Would you start taking a hypertension medication without checking your blood pressure first? Well, when it comes to anti-anxiety medications, it seems millions of patients are given these medications every year without having an actual diagnosable anxiety. According to research published in the April 2011 edition of the Journal of Clinical Psychiatry, about 25% of people who are given these dangerous medications do not have a proper diagnosis. In many cases, these drugs are given as a way to suppress general mood issues or sedate people who cannot sleep.
These anti-anxiety and antidepressant medications are among the most prescribed in the United States - and possibly the most dangerous. According to a report in the 2010 Canadian Journal of Psychiatry, people who use anti-anxiety medication have a 36% increased mortality risk. That means persons using these drugs are almost 40% more likely to die than people who do not use them. Yikes.
There is no question that when absolutely needed, anti-anxiety medications can help calm dangerous situations and possibly take a patient out of harm's way. When used in this conservative way, they can save a life. But in many cases, this urgency is not present and only increases risk to life. Given the dire side effects, it does not make sense to pummel patients with these drugs when they are not needed. And even after an urgent situation has passed, many patients tend to remain on them indefinitely because doctors are not sure how to help patients wean off these, and/or prescribe non-pharmaceutical remedies.
Blunted Coping Skills
Besides the physical side effects, I also find in my clinical experience that these drugs hinder long-term coping skills. When you lift a heavy weight, there is muscle tearing and growth that happens which helps you the next time you lift that burden. Psychological difficulty and experience affords the same growth of our brain when we traverse challenging times. It seems the drugs do not allow this learning to happen.
For example, I had one patient who was placed on anti-depressants during the challenging time of divorce. Ten years after this traumatic event, she came in to see me because she wanted to discontinue the medication due to side effects, but every time she tried to stop, all those anxious feelings she thought were long gone came flooding back and became as present as ever. In truth, anxiety and depression are not Paxil or Prozac deficiencies - and at some point, the grief and anxiety that comes with trauma and loss will need to be processed. This patient and I decided on a regimen of acupuncture, some amino acids to cushion the neurotransmitter changes, and created a plan to start processing the divorce that had been swept under the pharmaceutical rug. Through this healing, she was able to slowly and safely wean off her medication.
So what does the natural medicine armamentarium have for mood disorders like anxiety? Although there is not one clear magic bullet treatment to take away all anxiety and mood problems, there are a number of wonderful choices that, when used in synergy, can help the anxious person regain composure, and control of her life.
The tenets of naturopathic care emphasize the importance of the basics: quality sleep, exercise, water intake, and good food. Each of these are helpful to reduce stress hormones in the body and raise the levels of calming brain chemicals such as serotonin and gamma amino butyric acid (GABA). Studies of people who perform outdoor activity among trees have shown lower levels of stress hormones. Those that get enough sleep have lower reactivity to stressful situations. And good food promotes a healthy digestive tract, where most of the neurotransmitters are made.
Certain supplementation can be beneficial as well. For instance, recent research suggests theanine (the relaxing component of green tea) can help calm anxiety even with difficult to treat schizophrenia and schizo-affective patients. Specific nutrients such as niacinamide, tyrosine and tryptophan may work on the same mechanisms as medications, but with minimal side effects. Magnesium, glycine, and vitamin B6 are important co-factors that can help the body's neurotransmitter production. I also recommend time-tested herbal remedies such as valerian, schizandra, and passiflora incarnata for short term help with unmanageable anxiousness.
Many studies support the use of meditation, qi gong and tai qi to help calm and center brain activity. In my clinic, acupuncture is a reliable remedy to help the mind and spirit rebalance, even if the conscious mind is not completely on board yet. It is also crucial to begin reprogramming unhealthy brain messages: sometimes I will read together with my patient Buddhist philosophy books to begin replacing negative thoughts with positive ones, while contemplating existential life questions that may be at the root of the anxiety.
There may be no one treatment for mood issues and anxiety. But, a thoughtful synergy of recommendations that address the various aspects of the body and mind can result in bringing anxiety under control while helping the brain process and heal.
Peter Bongiorno ND, LAc practices in New York, and recently authored Healing Depression: Integrated Naturopathic and Conventional Therapies and will be teaching Natural Approaches to Emotional Healing at the Open Center in New York City during the first three Wednesday evenings in August 2011. He can be reached by visiting InnerSourceHealth.com.
Partial Reference List:
Reference: Pagura J, Katz LY, Mojtabai R, Druss BG, Cox B, Sareen J. Antidepressant use in the absence of common mental disorders in the general population. J Clin Psychiatry. 2011;72(4):494-501.
Reference: Belleville G. Mortality hazard associated with anxiolytic and hypnotic drug use in the National Population Health Survey. Can J Psychiatry. 2010;55(9):558-67.
Reference: Ritsner MS, Miodownik C, Ratner Y, Shleifer T, Mar M, Pintov L, Lerner V. L-theanine relieves positive, activation, and anxiety symptoms in patients with schizophrenia and schizoaffective disorder: an 8-week, randomized, double-blind, placebo-controlled, 2-center study. J Clin Psychiatry. 2011 Jan;72(1):34-42.