Natural Practitioner — January/February 2012
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Natural Approaches To Treating Stress & Anxiety
Janet Poveromo

Wholistic practitioners offer a well-rounded dose of natural support for the overly stressed.

The stress level of most Americans (unsurprisingly) is quite high. Faced with today’s all-too-common issues, such as paying bills, finding work, raising children, a hectic lifestyle and any number of other daily challenges, it’s no wonder that many U.S. adults confess to being “stressed out.”

According to the 2010 Stress in America survey conducted by the American Psychological Association (APA), 44 percent of American adults said their stress levels have increased over the past five years. Survey findings further showed that the majority of Americans are living with either “high” (8 or more on a scale of 1-10) or “moderate” (4 to 7) levels of stress on a daily basis.

This type of unrelenting stress eventually has physical consequences. Some of the most common physical manifestations of stress reported included irritability (45 percent), fatigue (41 percent), lack of energy or motivation (38 percent), as well as occasional problems sleeping, indigestion, weight gain, hormonal balance and reduced libido, said the APA. And while Americans understand that this is not healthy, efforts to make changes can also be viewed as overwhelming and stressful.

Anxiety disorders are the most common mental illness in the U.S. with 19.1 million (13.3 percent) of the adult U.S. population (ages 18-54 years) affected. According to “The Economic Burden of Anxiety Disorders,” a study commissioned by the Anxiety Disorders Association of America (ADAA) and published in the Journal of Clinical Psychiatry, anxiety disorders cost the U. S. more than $42 billion a year, almost one third of the $148 billion total mental health bill for the U.S.

The Causes

Money (76 percent), work (70 percent) and the economy (65 percent) are cited as the greatest sources of stress for Americans, while family responsibilities (58 percent) and personal relationships (55 percent) round out the top five, according to the APA’s survey. Nearly half (49 percent) of adults reported that concern over job stability was a source of stress in 2010, compared to 44 percent in 2009. At the same time, fewer Americans are satisfied with the ways their employer help them balance work and nonwork demands (36 percent in 2010 compared to 42 percent in 2009).

“The causes of anxiety aren’t completely understood, but a number of factors— including genetics, brain chemistry and environmental stresses—appear to contribute to its development,” said Cheryl Myers, an integrative health nurse and chief science and education officer at Wisconsin-based nutritional supplement supplier EuroPharma. “Having a family history tends to increase the likelihood that an individual will develop an anxiety disorder. Abnormal levels of neurotransmitters in the brain, such as serotonin, dopamine and norepinephrine, can alter the way the brain reacts in certain situations, leading to anxiety. Traumatic events and chronic stress can also bring about anxiety disorders. Nutrition, or the lack thereof, can’t be ruled out either.”

“In my clinical experience, most people assign stress to the daily requirements of their jobs, often combined with obligations in their family life,” said Jaclyn Chasse, ND with New Hampshire-based Emerson Ecologics, supplement supplier to health care professionals. “In addition, financial stressors, relationship stressors and health concerns for self or loved ones can add to this burden of stress. Unfortunately, most people don’t experience stress from only one source, and if you are without a strong supportive network of people around you, these burdens can be even more difficult to bear.”

Realizing the potential negative health consequences of stress can be even more stress-inducing: heart disease, digestive problems, insomnia, depression, obesity, skin conditions and autoimmune diseases are just some of the health issues caused or exacerbated by stress.

What to Recommend

Almost every discipline in medicine values some approach to stress management. “Different practitioner groups share in common the need to care for the basic tenants of health: good nutrition, adequate sleep, physical activity, social support and living a balanced lifestyle,” said Dr. Chasse. “Each different practitioner type may also encourage additional stress management techniques, either behavioral or biochemical. For example, you may see an ayurvedic practitioner recommend yoga, or an acupuncturist recommend meditation. Most chiropractors and naturopathic doctors welcome a variety of these behavioral tools.

