Relaxation and Calming Supplements
It is no surprise that dietary supplements marketed for promoting relaxation, reducing anxiety, and alleviating stress are among the top-selling products on the market. Millions of tired and stressed-out people (many of whom may be reading this book) can relate to promises of natural products that will enhance their brain function and make them feel better.
As discussed previously, physiologists and nutritionists regularly document the dramatic improvements in mood, emotions, confidence, and self-efficacy that result from some very simple lifestyle modifications. Regular exercise and adequate diet can result in profound changes in the body's own production of mood-elevating chemicals, such as the endorphins that cause "runner's high" and the neurotransmitters like serotonin that contribute to emotional well-being. In general terms, any amount of exercise can help to induce feelings of relaxation and calmness. Walking for twenty minutes on as many days of the week as possible (but at least three times per week) might be a good place to start.
On the nutritional side of things, it will probably come as no surprise that diet is intimately tied to emotions. Just think about your feelings as you contemplate gorging on that hot fudge sundae (weakness), followed by your feelings when you finally give in to the temptation (guilt) and start eating (elation), until you get to the bottom of the bowl (disappointment). All kidding aside, the foods we eat directly influence our moods, because the macronutrients (carbohydrates, proteins, fats) and micronutrients (vitamins, minerals, and phytonutrients) they contain ultimately act as potent neurochemicals. For example, a higher-protein diet can leave some people feeling energized, while a higher-carbohydrate diet can leave others feeling hungry, lethargic, and depressed.
For most people, the best advice for getting a handle on their emotional balance is to take a week or so to analyze how their diet affects their mood. Pay attention to every speck of food you eat and how it makes you feel. This is made easier by keeping a "food and mood" diary for seven to ten days, wherein you record every bite of food eaten (including quantities), time of day eaten, and mood and energy levels before and afterward. The patterns revealed in a food diary can be enlightening. But if the thought of adding such a task to your busy schedule stresses you out, then a less formal period of observation can be informative, too. Once you feel you know a bit about how certain foods influence your emotions, then you can decide where some of the dietary supplements outlined below may (or may not) fit into your lifestyle.
In very general terms, a number of popular herbs are used to help "take the edge off" after a particularly stressful day. Many of the herbs in this category are found in relaxing herbal teas and include chamomile, melissa, lemon balm, hops, oats, skullcap, and passionflower. Even though these herbs are widely used to help soothe ragged nerves (again, mostly as herbal teas), none of them have any strong or convincing scientific evidence to support their effectiveness against stress, anxiety, or elevated cortisol levels. This certainly doesn't mean they are useless—after all, a warm cup of tea can sometimes be just the thing to help reduce stress and bring you back to a more relaxed state.
Some of the more specific and effective dietary supplements for promoting relaxation are outlined in greater detail in the rest of this section. Many of these supplements are also used to treat mild forms of depression, anxiety, and insomnia, but they all have a general calming quality that can contribute to overall feelings of relaxation.
Kava (Piper methysticum) is a root from a pepper plant used for centuries by Pacific Islanders (e.g., Fijians and Hawaiians) as a ceremonial intoxicant to help people relax and socialize. Modern-day usage of kava is as a dietary supplement for relieving anxiety and tension. The active ingredients in kava, chemicals called kavalactones, act as a mild central nervous system depressant, but typically do not produce the hangover effects associated with alcohol.
Traditional preparation of the kava root involves cutting up freshly dug roots, chewing them, and then spitting them into a large communal bowl containing water or coconut milk. This unappetizing combination is then mixed, strained to remove any remaining large pieces, and passed around for everyone to share. It all sounds (and tastes!) pretty disgusting, but early Christian missionaries to the islands actually tried to ban kava parties because people were having such a good time preparing and passing the kava drinks. If you can't stomach the chewing and spitting part of kava preparation, the roots can be pounded until soft, then soaked in a fluid before drinking. The brew has a somewhat bitter taste and a slightly numbing or tingling sensation on the tongue.
Of course, kava is not very often prepared or consumed in the traditional way by average supplement users in the United States. Instead, the kava roots are dried and ground into a powder by machines. The powder can then be packed into capsules or tablets, blended into drinks, or dissolved in an alcohol-based extract. Americans spend about $30–$50 million annually on kava-containing products—a powerful testament to our high-stress lifestyles and our need for help in relaxing.
Although few well-designed studies have been conducted in the United States on kava in humans, several projects have been carried out in Europe. These trials have mostly been conducted in Germany, and have found kava (at a dose containing 50–150 mg per day of kavalactones) to be helpful in alleviating anxiety and other emotional problems related to stress. One study assessed various psychological stressors and found that after four weeks the group taking kava supplements showed significant decreases in stress in every category measured, in contrast to the placebo group, which showed little variation in any area.
No side effects or withdrawal symptoms have been noted during kava-supplementation studies or when people stopped taking the supplement, but recently several case studies have shown that kava supplementation may be linked to various forms of liver damage in some people. In light of these findings, some supplement companies are voluntarily removing their kava-containing products from the market. Additionally, the U.S. Food and Drug Administration in early 2002 issued a warning that kava carries a "potential risk" of causing severe liver damage and urged kava users and their doctors to be on the lookout for signs of liver injury. Therefore, until we know more about the potential liver toxicity associated with kava supplements, it would be prudent for people with liver damage to avoid kava and for healthy people to consume no more than 50 mg of kavalactones per day.
