Over a year into a global pandemic, it’s no surprise that Americans are experiencing higher levels of anxiety. According to a U.S. Census Bureau Household Pulse survey, in Jan. 2021, 41% of adults reported symptoms of anxiety or depression compared to 11% in 2019. Even before the pandemic, anxiety was the most common mental illness with 40 million adults in America experiencing anxiety every year. If you’re considering entering the health care field, anxiety is one ailment you can expect to encounter among your patients.
Rather than simply prescribing medication, naturopathic medicine doctors (NDs) have a vast array of natural tools available to them to treat this condition. Here are some of the ways NDs are treating patients with anxiety today.
Getting to the root cause
In order to get to the root cause of a patient’s anxiety, NDs spend a significant amount of time meeting with patients to understand their specific symptoms and needs. During the first visit with an ND, a patient provides detailed medical history including information about underlying medical symptoms, family history and any past trauma.
This individualized approach is one factor that sets naturopathic medicine apart from conventional medicine. While conventional medical doctors typically spend an average of 20 minutes with patients, NDs spend between one and two hours face-to-face with patients during their initial appointment, and 30 to 60 minutes in subsequent appointments, according to the Institute for Natural Medicine.
Focusing on the determinants of health
For NDs, the basis of a patient’s treatment plan is ensuring that the patient is receiving the proper nutrition, lifestyle habits, sleep, other factors required for good overall health. NDs believe these determinants of health are the foundation for supporting the body’s natural healing ability. It is one of the tenets within naturopathic medicine that students in National University’s ND program build on in both their basic and clinical science training. These determinants include genetic and environmental factors like intrauterine influences, nutrition, patterns of exercise and rest, past illness and medical interventions, physical and emotional traumas, stresses and exposures.
To see if these needs are being met, NDs will not only gather medical history but perform a physical exam and conduct various laboratory tests. These tests can include a thyroid panel, food allergy testing, microbiome assessment, stress hormone testing and nutritional testing.
For anxiety, dietary modifications often make up a large portion of ND’s lifestyle recommendations. By eating less processed food and more whole foods high in omega 3s, patients will help reduce inflammatory load on the body. An ND will also recommend eliminating any foods they are allergic to and reducing caffeine consumption. According to research, inflammation can affect brain regions relevant to reward and threat sensitivity and can lead to symptoms of anxiety along with reduced motivation and motor slowing.
Other lifestyle recommendations include exercise, which research has shown can work just as well as medication to decrease anxiety and depression. NDs can also help identify stressors in their patient’s life along with ways to reduce those stressors.
Treating the gut microbiome
Research continues to recognize the role that bacteria in your gut can have on mental health. Since neurotransmitters are produced in the gastrointestinal tract, it’s important to ensure it is functioning properly. Some of ways an ND will make sure your gut microbiome is in top shape is by recommending a healthy diet of whole foods. Taking pre and probiotic supplements and eating probiotic-rich foods like yogurt and kefir has proven beneficial for diversifying gut bacteria while omega 3s, vitamin D, lion’s mane mushrooms, zinc, glutamine and turmeric have been shown to help heal the gut.
NDs will also focus on treating the vagal nerve, which runs down from the brain to the gut. Vagal tone exercises can help improve with the gut-brain connection provided by this nerve. These exercises include diaphragmatic breathing, singing, gargling and contrast showers that alternative between hot and cold.
In addition to recommending nutritional and lifestyle changes, NDs specialize in using botanical and other herbal supplements to treat various ailments including anxiety. Many herbs have been shown to be effective in the management and treatment of anxiety and depression.
Some herbs that are commonly used for anxiety are magnolia, lemon balm and lavender. Other herbs like Siberian ginseng, rhodiola, and schisandra can even help lower elevated levels of cortisol, the stress hormone.
Physical modalities such as constitutional hydrotherapy, chiropractic adjustments and manual therapy can have a significant impact on improving mental health. At NUHS, ND students are trained in all three modalities. At the NUHS Whole Health Center’s Hydrotherapy Suite, interns are trained in constitutional therapy, which involves the alteration of hot and cold towels. This relaxing therapy has been shown to stimulate the parts of the nervous system that govern rest and digestion along with the flight or fight response.
Chiropractic adjustments, which are taught to National University’s naturopathic students alongside its chiropractic students, have been shown to have positive effects on the nervous system as well.
NDs can also apply their training in manual therapy or recommend a massage. Both can help reduce blood pressure and, as a result, decrease symptoms associated with anxiety and depression.
Additionally, there are modalities patients can perform themselves. During a visit, an ND can help instruct patients how to practice mindfulness, yoga, breathing techniques and meditation.
Co-managing with psychotherapists
While NDs have many tools available to them for treating anxiety, they often work with other medical providers to ensure the most well-rounded care for their patients. When emotional and/or psychological factors are involved, NDs understand the positive affects of talk therapy as a treatment method.
In addition to medical doctors, NDs work collaboratively with mental health professionals to identify and address depression, anxiety and stress. As primary care physicians, NDs have the expertise to identify these conditions and provide appropriate referrals for counseling.
While NDs recognize that medication doesn’t cure anxiety, if symptoms are interfering with a patient’s day-to-day life, an ND may prescribe medication, depending on regulations in some states.
As part of the NUHS naturopathic program, students spend 100 hours studying pharmaceuticals so they know how to safely use their treatments integratively with conventional medicine. They are well-equipped to prescribe medications depending on where they practice as allowed by state regulations. This is especially important when working with chronically ill patients who are often taking various other medications.
Depending on a patient’s specific needs, an ND will utilize various combinations of these natural and noninvasive treatment methods. Compared to simply taking medication, this individualized and whole-body approach is more likely to result in improvements in anxiety. ND patients are also more likely to see results that are long lasting.
About the Author
Dr. Amanda Bose