Natural treatments for stress

• PRINCIPAL PROPOSED NATURAL TREATMENT: Panax ginseng

• OTHER PROPOSED NATURAL TREATMENTS: Adrenal extracts, alternative therapies (such as biofeedback, guided imagery, hypnotherapy, massage, relaxation therapy, Tai Chi, and yoga), ashwagandha, astragalus, bach flower remedies, Eleutherococcus senticosus, gamma-aminobutyric acid, kava, lysine plus arginine, maitake, multivitamin-multimineral supplements, phosphatidylserine, reishi, rhodiola, schisandra, shiitake, suma, theanine from black tea, tyrosine, valerian

DEFINITION: Treatment of conditions associated with emotional, mental, and physical stress.

Introduction

The effects of stress on health can be far-reaching. Some conditions often associated with stress include insomnia, high blood pressure, tension headaches, anxiety, depression, decreased mental function, and drug or alcohol abuse. Stress is known to cause changes in the body’s chemistry, altering the balance of hormones in ways that can lower our resistance to disease. As a result, people can become more susceptible to colds, flu, and other types of illness. Too much stress sometimes brings on outbreaks of cold sores or genital herpes for people who carry these viruses. Other chronic diseases such as irritable bowel syndrome, asthma, inflammatory bowel disease, and rheumatoid arthritis may also flare up during times of stress.

Avoiding situations that cause one to feel tense, unhappy, or worn down is beneficial. However, it is not possible to live a stress-free existence. Work deadlines, family demands, relationship problems, traffic jams, missed appointments, forgotten birthdays, personality conflicts, college exams—all these things, and many more, can be sources of stress. Even wonderful events, such as weddings, vacations, and holidays, can be stressful. However, everyone perceives and processes stress differently, and how one manages stress can determine its impact.

There are many methods of dealing with stress. Practicing the basics of good health helps in coping with stress—eating a balanced diet and getting adequate rest helps the body adapt and respond to life events. Ironically, stress can interfere with one’s ability to care for oneself this way. When a person worries so much that they cannot sleep, getting adequate rest becomes impossible. Stress can also impact eating habits. Many stress management tools can help a person break from a stress-induced downward spiral, including exercise, meditation, and biofeedback.

For some people, stressful circumstances can trigger symptoms severe enough to warrant seeking medical attention. Conditions associated with stress, such as insomnia, anxiety, depression, and panic attacks, may become severe enough to require medication.

Principal Proposed Natural Treatments

One proposed natural approach to treating the physical consequences of stress involves the use of adaptogens. The term “adaptogen” refers to a hypothetical treatment described as an adaptogen that helps the body adapt to stresses of various kindsheat, cold, exertion, trauma, sleep deprivation, toxic exposure, radiation, infection, or psychological stress. Furthermore, an adaptogen should cause no side effects, be effective in treating a wide variety of illnesses, and help return an organism toward balance no matter what may have gone wrong.

However, physical exercise is the only indubitable example of an adaptogen. There is no solid evidence that any substance functions in this way. However, there is some suggestive evidence for the herb Panax ginseng.

Panax ginseng. Most of the evidence cited to indicate that Panax ginseng has adaptogenic effects comes from animal studies involving ginseng extracts injected into the abdomen. Such studies are of questionable relevance to the oral use of ginseng by humans; furthermore, most of these studies were performed in the former Soviet Union and failed to reach acceptable scientific standards. However, a few potentially meaningful studies in humans have found effects that are at least consistent with the possibility of benefits in stressful situations.

Animal studies. According to a number of animal studies, most of which were poorly designed and reported, P. ginseng injections into the bloodstream or abdomen can increase stamina; improve mental function; protect against radiation, infections, toxins, exhaustion, and stress; and activate white blood cells. However, when ginseng is injected into the abdomen or bloodstream, it enters the body directly without going through the digestive tract. This mode of administration is strikingly different from taking ginseng by mouth.