“Natural practitioners also often recommend biochemical support in the form of additional B vitamins or adaptogenic herbs, such as ginseng, ashwagandha, holy basil, rhodiola, reishi and much more,” she continued. “These can assist with healthy production of stress hormones and can support healthy energy levels even in those under physical or emotional stress.”

Ken Whitman, president of Texas-based Natural Vitality, maker of the Natural Calm magnesium supplement, said, “Due to the fact that magnesium is essential to so many functions including heart and bone health, most people are magnesium deficient and the list of magnesium deficiency systems is so long and inclusive of many common complaints, more natural practitioners are correcting low magnesium status early in treatment. Some actually prescribe magnesium first and have the patient come back in two weeks to see what, if any, complaints remain to be addressed.”

Whitman explained that bodily stress begins at a cellular level: when the cell is at rest, magnesium is inside the cell and calcium is outside the cell.When the cell is in its active state (such as the contraction of a muscle), calcium is inside the cell and magnesium is on the outside. “Then magnesium flows back into the cell pushing the calcium out through the calcium channels. Magnesium then blocks the calcium channels and the cell is again in its resting state,” he said. “This happens every time your heart beats, for example.

“In a magnesium-deficient state, the calcium continues to leak into the cells,” Whitman added. “The cells are never completely at rest. It is like having the current to a light half on. Unless the calcium channels are blocked, the cell will contract and not relax. This is the mechanism behind muscle cramps, headaches, etc. It is the anatomy of stress on a cellular level.”

Adoptogens

Herbalist and practitioner Trinity Ava, the national educator from Floridabased Organix-South, said a primary category of herbs she encourages natural practitioners and their patients to explore is adaptogens. “As many clinicians are already aware, adaptogens are a category of herbs or agents that help our body adapt to physical, biological, emotional and environmental stressors in a non-specific manner,” she said. “Meaning that these brilliant botanicals help to restore and preserve balance in the body and mind. The classification of an adaptogenic agent was officially defined in 1968, however the use of herbs for rejuvenation and longevity dates back many thousands of years. Adaptogens help our body/mind to be smart and more resilient, and they create a normalizing effect so that we are better able to maintain our individualized state of balance.”

Ava described her strategy for explaining herbal adaptogen formulas to clients. “Some practitioners might find it helpful to offer a taste test of the herbs intended for use prior to your custom formulation or offering them a formula from a manufacturer,” she said. “Have your client notice how their body responds by taste, smell and feel to one herb at a time, and then begin to create formulations that are energetically right for them based upon their feedback and your herbal knowledge. This participation also creates a deeper sense of empowerment, connection to themselves, connection to the plants and, most importantly, what the formula is offering them.”

She also suggested giving clients advanced warning about unpleasanttasting herbs. “Expect a good amount of laughter during the taste test,” she said. Some of the herbs that Ava recommends for stress relief include: ashwagandha (Withania somnifera), eleuthero— Siberian ginseng (Eleutherococccus senticosus), guduchi (Tinospora cordifolia), schisandra (Schisandra chinensis) and tulsi—holy basil (Ocimum sanctum).

While Organix South offers products, such as TheraVeda Stress Ease and TheraVeda Sleep Ease, Ava also suggested natural practitioners recommend TheraVeda Immune Support Formula for stressed-out clients. “I am mentioning this as it is like an herbal multivitamin and ideal for many for regular use.”

Trendsetting

Garnering much buzz in the natural products industry recently is curcumin, the principal curcuminoid found in the spice turmeric. “There has been increasing interest in applying curcumin to neurological health,” noted EuroPharma’s Meyers. The ingredient has been studied for its active role in the treatment of various central nervous system disorders— demonstrating neuroprotective properties in Alzheimer’s disease, tardive dyskinesia, major depression, epilepsy, and other related neurodegenerative and neuropsychiatric disorders, Myers said. EuroPharma offers CuraPro, a clinically studied, bioavailable curcumin product with a high antioxidant ORAC value, she noted.

