Ashwagandha extract is a potential natural and alternative treatment for anxiety, stress, depression, and insomnia.
Stress is unavoidable. People have their own strategies when coping with loss, grief, trauma, and other stressors. Some may relieve stress through physical activities, journal writing, or hanging out with family and friends; while others seek treatment, which can include alternative treatment for anxiety. Stress and anxiety go hand-in-hand. Anxiety is a normal response to stress resulting in nervousness, worry, and unease. Other symptoms of anxiety involve increased heart rate, breathing rapidly, and insomnia. Unfortunately, stress may appear more severe in individuals with an anxiety disorder that can intensify their mood, existing anxiety, and depression.
Anxiety disorder occurs when an individual possesses irrational fears and experiences frequent, severe anxiety symptoms. The severity can significantly impair their normal daily functioning. Generalized anxiety disorder (GAD) is the most common type of anxiety disorder.
The Centre for Addiction and Mental Health (CAMH) recommends psychological therapies, as the first line treatment for anxiety. These psychological treatments include relaxation techniques, meditation, biofeedback, and stress management, supportive counselling or family therapy and cognitive-behavioral therapy (CBT). Current research shows that CBT is the most effective. If the anxiety disorder has no response to psychological therapies, then there are medications that have also been proven effective for treating anxiety.
There has been a recent resurgence of Chinese and Ayurvedic herbs, known as adaptogens, as an alternative treatment for anxiety. Adaptogens are marketed to potentially improve the body’s ability to handle physical or biological stress. However, there is relatively little scientific research on how adaptogens truly work. Dr. Brenda Powel, a co-medical director from the Cleveland Clinic’s Wellness Institute, quoted from a 2018 Time article, “Each adaptogen has a slightly different function, so the best one for you depends on the specific ailment you’re experiencing. They’re meant to bring us back to the middle.”
Ashwagandha is one of the most commonly used and extensively studied adaptogens. It is also known as Withania somnifera Dunal, Indian Ginseng or Winter Cherry. Ashwagandha literally means “smell of horse.” It was believed that the consumption of the herb’s extract gives the consumer the strength and vitality similar to a horse! In Ayurvedic medicine, ashwagandha is considered a “royal herb” for its diverse healing effects on the human body’s nervous system, immune system, energy-production, endocrine system, and reproductive system.
Pharmacological studies have identified the major chemical components that relate to ashwagandha’s healing effects. Animal studies have reported that the herb can reduce stress, reduce depression, protect the loss of neurons, and influence sex hormone production.
Ashwagandha human trials are still limited but show promising results, especially in people with anxiety. Recent human studies have revealed that ashwagandha reduces anxiety in adults with GAD and reduces stress hormones (such as cortisol), heart rate, and blood pressure in chronically stressed adults. It must be noted however, that these human studies had a small number of participants and short-term treatment duration.
Two 60-day studies assessed the safety and effectiveness of ashwagandha extract in reducing stress, anxiety and depression in adults, aged 18 to 65 years. Both studies evaluated stress levels using stress-assessment questionnaires.
- The first study enrolled 64 healthy adults suffering from high stress. Participants received either a 300 mg capsule of the extract, or placebo, twice daily. The participants’ stress levels were scored and assessed with three questionnaires. Mild side effects were reported from participants in both groups and did not appear to relate to the extract.
- The second study investigated 60 healthy adults suffering from mild stress. Participants received either 240 mg of the extract, or placebo, once daily. The participants’ stress levels were scored and assessed with two questionnaires.
- The two studies also looked into how ashwagandha affects production of the stress hormone cortisol.
- Both studies resulted in significant overall reductions in stress, anxiety, and cortisol levels from participants taking the ashwagandha extract, in contrast to the participants on placebo.
A recent study determined the safety and effectiveness of ashwagandha extract in patients with insomnia and anxiety.
- A total of 60 adults, aged 18 to 60 years, diagnosed with insomnia were enrolled.
- The patients received either 300 mg capsule of ashwagandha extract, or placebo, twice daily for 10 weeks.
- Patients were primarily assessed for sleep onset latency (SOL), which is the amount of time it takes to transition from full wakefulness to sleep.
- At the end of the study, patients on ashwagandha had significantly shorter SOL, in contrast to placebo. The study also discovered that taking ashwagandha increased total sleep time, improved sleep quality and decreased anxiety.
Overall, ashwagandha has the potential to safely and effectively improve stress and overall well-being. It is also a potential natural treatment for reducing anxiety, depression, and insomnia. Healthy adults using ashwagandha have reported good tolerability with no significant side effects. Future research with larger and diverse sample sizes and long-term duration of treatment will reveal a more robust understanding of the effects of Ashwagandha and its use as an alternative treatment for anxiety. If you are planning to start herbal supplements with other medications, it is important to consult with your doctor before starting. Herbal supplements may have the potential to interact with other medications.
Written by, Manuel Bangsil, PharmD, MBA, BCMAS
References:
- Barnhill, J. Overview of Anxiety Disorders. https://www.merckmanuals.com/home/mental-health-disorders/anxiety-and-stress-related-disorders/overview-of-anxiety-disorders. Published 2020. Accessed July 5, 2020.
- Government of Canada. Mood and anxiety disorders in Canada. https://www.canada.ca/en/public-health/services/publications/diseases-conditions/mood-anxiety-disorders-canada.html. Published 2015. Accessed July 5, 2020.
- Pelletier L, O’donnell S, Mcrae L, Grenier J. The burden of generalized anxiety disorder in Canada. Health Promot Chronic Dis Prev Can. 2017;37(2):54-62.
- Rector N, Bourdeau D, Kitchen K, Joseph-Massiah L. Chapter 3. Treatments for anxiety disorders. Canada: Centre for Addiction and Mental Health; 2008. https://camh.ca/-/media/files/guides-and-publications/anxiety-guide-en.pdf?la=en&hash=DEEF0BBD7FC131D116F13D4DFF609D93B726C210. Accessed July 5, 2020.
- Liao LY, He YF, Li L, et al. A preliminary review of studies on adaptogens: comparison of their bioactivity in TCM with that of ginseng-like herbs used worldwide. Chin Med. 2018;13:57.
- Ducharme J. What are Adaptogens and Why Are People Taking Them? Time. https://time.com/5025278/adaptogens-herbs-stress-anxiety/. Published 2018. Accessed July 5, 2020.
- Chandrasekhar K, Kapoor J, Anishetty S. A prospective, randomized double-blind, placebo-controlled study of safety and efficacy of a high-concentration full-spectrum extract of ashwagandha root in reducing stress and anxiety in adults. Indian J Psychol Med. 2012;34(3):255-62.
- Lopresti AL, Smith SJ, Malvi H, Kodgule R. An investigation into the stress-relieving and pharmacological actions of an ashwagandha (Withania somnifera) extract: A randomized, double-blind, placebo-controlled study. Medicine (Baltimore). 2019;98(37):e17186.
- Langade D, Kanchi S, Salve J, Debnath K, Ambegaokar D. Efficacy and Safety of Ashwagandha (Withania somnifera) Root Extract in Insomnia and Anxiety: A Double-blind, Randomized, Placebo-controlled Study. Cureus. 2019;11(9):e5797.
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