20 Top Supplements to Calm Anxiety, Depression & Insomnia

On a daily basis in my medical practice I have patients approach me with terrible stomach issues, sleeping problems, heart palpitations, headaches, attention difficulty, and other issues frequently linked to the effects of stress hormones. In chronic stress and anxiety, the hormone cortisol drips through the body like a leaky fight-or-flight faucet. We need cortisol to survive, but too much for too long has toxic ramifications—the body and mind can compensate for a time, but, eventually, other health issues will manifest from cortisol’s unmitigated release, such as thyroid problems, chronic pain, eating disorders, adrenal fatigue, irritable bowel syndrome, hair loss, weight issues, hormonal imbalance, insomnia, immunosuppression, ulcers, heartburn, and much, much more.

Below, I list several herbs, foods, vitamins, amino acids, and more that have shown benefit in lowering anxiety, aiding sleep, and relieving depression. I also provide links to my favorite brands-our readers can access these suggestions and any other supplement they may want for 10-15% off suggested retail price by creating an account on our Fullscript dispensary: https://us.fullscript.com/welcome/hearthsidemedicine/signup

For those who don't know me well, I am a family nurse practitioner (FNP) trained in conventional family medicine and integrative + functional medicine. Prior to my FNP degree I worked as an RN in emergency medicine, ICU, maternal child health, and mental health. Alongside my partner, I own and operate Hearthside Medicine Family Care, an integrative medicine primary care practice. I will frequently blend herbs and nutrients into my primary care practice, sometimes as a stand-alone treatment or as an adjunct to a prescription. For nutrient levels, including all vitamins, minerals, antioxidants and omega-3 fatty acids, I often order a comprehensive nutrient panel on patients to check their baseline nutrient levels to determine which supplements are needed most and in what dose.

My mission is helping patients live a fuller life by getting to the root cause of their symptoms. Because I have personally dealt—off and on, and for much of my adult life—with anxiety and insomnia, I understand and empathize with my patients. First and foremost, I am adamant about destigmatizing mental health discussions. Thus, I've also written a brief blog on which prescription medications may be useful to incorporate here: https://www.hearthsidemedicine.com/post/anxiety-to-medicate-or-not-medicate-and-which-ones-if-so

Please be aware that there are books and books containing volumes of warnings regarding possible drug-herb interactions and unpleasant side-effects and adverse reactions; I strongly advise discussing your personal health profile with me or another knowledgeable provider before beginning any of these options, as some may have dangerous consequences when combined with certain prescription meds or in the context of one's unique health picture. I list a few cautions, but certainly not all of them, so, again, it is vitally important that you seek professional guidance for any new regimen.

1. High Potency Lavender Extract:

Taken on a regular basis about an hour before sleep, the European lavender extract product Lavela has demonstrated efficacy favorable to that of benzodiazepines in reducing anxiety, with none of the side effects or addictive potential. Findings of two studies suggest that standardized extracts of lavender may have anti-anxiety effects similar to paroxetine (Paxil™) and lorazepam (Ativan™) (Kasper et al 2014; Woelk & Schlafke 2010).

Lavender oil can also be used as aromatherapy in a diffuser. On your pillow before sleep, in a bath, or a few drops applied topically to reduce acute anxiety symptoms.

The dose of lavender oil, as you find in the above product, is 80 mg/day.

Lavender relaxation tea: here is a nice recipe from Aviva Romm, MD:

½ tsp of each of the following: lavender blossoms, chamomile blossoms, and lemon balm leaf, and steep in a tea-pot or herbal tea infuser for 20 minutes in 1 cup of boiling water. The dose is 1 cup. Tincture dose is 1-2 mL in ¼ cup of water, up to 4 times/day.

Who should NOT use Lavender:

Lavender has been found to have mildly estrogenic actions (increasing estrogen),so if you have a history of estrogen receptor positive cancer, stick with gentle teas now and then, or skip this herb and choose from the other options below. Oral lavender can cause constipation and headaches. It can also increase appetite, increase the sedative effect of other medications and supplements, and cause low blood pressure.

