Sunday, 13 April 2014

Natural anxiety relief



It goes without saying that you're probably feeling more stress and anxiety than you want to be feeling. If you find yourself seizing up with anxiety, you can rest assured you're not alone. Over 40 million people in the US suffer from some form of anxiety disorder, and more deal with milder anxiety. Unfortunately, prescription medications may not benefit everyone, and SSRIs in particular, can cause more problems than they allegedly fix.


What causes anxiety?


The cause of anxiety is largely unknown. Whilst scientists know of many things that can provoke pre-existing anxiety, they're not entirely sure why it happens. One belief is that there is either an excess of the fight or flight neurotransmitters, or there is a deficiency of GABA in the brain.

Source: Flickr
The fight or flight response occurs when you receive a shock, and this response is meant to spur you into action by fueling your muscles with glucose and kick-starting your heart. This is achieved through epinephrine and norepinephrine, which are two of the brain's primary neurotransmitters. These are sometimes referred to as adrenaline and noradrenaline. When your body produces too much of these neurotransmitters, you feel jittery and anxious. If you've ever felt jittery from caffeine, this is due to an increase of neurotransmitters, and an inhibition of GABA.

GABA on the other hand, is an inhibiting neurotransmitter. Whilst epinephrine incites you to action, GABA calms you down. A deficiency of GABA in the brain can lead to anxiety because transmissions in the brain are left uninhibited when you should be relaxed.


The role of serotonin


SSRI withdrawal

When you increase the action of a receptor, your body eventually realizes what is happening. As far as your body knows, that receptor is being stimulated too much, so it cuts down the stimulation at the receptor in order to reach homeostasis again.

This can be achieved through either down-regulation of the receptor, so that it produces a weaker response, or internalization of the receptor, where the receptor is relocated inside the cell and can't be stimulated. The end result is that by taking the drug, you reach a state of normal, and this happens with SSRIs.

When you stop taking the SSRI, because your receptors have been down-regulated, the amount of serotonin your body naturally produces, isn't enough to stimulate them properly, so you end up going through withdrawal.

Whilst the popular consensus is to call this 'SSRI discontinuation syndrome', it is a drug withdrawal, and is exactly the same process that happens when you stop taking opiates, benzodiazepines, or alcohol. Any medication that increases or decreases the action of a receptor, should not preferably be taken on a long-term basis or physical addiction will result. 

There is evidence that anxiety can stem from down-regulated 5-HT1A serotonin receptors in the brain, hence the prevailing use of serotonin reuptake inhibitors like fluoxetine (Prozac). SSRIs like Prozac bind to the serotonin transporter and inhibit it. Normally the transporter would recycle serotonin, removing it from the synapse, but when it is inhibited with an SSRI, serotonin accumulates in the synapse and thus has a greater effect.

Basically, SSRI antidepressants work by blocking the removal of serotonin, and whilst there is evidence pointing towards a relationship between anxiety and the 5-HT1A receptors, the details of such a relationship are still blurry at best. Furthermore, in order to increase the stimulation at these receptors, serotonin is increased overall, so other serotonin receptors are activated by this increase, leading to side effects.

Whilst it's likely science will gain greater knowledge of the serotonin receptors and finally be able to say with some certainty whether 5-HT1A should be targeted for anti-anxiety, until then, SSRIs are messy drugs and probably not the best treatment. It is even likely that selective 5-HT1A agonists will arise in the following years, meaning that the 5-HT1A serotonin receptor can be targeted instead of hitting every receptor at once and hoping for the best.

SSRIs have a range of side effects like weight gain, sexual dysfunction, mood changes, and with long-term use can cause an addiction. The withdrawal effects lead to an increase of anxiety and depression, as well as other effects to mood, so it's unsurprising that many people would rather avoid them.


Benzodiazepines


Xanax bars - source: flickr
Benzodiazepines are another option for the treatment of anxiety. Some people are prescribed benzodiazepines like Valium and Xanax for occasional use to abort panic attacks and during times of higher anxiety. Others however, will be placed on a benzodiazepine for a period of time whilst they commence treatment with antidepressants. This is done to relieve anxiety until the antidepressant begins to take effect.

