How Do Naturopathic Doctors Treat Anxiety?

How Do Naturopathic Doctors Treat Anxiety?

View the printable PDF version.   

The AANP and INM would like to acknowledge Moira FitzpatrickPhD, ND, FICPP, CHT, for her contributions to the content of this FAQ.

40 million adults in America suffer from anxiety, the most commonly diagnosed mental condition in the country. Unique for every person, Generalized Anxiety Disorder (GAD) is often experienced as excessive, uncontrollable worry about a variety of topics in a manner disproportionate to their potentially posed risk. Chronic nervousness, agitation, a restless mind, muscle tension, racing heart, and sleep disturbance are common symptoms.
Anxiety can have a variety of root causes from genetic to biological to environmental. Common first-line treatments often focus on prescription medications and/or therapy. While pharmaceutical drugs can provide symptom relief, these same drugs often have limited effectivenessDrugs such as Benzodiazepines can also be highly addictive and can cause unwanted side effects. A growing body of research is uncovering dangers associated with commonly prescribed drug treatments including selective serotonin reuptake inhibitors (SSRIs) such as Prozac and Lexapro, and with benzodiazepines such as Xanax and Ativan.

Licensed naturopathic doctors (NDs) excel at treating anxiety because they focus on treating the whole person, and on addressing the underlying causes of the condition. NDs have a deep toolbox of evidence-based, natural therapies including clinical nutritionbotanical medicine, and behavioral medicine to draw from.

Identifying Underlying Causes of Anxiety
Naturopathic doctors begin by assessing the whole person. Initial appointments often last one hour or more and include a detailed family history, medical history, discussion of diet, physical activity, environmental exposures, sleep patterns, and psycho-emotional stressors. There are a wide variety of underlying causes for anxiety. Naturopathic doctors consider:

Genetic predisposition— An understanding of genetic markers and pathways contributes to a more precise and personalized approach to treatment. Single Nucleotide Polymorphisms (SNPs) are the most frequent type of mutation. NDs look at patterns in SNPs and see how they affect B vitamins, hormones, nutrients, neurotransmitter production, and breakdown. This information provides foundational support to treatment planning.

Neurological imbalance—The balance of chemicals in the brain helps control mood and can play an important role in anxiety. Your ND will look for imbalances in serotonin, gamma-aminobutyric acid (GABA), and norepinephrine.

Digestive/microbiome dysfunction—The microbiome or ‘good germs’ that line your digestive tract play an important role in balancing your nervous, hormonal, and immune systems. Your ND may order a stool analysis test to evaluate the health of your GI tract. You can also expect a detailed discussion of your diet, and potential labs to identify food sensitives and nutritional deficiencies.

Dysfunction of the hypothalamic-pituitary-adrenal (HPA) axis—Your HPA axis is your body’s stress response system. In the face of chronic psychological stress, the adrenal glands excrete an abnormal amount of cortisol in an abnormal rhythm. This can be caused by a number of factors, including blood sugar imbalance, lack of sleep, caffeine, toxins, and allergens. Your ND may order lab testing if this condition is suspected.

Evidence-Based Naturopathic Medicine Treatments 
Naturopathic doctors provide highly individualized therapies. They are trained in the pharmacological treatments commonly prescribed by conventionally trained MDs, and in some states, have scope for prescription of pharmaceuticals when necessary. When it is necessary to use medications, genetic testing can help determine which medications you will be responsive to with the least side effects. NDs lead with minimally invasive therapies that support the body to restore healthy function. Naturopathic therapies include:

Improve gut health. Research on the biology of stress, fear, anxiety-related behaviors, and the gut-brain connectionsupports the importance of a nutritional and diverse diet, and supplementation with probiotics. NDs have the expertise to balance the microbiome and address food sensitivities and leaky gut thanks to their rigorous training in clinical nutrition.

Repair and restore with nutritional and botanical supplements. NDs utilize a multitude of evidence-based nutritional and botanical supplements for their calming effects to help reduce the frequency, severity, and duration of generalized anxiety and panic disorders. These treatments are individualized and evaluated carefully for safety in every patient. Effective supplements include: Gamma-aminobutyric acid (or GABA), L-theaninepassionflowerscutellaria lactiflora (skullcap), hopsPiper methysticum (kava), lavender, adaptogens such as Withamnia Somnifera (ashwagandha), lithium orotate, and magnesium.

Manage stress with behavioral medicine. NDs are trained to evaluate your symptoms in the context of your lifestyle, behavior, and social-cultural environment. By examining the details of your diet, stress level, sleep, physical activity, and more, they can prescribe the most effective, evidence-based behavioral medicine treatments and mind-body medicine techniques. These include mindfulness, therapeutic exercise/yoga, biofeedback, progressive muscle relaxation, breath work, and meditation. For some patients, addressing repressed or current trauma can play a significant role in treating anxiety. Naturopathic doctors who are highly specialized in mental health, such as those certified by the Psychiatric Association of Naturopathic Physicians, can offer energy-based therapies which focus on the release of trauma. These may include hypnotherapy, guided visualization, cranial sacral therapy, and other specialized modalities.

Optimize lifestyle factors. Because of the extra time they spend getting to know you, NDs uniquely tailor recommendations to optimize lifestyle habits such as sleep, diet, exercise, and reduction of stimulants, all of which play contributing roles in anxiety. 
NDs may evaluate and utilize additional strategies and therapies for different types of anxiety disorders, including anxiety in perimenopausal women, post-traumatic stress disorder (PTSD), obsessive-compulsive disorder, and panic disorder.

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