Understanding Brain Chemistry: Natural Treatments for Anxiety & Panic By Antonio Reale, ND, MS
properties can quickly dampen symptoms of anxiety. Some of these herbs may be familiar, frequently discussed in everyday culture; herbs like Passionflower, Oats, and Lemon Balm have wonderful calming qualities and many have used Valerian for its sedative properties in promoting sleep. I often give patients the example of Hops, which is used to make beer, and describe the use of Kava in the islands of the South Pacific to quell social anxi- ety. Another classic example of an herbal sedative is Chamomile, famous in households across the globe as a relaxing tea. It's here that I usually differentiate between a tea and an herbal tincture so patients can better understand how a botanical extract is different from the tea they have at home.
N Botanical Tincture
Most of us are familiar with a tea or infusion, where the herb is steeped in water for several minutes. A botanical tincture is a liquid herbal mixture in which alcohol is used to extract the medicinal constituents, usually over a period of weeks. This process strengthens the liquid, rendering it much more potent than a household tea, which is why a Chamomile tincture is more effective in treating an anxiety than the common tea. When we're treating children, adolescents, or adults wishing to avoid an alco- hol base, we can use tinctures called glycerites, using vegetable glycerin rather than alcohol to extract the plant's medicinal quali- ties. Of course, these herbs are also available in pills or capsules for those who prefer to avoid the liquid form.
With so many herbs to choose from, finding the right pre- scription sometimes involves taking into account an individual's constitution, (such as whether the patient is a "warm" or "cold" person), as well as the other healing properties of the herbs. For instance, an herbalist might choose to avoid Lemon Balm for its ef- fects on the thyroid gland or to include Kava in a patient suffering from muscle spasms. Choosing the right tincture for a patient and
26 Natural Nutmeg - November/December 2018
aturopathic medicine's proverbial toolbox is full with herbs that can help treat anxiety and panic disorder. Plants with sedative or anxiolytic, (literally, "anxiety breaking")
deciding its proportions is part of the "art" of botanical medicine, allowing for a much more personalized approach to the treatment of anxiety.
Beyond Herbs: Amino Acids & Neurotransmitters
Herbs can be very effective at calming anxiety and panic, but most times, we are looking to address potential imbalances in the brain chemistry that can be causing symptoms. I tell my patients to imagine two opposing factors in the brain, glutamate and GABA, neurotransmitters working opposite one another with very different effects on mood. We can imagine glutamate as excitatory and neuro-stimulatory, increasing symptoms of anxiety and alertness. Glutamate is opposed by GABA, which is instead inhibitory and exerts calming effects. The goal in the treatment of anxiety becomes to either decrease glutamate or increase GABA to restore balance in the brain. Many of the sedative herbs discussed earlier, such as Valerian, exert their calming effects by suppressing glutamate.
Neurotransmitters can be difficult to measure so it's not
always clear whether the anxious patient suffers from too much glutamate or too little GABA. In reality, it's likely that the anxiety can be helped by restoring balance to both neurotransmitters. In the case of GABA, the simplest and most direct way to increase levels in the brain is to supplement with GABA itself, in pill form. In private practice, I have found GABA to be especially benefi- cial in some patients, but there is constant debate in the medical community on GABA's ability to effectively cross what is known as the blood-brain-barrier (BBB). Fortunately, we can avoid this by supplementing instead with l-theanine, an amino acid that helps to produce GABA in the brain, avoiding any absorption issues.
L-theanine is a component of green tea, responsible for the so- called "zen" state of relaxation, affecting alpha waves in the brain which are created during states of meditation and mindfulness. Since theanine has a role in affecting mindfulness and aware- ness, it is unique in that it can improve mental clarity and focus. Theanine's role in promoting mental performance separates it
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