Benzodiazepines work to relieve anxiety by binding to GABA receptors in the brain. When Valium binds to the GABA-A receptor, it increases the effect of the brain's own GABA, and this causes relaxation and anxiety relief. Whilst they are highly effective, and very safe drugs, they are addictive and many people abuse them. For this reason, they aren't used for long-term treatment of anxiety. Benzodiazepines are most effective when they are only taken every few days, to ease anxiety when you really need relief. You run the risk of addiction and withdrawals if you can't manage to use them intermittently like this.


Natural anxiety relief supplements


If you'd rather try natural anxiety relief as opposed to the standard treatments, there's a few options available to you and they're surprisingly useful. Some of these supplements include:

  • Picamilon
  • Phenibut
  • L-theanine
  • Valerian root

Picamilon


Picamilon is a combination of two natural ingredients: gamma aminobutyric acid, and niacin. You're more likely to know niacin by the name vitamin B3, as it's a necessary vitamin that your body needs every day. B vitamins allow your body to metabolise nutrients and produce energy. A deficiency of these vitamins will leave you feeling run-down and lazy, as well as leaving you more prone to stress and anxiety.

Source: Flickr
Gamma aminobutyric acid (GABA), is the brain's primary calming signal that tells you to relax. You couldn't simply take GABA in order to relieve anxiety though, because it can't cross the blood brain barrier in any useful quantity. GABA needs to enter the brain in order to actually work, and whilst there are many GABA supplements on the market, these are largely useless for this reason. In high doses, these supplements can have a peripheral effect on the body, but they don't produce the central effect that is able to relieve anxiety.

Picamilon however, can cross the blood brain barrier because of the vitamin B3. When GABA is bound to niacin, the niacin acts somewhat like a taxi, shuttling GABA into the brain. Once picamilon crosses the blood brain barrier, it breaks back down into niacin and GABA at its destination. The GABA is then free to calm you down and relieve anxiety.

Medications like Valium are famous for their anti-anxiety, muscle-relaxant, and hypnotic effects. Whilst picamilon makes more GABA available to the brain and has similar effects, it is nowhere near as strong. Because of this, picamilon is much more gentle than benzodiazepines but is still a powerful form of natural anxiety relief.

Picamilon will also help you sleep, and helps you focus when you're feeling foggy. There's some evidence to suggest it can prevent excitotoxicity in the brain and protect against brain damage. It's also thought to help improve blood flow and the niacin in picamilon lowers blood pressure, so there's more than one reason to take picamilon.


How to take picamilon


For natural anxiety relief with picamilon, it is best to take low doses spread out over the day, and to only take picamilon every few days so it doesn't lose effect. Take either two - three doses of 50mgs to control mild symptoms, or two doses of 100mgs for stronger relief. To stop a panic attack as it begins to happen, take 100 - 150mgs at the onset of symptoms and it will quickly work to ease your anxiety and stop the panic attack from becoming worse. 

Whilst it's preferable to take picamilon on an empty stomach for maximum absorption and quick effects, this may not be possible if you're beginning to feel a panic attack coming on and you've already ate. Picamilon will still work when taken after eating, but the beneficial effects are reduced slightly.


Phenibut


Phenibut is similar to picamilon in that it interacts with the brain's GABA receptors. Phenibut doesn't do this by increasing gamma aminobutyric acid like picamilon however. The GABA present in phenibut is modified with a phenyl ring and acts as a slightly different molecule. Whilst it still acts on the GABA receptors, it does so differently.

Phenibut binds to the gaba-b receptors, in comparison to GABA, which binds to both receptors. These receptors are slower to respond to stimulation, and when they are stimulated, they have a calming effect that is somewhat different. Phenibut calms the body and relaxes the muscles much more than it sedates you. In this sense, phenibut can relieve anxiety without making you tired or causing a rebound once it wears off like Valium does.
In particular, phenibut is highly useful as a treatment for social anxiety, because it allows you to leave the house feeling confident without feeling tired and foggy. It can also ease sore muscles and help you relax after a hard day.