Echinacea is one of the best-known herbal remedies in the world and is widely used to support immune system function. Myers singled out Echinacea angustifolia root extract for helping reduce anxiety and restore calm. “This effect has never been previously reported, even with millions of people worldwide using echinacea for immune support,” she said. That’s because only one species, grown in controlled conditions and processed using special extraction procedures, produces the echinacosides needed, she said. In addition, the high doses used for immune support don’t work for relieving anxiety. “The anxiety relieving effects are only produced at low doses by active compounds that work in a narrow therapeutic window of activity,” she added.

In the comparison study conducted at the Institute of Experimental Medicine, Department of Behavioral Neurobiology, Budapest, Hungary, five different echinacea preparations were tested in 30 human volunteers experiencing increased anxiety and tension. A standardized assessment tool was used to measure subjects’ feelings of stress or anxiety at baseline, and then again at days one, three and seven after taking the specialized extract. After only one day of use, the participants experienced a significant reduction on the anxiety measurement scale, which increased to a 25 percent reduction after one week. The participants did not have issues with drowsiness or confusion, and there was no interference with their daytime activities. Results of the study were published in Phytotherapy Research (November 2010). EuroPharma has exclusive rights to this extract for North America.

AnxioFit-1 by EuroPharma provides a specific type and ratio of echinacosides that are not found in any other echinacea product, Myers said. Study results on the product found that it not only met or exceeded effects, but also did not cause drowsiness, she added.

Ayurveda

Ayurvedic practitioner Amber Vitse, LMT, CN, director of ayurveda education at New York-based Nature’s Formulary, said well-recognized, commonly used herbs for stress are shankh pushpi (for mood and anxiety in Vata and Pitta dominant types) and ashwagandha (an adaptogen for stress management in Vata and Kapha types predominantly).

Vitse explained that shankh pushpi helps with mental stress and rejuvenating the mind, improving memory and concentration. “It can be used in mental and emotional exhaustion. Like brahmi or gotu kola, it increases circulation to the brain.”

An adrenal adaptogen, ashwagandha helps the body to physiologically manage stress. “Likened to ginseng, it aids in physical exhaustion or debility, but also in stress-induced insomnia,”Vitse said, also recommending pranayama, or breathing exercises, as suitable for each doshic imbalance.

“Chyawanprash is excellent for helping the body, especially the immune system, cope with the side effects of stress,” she said. “Bhringaraj and brahmi are excellent calming nervines good for all three doshas, and are often found in oil for application and inhalation. Tulsi is another favorite adaptogen for relieving stress and balancing the immune system, and there are several different kinds.”

Chyawanprash is a potent antioxidant paste, created by the synergistic blending of over 40 herbs and spices. “Due to the tannoid complexes that form in the preparation of this formulation, the vitamin C in the mix is much more potent and absorbable than ascorbic acid alone,” said Vitse. “Brahmi purges toxins and blockages from the nervous system, and can aid in all kinds of addictions and habits. Yogis take it to promote a clearer mind and improve meditation, as can any of us.”

Nature’s Formulary offers shankh pushpi and ashwagandha, sustainably wildcrafted or organic, and chyawanprash produced from the original recipe used for thousands of years. “Look for brahmi and bhringaraj oils, brahmi ghee, or teas,”Vitse added.“Many great companies produce tulsi, but it is quite enjoyable as a tea.”

While there have been numerous studies on the benefits of ashwagandha, Dr. Virender Sodhi, CEO of Washingtonbased herbal supplement marketer Ayush Herbs, noted a study published in the February 2005 Journal of Ethnopharmacology that suggested saffron may be effective for treating mild to moderate mood disorders. The small study, which looked at 38 people over six weeks, concluded that saffron was as effective as fluoxetine (Prozac) in reducing symptoms of depression.

Ayush Herbs recently introduced AyuDep, a proprietary ayurvedic formula featuring saffron, available to health care professionals for their patients.