2. Curcumin

One of the principal active ingredients derived from the spice turmeric, has particularly powerful anti-inflammatory effects, found to be helpful in reducing anxiety specifically associated with a chronically activated stress response. *Side Note: Curcumin is one of my go-to nutrients for gut health issues, high cholesterol and/or chronic pain and inflammation as well!

For best absorption, take curcumin extract. The key ingredient that helps with both anxiety and inflammation is called "curcuminoids". Curcumin has decent evidence for indications for anxiety, chronic pain, inflammation, depression, IBS, lowering cholesterol and possibly aiding in weight loss.

Dose: Studies typically use doses of 500–2,000 mg of curcumin/ day, often in the form of an extract with a curcumin concentration that is much higher than the amounts naturally occurring in foods. Some brands include Meriva or Theracurmin, which have been properly enhanced for best absorption; curcumin can be used safely in breastfeeding.

Side effects: High doses may result in nausea and gastrointestinal problems. Side effects of curcumin included sore throat, gastrointestinal bloating, swelling around the eyes and itching.  These side effects were more frequent at doses higher than 1,200 milligrams. I suggest patients start with a dose of 500 mg /day x 1 week and increase as tolerating.

Important note before you buy: Often, cheaper supplements contain just turmeric root powder, which contains about 2-4% curcuminoids. The key amount of curcuminoids you need for an effective turmeric supplement is around 500- 1200 mg of 95% curcuminoids. Look on the label for the words "turmeric root extract" not just "turmeric root" or "turmeric root powder", generally speaking. Avoid supplements that list a "proprietary blend" in their ingredient list--this often means there is no guarantee of how many curcuminoids you are actually getting because they don't have to disclose it.

Who should use caution/avoid use: Due to scant safety data in pregnancy, I advise to not use during pregnancy. Avoid if you have iron deficiency anemia. And finally, like many supplements, there are some reports that some brands may have lead contamination or contamination with other substances, so be sure to by a reputable brand that is USP verified and/or has a certificate of analysis (see more on this below).

3. Adaptogens

Adaptogens are a class of herbs that safely, gently, and effectively regulate the body’s stress response via their tonic actions on the adrenal glands. They are best used for chronic anxiety and depression rather than for panic attacks (acute anxiety) and work well for adrenal fatigue or insomnia as well. They start working their best after 30 days of use, much like anti-depressant prescription drugs.

I have had multiple patients with depression and/or anxiety start Ashwagandah instead of an SSRI (prozac, lexapro, zoloft, etc) and report a major shift in their mood. It is safe to take with an SSRI as well. It can also help with ADHD and adrenal fatigue.

Adrenal fatigue is a disorder that is associated with a variety of symptoms, including fatigue, lightheadedness, body aches, and low blood pressure. When your adrenal glands can’t work properly, mostly due to chronic physical and mental stress, you start experiencing the mentioned symptoms.

Adaptogens are meant to be taken daily, over a period of 3 months to a year for optimal results. They are safe for most adults (not for pregnant folks, and if you are on medications for an autoimmune disease talk with your medical provider first). Some can be used with children, too (check with your child’s provider).

Examples include Ashwagandha (Withania somnifera), Rhodiola (Rhodiola rosea), Eleutherococcus (Eleutherococcus senticosus) , Reishi mushroom, Ginseng (Panax ginseng) , and Schisandra (Schisandra chinensis) and Holy Basil (Tulsi). Please note that some herbs, including some of these (like ginseng, may increase risk of bleeding if taken in large amounts, which can be significant for those on blood-thinners or with clotting disorders.

One of my own favorite blends is Vital Adapt by Natura Natural Products. It contains these adaptogens as well as additional supporting herbs. There are many adaptogen blend products I love, and I generally choose the calming adaptogens like holy basil and rhodiola for anxiety and the energizing adaptogens like eleuthero, ashwagandha and ginseng for depression.

