Introduction
What are essential oils?
Essential oils (EO) are concentrated plant extracts that retain the complex aroma and flavour of their source.1 They are produced through steam distillation and can vary depending on climate, rainfall and geographical origin.2 Each essential oil is unique and has different effects on your body.
What is anxiety?
Anxiety is a feeling of unease, worry or fear that the majority of us experience at some point in our lives. This can be debilitating and lower your quality of life. Anxiety disorders are more intense and require treatment. According to the World Health Organisation (WHO) in 2019, anxiety disorders are the most common mental illness affecting 301 million people worldwide. Interestingly, women are affected more than men.
Considering the high number of people that are affected by anxiety, mild or severe, the application of essential oils could play a key role in improving symptoms and quality of life. This article will look at the following:
- What are the symptoms, causes, and impact on daily life?
- What are essential oils?
- How do essential oils work?
- How can I use popular essential oils to help with anxiety?
- Is there any evidence for the use of essential oils?
- How can I integrate essential oils into my routine?
- What precautions should I take?
Understanding Anxiety
Symptoms of anxiety
A large proportion of the population experiences occasional anxiety about daily life over issues such as those related to work, money and family. If your anxiety becomes more severe and does not go away it can develop into a disorder and greatly impact your daily activities. Severe anxiety can cause health-related issues such as sleep dysfunction, panic attacks, social anxiety and phobias.3 Anxiety disorders and their related symptoms are listed below:
- Generalised anxiety disorder (GAD); easily fatigued, irritable, restless, headaches or unexplained pains, sleep problems
- Panic disorder; sweating, chest pain, pounding heart, feeling of impending doom, trembling
- Social anxiety disorder; rigid posture, sweating, trembling, stomachaches, feeling self-conscious
- Phobia-related disorders; irrational fear about a specific object or situation, experiencing immediate intense anxiety when the item is encountered e.g. flying
- Social anxiety disorder; general intense fear, or anxiety about social or performance situations
If you are experiencing any of these symptoms of anxiety and are concerned about your well-being please consult a health professional.
Causes and triggers
Anxiety is associated with many health-related issues such as anxiety disorders and sleep dysfunction. Fear is linked to anxiety because it is a state of alarm characterised by the fight or flight response due to the presence of danger.4 Anxiety is a complex behavioural response that prepares the body to face an imminent threat.4 The anticipation of certain events can trigger a range of symptoms that negatively affect your mood. General risk factors for the development of anxiety disorders include; a family history of mental health illness, exposure to traumatic events, substance abuse and previous issues with distress during childhood.3 Other factors that can enhance anxiety are caffeine, medications or health problems such as an irregular heart beat (arrhythmia).
Impact on daily life
It’s estimated that 4% of the global population experience an anxiety disorder.5 Patients with anxiety disorders may find that it interferes with daily activities such as working, socialising and the ability to maintain relationships. Anxiety disorders can be difficult to control and can last a long time if left untreated.5 Long-term follow-up of patients is recommended as the risk of relapse is high and associated with high morbidity. Social anxiety disorder can lead to a very low quality of life and is linked to a high rate of suicide.4 Anxiety can have a severe impact on daily life which is why it is vital to control symptoms.
Basics of essential oils
How do essential oils work?
These volatile oils are concentrated from plant substances such as flowers, leaves, stalks, roots and fruits.6 Essential oil therapy is associated with relieving stress, rejuvenating your body and regenerating your mental state.6 Inhaling essential oil stimulates your emotions, impulses and feelings through the olfactory nerves in the nose to the brain and the central nervous system (CNS) for an immediately relaxing effect via the limbic system.12 Other studies have shown their antibacterial, antibiotic and antiviral properties.6 These could prove useful in treating a range of diseases such as Alzheimer's, cancer, and cardiovascular problems.
How should I use essential oils for anxiety?
Essential oils can be applied in various ways such as aromatherapy, topical application, and addition to bath and cosmetic products. In the pharmaceutical industry, research into alternative, natural and environmentally friendly medicines to treat disease is increasing.6
Aromatherapy: diffusers, sprays, and inhalers
Aromatherapy uses essential oil as a major therapeutic agent to treat disease. History has long recorded the aroma of organic plant molecules as an alternative therapy in ancient civilisations such as Egypt.6 Research has proven the skin permeability property of essential oil which allows them to work at the site in the body that is affected.6 Cosmetic aromatherapy utilises essential oil to moisturise, tone and cleanse to obtain healthy skin.6 The beneficial effects of essential oil enable them to help with a variety of health problems such as depression, insomnia, headaches and muscle pain.6 Inhalation can improve the feeling of calmness or relaxation through inhalers, sprays or diffusers.