In addition to supplements, Sodhi added, “If we can decrease our stress through balancing daily routines and supportive nutritional herbs, we are well on our way to better overall health, increased focus for dealing with life’s ups and downs, and a renewed perspective where we see challenges as opportunities.”

In a 2010 survey, 44 percent of American adults said their stress levels had increased over the previous five years.

Money, work and the economy are Americans’ greatest source of stress.

Magnesium deficiency is the anatomy of stress on a cellular level.

Herbal adaptogen formulas help the body adapt.

Shankh pushpi, ashwagandha, chyawanprash, bhringaraj and brahmi are commonly used in ayurveda for stress.

Good nutrition, adequate sleep, physical activity, social support and living a balanced lifestyle as well as yoga and meditation are encouraged for stress management.

FOR MORE INFORMATION:

American Psychological Association,
www.apa.org

Anxiety Disorders Association of America, www.adaa.org

Ayush Herbs Inc., (800) 925-1371, www.ayush.com

Emerson Ecologics, (800) 654-4432, www.emersonecologics.com

EuroPharma, (866) 598-5487, www.europharmausa.com

Natural Vitality, (800) 446-7462, www.naturalvitality.com

Nature’s Formulary, (800) 923-9338, ext. 10, www.naturesformulary.com

Organix-South, (800) 232-3142, www.organixsouth.com

Anxiety Action

Acob Teitelbaum, MD, a board certified internist and medical director of the national Fibromyalgia and Fatigue Centers and Chronicity, said that when it comes to treating anxiety, unfortunately, all that most doctors have to offer are medications, such as valium and antidepressants. “These are often not only addictive and ineffective, but also rife with side effects,” he said.

“Fortunately, natural therapies can be as or more effective. In addition, it is important to treat both the psychological and physical underlying causes.”

Here, Teitelbaum offers his thoughts on the best natural anxiety remedies:

Diet and Exercise:

• Increase your exercise (especially walking in the sunshine)

• Avoid sugar and caffeine

• Green tea

Nutrients:

• Vitamin B1: Very high dose thiamine (vitamin B-1) at 500 mg three times a day.

• Vitamin B3: Niacin (vitamin B3) is a natural tranquilizer—without being addictive. Some experts go so far as to call niacin “nature’s valium.”

• Vitamin B6: Pyridoxine (vitamin B6) is critical in the production of two brain chemicals (neurotransmitters) that prevent anxiety (GABA and serotonin). Low vitamin B-12 has also been shown to be associated with anxiety.

• Vitamin B5: Pantothenic acid (vitamin B5) is another B vitamin that is critical for the treatment of adrenal fatigue. Adrenal fatigue is a very common trigger for low blood sugar induced anxiety.

• Magnesium: Called the “antistress mineral,” magnesium relaxes muscles, helps sleep and relieves tension. Dropping magnesium levels can trigger hyperventilation/panic attacks (and even seizures if very severe), which are often relieved with magnesium therapy.

• Theanine: Research has shown that theanine works by two mechanisms. The first is that it increases alpha brainwave activity, creating a state of deep relaxation and mental alertness similar to what is achieved through meditation. Second, it is involved in the formation of the calming neurotransmitter, gamma amino butyric acid (GABA). It also naturally stimulates the release of the “happiness molecules” serotonin and dopamine.

• Passionflower extract: This is one of the best-known herbs for the treatment of anxiety. In fact, in South America when people are anxious, their friends often tell them to “go get a passion flower drink.”

• Magnolia bark: With a long history of use in traditional Chinese formulas, it relieves both anxiety and depression without leaving you feeling like you’ve been drugged.

Express Your Anger:

“From a psychological perspective, anxiety usually represents (often repressed) anger toward someone else or fear about a situation,” concluded Dr. Teitelbuam. “These feelings need to be acknowledged and expressed—and then released. You can tell when the anger is healthy because it will feel good to express it. When it stops feeling good, release it.”
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