"That terrible event could happen, and I might not be able to deal with it, but I've got to be ready to try."
This is how the feeling of anxiety can be put into words, according to world-renowned and award-winning U.S. psychologist professor David Barlow (1).
While it may be normal to feel anxious sometimes, a continuous or excessive state of anxiety is not. Instead, it can lead to a medical condition called anxiety disorder.
Without proper management, it can literally turn your life into a daily struggle and make normal everyday activities seem impossible.
So how can you prevent that? If you are looking for both natural and scientific ways to cope with anxiety, then you are at the right place.
In this article, we will break down the science of anxiety and the anxiolytic effects of the most potent natural adaptogen - ashwagandha.
What is anxiety?
Anxiety is an emotion that starts in the amygdala - an area of the brain that manages emotional responses, including fear and aggression.
Although anxiety and fear may sound similar, it's essential to differentiate between them.
Fear is an adaptive response in the face of imminent danger that puts you in a "fight-or-flight" mode. It is evolutionarily programmed in your brain to help you survive critical situations, and it's common to most living species.
On the other hand, anxiety is "a person's conscious state of worry over a future unwanted event or actual situation" (2).
When experiencing anxiety, your body has the same "fight-or-flight" stress response, but it's usually unreasonable, excessive, and disproportionate to the triggering event.
Nevertheless, it's natural to feel unease or tension in certain situations, like when going to a job interview, during an exam, or when you are about to talk for the first time to someone you like.
Anxiety becomes a medical problem when it impedes how you function and interferes with your daily life. This usually happens when the feeling continues or keeps recurring for many weeks, months, or years.
Furthermore, the symptoms often worsen over time, even though the stressful event has passed or never occurred in the first place.
When your body remains in "fight-or-flight" for too long, it continuously produces stress hormones such as adrenaline and cortisol.
While the short-term release of these substances may be beneficial, prolonged exposure can have a detrimental effect on your health and leads to some of the most common symptoms of anxiety disorders.
How do you know if you have anxiety?
If you struggle with excessive worrying, agitation, and restlessness, which affect your daily functioning, this may indicate an anxiety disorder.
Due to the persistence of the condition, you may experience symptoms such as:
- chronic fatigue
- trouble concentrating
- sleeping problems
- tense muscles
- panic attacks
Anxiety disorder is diagnosed if your complaints continue for at least 6 months. But regardless of how long you have had symptoms, you should always consult with a medical doctor if your emotions are interfering with your life.
Currently, the condition is estimated to affect more than 40 million Americans, most of whom are not receiving proper help.
According to researchers who collected data from over 9,000 individuals, anxiety disorders are the most prevalent type of mental condition, with a lifetime prevalence of almost 30% (3).
Furthermore, more recent surveys report up to 33.7% lifetime prevalence (4).
This means that one-third of all people will struggle with anxiety at some point in their life.
What are the health consequences of anxiety?
Anxiety that lasts for too long can lead to debilitating health consequences and reduce the quality of your life. It can affect the function of several organs and systems in your body, including your:
- cardiovascular system
- respiratory system
- digestive system
- immune system
- urinary system
For example, anxiety may increase the urge to urinate or defecate, cause rapid shallow breathing and feelings of suffocation, trigger muscle tension, interfere with your sleep, or lead to social isolation.
Furthermore, anxiety disorders involve a long-term increase in cortisol production, which may suppress your immune function and increase your risk of getting ill.
Anxiety can increase your heart rate and blood pressure, trigger palpitations, and cause changes in the blood flow to some of your organs, including the heart.
Patients with preexisting heart disease may be at an increased risk of complications such as arrhythmia or heart attack. According to researchers, anxiety may even increase the risk of cardiovascular conditions such as coronary heart disease (5).
The function of the gastrointestinal system is often the one most severely affected by anxiety. That's likely due to the unique interaction between the digestive tract and the brain via the enteric nervous system.
For example, sudden stress may cause rapid bowel movements and diarrhea. At the same time, as the feelings of anxiety are prolonged, digestion is slowed down, which often leads to bloating, stomach cramping, and constipation.
A large meta-analysis of 18 studies also revealed that a common gastrointestinal condition called irritable bowel syndrome (IBS) is often associated with anxiety (6).
IBS affects about 10% of the population and includes symptoms of pain and bloating, diarrhea, constipation, or a fluctuation between the two.
How can you improve anxiety levels?
If your symptoms are severe, seek professional help from a licensed medical doctor or psychologist. Your doctor may prescribe you medication that will help you control your symptoms.
Medication is not always a permanent solution, and you shouldn't discontinue it as soon as you feel better. Quitting your medication prematurely has a 25% chance of symptom recurrence in the first month and 80% in the first year (7).