Topical application: massage oils and body lotions
Directly applying essential oil to the affected area through massaging or using body lotions can provide antimicrobial, anti-inflammatory and wound-healing properties.7 Future research will increase our knowledge of the dermatological application of oils to develop specific treatments and better skin care products.7
Bath and body products: bath salts, soaps, and shampoos
Bathing can be relaxing and soothing to relieve symptoms of anxiety or stress. Incorporating essential oil bath products into your daily life such as salts, soaps and shampoos can encourage rejuvenation and a state of calm in your mind and body.
Safety tips and dilution guidelines
The use of essential oil whether it is aromatherapy, topical application or in a bath requires dilution to prevent a reaction to a highly concentrated and potent product. Essential oil can be diluted in water (e.g. a bath) or in a carrier oil (e.g. coconut oil). Direct undiluted application onto your skin should be avoided to reduce the risk of sensitisation. Essential oil contain many plant-derived chemicals which can irritate the skin causing contact dermatitis.8 Handling essential oil can expose the skin to a range of allergens due to their complex formulation.8 If you suspect that you may be developing a hypersensitivity such as allergic contact dermatitis (ACD), please consult a healthcare professional.
Popular essential oils for anxiety
Lavender: calming and relaxing
Lavender is a purple herb that contains beneficial components such as linalool and linalyl acetate.6 Studies have indicated that maximum skin absorption occurs during a massage which positively impacts the CNS. Linalool has a sedative effect whilst linalyl acetate has been described as having narcotic properties.6 Lavender is popular in products that can help induce sleep in patients with anxiety such as sleep mist sprays.6 The oil also has antibacterial and antifungal properties showing its therapeutic benefits to improve overall health.6
Bergamot: uplifting and balancing
Bergamot oil inhalation has been proven to be uplifting and improve your mental health and well-being.9 The mood-boosting properties of this natural remedy are due to high concentrations of limonene, linalool and linalyl acetate.9 Research has demonstrated its beneficial effects including reducing heart rate, blood pressure, depression and anxiety.9
Chamomile: soothing and sleep-inducing
Many herbal night time teas contain the ancient medicine chamomile to help include sleep and soothe an overthinking mind. Chamomile contains apigenin, a flavonoid, that binds to specific receptors in the brain causing a sedative effect.10 Chamomile has been used to treat patients with GAD, hay fever, insomnia, rheumatic pain, and inflammation.10
Frankincense: stress relief and emotional balance
Frankincense has been described as anti-inflammatory, antimicrobial and antitumour.11 Frankincense oil may also enhance learning and memory.11 The two major components are limonene and ⍺-pinene which can help to treat conditions associated with stress, anxiety and poor sleep.11 These include asthma, bowel disease, cancer and chronic pain syndrome.
Ylang Ylang: easing fear and optimising relaxation
The essential oil ylang ylang has been proven to act as an antidepressant by reducing fear, anxiety and frustration.12 Ylang-ylang can aid relaxation by reducing blood pressure.12
Scientific evidence and research
Studies supporting the use of essential oils for anxiety
Extensive research into using essential oil has demonstrated the benefits of plant-derived products on human health. Aromatherapy can reduce anxiety by stimulating the secretion of neurotransmitters such as serotonin and dopamine.13 Low serotonin levels have been linked to depression which can be treated with selective serotonin reuptake inhibitors (SSRIs).14 Massage aromatherapy using lavender, chamomile, and rosemary can also positively affect anxiety and self-esteem, improving the quality of life in cancer patients.10 Chamomile has been frequently used to calm nerves and treat anxiety.10 Other essential oils that can be used to relieve stress and anxiety are geranium, basil and angelica.6
Limitations and considerations
Aromatherapy contains many unknown variables such as essential oil standard dosage, treatment duration and frequency.12 Research into essential oils often lacks high-quality study design such as adequate placebo treatments (e.g. non-odour substance), low sample size and treatment standardisation for a clinical trial setting.15 Usually clinical trials investigate different levels of dosages and dilution for more robust results. However, studies indicate that topical application of essential oil and aromatherapy have moderately positive effects on blood pressure reduction, stress in healthy adults, sleep quality, depression and anxiety.15
Integrating essential oils into your routine
Creating a calming routine
Inhalation and external application of essential oil can provide a relaxing and calming effect to your daily routine. Holistic medicine often recommends the use of essential oil to relieve stress, anxiety and depression.6 Different oils have different properties, some can help you wind down before bedtime (e.g. adding a few drops of lavender to a bath) or increase your energy levels to start the day (e.g. inhalation of rosemary). Choosing the appropriate essential oil to improve your well-being is crucial in gaining the maximum benefits within a calming routine.