A smaller number of animal studies (again, most of them poorly designed) have looked at the potential benefits of ginseng administered orally and have often reported benefit. In addition, studies in mice found that consuming ginseng before exposure to a virus significantly increased the survival rate and number of antibodies produced.

Human studies. Human studies of P. ginseng have only indirectly examined its potential benefits as an adaptogen. For example, a double-blind, placebo-controlled study found evidence that P. ginseng may improve immune system response. This trial enrolled 227 participants at three medical offices in Italy. One-half were given ginseng at a dosage of 100 milligrams (mg) daily, and the other one-half received placebo. Four weeks into the study, all participants received influenza vaccine.

The results showed a significant decline in the frequency of colds and flu in the treated group, compared with the placebo groupfifteen versus forty-two cases. Also, antibody levels in response to the vaccination rose higher in the treated group than in the placebo group. Some researchers have taken these findings to support their belief that ginseng has an adaptogenic effect. However, the study might instead simply indicate a general form of immune support unrelated to stress.

In another study which compared the ability of P. ginseng to treat depression to the impacts of the common antidepressant fluoxetine (Prozac), found that people who used the natural product experienced similar results. The ginseng lowered stress, which led to less depression and better memory.

Other studies have looked at P. ginseng’s effects on overall mental function, general well-being, and sports performance. While it is true that positive results in such studies might tend to hint at an adaptogenic effect, the results were, in general, too mixed to provide conclusive evidence for benefit. It is not clear that P. ginseng offers general benefits for stress.

Other Proposed Natural Treatments

Multivitamins plus minerals. A treatment as simple as multivitamin-multimineral tablets may be helpful for stress. In a double-blind, placebo-controlled study, three hundred men and women were given either a multivitamin-multimineral tablet or placebo for thirty days. The results showed that people taking the nutritional supplement experienced less anxiety overall and an enhanced ability to cope with stressful circumstances. The supplement used in this study supplied the following nutrients and dosages: vitamin B₁ (10 mg), vitamin B₂ (15 mg), vitamin B₆ (10 mg), vitamin B₁₂ (10 micrograms), vitamin C (1,000 mg), calcium (100 mg), and magnesium (100 mg).

Benefits were seen in another double-blind, placebo-controlled trial that enrolled eighty healthy male volunteers. The supplement used in this trial was similar but not identical.

Eleutherococcus senticosus. In the 1940s, the same scientist who first dubbed P. ginseng an adaptogen decided that a much less expensive herb, Eleutherococcus senticosus, is also an adaptogen. A thorny bush that grows much more rapidly than true ginseng, this plant later received the misleading name of “Siberian ginseng” or “Russian ginseng.” Its chemical makeup, however, is unrelated to that of P. ginseng.

As with P. ginseng, many animal studies finding adaptogenic benefits with Eleutherococcus have been reported, but most were relatively poorly designed and used injections rather than oral administration of the herb, making the results not particularly relevant to the normal human usage of the herb. Numerous human trials of Eleutherococcus have been reported as well, some involving enormous numbers of participants. However, most of these were not double-blind, and many were not even controlled, making the results nearly meaningless.

As with P. ginseng, a few reasonably well-designed human studies have been reported that may have indirect bearing on the herb’s potential adaptogenic properties. For example, in one double-blind trial, participants took either ten milliliters of extract of Eleutherococcus or placebo three times daily for four weeks. Blood samples were analyzed to determine changes in immune cells. A statistically significant increase in numbers of cells important to immune functions was observed in the treatment group compared with the placebo group.

This study has been widely advertised as proving the Eleutherococcus strengthens immunity. However, mere changes in immune cell profile do not automatically translate into enhanced immunity. More meaningful data were obtained in a double-blind, placebo-controlled study involving ninety-three people who experienced recurrent flare-ups of herpes. The use of Eleutherococcus significantly reduced the severity, frequency, and duration of herpes outbreaks relative to placebo during the six-month trial. This study does suggest a possible immune-strengthening effect.

