Supplements that Can Help Reduce Anxiety, According to a Psychiatrist

While supplements have been known to yield many physical benefits, in recent years, they’ve been used more commonly to promote psychological well-being.

Supplements can help manage many health conditions, from high cholesterol to chronic stomach upset and even anxiety. The trick? They have to be used right.

It’s important to talk to a doctor – whether it’s your primary care provider, psychiatrist or other specialist – before trying new supplements. We sat down with psychiatrist Dr. Leslie Madrak, who is board-certified in both integrative medicine and addiction medicine, to learn what supplements can work for anxiety and how you can get started.

How can supplements help with anxiety?

The mechanisms in many supplements work similarly to SSRIs (selective serotonin reuptake inhibitors), which are often prescribed for anxiety and depression, explains Dr. Madrak. They can help the body reabsorb neurotransmitters, like serotonin, to help reduce anxiety the same way a medication like Prozac would.

What to know before you hit the shelves

Dr. Madrak warns that supplements aren’t a “cure,” and you have to be careful, keeping in mind that:

• Anyone can benefit from supplements, but they may not work the same for everyone.
• Changes aren’t immediate.
• Some supplements may have dangerous interactions with other medications.
• Supplements aren’t FDA-approved, and you should always talk to your provider before taking any.

Supplements for anxiety

Vitamin D3: 

Vitamin D3 can improve mood and energy, and it has been a must for many of my patients throughout the pandemic, says Dr. Madrak. While lack of sunlight isn’t a sole contributor to anxiety, vitamin D deficiency can hinder mental well-being.

The best source of vitamin D3 is direct sunlight. “It’s ideal to have 15-20 minutes of sun exposure per day, but in the winter that can be difficult,” continues Dr. Madrak. “You should talk to your doctor about having blood work to check your vitamin D3 levels and whether or not you may need supplementation.”

Suggested dose: 2,000 IU (international units) for most adults; if you’re deficient, you may need around 5,000 IU or a prescription-level dose.

Magnesium: 

Magnesium can help manage anxiety and insomnia by regulating serotonin and improving brain function, explains Dr. Madrak. Plus, it can improve other areas of our health, including digestion, cardiac function and sleep patterns.

Suggested dose: Up to 250 milligrams before bed.

Melatonin: 

Melatonin is the most common sleep aid; it is easily tolerable and can be safely combined with most prescription medications. Melatonin is a naturally occurring hormone that tells us when it’s time to sleep and wake up, but some people don’t produce enough of it, Dr. Madrak explains. “It’s often used for insomnia, but can also help reduce negative feelings associated with anxiety (that keep us awake at night).”

Suggested dose: 1-10 milligrams before bed.

Omega-3 fatty acids: 

Found in fish oil and krill oil (from small shellfish), these compounds are best known for their benefits on cardiovascular health, but studies show they may also improve brain function and mood, adds Dr. Madrak. Some theories suggest poor cardiovascular health and inflammation contribute to anxiety – thus improving one could improve the other.

You can incorporate whole food sources of omega-3 into your diet by consuming more salmon, mackerel, herring, sardines and anchovies. Flaxseeds, chia seeds, spinach and Brussel sprouts are also good options for those who have shellfish allergies or are plant-based.

Suggested dose: 1,000 – 1,200 milligrams a day.

Chamomile: 

Often consumed in tea, chamomile aids in relaxation due to an antioxidant known as apigenin, which binds with specific receptors in the brain to decrease anxiety. You should be cautious of consuming too much chamomile if you’re on blood thinners, as it can have a blood-thinning effect. If you have a heart or vascular condition, you should consult with your provider before adding chamomile into your routine.

Suggested dose: 800-1,600 mg around 30 minutes before bed.

Valerian root: 

Valerian root works well with the GABA receptor and subtly increases its levels, says Dr. Madrak. GABA is an amino acid that acts as a neurotransmitter to decrease anxiety and depression symptoms. GABA can also help manage premenstrual syndrome (PMS) and attention deficit-hyperactivity disorder (ADHD). You should be extra cautious with valerian root if you take benzodiazepines or other sedating medication.

Suggested dose: 300-600 milligrams before bed.

Ashwagandha: 

Considered an adaptogen, ashwagandha is a natural substance that has sedative effects and helps the body adapt to stress by decreasing cortisol (the stress hormone) levels, explains Dr. Madrak. It’s one of the more highly recommended natural products.

Suggested dose: 500 – 1,000 milligrams daily.

Kava: 

Kava causes dopamine levels to rise and works with other receptors to reduce anxiety symptoms. Some people describe Kava’s effects as “euphoric,” says Dr. Madrak, which has led to harmful, recreational use of it. Research into medicinal advantages is still controversial. You should be extra cautious with Kava if you take benzodiazepines or other sedating medication.

Suggested dose: 1,000 – 1,400 milligrams daily.

Are there any supplements you should avoid?

Kratom, says Dr. Madrak. Kratom has strong stimulant and sedative properties, and while some have claimed it helps with opioid dependencies, it’s addictive itself. It can even contribute to psychosis, or disconnection from reality. 

What are the risks?

“Some people assume that just because something is natural, it’s safe,” says Dr. Madrak. “But supplements are strong, and, without professional guidance, they can be dangerous. Overuse and certain combinations can trigger harmful effects, such as difficulty breathing, decreased mental clarity and even liver damage.

St. John’s wort, when combined with an SSRI, can lead to a potentially life-threatening medical condition known as serotonin syndrome, explains Dr. Madrak, which causes mood changes, muscle stiffness, fever, arrhythmia (rapid or abnormal heartbeat) and high blood pressure.

Contrary to its popularity, many of the studies for St. John’s wort are conflicting, so it’s important to be extra cautious. While it may help with anxiety and depression, it is known that frequent use of St. John’s wort can decrease the effect of birth control pills (or oral contraceptives), as well as medications used for organ transplant, heart conditions, chronic pain, HIV, cancer and more.

Generally, vitamins and minerals are safer than herbal supplements, but it depends on the individual, notes Dr. Madrak. 

How can I get started?

Do your research and talk to your doctor about what supplements may work for you, says Dr. Madrak.  Always disclose any natural supplements that you are taking with your doctor to prevent any serious drug-drug interactions.

From there, regular bloodwork may be ordered to find out if you’re deficient in any vitamins or minerals that could be contributing to your symptoms.

“It’s best to start slow; maybe that means taking vitamin D and magnesium,” recommends Dr. Madrak. “If you’re interested in a holistic approach, pay attention to what you eat. Gut health has a proven link to the brain. A healthy diet and exercise should be at the base of your routine. Fulfilling basic needs helps a lot more than people realize.”

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