal tradition, skullcap extract was recommended for two specific indications: “The first is where there is irritability of the nervous system, with restlessness and nervous excitability; inability to sleep without pain; general irritability with insomnia from local physical causes. The second is where there is nervous disorder, characterized by irregular muscular action, twitching, tremors and restlessness, with or without incoordination.”

Skullcap has a soothing influence upon the nervous system that encourages quiet relaxation and restful sleep, without sedation. Combined with Avena sativa, it is the classic nervine duo for calming, tonifying, and regenerating the entire nervous system.[9]

Saffron (Crocus sativa)

Since ancient times, the dark red stigmas of saffron (Crocus sativus L.) flowers have been used to treat a wide variety of illnesses and disorders, including insomnia and anxiety. Research studies indicate that the primary active constituents in saffron—crocin and safranal—have anxiolytic (anxiety reducing) and hypnotic (sedative and sleep inducing) effects.[10]

Saffron is a rich source of carotenoids, which have been shown to increase the supply of oxygen in the blood, dissolve plaque and absorb cholesterol. Saffron has also been shown to lower blood pressure because of its artery cleansing effects.[11],[12] In addition, test tube studies show that saffron extract has inhibitory effects on carcinoma, sarcoma, leukemia, and several other malignant cells, and saffron was shown to increase the life span of treated tumor-bearing mice compared to untreated animals by 45–120%.[13]

Oat seed (Avena sativa)

The fresh extract made from the milky seed of Avena sativa strengthens and nourishes the nervous system. Traditionally, oat seed has been used for nervous exhaustion, anxiety, impaired sleep patterns, poor libido, and as a tonic for those who are “burning the candle at both ends.”  Milky oats are a nutritive tonic rich in minerals, particularly calcium and magnesium, which are important nutrients for the nervous system. Other beneficial constituents of milky oat seed include proteins, glycosides, flavones, and vitamin E.

Avena is a classic nervine tonic used to build energy and reduce stress. It is an excellent remedy for “feeding” the nervous system, helping to restore vital energy and to aid recovery from illness and prolonged stress. Avena has also been used to assist in recovery from various addictions including tobacco, cannabis and opium.

Magnolia bark (Magnolia grandiflora/officinalis)

Magnolia bark (Magnolia grandiflora/officinalis) has been used in traditional Chinese medicine (TCM) for centuries for treating “stagnation of qi” (low energy) as well as a variety of syndromes, such as digestive disturbances caused by emotional distress. Magnolia contains compounds (biphenols and eudesmol) that are reported to have anxiolytic effects, enabling enable better control of the stress hormone cortisol and thus modifying the stress response. Honokiol is the most significant of the constituents that have been researched; in numerous animal studies, honokiol has been shown to act as an anti-stress agent, while also acting as a potent suppressor of oxidative damage and cancer.

In a 2007 study, honokiol was compared with diazepam (Valium), a well-known pharmaceutical anxiolytic. Honokiol was found to be five times stronger than diazepam in reducing anxiety without the side effects of diazepam. While diazepam does reduce anxiety, it also induces muscle relaxation, an effect not shared by honokiol. It appears that honokiol is less likely than diazepam to induce physical dependence, central nervous system depression, motor nerve disruption, or amnesia at doses eliciting the anxiolytic effect.[14]


Theanine is an amino acid found in green tea (Camellia sp.) that produces tranquilizing effects in the brain. Clinical studies show that L-theanine creates a sense of relaxation approximately 30-40 minutes after ingestion via two different mechanisms: First, it directly stimulates the production of alpha brain waves, creating a state of deep relaxation and mental alertness similar to what is achieved through meditation. Second, L-theanine is involved in the formation of the inhibitory neurotransmitter, gamma amino butyric acid (GABA). GABA influences the levels of two other neurotransmitters, dopamine and serotonin, producing the key relaxation effect.[15]

Theanine also appears to be the common denominator in lowering blood pressure, improving cardiovascular health, and may be beneficial for patients with neurodegenerative diseases, such as Alzheimer’s disease. Laboratory studies indicate that theanine can reverse glutamate-induced toxicity, a major cause of degenerative brain disease.[16]