Reishi (adaptogen). This is safe to use while breastfeeding. The dose is 3 to 9 g dried mushroom in capsules or tablets daily or 2 to 4 mL tincture in water 2 to 3x/day

Ashwagandha can significantly reduce the symptoms of anxiety, and has been shown to improve cortisol levels by resetting adrenal-associated stress, overall reducing your predisposition to anxiety. Adaptogens do not work overnight. They are best taken daily, not “as needed”, to reach full effectiveness.

Ashwagandha helps balance hormones that contribute to anxiety and depression as well as helping induce relaxation . A number of studies support the effectiveness of the herb as a natural anxiety & depression remedy. In 2012, a study found that patients diagnosed with anxiety disorder showed significantly lower anxiety and 28% lower levels of serum cortisol when taking Ashwagandha as opposed to a placebo. I advise taking it in the morning, starting with 500 mg/day x 1 week, then slowly increase up to 1800 mg /day if needed/tolerated.

You can add 1-2 tsp of the powder to smoothies or other foods, it can be taken in capsules, 500-1000 mg twice daily, or in tincture form, 2-4 mL, twice daily. I don't care for the grassy taste so stick to the pills. Most patients tolerate this relatively well, but caution should be advised if there are underlying thyroid concerns, and some studies suggest that intermittent thyroid levels be checked. I have had a couple patients report increased anxiety taking it, so as with anything, “start low, go slow” with the dose to see how your body responds to it.

Holy basil

Also know as tulsi, holy basil is another adaptogen often used together with ashwagandha and/or rhodiola. This combination is often helpful for those with anxiety-induced sleep disorders as well. There is some evidence that holy basil may help lower cholesterol as well as high blood sugar levels (such as in pre-diabetes or frank diabetes). Holy basil is one of my favorites to calm an over-stimulated brain and nervous system.

Contraindications: Holy Basil (Tulsi) and Ashwagandah are contraindicated if you have hypoglycemia, are pregnant or breastfeeding.

Rhodiola. The bright yellow-green plant is also known as golden root or roseroot. Rhodiola is an adaptogen herb and is the second-most-consumed in traditional medicine. As an adaptogen herb, it can have a direct effect on your stress levels and ability to control and manage stress. The herb has been shown to have beneficial qualities in the relief of anxiety symptoms. Rhodiola encourages calmness and relaxation as well as being a natural stress reducer. I find this adaptogen to be incredibly helpful for high anxiety and stress.

For a calming blend of adaptogens, I like Gaia's Daytime HPA.

4. Chamomile

Chamomile is a gentle, effective and natural way to treat anxiety. If you’re not a fan of tea, it’s also available in pill form. It’s also been known to ease digestion issues and encourage sleep, helping many insomnia sufferers. Chamomile tea is safe during pregnancy and while breastfeeding. It is a good option for children as well.

Limited data shows that short-term use of chamomile is generally considered safe and can be effective in reducing symptoms of anxiety. It also works well for stomach cramps and indigestion. It can be taken as a stand-alone or in combination with other calming ingredients for sleep such as 5-HTP, L-theanine, hops, passionflower and GABA. An example of some combo supplements I like are Botanicalm, Sleep and Neurosera.

Caution: chamomile can increase the risk of bleeding when used with blood-thinning drugs (or with other blood-thinning foods and supplements such as gingko, ginger, and garlic).

Use of chamomile can cause allergic reactions in some people who are sensitive to the family of plants that includes chamomile. Other members of this family are ragweed, marigolds, daisies and chrysanthemums. Don't take it for more than a few weeks at a time, unless your medical provider approves. It can cause some side effects such as headaches, dizziness and drowsiness. Some compounds in chamomile (Matricaria recutita) bind to the same brain receptors as drugs like Valium.

You can take chamomile extract as a supplement, typically standardized to contain 1.2% apigenin (an active ingredient). In one study at the University of Pennsylvania Medical Center, in Philadelphia, patients with generalized anxiety disorder (GAD) who took chamomile supplements for eight weeks had a significant decrease in anxiety symptoms compared to patients taking placebo.