Instead, it's best to combine your treatment with adjuvant methods that are proven effective in reducing anxiety symptoms. The most successful ones include lifestyle changes and natural herbs such as ashwagandha.
The lifestyle changes you may apply comprise increasing your physical activity and improving your diet if needed. A systematic review of 12 controlled studies revealed that regular exercise was significantly more effective than a placebo in reducing anxiety symptoms (8).
Furthermore, researchers suggest that aerobic and non-aerobic exercise can successfully alleviate the complaints of patients with anxiety disorders (9).
According to research on obese individuals, combining exercise with a weight-loss dietary program appears to provide additional benefits for reducing anxiety symptoms (10).
What is ashwagandha, and how does it work?
Ashwagandha (Withania somnifera in Latin) is a medicinal plant used in traditional Indian medicine called Ayurveda for over 3,000 years. The herb contains various bioactive molecules which possess various health benefits for the human body.
For example, it is rich in saponins known as Sitoindosides. In particular, two of them, sitoindoside VII and sitoindoside VIII, have shown potent anxiolytic properties in animal trials (11).
Scientists suggest that their effects may be potentiated by another group of bioactive molecules unique to ashwagandha, known as withanolides. The most notable one is Withanolide A
There are several mechanisms through which ashwagandha may reduce anxiety. A randomized, double-blind, placebo-controlled study of Ashwagandha for anxiety has revealed that ashwagandha attenuates the activity of the hypothalamic-pituitary-adrenal (HPA) axis (12).
HPA is an endocrine axis that regulates the production of stress hormones such as cortisol and adrenaline. Ashwagandha helps relieve chronic stress and anxiety by suppressing the production of these hormones, decreasing adrenaline and cortisol level.
Animal experiments suggest that ashwagandha activates receptors in the brain known as GABA-AR (Gamma-aminobutyric acid type A receptors) (13).
Activating these receptors has anxiolytic, anticonvulsant, sedative, and relaxing properties. They are also a target of many anxiolytic drugs and antidepressants.
The neurotransmitter serotonin is another common target of most anxiolytics since its levels are usually decreased in patients with anxiety and depression.
An animal study revealed that supplementing stressed mice with an ashwagandha root extract could restore serotonin levels and reduce stress response (14).
Yet, the herbal supplement does not dramatically increase serotonin levels, so it's safe to take antidepressants such as selective serotonin reuptake inhibitors (SSRIs).
Scientific studies on Ashwagandha's benefits?
There is an abundance of clinical trials reporting the effectiveness of ashwagandha supplementation in reducing anxiety symptoms. A 2014 systematic review concluded that all 5 studies included in the analysis showed clear benefits on different anxiety or stress scales (15).
One of the trials included in the review reported that anxiety scores decreased by 56.5% for the ashwagandha group compared to 30.5% for the control group undergoing psychotherapy (16).
Another study comparing ashwagandha root extract to placebo reported a 44.0% reduction in stress scores and a 69.7% reduction in anxiety compared to 5.5% and 11.6% in the control group (17).
According to the researchers, Withania somnifera appears to be most beneficial for certain types of anxiety, such as social anxiety (social phobia).
More recent trials also support the effectiveness of ashwagandha in reducing stress response and anxiety.
Most studies report significant improvements in the ashwagandha group as soon as 2 months of supplementation, with doses between 240 and 600 mg per day (18, 19).
In another trial, patients taking SSRIs along with ashwagandha experienced an improvement in just 6 weeks (20).
What is the best way to take Ashwagandha?
The best way to take ashwagandha is to consume the root, which is usually in the form of a tea, powder, or dietary supplement.
The most reliable way to reap the benefits of ashwagandha is to take a supplement that's produced in the U.S. and can guarantee its quality via third-party testing.
Good Vibes by Nutri|Rise is one of the few products on the market which can provide an optimal dose of Withania somnifera from 100% organic ashwagandha. NutriRise's ashwagandha also comes from natural and sustainable sources.
It provides up to 1950 mg of ashwagandha extract per serving and is manufactured in a U.S. facility that complies with Current Good Manufacturing Practices (cGMP).
The process includes 3rd party testing by an independent organization to ensure the quality and potency of the product.
You can enjoy the most benefit from NutriRise ashwagandha supplements, thanks to the incorporation of 15 mg of black pepper extract with every serving. The extract contains piperine, which boosts supplements' digestibility and bioavailability.
But that's not all - piperine is also a powerful antioxidant that will enhance the properties of ashwagandha, aiding the body in the fight against free radicals and oxidative stress.
Note: This article is for informational purposes only and not intended for use as medical advice. Always consult your healthcare provider before starting any dietary supplement.