Overview

It is hard to go through life without feeling anxious at some point, whether it is a big job interview you have to prepare for, or there is a major exam coming up. There are many factors that can contribute to feeling anxious, and it’s normal in moderation. However, anxiety that starts to affect your ability to do daily activities or tasks is more of an issue.

What is anxiety?

Anxiety is an unpleasant feeling of uneasiness or worry. Symptoms can range from mild to severe to the point where they can be debilitating. Anxiety disorders affect nearly 30% of adults at some point in their lives and are considered to be the world’s most common mental health disorders.¹ 

Anxiety disorders are estimated to have affected roughly 301 million people in 2019, with treatment being variable in terms of helpfulness.² The mechanism behind anxiety is mainly within the autonomic nervous system, especially the sympathetic nervous system, which activates the symptoms of anxiety. 

There are many different types of anxiety disorders. An accurate diagnosis will help you to understand your emotions and the most suitable treatment for you. 

The types of anxiety disorders are:

• Generalised anxiety disorder - chronic anxiety, often with no obvious individual triggers
• Panic disorder - involves repeated episodes of sudden intense feelings of anxiety and fear that peak within minutes. These can also involve physical symptoms such as rapid breathing, and palpitations, and are known as panic attacks
• Social anxiety disorder - a severe fear of social situations and being judged negatively by others 
• Phobia-related disorder - excessive fear towards a specific object, situation, or activity

Anxiety disorders can be caused by numerous factors in your life. They can also seem like they have not been triggered by anything in particular, (which is considered to be general anxiety disorder).

Causes of anxiety disorders

• Genetics - anxiety can run in the family
• Brain chemistry - disruption in the emotional processing centre of the brain can cause symptoms of anxiety
• Environmental stress - external factors causing stress or strain in our lives
• Medical factors where anxiety can be linked to an underlying health issue. This can include neurodivergence, such as autism or ADHD

Symptoms of anxiety include:

• Having trouble concentrating or making decisions
• Feeling irritable, tense, or restless
• Experiencing nausea
• Having heart palpitations
• Sweating, trembling, or shaking
• Having trouble sleeping
• Frequently getting headaches, muscle aches, or unexplained stomach aches 
• Having a sense of impending doom 

Having anxiety can also increase the risk of developing depression. Anxiety can lead some people to abuse substances in order to cope with their difficulties, engage in other risky behaviour, or feel suicidal. A combination of medication and talking therapies can help.²

Methods to treat generalised anxiety disorder include:

• Cognitive behavioural therapy
• Antidepressant medication such as selective serotonin reuptake inhibitors (SSRIs) and serotonin and noradrenaline reuptake inhibitors (SNRIs)
• Anticonvulsants such as Pregabalin
• Sedatives such as benzodiazepines

Medication such as benzodiazepines are usually prescribed for moderate to severe anxiety and typically help relieve symptoms, especially for acute anxiety episodes. However, benzodiazepines are associated with serious risks such as drowsiness, confusion, and sedation. They also carry a high risk of dependency and severe withdrawal symptoms, making them difficult to stop taking.

SSRIs and SNRIs are more effective for long-term management of anxiety, such as for coping with everyday anxiety. 

As there can be unpleasant side effects to some of these anti-anxiety medications, it is tempting to explore a holistic approach. Natural remedies such as using valerian root can be used as a possible treatment for anxiety. In comparison to the anti-anxiety medication, there are fewer side effects and it is not known to be addictive, making it a safer alternative for long-term use.

What is valerian root?

Valerian root (Valeriana Officinalis) is a plant native to Europe and Asia. It has a distinctive odour that many people find quite unpleasant. It is a common ingredient found in sleeping aids or mild sedatives as it is believed to help with sleeping difficulties such as insomnia.

There are many ways to take valerian root, depending on your preference. The most common forms of the remedy are as supplements and as a tea. 

The general dosage for taking valerian root for insomnia is between 400-600mg, taken once a day just before bedtime.³ However, for anxiety the dosage would be lower and taken more frequently to manage the symptoms better. If you are taking valerian root for anxiety, you are also advised to start at a lower dose to identify how your body responds. 

How valerian root helps to relieve anxiety

It is known that people who experience anxiety often also experience sleep issues. This is because the excess stress and fear associated with anxiety can make it harder to fall asleep and to stay asleep throughout the night. 