5. Lemon balm

Lemon balm is used classically to promote relaxation and improve outlook; motherwort, a bitter tasting herb, is also gentle go-to for anxious moments and often combined with lemon balm. Lemon balm may also be helpful in treating digestive issues and headaches. Motherwort is generally considered safe while breastfeeding only (not pregnancy). The full dose is 300 milligrams up to four times a day.

In one study of healthy volunteers, those who took standardized lemon balm extracts (600 mg) were more calm and alert than those who took a placebo. Lemon balm is sold as a tea, capsule, and tincture. It's often combined with other calming herbs such as hops, chamomile, and valerian. Capsules: Take 300 to 500 mg dried lemon balm, 3 times daily or as needed

A calming combo product that can be taken during the day for those with high anxiety, or at night for those with sleep concerns, is "Sleep Aide" by Vital Nutrients: lemon balm, ashwagandha, L-theanine, magnolia, cordyceps and phosphatidylserine:

Caution: Lemon balm is generally well-tolerated and considered safe for short-term use, but can cause nausea and abdominal pain.While it's generally safe, be aware that some studies have found that taking too much can actually make you more anxious. So follow directions and start with the smallest dose.

6. Kava kava (Piper methysticum)

Extracts of kava mediate anti-anxiety effects by binding to neurotransmitter receptors for GABA, dopamine, and the opioid receptors. Research findings support that an effective dose of kava for reducing symptoms of generalized anxiety is between 120 and 300mg of a standardized extract.

Caution: Kava inhibits certain liver enzymes involved in the metabolism of different medications, resulting in potential herb-drug interactions in individuals who take antidepressants, benzodiazepines and beta-blockers.

Kava is an excellent “emergency remedy” for a panic attack, and is great for use when there is stage fright, test anxiety, or fear of flying. 3-5 drops is often a sufficient dose of kava, though you can go up to even 30 drops at a time-- give it 30 minutes before you take more at any given time because it doesn’t always ‘hit’ right away.

Caution: While it is overwhelmingly safe for occasional use (a few times a month, for example) and even daily use at very low doses, for higher doses, taken regularly, I recommend working with a licensed practitioner, because there is a remote risk of it affecting the liver (do not use if you have liver disease!)

Its side effects may include stomach complaints, restlessness, headache and fatigue. Of more concern are interactions between kava and other medications. Kava can intensify sleepiness if taken with sedatives, sleeping pills, antipsychotics or alcohol, raising the risk of injury during activities such as driving and using heavy machinery. It may also enhance the sedating effects of anticonvulsants and worsen the side effects associated with antipsychotic medication

7. Vitex (also called Chasteberry or Chaste tree)

Vitex is often used for hormonally-related mood swing support caused from low progesterone. Vitex works by decreasing levels of the hormone prolactin. This helps rebalance other hormones, including estrogen and progesterone — thus reducing PMS/PMDD symptoms.

Dose: Vitex is best taken in one dose, first thing in the morning with water. If you’re taking capsules, you need to be taking about a 900-1000 mg a day. Vitex is also available as a liquid extract. If you choose this option, take 2-3 dropperfuls (or follow the suggested use of the manufacturer of the product you purchase). You can start to see results in about 10 days. Vitex, however, takes some time to be effective. The amount of time it takes to see results in part depends on the severity of hormonal imbalance, sometimes up to 2-3 cycles.

Vitex is well-known for hormonal mood support, often easing depression and anxiety that may occur during PMS and can reduce PMS symptoms in general. Motherwort is another herb often combined with vitex for hormonal support.

Because chasteberry affects hormones, it may worsen some diseases, including breast, uterine and ovarian cancer. Avoid chasteberry if you have any of these or another condition that’s negatively impacted by hormonal changes. Don’t take chasteberry if you’re pregnant or breast or chestfeeding.

8. Essential Fatty Acids:

Our nervous system requires essential fatty acids for healthy brain functioning. They can be obtained from foods that contain them, for example, cold water fish, walnuts, and flax seed oil all contain different types. They can also be obtained by supplementation – which I recommend as an addition to a healthy diet if you have anxiety, depression, ADHD, OCD, or Bipolar disorder.

