The Best Supplements for Anxiety of 2022, According to a Dietitian

Anxiety disorders are complex and their cause is not fully understood. Treatment for anxiety ranges from lifestyle changes, meditation, and cognitive behavioral therapy to prescription medications and supplements. Healthy eating habits, getting enough sleep, exercising, and not smoking have been linked to a lower risk of  anxiety, so that may be a first step for some. That said, lifestyle changes can take time and may not be enough for those with moderate to severe anxiety.

“Vitamins, minerals, and supplements can certainly play a role in helping to manage anxiety (if deemed safe under the advisement of a doctor), but it is important to keep in mind that they alone will not ‘cure’ anxiety,” says Steinberg. 

When considering a supplement, it’s important to understand that some supplements—especially herbal supplements—don’t address the root cause of the anxiety, may interact with certain medications, and, in some cases, should not be taken regularly. If you have anxiety, work with a healthcare provider to develop the best treatment for you, which may or may not include supplements. If you do choose to take a supplement, understand the potential benefits and drawbacks of each supplement type and look for products that are quality tested, safe, and appropriately dosed.

Is a Supplement Beneficial for Anxiety?

Occasional mild anxiety isn’t always a problem and may not require treatment, but if it’s disturbing your life, we recommend seeking help. “Some common symptoms of anxiety that might indicate a need for treatment include racing, disturbing, and repetitive thoughts, insomnia, and distractibility. Physical symptoms that can go along with panic such as heart racing, shortness of breath, GI upset, muscle tension, and tingling sensations are also signs,” says Emily Steinberg, MD, PC, Assistant Professor of Psychiatry at Icahn School of Medicine at Mount Sinai.

Gauri Khurana, MD, MPH, Clinical Instructor at the Yale School of Medicine adds that self-medicating with alcohol, marijuana, food, or other numbing behaviors like binge-watching TV are indications that treatment would be helpful. 

Pharmacotherapy, or prescription medications such as antidepressants, SSRIs, and benzodiazepines, as well as therapy techniques such as CBT are proven treatments for anxiety. CBT is a fantastic long-term option, and medications can work well for some but may come with unwanted side effects for others. Complementary and alternative medicines (CAM) can also be a useful avenue to explore for treating anxiety. These include tools such as yoga, meditation, acupuncture, hypnosis, dietary changes, and supplements. 

Supplements may be especially helpful for the following people: 

People with a known nutrient deficiency. Studies have shown that low magnesium and vitamin D is linked to anxiety, and supplements may both improve nutrient status and anxiety symptoms.

People who don’t respond to more traditional therapies. “Those who are not getting an adequate response from more standardized treatments of anxiety using psychotherapy and psychopharmacological approaches or who may not have had good results from medications may opt to try supplements as an alternative or adjunctive treatment for anxiety,” says Steinberg.

People resistant to taking medication. Anxiety medications can have unwanted side effects, making them difficult for some people to take consistently. Supplements may be helpful in reducing some symptoms, especially those that are more mild. “Vitamin, mineral and herbal supplements are often used by patients who are reluctant to try prescription medications and these are often a good first step towards providing some level of relief. For my patients that do not want to continue with prescription medications, I often help them transition to herbal supplements after we have achieved a period of remission” says Khurana. 

People with occasional and mild symptoms. Supplements like ashwagandha have been shown to reduce stress-related anxiety in otherwise healthy people. However, supplements may not be effective for those with more severe anxiety. “In my clinical experience, the best treatment for panic attacks and debilitating anxiety is prescription medication,” says Khurana.

The effectiveness of various supplements is still being explored and is highly individualized, so it’s essential you work closely with a healthcare provider to determine if a supplement is appropriate for you. “Not everyone responds the same to the same supplements.  While one person may get a relaxing effect from a particular adaptogen or from CBD, for a segment of the population the same supplement can have an undesirable stimulating effect instead,” says Sharon Puello MA RD CDN CDCES. 

It’s also important to note that long-term use of many herbal supplements is not recommended. Most studies testing the effectiveness of herbal supplements are a short duration (around 8 weeks) and we don’t know much about the safety of long-term use.

Who May Not Benefit from Supplements for Anxiety

Supplements may seem benign because they are ‘natural,’ but they can be potent and come with negative or even dangerous side effects for some people. 

People taking certain medications. Many supplements, especially herbal supplements like ashwagandha, l-theanine, and valerian root interact with common medications like thyroid, diabetes, cholesterol, and blood pressure medications, making them less effective or more potent, which can be problematic. Review any supplements you’re considering with a healthcare provider to understand if they are safe and effective to take with other medications.

People with other psychiatric illnesses. “When there are comorbid psychiatric conditions, especially bipolar disorder, some supplements or ingredients in them may precipitate a psychosis or mania. In addition, some psychiatric medications (such as SSRIs like prozac, zoloft, paxil, lexapro and celexa) combined with certain supplements can be dangerous,” says Khurana. 

Pregnant or breastfeeding people. Most supplements are not studied in pregnant breastfeeding people and the safety of supplementing to treat anxiety during this time is not known or understood. 

People with moderate to severe anxiety. Supplements have varying levels of success in treating anxiety symptoms, but in general, they are not enough for more significant debilitating anxiety. “For those with more severe levels of anxiety, supplements can be used as needed, but their level of illness would not be adequately treated with only supplements,” says Khurana.

It’s also important to understand that, unless you are addressing a nutrient deficiency, supplements (like many other therapies) don’t address the root cause of the anxiety. “It’s essential to distinguish between treating anxiety symptoms versus the cause,” says Samantha Gambino, PsyD. Because supplements may not be safe to take long-term, it’s important to determine and ultimately address the underlying reason for anxiety, while developing tools to manage it.