Combining essential oils with other anxiety-relief techniques
Anxiety-relief techniques such as controlling your breathing, progressive muscle relaxation (PMR) and visualising a calming environment can be more effective in combination with essential oil.16 Inhaling relaxing essential oils such as lavender alongside breathing techniques or PMR can lower cortisol levels which are linked to stress.16 Variations of relaxation strategies can work differently depending on the individual. Generally, they reduce symptoms associated with anxiety such as shortness of breath, muscle tension and increased heart rate.16
Tips for selecting high-quality essential oils
Choosing pure, organic essential oils is a highly recommended way to avoid added chemicals. Methods to assess the quality of essential oils include gas chromatography (GC) or mass spectrometry (MS).17 Check the labelling for the concentration, country of origin, method of extraction and correct botanical name as a low concentration can suggest that the essential oil has been diluted with a cheaper, lower-quality oil. For example, authentic lavender oil is sometimes mixed with lavender oil.18 Labels stating that it is a ‘perfume’, ‘therapeutic grade’, ‘aromatherapy grade’ or ‘fragrance’ oil should be avoided. Especially as there is no standard grading for essential oil. The storage container also affects the rate of deterioration. Essential oils should be transferred to a dark-coloured glass rather than being left in clear glass or plastic.
Precautions and side effects
Understanding possible side effects
The majority of studies have proven that essential oils used in aromatherapy are not harmful.6 Herbal medicine has continued to be a common treatment due to minimal toxic side effects.10 Despite essential oils being labelled as pure, they are complex products and can cause numerous allergic reactions including minor irritation and sensitisation, ACD and in extreme cases anaphylaxis.8,19
Interactions with medications and health conditions
Essential oils can be dangerous, toxic and flammable.21 Their volatility means it is likely they will interact with other drugs. Other than skin dermatitis, essential oils can also cause oral toxicity if ingested.21 Some prescription and herbal medicines use essential oils for flavouring and are safe to ingest internally.21 If you are considering introducing a substance into your daily routine and you’re on medication or have a health condition, it is important to exercise caution and seek advice from a health professional.
Importance of patch testing
For patients who have a history of contact dermatitis or are regularly in contact with oils, conducting a patch test is an important precaution to consider.8 Patch testing is a valuable tool to determine the allergic agent that could cause a potential reaction.20A series of allergens can be tested simultaneously on the skin surface in a controlled manner. Patients with certain skin conditions such as eczema may find that essential oils aggravate their symptoms.20
Summary
Anxiety is a negative feeling that occurs in the daily lives of most of us. Mild symptoms occur that are linked to work, relationships and money. If left untreated, anxiety can lead to disorders that affect millions globally which can be extremely debilitating and reduce quality of life. Essential oils such as lavender, bergamot and chamomile can help to control anxiety, reduce depression, and stress and improve sleep quality. Research has shown how aromatherapy, topical application and bath products can provide many beneficial effects to aid relaxation, rejuvenation and regeneration of your physical and mental well-being.
It is essential to select organic oils, check the labelling properly and ensure that they are stored in dark-coloured glass bottles when introducing essential oils into your daily routine. Essential oils are complex products that can elicit allergic reactions. Dilution is crucial to limit any unwanted side effects. If you are introducing a new product into your routine, please do so responsibly. Patients with a health condition should seek advice from a healthcare professional if they are concerned about medication interaction.