Because kava depresses the nervous system, it should not be taken with alcohol or in conjunction with antianxiety drugs. In addition, although kava appears to be helpful for alleviating cases of mild to moderate anxiety, self-medication with kava is probably not appropriate for individuals with major anxiety conditions. It is also advisable to refrain from using kava before driving. An interesting case occurred in Maryland a few years ago wherein a police officer pulled a man over for driving erratically. The man slurred his speech and had difficulty walking, so the officer assumed he was intoxicated, despite the man's insistence that he had not been drinking. Blood-alcohol measures indicated no alcohol in the man's system. After further questioning, it was discovered that the man had recently consumed several cups of kava tea.
Melatonin is a hormone produced in the pineal gland of the brain from the amino acid tryptophan. It is used in the body to help regulate sleep/wake cycles. Melatonin levels are lowest during midday and highest at night. Daylight is known to slow the production of melatonin, while darkness increases its production.
Dietary supplements containing melatonin promote relaxation and sleep, but the best evidence of its effectiveness comes from studies of people who have disturbed sleep/wake cycles, such as from jet lag and shift work. Several studies show that low-dose melatonin supplements (1–5 mg taken thirty to sixty minutes before bedtime) can help people sleep better, fall asleep faster, and have higher energy and alertness levels upon waking. Theoretical reasons also exist for melatonin's apparent benefits in alleviating depression, especially the type of depression brought on by a lack of sunlight during winter months and often referred to as seasonal affective disorder (SAD, also known as the "winter blues"). On the other hand, some studies suggest that melatonin can induce or deepen depression in susceptible individuals.
The interaction of melatonin with other supplements or drugs is unknown, but melatonin supplements may be dangerous for people with cardiovascular risks, due to the possibility of vasoconstriction and increased blood pressure. Additionally, the National Institutes of Health have warned about possible dangers of melatonin supplementation, including infertility, reduced sex drive in males, hypothermia, retinal damage, and interference with hormone replacement therapy. Information regarding the long-term effects of melatonin supplements is unavailable.
Melatonin can be viewed as a relatively inexpensive and nonaddictive alternative to over-the-counter chemical sleep aids. It may be particularly useful as a short-term regulator of sleep/wake cycles in cases such as getting the body clock back on schedule after crossing several time zones (jet lag). Studies of melatonin as a sleep aid or for relief of symptoms associated with jet lag have shown 1–10 mg to be effective, depending on the degree of sleep disturbance. Be careful, though, because the higher end of this dosage range can cause some people to experience vivid nightmares. High-dose melatonin supplements (around 50 mg) may disrupt female fertility and menstrual patterns and should be avoided except under the supervision of a reproductive physician.
Valerian (Valeriana officinalis) has been used as a medicinal antianxiety herb and sleep aid since the days of the Romans. The dried roots of the plant are used in teas, tinctures, capsules, and tablets for promoting relaxation, inducing sleep, calming nerves, and reducing anxiety. It is unclear which of valerian's numerous compounds is the true active ingredient, but the combination of compounds appears to work together in the brain in a manner similar to the action of prescription tranquilizers such as Valium and Halcion. One problem, however, is that valerian is notoriously unstable; it loses its activity very quickly if it is not processed, packaged, and stored in exactly the right way.
Numerous studies in animals and humans support the effect of valerian as a mild sedative and sleep aid. In several studies, 400–600 mg of valerian extract, taken approximately one hour before bedtime, provides benefits in terms of overall relaxation, reduction of tension, and ability to fall asleep. Some products combine valerian with support herbs such as hops or melissa (lemon balm), both of which offer their own additional relaxation benefits with none of valerian's characteristic sweaty-sock odor.
Taken before bedtime, valerian appears to reduce the amount of time required to fall asleep. It is unknown, however, whether the quality of the sleep is affected by valerian consumption. Valerian is generally regarded as a mild tranquilizer and has been deemed safe by the German Commission E (the German regulatory body for herbal medicines) for treating "restlessness and sleeping disorders brought on by nervous conditions."
Because the activity and strength of valerian preparations can vary significantly from one product to the next, it is recommended whenever possible to select a standardized preparation containing 0.5–1.0 percent valerenic acids and to follow the package instructions for the particular product. As a general guideline, approximately 250–500 mg of a 5-to-1 or 6-to-1 extract can be taken before bed (as a sleep aid) or as needed as a mild tranquilizer.
Although valerian does not appear to be habit-forming or to result in hangover-like morning drowsiness, it does seem to impair one's ability to concentrate for a few hours after taking it. Occasional reports of headaches and mild nausea are documented, but habituation or dependency is unlikely when it is used as directed. Valerian should be avoided by pregnant and lactating women, and by children. Individuals currently taking sedative drugs or antidepressant medications should consult with their personal physician before taking valerian, and no one should take the herb in conjunction with alcohol or other tranquilizers, or for a period of more than two weeks.
Mark, the building contractor whom we met earlier, struggled with stress-related insomnia. Mark already got a great deal of physical activity at work, and because his wife (a fitness instructor) knew a lot about nutrition, he had help in eating a very well-balanced diet. He started on a supplement regimen that was targeted to control his cortisol levels and help him relax and sleep better. Mark's program included both theanine (100 mg taken with a bottle of water as he left the job site in the late afternoon) and valerian (250 mg taken thirty minutes before bedtime). The theanine helped him to relax without getting drowsy on his way home from work, and the valerian helped him to relax just a bit more and drop off to sleep faster. After only a few days on this regimen, Mark reported a deeper and more restful sleep than he had experienced in months. As a result of his better sleep quality, Mark's energy levels went up and his ability to concentrate at work was much improved.