Anxiety versus Stress

Anxiety is a feeling of worry, nervousness, or fear about an event or situation. It’s normal for people to feel anxious in response to stress. Sometimes, however, anxiety becomes a severe, persistent problem that’s hard to control and affects day-to-day life; if you have this type of problem, you may have an anxiety disorder. About 19 percent of U.S. adults have an anxiety disorder in any given year, and an estimated 31 percent have an anxiety disorder at some time in their lives. Anxiety disorders are generally treated with psychotherapy, medication, or both. If you think you may have an anxiety disorder, talk with your health care provider.

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Researchers are examining ways in which complementary and integrative approaches might reduce anxiety or help people cope with it. Some studies have focused on the anxiety that people experience in everyday life or during stressful situations, while others have focused on anxiety disorders.

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What the Science Says

Complementary approaches can be classified by their primary therapeutic input (how the therapy is taken in or delivered), which may be:

• Nutritional (e.g., special diets, dietary supplements, herbs, probiotics, and microbial-based therapies).

• Psychological (e.g., meditation, hypnosis, music therapies, relaxation therapies).

• Physical (e.g., acupuncture, massage, spinal manipulation).

• Combinations such as psychological and physical (e.g., yoga, tai chi, dance therapies, some forms of art therapy) or psychological and nutritional (e.g., mindful eating).

Nutritional approaches include what the National Center for Complementary and Integrative Health (NCCIH) previously categorized as natural products, whereas psychological and/or physical approaches include what was referred to as mind and body practices.

Some complementary health approaches may help to relieve anxiety during stressful situations, such as medical procedures. Less is known about whether complementary health approaches can help to manage anxiety disorders.

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Psychological and Physical Approaches

• Relaxation techniques may reduce anxiety in people with chronic medical problems and those who are having medical procedures. However, cognitive behavioral therapy (a type of psychotherapy) may be more helpful than relaxation techniques in treating at least some types of anxiety disorders.

• Although some studies suggest that acupuncture might reduce anxiety, the research is too limited to allow definite conclusions to be reached.

• Hypnosis has been studied for anxiety related to medical or dental procedures. Some studies have had promising results, but the overall evidence is not conclusive.

• In some studies in people with cancer or other medical conditions, massage therapy helped to reduce anxiety; however, other studies did not find a beneficial effect. Little research has been done on massage for anxiety disorders, and the studies that have been done have had conflicting results.

• Studies have looked at the effects of interventions involving mindfulness meditation on anxiety in various groups of people, including cancer patients, people with other chronic diseases, family caregivers, pregnant women, health care providers, employees, and students. Many but not all of these studies indicated that mindfulness was helpful for anxiety. There’s some evidence that Transcendental Meditation may have a beneficial effect on anxiety. There hasn’t been enough research to know whether mindfulness or other types of meditation are helpful for anxiety disorders.

• There is evidence that listening to music can reduce anxiety during illness or medical treatment.

• Studies suggest that meditative movement therapies (tai chi, qi gong, or yoga) might reduce anxiety, but the research is too limited to allow definite conclusions to be reached.

• Reiki and therapeutic touch have not been shown to be helpful for anxiety.

Nutritional Approaches

• Two studies, both supported by NCCIH, suggest that a chamomile extract might be helpful in managing generalized anxiety disorder, but the studies are preliminary, and their findings are not conclusive.

• Kava may have a beneficial effect on anxiety. However, the use of kava supplements has been linked to a risk of severe liver damage.

• Melatonin has been studied as a possible alternative to conventional anxiety-reducing drugs for patients who are about to have surgery, and the results have been promising.

• There isn’t enough evidence on passionflower or valerian for anxiety to allow any conclusions to be reached.

Other Complementary Approaches

• Aromatherapy and homeopathy haven’t been shown to be helpful for anxiety.

Side Effects and Risks

• Psychological and/or physical approaches are generally safe for healthy people if properly performed by a qualified practitioner or taught by a well-trained instructor. As with any physical activity, practices that involve movement, such as yoga, pose some risk of injury. People with health conditions and pregnant women should talk with their health care providers about any complementary health approaches  they are considering and may need to modify or avoid some of them.

• Dietary supplements may have side effects and interact with medications.

 

 

This publication is not copyrighted and is in the public domain. Duplication is encouraged.

NCCIH has provided this material for your information. It is not intended to substitute for the medical expertise and advice of your health care provider(s). We encourage you to discuss any decisions about treatment or care with your health care provider. The mention of any product, service, or therapy is not an endorsement by NCCIH. Last Updated: December 2018.

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