References
- National Institute of Environmental Health Sciences [Internet]. [cited 2024 Feb 3]. Essential Oils. Available from: https://www.niehs.nih.gov/health/topics/agents/essential-oils
- Ríos JL. Chapter 1 - Essential Oils: what they are and how the terms are used and defined. In: Preedy VR, editor. Essential Oils in Food Preservation, Flavor and Safety [Internet]. San Diego: Academic Press; 2016 [cited 2024 Feb 3]. p. 3–10. Available from: https://www.sciencedirect.com/science/article/pii/B9780124166417000018
- Anxiety disorders - national institute of mental health(Nimh) [Internet]. [cited 2024 Feb 6]. Available from: https://www.nimh.nih.gov/health/topics/anxiety-disorders
- Chand SP, Marwaha R. Anxiety. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 [cited 2024 Feb 6]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK470361/
- Anxiety disorders [Internet]. [cited 2024 Feb 6]. Available from: https://www.who.int/news-room/fact-sheets/detail/anxiety-disorders
- Ali B, Al-Wabel NA, Shams S, Ahamad A, Khan SA, Anwar F. Essential Oils used in aromatherapy: A systemic review. Asian Pacific Journal of Tropical Biomedicine [Internet]. 2015 Aug 1 [cited 2024 Feb 6];5(8):601–11. Available from: https://www.sciencedirect.com/science/article/pii/S2221169115001033
- Lin TK, Zhong L, Santiago JL. Anti-inflammatory and skin barrier repair effects of topical application of some plant oils. Int J Mol Sci [Internet]. 2017 Dec 27 [cited 2024 Feb 6];19(1):70. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5796020/
- Sindle A, Martin K. Art of prevention: Essential Oils - natural products not necessarily safe. Int J Womens Dermatol [Internet]. 2020 Nov 12 [cited 2024 Feb 6];7(3):304–8. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8243157/
- Han X, Gibson J, Eggett DL, Parker TL. Bergamot (Citrus bergamia) Essential Oil inhalation improves positive feelings in the waiting room of a mental health treatment center: a pilot study. Phytother Res [Internet]. 2017 May [cited 2024 Feb 6];31(5):812–6. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5434918/
- Srivastava JK, Shankar E, Gupta S. Chamomile: A herbal medicine of the past with bright future. Mol Med Report [Internet]. 2010 Nov 1 [cited 2024 Feb 6];3(6):895–901. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2995283/
- Okano S, Honda Y, Kodama T, Kimura M. The effects of frankincense Essential Oil on stress in rats. J Oleo Sci [Internet]. 2019 [cited 2024 Feb 6];68(10):1003–9. Available from: https://www.jstage.jst.go.jp/article/jos/68/10/68_ess19114/_article
- Gnatta JR, Piason PP, Lopes C de LBC, Rogenski NMB, Silva MJP da. Aromatherapy with ylang ylang for anxiety and self-esteem: a pilot study. Rev esc enferm USP [Internet]. 2014 Jun [cited 2024 Feb 6];48:492–9. Available from: https://www.scielo.br/j/reeusp/a/pxVJcRwHMzPQmNkcKdYJGLn/?lang=en
- Gong M, Dong H, Tang Y, Huang W, Lu F. Effects of aromatherapy on anxiety: A meta-analysis of randomized controlled trials. Journal of Affective Disorders [Internet]. 2020 Sep 1 [cited 2024 Feb 7];274:1028–40. Available from: https://www.sciencedirect.com/science/article/pii/S016503271933160X
- Moncrieff J, Cooper RE, Stockmann T, Amendola S, Hengartner MP, Horowitz MA. The serotonin theory of depression: a systematic umbrella review of the evidence. Mol Psychiatry [Internet]. 2023 Aug [cited 2024 Feb 7];28(8):3243–56. Available from: https://www.nature.com/articles/s41380-022-01661-0
- Freeman M, Ayers C, Peterson C, Kansagara D. Summary and discussion. In: Aromatherapy and Essential Oils: A Map of the Evidence [Internet]. Department of Veterans Affairs (US); 2019 [cited 2024 Feb 7]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK551018/
- Norelli SK, Long A, Krepps JM. Relaxation techniques. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 [cited 2024 Feb 7]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK513238/
- Beale DJ, Morrison PD, Karpe AV, Dunn MS. Chemometric analysis of lavender Essential Oils using targeted and untargeted gc-ms acquired data for the rapid identification and characterization of oil quality. Molecules [Internet]. 2017 Aug 11 [cited 2024 Feb 7];22(8):1339. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6152028/
- Marincaş O, Feher I. A new cost-effective approach for lavender Essential Oils quality assessment. Industrial Crops and Products [Internet]. 2018 Dec 1 [cited 2024 Feb 7];125:241–7. Available from: https://www.sciencedirect.com/science/article/pii/S0926669018308082
- Maddocks-Jennings W. Critical incident: idiosyncratic allergic reactions to Essential Oils. Complementary Therapies in Nursing and Midwifery [Internet]. 2004 Feb 1 [cited 2024 Feb 7];10(1):58–60. Available from: https://www.sciencedirect.com/science/article/pii/S1353611703000842
- Lazzarini R, Duarte I, Ferreira AL. Patch tests. An Bras Dermatol [Internet]. 2013 [cited 2024 Feb 7];88(6):879–88. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3900336/
- Farrar AJ, Farrar FC. Clinical aromatherapy. Nurs Clin North Am [Internet]. 2020 Dec [cited 2024 Feb 7];55(4):489–504. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7520654/