Like P. ginseng, Eleutherococcus has been studied for enhancing sports performance, but published studies have not been encouraging. One small, double-blind, placebo-controlled trial of endurance athletes found that the use of Eleutherococcus actually may increase physiologic signs of stress during intensive training.

Other possible adaptogens. Three small double-blind trials suggest that the herb rhodiola (Rhodiola rosea) may improve mental alertness in people undergoing sleep deprivation or other stressful circumstances. Rhodiola contains several phytochemicals—phenylpropanoids, flavonoids, phenylethanoid derivatives, monoterpene derivatives, Triterpenes, and phenolic acids—that are credited for rhodiola’s ability to aid in human stress. In a small study evaluating the resilience of individuals taking rhodiola supplements, researchers reported positive findings after only a few weeks. However, the study was small, and confirmatory data is necessary.

Numerous other herbs are also adaptogens, including ashwagandha, astragalus, maitake, reishi, shiitake, suma, and schisandra. However, there is little evidence that they have adaptogenic effects. One study failed to find greater adaptogenic effects with fish oil compared with placebo.

Greenery. Several studies have found that spending time in nature or surrounding one's self with greenery improves mood, decreases stress, and aids in overall well-being. Some studies found that even a small amount of greenery, such as potted plants in an office or living space, or a green wall improved stress levels. As few as twenty minutes walking in nature appears to improve human functioning and outlook.

Other options. Preliminary evidence, including small double-blind trials, suggests that the amino acid tyrosine may improve memory and mental function under conditions of sleep deprivation or other forms of stress. Another double-blind study found that the use of vitamin C at slow release doses of 3,000 mg daily reduced both physical and emotional responses to stress.

In small double-blind studies, theanine, a constituent of black tea, appeared to reduce the body’s reaction to acute physical or psychological stress. Benefits have also been seen with a combination of lysine (2.64 grams per day) and arginine (2.64 grams per day).

One double-blind study found evidence that a processed form of casein (a protein found in milk) may reduce a variety of stress-related symptoms. According to another small double-blind trial, a mixture of soy phosphatidylserine and lecithin may decrease the physiological response to mental stress. Another study evaluated the use of phosphatidylserine for reducing stress in golfers, but the benefits seen failed to reach statistical significance.

A proprietary Ayurvedic herbal formula containing Bacopa monniera and almost thirty other ingredients has shown some promise for treating symptoms of stress. In a three-month, double-blind, placebo-controlled trial of forty-two people in high-stress jobs who complained of fatigue, participants using the herbal formula reported fewer stress-related problems. Also, in a three-month, double-blind, placebo-controlled study of fifty adult students, this formula appeared to improve memory and attention and to reduce other signs of stress.

In naturopathic medicine, adrenal extract is often recommended for the treatment of stress, but there is no evidence that this treatment is effective. Equivocal evidence hints that valerian, alone or with lemon balm, might reduce anxiety symptoms during stressful situations.

Many people report experiencing stress relief using alternative therapies such as biofeedback, guided imagery, hypnotherapy, massage, relaxation therapy, Tai Chi, and yoga. One study failed to find regular massage more effective for controlling stress than following a relaxation recording. Another study failed to find either cognitive behavioral therapy or increased physical activity helpful for stress-related illnesses. Further research reported that yoga can reduce stress by changing an individual’s psychosocial resources, offering time for introspection, and altering the perception and natural reaction to stress. Many other studies found similar results for other physical activities like Tai Chi and Qigong, but the benefits greatly varied by individual.

Three studies failed to find Bach flower remedies helpful for situational anxiety (anxiety caused by stressful situations). Further research was unable to find any scientific basis for their efficacy, but they remain relatively popular for self-treating stress, anxiety, depression, emotional and physical trauma, cancer, and HIV.

Bibliography

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