Generalized Anxiety Disorder Contributions by sshowalter

Yoga is a great treatment for any health condition, even mood disorders like generalized anxiety disorder. In addition to being good for the body (with the poses and stretching) the conscious breathing and meditative states can help encourage an even-keeled state of being, thus calming anxiety.

Relaxation

There are many types of relaxation therapies, and they use a variety of techniques.

Some common relaxtion therapies are:

• Meditation
• Guided Imagery
• Visualization
• Aromatherapies
• Jacobson's progressive relaxation
• Autogenic training
• Applied relaxation
• Many more

However, regardless of which relaxation therapy is used, most of them share certain related features.

One of the great medical discoveries of the last century involved the identification of the nutritional substances necessary for life. Along with the “macronutrients” (fat, carbohydrate, and protein), these “micronutrients” make up the essential ingredients of a healthful diet.

Vitamins and minerals have been available as supplements since at least the 1930s. There are two main ways to use vitamins and mineral supplements: "megadose" and nutritional therapy.

To read more about these two types and which is recommended, read the main Nutritional Support page.

One study found that week-long oral treatment with lysine (2.64 g per day) and arginine (2.64 g per day) could reduce general levels of anxiety.⁵⁷

Relaxation

There are many types of relaxation therapies, and they use a variety of techniques.

Some common relaxtion therapies are:

• Meditation
• Guided Imagery
• Visualization
• Aromatherapies
• Jacobson's progressive relaxation
• Autogenic training
• Applied relaxation
• Many more

However, regardless of which relaxation therapy is used, most of them share certain related features.

1. American Music Therapy Association. Frequently Asked Questions. Accessed on July 15, 2010 from http://www.musictherapy.org/faqs.html
63. Horne-Thompson A, Grocke D. The effect of music therapy on anxiety in patients who are terminally ill. J Palliat Med. 2008;11:582-590.

Massage has been used for centuries to help relax the body and (subsequently) the mind. Because anxiety symptoms often exhibit a chicken-and-the-egg scenario where the body and the mind are both tense and aggravating one another, massage can help to relax both body and mind. (Massage is often done with essential oils - check out the article on generalized anxiety disorder and aromatherapy.)

With the right combination of herbs, the calming effects of aromatherapy can help to reduce anxiety.

Acupuncture (especially when used in conjunction with Chinese herbs) is said to help restore balance to the energy fields that run through the body. Acupuncture uses sterile, disposable, single-use, and hair thin needles which are inserted into points on the body that have scientifically and empirically validated therapeutic effects on the brain, nervous system, blood circulation, internal organs, and hormones. The brain and spinal nerves, when stimulated with acupuncture needles by a qualified Acupuncture Physician, can aid in treating the symptoms associated with many conditions including anxiety.

The mechanism of action is unknown, but gamma oryzanol is sometimes thought to be useful for treating generalized anxiety disorder.

Gamma oryzanol is a mixture of substances derived from rice bran oil, including sterols and ferulic acid. Rice bran oil is the principal source of gamma oryzanol, but it is also found in the bran of wheat and other grains, as well as various fruits, vegetables, and herbs. However, to get enough gamma oryzanol to reach typical therapeutic dosages, you will need to take supplements.

Gamma oryzanol is a mixture of substances derived from rice bran oil, including sterols and ferulic acid. Rice bran oil is the principal source of gamma oryzanol, but it is also found in the bran of wheat and other grains, as well as various fruits, vegetables, and herbs. However, to get enough gamma oryzanol to reach typical therapeutic dosages, you will need to take supplements. gamma oryzanol The mechanism of action is unknown, but gamma oryzanol is sometimes thought to be useful for treating generalized anxiety disorder.

As cultivation of hops for beer spread through Europe, it gradually became obvious that workers in hop fields tended to fall asleep on the job, more so than could be explained by the tedious work. This observation led to enthusiasm for using hops as a sedative. However, subsequent investigation suggests that much of the sedative effect seen in hop fields is due to an oil that evaporates quickly in storage.