[1] Movafegh et al., 2008 A. Movafegh, R. Alizadeh, F. Hajimohamadi, F. Esfehani and M. Nejatfar, Preoperative oral Passiflora incarnata reduces anxiety in ambulatory surgery patients: a double-blind, placebo-controlled study. Anesth. Analg.,  106  (2008), pp. 1728–1732

[2] Moon YJ, Wang X, Morris ME. Dietary flavonoids: effects on xenobiotic and carcinogen metabolism. Toxicol In Vitro. 2006 Mar;20(2):187-210. Epub 2005 Nov 11.Wolfman C, Viola H, Paladini A, Dajas F, Medina JH. Possible anxiolytic effects of chrysin, a central benzodiazepine receptor ligand isolated from Passiflora coerulea., Pharmacol Biochem Behav. 1994 Jan;47(1):1-4.

[3] Salgueiro JB, Ardenghi P, Dias M, Ferreira MB, Izquierdo I, Medina JH. Anxiolytic natural and synthetic flavonoid ligands of the central benzodiazepine receptor have no effect on memory tasks in rats. Pharmacol Biochem Behav. 1997 Dec;58(4):887-91.

[4] Medina JH, Paladini AC, Wolfman C, Levi de Stein M, Calvo D, Diaz LE, Pena C. Chrysin (5,7-di-OH-flavone), a naturally-occurring ligand for benzodiazepine receptors, with anticonvulsant properties. Biochem Pharmacol. 1990 Nov 15;40(10):2227-31.

[5] Eaton, E.A. et al. Flavonoids, potent inhibitors of the human P-form phenolsulfotransferase. Potential role in drug metabolism and chemoprevention. (1996) Drug Metab Dispos, 24 (2): 232-7.

[6] Tordera, M. et al., Influence of anti-inflammatory flavonoids on degranulation and arachidonic acid release in rat neutrophils. (1994) Z Nuturforsch ICI, 49 (3-4): 235-240.

[7] Campbell DR, Kurzer MS, Flavonoids inhibition of aromatase enzyme activity in humans preadipocytes:, Biochem Pharmacol 1999 Aug 1; 58(3): 431-8

[8] Wing YK: Herbal treatment of insomnia. Hong Kong Med J. 2001,7(4):392-402.

[9] ELLINGWOOD, FINLEY M.D. American Materia Medica, Therapeutics and Pharmacognosy – Page 392, 1919

[10] Hosseinzadeh H, Noraei NB. Anxiolytic and hypnotic effect of Crocus sativus aqueous extract and its constituents, crocin and safranal, in mice. Phytother Res. 2009 Jun;23(6):768-74.

[11] Nair, S.C., etal. 1995.  Saffron chemoprevention in biology and medicine:  a review.  Cancer Biotherapy 10 (4):257-264.

[12] Escribano, J., etal. 1996.  Crocin, safranal and picrocrocin From saffron inhibit the growth of human cancer cells In vitro.  Cancer Letters  100 (1-2) : 23-30.

[13] Nair SC, Panikkar B, Panikkar KR. Antitumor activity of saffron (Crocus sativus). Cancer Lett 1991;57:109–114.

[14] Xu Q, Yi LT, Pan Y, Wang X, Li YC, Li JM, Wang CP, Kong LD. Antidepressant-like effects of the mixture of honokiol and magnolol from the barks of Magnolia officinalis in stressed rodents. Prog Neuropsychopharmacol Biol Psychiatry. 2007 Nov 28.

[15] Mason R. 200 mg of Zen; L-theanine boosts alpha waves, promotes alert relaxation. Alternative & Complementary Therapies 2001,April; 7:91-95

[16] Di X, Yan J, Zhao Y, Zhang J, Shi Z, Chang Y, Zhao B. L-theanine protects the APP (Swedish mutation) transgenic SH-SY5Y cell against glutamate-induced excitotoxicity via inhibition of the NMDA receptor pathway. Neuroscience. 2010 Jul 14;168(3):778-86. Epub 2010 Apr 21.

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