It's important to note that phenibut is a modified derivative of natural GABA. In this sense, some might consider it synthetic. Nevertheless, it is included in this list because it is highly effective and not entirely synthetic. It was invented in Russia and became a necessary medication to stock on space missions because it can reduce anxiety and stress without impairing the performance of astronauts like benzodiazepines would.


How to take phenibut


Phenibut is best taken in small dosages across the day. Take 250mgs up to three times a day to control mild anxiety, up to a maximum of 500mgs for anxiety that is harder to control. To abort a panic attack, take 500 - 1000mgs once, at the start of symptoms.To get the most out of phenibut, use it for a maximum of two days continuously before taking a break of at least three days. Alternatively, you can also use it only as-needed when panic attacks occur.


L-theanine


L-theanine is another supplement that works through similar mechanisms to picamilon and phenibut. This compound is found naturally in tea, especially green tea, and is responsible for tea's calm yet stimulating effect, because l-theanine prevents jitters and over-stimulation from the caffeine, whilst increasing focus.

Unlike picamilon and phenibut however, l-theanine is thought to act at the NMDA receptors to balance glutamate and GABA. Whilst GABA slows your brain down, glutamate is excitatory and speeds it up. Should GABA drop or glutamate increase, anxiety can result, but l-theanine can help balance the two neurotransmitters to relieve anxiety.


How to take l-theanine


L-theanine can either be consumed in green tea, or can be taken as a supplement. Green tea also contains caffeine however, so this may not be a good option if you're sensitive to caffeine, and the caffeine itself reverses some of the effect of l-theanine. 

Should you choose to drink green tea however, gyokuro is one of the most concentrated sources of l-theanine, containing far more than other forms of tea, thanks to the way it is grown. The way it is shaded before harvesting leads to a buildup of l-theanine, and the tea gains a sweeter, fresh flavour that is easily distinguishable from other green teas. It is considered Japan's finest green tea.

As far as supplements go, l-theanine can be supplemented at a dosage from 20 - 100mgs. The average tea drinker in Japan consumes 20mgs of l-theanine in tea, but this might not be effective enough for you. In any case, the FDA has determined that high dosages don't pose a danger, and l-theanine itself may be protective against excitotoxicity, heart disease, and cancers.


Valerian root


Source: Flickr
Valerian is a herb that has traditionally been used for the relief of insomnia, anxiety, and other conditions. Evidence points towards it having an effect on the GABA system, and this would explain why it can act as a mild sedative and anxiolytic. It's not entirely clear to what extent valerian root is able to influence GABA, but many people swear by it for anxiety and insomnia.


How to take valerian root


Dosages between 400 - 900mgs have been used in research models, but valerian doesn't tend to be standardised so it is difficult to find a correct dosage. With valerian, it is a case of titrating the dosage to find what works for you. Many people report that the best effects are seen with continuous use over several days, so it might take time to build up effects. It can cause side effects like dizziness and headaches but isn't considered harmful.

If you'd like to give valerian root a chance, then by all means do so, but it may not work. Picamilon, phenibut, and l-theanine will always work to some extent, because they're proven to work at the cause of anxiety. However, everyone is different, and it's up to you and your doctor to find the best medication for your own needs.


Taking anxiety supplements


If you're taking supplements for anxiety, it's important to let your doctor know and listen to your doctor's advice first. Your doctor knows your medical history and needs, and can provide input to help you choose the supplement or medication that will benefit you the most. 

Furthermore, it is important that always take a few days break from using any anxiety medication. The same rule goes for any medication, used for any purpose, that binds to a receptor. This includes opiates like codeine and morphine; benzodiazepines like diazepam, alprazolam, and temazepam; tramadol; stimulants; and many other medicines. It's not just recreational drugs that cause addiction. Medicines and supplements that are prescribed to you or purchased OTC at a pharmacy can be physically addictive too. 

The key is always balance. Don't allow medications to become a crutch, and don't take them without break if they're addictive. You'll always stay in control if you can do this, and you'll be a stronger person as a result.

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