Despite the absence of this oil, dried hop preparations do appear to be somewhat calming. While the exact reason is not clear, it seems that a sedating substance known as methylbutenol develops in the dried herb over a period of time.¹ It may also be manufactured in the body from other constituents of dried hops.

Linden flowers have a pleasant, tangy taste, and for this reason the tree is sometimes called “lime flower.” Besides use in beverages and liqueurs, linden flower has a long history of medicinal use for such conditions as colds and flus, digestive distress, anxiety, migraine headachesheadaches, and insomnia. The wood of the linden tree has been used for liver problems, kidney stones, and gout.

Galphimia Glauca is a homeopathic herb that has been tested for use as a treatment for GAD. Homeopathic remedies do not work in a direct or obvious way. Homeopathic theory has some relationship to ancient healing traditions, but in many ways stands uniquely on its own ground, unrelated to other approaches. The term "homeopathy" is formed from the combination of two Greek words: omio meaning “same” and pathos meaning "suffering." This reflects the homeopathic belief that a substance that causes certain symptoms in a healthy person can cure an ailing person of similar symptoms. This belief is the basis for how homeopathic remedies are formulated and recommended. Galphimia Glauca is an herb sometimes used in this homeopathic vein.

Galphimia Glauca is a homeopathic herb that has been tested for use as a treatment for GAD. Homeopathic remedies do not work in a direct or obvious way. Homeopathic theory has some relationship to ancient healing traditions, but in many ways stands uniquely on its own ground, unrelated to other approaches. The term "homeopathy" is formed from the combination of two Greek words: omio meaning “same” and pathos meaning "suffering." This reflects the homeopathic belief that a substance that causes certain symptoms in a healthy person can cure an ailing person of similar symptoms. This belief is the basis for how homeopathic remedies are formulated and recommended.

Native Americans as well as traditional European herbalists used skullcap to induce sleep, relieve nervousness, and moderate the symptoms of epilepsy, rabies, and other diseases related to the nervous system. In other words, skullcap was believed to function as an herbal sedative.

A relative of skullcap, Scutellaria baicalensis, is a common herb used in Chinese herbmedicine. However, the root instead of the above-the-ground portion of the plant is used, and overall effects appear to be far different. The discussion below addresses European skullcap (Scutellaria lateriflora)only.

Gotu kola is a creeping plant native to subtropical and tropical climates. Gotu kola has a long history of use in Ayurvedic medicine (the traditional medicine of India) to promote wound healing and slow the progress of leprosy. It was also reputed to prolong life, increase energy, and enhance sexual potency.¹ Other uses of gotu kola included treating skin diseases, anxiety, diarrhea, menstrual disorders, vaginal discharge, and venereal disease.

Based on these many traditional indications, gotu kola was accepted as a drug in France in the 1880s. British physicians in Africa used a special extract to treat leprosy.

There have been at least 11 placebo-controlled studies of kava, involving a total of more than 700 people.^{13,16,18,38,39,41-43, 55} Most found kava helpful for anxiety symptoms.

One of the best of these was a 6-month, double-blind study that tested kava's effectiveness in 100 people with various forms of anxiety.¹³ Over the course of the trial, they were evaluated with a list of questions called the Hamilton Anxiety Scale (HAM-A). The HAM-A assigns a total score based on such symptoms as restlessness, nervousness, heart palpitations, stomach discomfort, dizziness, and chest pain. Lower scores indicate reduced anxiety. Participants who were given kava showed significantly improved scores beginning at 8 weeks and continuing throughout the duration of the treatment.

This study is notable for the long delay before kava was effective. Previous studies had shown a good response in one week.^14,15,16 The reason for this discrepancy is unclear.

Several double-blind, placebo-controlled studies have specifically tested kava for the treatment of the anxiety that often occurs during menopause.^{15,16, 38} In one study, 40 women were given either kava plus standard hormone therapy or hormone therapy alone for a period of 6 months. The results showed that women given kava experienced greater improvement in symptoms than those given hormone therapy alone.