Poor quality sleep will also exacerbate anxiety. Therefore, improving the quality of sleep will help to lower stress levels and potentially reduce anxiety.

The active ingredients Valepotriates and valerenic acid are responsible for the plant’s sedative and anxiolytic effects.⁶

The mechanism behind valerian root’s anxiety-reducing properties involves the inhibitory neurotransmitter gamma-aminobutyric (GABA). 

GABA plays an important role in our ability to feel calm and relaxed. It blocks certain signals, which slows down functions in our brain. Valerian root is thought to enhance the release of GABA from the brain's nerve endings, and then blocking it from re-entering the nerve cells. 

This increases the brain’s exposure to GABA, extending the duration of GABA in the system to initiate a calming effect that aids sleep and reduces anxiety.⁵

The evidence base for valerian’s efficacy

One study into the effects of valerian root on anxiety symptoms included 39 patients with hemodialysis split into two groups. One group received valerian while the other group were given a placebo. 

The researchers conducted a two-phase clinical trial. During the first phase, group A took the valerian whilst group B received the placebo. There were significant reductions in the state anxiety scores in group A compared to B. 

In phase two, the group swapped over, so group A received the placebo while group B took the valerian. Again, the state anxiety scores were reduced. However, the reduction was significantly lower in group A compared to group B this time.

Although this study was limited by a small sample size, it demonstrated that valerian root had a positive anxiolytic (anti-anxiety) effect.⁷ Other studies have supported this finding. For example,

from a meta-analysis, valerian root was seen to reduce anxiety in HIV-positivepeople, anxious dental patients undergoing and surgery, and people experiencing premenstrual anxiety.⁵

 Another study that supports these findings consisted of a randomised controlled trial involving 36 participants with generalised anxiety disorder. Participants took either valerian, diazepam, or a placebo and were scored using the Hamilton anxiety scale (HAM-A). 

The HAM-A value reduced significantly in all three groups during the 4-week trial, but there was no significant difference in the scoring between the patients taking valerian compared to patients taking diazepam or the placebo. Although the greatest symptom improvement was seen in the group of people diazepam, it should be noted that this study also had a small sample size.⁸

Lastly, a large-scale study of 391 participants with anxiety and insomnia found that valerian root does not reduce anxiety or insomnia significantly compared to a placebo. This suggests that valerian root is not as effective as it has been believed to be.⁹

These mixed results do not give us a firm answer about whether valerian root is effective for anxiety, and call for further reliable research.

Risks when using valerian root

The correct potency of valerian root is important, to ensure you are taking the appropriate amount for the full benefits, while minimising the risk of adverse effects.

Although valerian root is considered safe, it can interact with other medications in ways that may alter their effects or be unsafe. It is therefore important to consult your doctor before taking valerian root.

Interactions with other substances include:

• Sedative medication such as barbiturates, benzodiazepines, or central nervous system depressants. This is due to amplification of the sedative effect of valerian
• Dietary supplements like St. John’s wort also can cause dizziness and confusion when taking with valerian⁴
• Alcohol, due to its depressant nature, which can enhance effects of valerian

As with anything, there are also risks when using valerian root, these are:

• Headaches
• Upset stomach
• Mental dullness
• Excitability
• Uneasiness
• Dry mouth 
• Vivid dreams
• Drowsiness the next morning after taking a high dose¹⁰

Due to these side effects it is advised to refrain from using heavy machinery or driving as valerian has sedative effects.

It is generally safe for short-term use by adults, as it has been used safely in studies that have lasted up to 28 days, but long-term safety use is still unknown. 

People who are pregnant and who are breastfeeding should not take valerian root as the risks are not fully explored yet.

It is always a good idea to consult with a healthcare provider before starting any new treatment, especially if you are already taking medication, as there could be potential interactions.

Summary

In conclusion, there are studies that suggest that valerian can be an effective treatment for anxiety. However, the results are not conclusive due to the small sample sizes that participated in the trials. Furthermore, as most of the studies are primarily focused on valerian root for insomnia or sleep, it is hard to find a selective study that specifically focuses on valerian root for anxiety, and its efficacy.

The evidence for valerian root is contradictory as well, demonstrated by the lack of difference in the state anxiety scores between study participants taking placebos and participants taking valerian. 

Therefore, further investigation is required to ensure valerian is an effective and safe treatment, especially for long-term use.