Natural Remedies for Stress, Anxiety and Insomnia

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Epidemic is not too strong a word to describe the rates of stress we are currently seeing in the United States. More and more Americans live much of their time in a constant state of stress and anxiety, leading to fatigue, depression, burnout and physical illness. A Gallup poll reports that up to 25 percent of the American work force suffers from excess stress or anxiety. Any change in your environment can cause stress, whether related to work, finances, relationships or lifestyle. Even positive change can be stressful.

Fifteen percent of the U.S. population has had an anxiety disorder, and according to the National Commission on Sleep Disorders, one in five Americans suffer from stress-related insomnia. The conventional medical treatment for stress, anxiety and insomnia consists of prescription drugs, usually Valium, Xanax and Klonopin, or other highly addictive "benzodiazepines."

A modern office worker afraid of being chewed out by the boss experiences many of the same physiological events as a caveman of 50,000 years ago about to be chewed on by a saber-toothed tiger. The "fight or flight" response, the complex set of physical and psychological responses we call "stress," erupts spontaneously in a human body mobilized for danger. Just as the caveman could see only two options--fight or flight, the chronic stress that pervades our lives limits our vision in every way, narrowing our view of what's possible in our jobs, our relationships and our society.

At the same time, many of us believe that we can't afford to give up our stress level for fear that we would lose our "edge." We put off relaxing until we complete the next project, contract or term paper. However, research shows that a state of relaxed alertness allows us to work better and smarter. True health involves both mind and body. The workaholic style, based on pushing ourselves "just a little harder," is not the answer.

Our bodies pay a steep price for the years of stress. Sixty-percent of doctor visits are connected to stress and the physical ailments it can cause, and the cost to business is estimated at $50-75 billion dollars a year. Modern research shows that stress is a major contributor to our most pernicious diseases--heart disease, high blood pressure, arthritis and cancer. Yet medicine as a whole has failed to deal effectively in the prevention of these conditions. The best it can do is treat the symptoms, with little focus on the underlying causes. Faced with soaring costs, the frustrations of managed care and the failure of modern medicine to provide adequate solutions to critical health problems, Americans are seeking alternative solutions in ever-increasing numbers.

There is now a marked trend toward the use of natural substances rather than drugs in the treatment of stress, anxiety and insomnia. A significant advantage of herbs, or "phytomedicines" over the targeted "magic bullet" effects of synthetic drugs is that herbs are complex combinations of many ingredients with multiple actions. This increases the beneficial effects while reducing possible side effects.

KAVA
A South Pacific herb called kava-kava, or just plain "kava," may be the perfect remedy for today's frantic, stress-filled lifestyle. It has been used ceremonially for centuries as a ritual drink and social beverage, as well as a medicine for a variety of ailments. Its long history of communal use has served to foster connection, communication and even conflict resolution. Modern clinical experience has shown it to promote similar effects; for example, with couples undergoing marital therapy.

Already commonly prescribed in Europe, scientific studies confirm that kava is as effective as Valium-type relaxants (benzodiazepines) in treating moderate anxiety, but without their sedative effects. One four-week German study of patients diagnosed with anxiety found that the participants experienced dramatic improvements after just one week of use, with the improvement continuing through week four. For 101 patients over a six-month period, the largest and longest study to date, kava gave significant relief of anxiety versus the placebo, or "dummy" pill, and with minimal side effects.

Kava is able to relax both muscles and emotions, reduce excessive mind chatter, increase focus and expand overall awareness, all without addiction, habituation, side effects or even a prescription. While a low daytime dose calms without sedating, in higher doses kava is a natural sleep enhancer.

Dosage: Kava is available in various forms--tinctures, tablets and capsules. The recommended daily adult dose is 135-250 mg of standardized extract containing 30 percent kavalactones (40-75mg total kavalactones) taken two to three times daily. It can also simply be used as needed for specific anxiety-producing situations such as a plane flight or a job interview. To induce sleep the dose is twice to three times that amount. Taken in these typical doses, kava possesses no known side effects or toxic consequences. Unlike the benzos, it does not suppress REM (rapid eye movement) or dream stage sleep which is essential to our emotional, mental and physical well-being.

VALERIAN, ST.-JOHN'S-WORT AND MORE
Other herbs and supplements can be used in combination with kava, including valerian, a natural tranquilizer in its own right. The usual dose is 50-100 mg 2-3 times daily for relaxation, and 150-300 mg about 45 minutes before bedtime, using standardized 0.8 percent valeric acid.

Anxiety is often combined with depression, making the natural antidepressant, St.-John's-wort, particularly useful. Besides enhancing the mood elevating chemical messengers (neurotransmitters) such as serotonin, it also has a calming effect, likely due to its action on the benzodiazepine receptor sites in the brain. Research shows it to be often as effective as prescription antidepressants but without their side effects. There is no addiction or withdrawal or problem when combined with alcohol, nor are there any accompanying food restrictions. The dose is 300 mg 3 times daily of a standardized extract of 0.3 percent hypericin.

Siberian Ginseng, known as an adaptogen, helps the body cope with stress. At doses of 200 mg 2-3 times daily it will support the adrenal glands, an essential part of our stress-fighting system that often becomes depleted.

Various vitamins and minerals are likewise needed, especially the B vitamins and the minerals, calcium, magnesium and potassium which are all depleted during stress. B vitamins are required for the smooth running of the nervous system and the production of adrenal hormones. The minerals have a relaxing effect on the body and emotions.

I have had patients with panic disorder, a severe form of anxiety disorder, who responded well to the combination of kava and St.-John's-wort, plus a vitamin and mineral regimen, with emphasis on the B vitamins and magnesium.

Supplements, however, are not a substitute for a proper diet and good diet helps to balance our moods and energy. We are "running on empty" if we do not replenish our stores of raw material that run our inner chemical factory.

Add lifestyle enhancers such as meditation, exercise, massage and other types of self-care for a well-rounded stress-reduction program. In many cases exercise alone goes a long way toward enhancing mood, calming anxiety and overcoming insomnia. The combination of all of the above, from herbs to diet and exercise to specific anti-stress techniques, can lead you out of the stress trap and into a more relaxed, healthy and fulfilling lifestyle.

For additional information see the following:

Cass, Hyla, and McNally, Terrence. Kava: Nature's Answer to Stress, Anxiety, and Insomnia (Prima Publishing, 1998). Review of physiology, diagnosis and treatment of stress, anxiety and insomnia, and the use of this herb in their treatment. Clinical cases, together with the history and politics of herbs in the U.S., give added dimension. To assess the number and severity of stressors to which you are exposed, and the anxiety symptoms you may be experiencing as a result, see specific self-administered questionnaires. (Paperback $13)

Cass, Hyla. St. John's Wort: Nature's Blues Buster (Avery Publishing, 1998).Combining clinical experience with a review of the scientific literature, this book provides a practical guide to the use of St.-John's-wort, alone or in combination with a variety of other supplements, and provides many case examples. (Paperback $9.95).

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By Hyla Cass, M.D.

Adapted by M.D.

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