However, not all studies have been positive. One double-blind, placebo-controlled study failed to find kava effective for people with generalized anxiety disorder (GAD).³⁹ Another study failed to find kava more effective than placebo for people with both anxiety and insomnia.⁵⁵

Besides these placebo-controlled studies, one 6-month, double-blind study compared kava against two standard anxiety drugs (oxazepam and bromazepam) in 174 people with anxiety symptoms.¹⁸ Improvement in HAM-A scores was about the same in all groups. Another study found kava equally effective as the drugs buspirone and opipramol.^44 ^

A 5-week, double-blind, placebo-controlled trial studied 40 people who had been taking standard anti-anxiety drugs (benzodiazepines) for an average duration of 20 months.17 Participants were gradually tapered off their medications and switched to kava or placebo. Individuals taking kava showed some improvement in anxiety symptoms. This would appear to indicate that kava can successfully be substituted for benzodiazepine drugs. However, participants who were switched from benzodiazepines to placebo showed little to no increase in anxiety, suggesting perhaps that they didn't really need medication after all! Thus, the results of this study are hard to interpret.

Note: This trial involved close medical supervision and very gradual tapering of benzodiazepine dosages. Do not discontinue anti-anxiety medications without supervision. Withdrawal symptoms can be life-threatening.

One study purported to find evidence that kava helps reduce reactions to stressful situations.¹⁹ Although, the results mean little because the study lacked a placebo group.

There have been at least 11 placebo-controlled studies of kava, involving a total of more than 700 people.^{13,16,18,38,39,41-43, 55} Most found kava helpful for anxiety symptoms.

One of the best of these was a 6-month, double-blind study that tested kava's effectiveness in 100 people with various forms of anxiety.¹³ Over the course of the trial, they were evaluated with a list of questions called the Hamilton Anxiety Scale (HAM-A). The HAM-A assigns a total score based on such symptoms as restlessness, nervousness, heart palpitations, stomach discomfort, dizziness, and chest pain. Lower scores indicate reduced anxiety. Participants who were given kava showed significantly improved scores beginning at 8 weeks and continuing throughout the duration of the treatment.

This study is notable for the long delay before kava was effective. Previous studies had shown a good response in one week.^14,15,16 The reason for this discrepancy is unclear.

Several double-blind, placebo-controlled studies have specifically tested kava for the treatment of the anxiety that often occurs during menopause.^{15,16, 38} In one study, 40 women were given either kava plus standard hormone therapy or hormone therapy alone for a period of 6 months. The results showed that women given kava experienced greater improvement in symptoms than those given hormone therapy alone.

However, not all studies have been positive. One double-blind, placebo-controlled study failed to find kava effective for people with generalized anxiety disorder (GAD).³⁹ Another study failed to find kava more effective than placebo for people with both anxiety and insomnia.⁵⁵

Besides these placebo-controlled studies, one 6-month, double-blind study compared kava against two standard anxiety drugs (oxazepam and bromazepam) in 174 people with anxiety symptoms.¹⁸ Improvement in HAM-A scores was about the same in all groups. Another study found kava equally effective as the drugs buspirone and opipramol.^44 ^

A 5-week, double-blind, placebo-controlled trial studied 40 people who had been taking standard anti-anxiety drugs (benzodiazepines) for an average duration of 20 months.17 Participants were gradually tapered off their medications and switched to kava or placebo. Individuals taking kava showed some improvement in anxiety symptoms. This would appear to indicate that kava can successfully be substituted for benzodiazepine drugs. However, participants who were switched from benzodiazepines to placebo showed little to no increase in anxiety, suggesting perhaps that they didn't really need medication after all! Thus, the results of this study are hard to interpret.

Note: This trial involved close medical supervision and very gradual tapering of benzodiazepine dosages. Do not discontinue anti-anxiety medications without supervision. Withdrawal symptoms can be life-threatening.

One study purported to find evidence that kava helps reduce reactions to stressful situations.¹⁹ Although, the results mean little because the study lacked a placebo group.