Dose: 2000-3500mg/day taken with food and Vit D/K/Mag

There are many excellent brands. I recommend Nordic Naturals most often because they test for mercury contamination, something to consider. For vegans, there is a non-animal derived variety:

9. Magnesium and Vitamin D:

Magnesium Dose: 400 – 600 mg/day of Magnesium glycinate. Taking magnesium can reduce insomnia--in fact, tt's my most commonly recommended supplement for anxiety and insomnia. I personally enjoy a cup of magnesium powder with warm water on nights I'm having difficulty sleeping or feel edgy or having restless legs.

Magnesium deficiency is quite common and not only contributes to anxiety, but to heart palpitations associated with anxiety attacks, muscle tremors, cramps, headaches, stomach aches, and restless legs and constipation.

Low vitamin D is also associated with higher anxiety and mental health issues in general. For Vitamin D, I generally like to check a patient's baseline blood (serum) levels before suggesting a starting dose. Here in Central Oregon, I find that many folks are low, especially in the winter, so a typical starting dose is 2,000-4,000 IU daily. Vit D needs Vit K2 and Magnesium to be properly absorbed safely.

That being said, there is such a thing as vitamin D toxicity, so I periodically check my patient's serum levels when advising them to take D. Further, D is best absorbed when taken with a healthy fatty meal. Getting plenty of sunshine can also help with increasing Vit D levels. Foods rich in D include salmon, mushrooms, cod liver oil, herring, sardines, canned tuna, egg yolks, fortified milk and juice.

10. B-Complex:

B vitamins are necessary for the production and breakdown of neurotransmitters involved in modulating anxiety. I recommend my patients to taking a methylated B-complex with active folate and B-12 daily, but I like to check their baseline levels first. Sometimes we also check for a genetic variant called MTHFR which can predispose them to low B vitamin levels and necessitates a special type of folate and B12 ( "methylated").

B-complex" is simply a vitamin composed of multiple types of B vitamins. B vitamins affect mood as well, including anxiety and depression. I often order a comprehensive nutrient panel on patients to check their baseline nutrient levels to determine which supplements are needed most.

If you’re low in certain B vitamins (more likely in vegans and vegetarians), you may feel extreme fatigue, or have cognitive difficulties, including foggy thinking and short term memory loss. Each B complex vitamin works a little differently, and impacts different aspects of health. Some people have health conditions that cause them not to absorb B12, which can cause serious medical problems. B vitamins are found in dark, green leafy (preferably organic) veggies, avocados, eggs, salmon, beans, or via a high-quality vitamin.

11. Amino Acids

Amino acids such as tryptophan, tyrosine, histidine and arginine are used by the brain for the synthesis of various neurotransmitters and neuromodulators. Free form amino acids are one of the most consistent and powerful tools available for supporting depression and other aspects of mental health. In patients struggling with mental health, you often find an underlying protein deficiency, even in patients eating a good quality diet. With amino acid testing, you can verify deficiencies. When deficient, free-form amino acids can rapidly replete the missing nutrients. Amino acid deficiency is common in those with gut problems.

Amino Replete by Pure Encapsulations is one of the few amino acid products on the market that contains a broad spectrum of amino acids in proper ratios, including L-tryptophan. I also really like putting a scoop of amino acid peptides into my smoothie or coffee. Vital proteins makes plain powder or creamer powder in coconut, vanilla, or chocolate flavors:

In response to supplementation, patients rapidly improve. Mood is elevated and energy levels increase. The effects are often dramatic, with patients describing a night and day difference when supplementing with free-form amino acids as compared to without.

L-theanine:

L-theanine is an amino acid derived from green tea. Able to cross the blood-brain barrier, at recommended doses it safely imparts a sense of calm and well-being, reduced mental stress and anxiety, and improves memory and cognitive function. It may interact with GABA and dopamine receptors in the brain, explaining its actions. While it is found in tea and coffee, the supplement allows you to get the benefits without the caffeine – which worsens anxiety for many.

Research shows that L-theanine helps curb a rising heart rate and blood pressure, and a few small human studies have found that it reduces anxiety. In one study, anxiety-prone subjects were calmer and more focused during a test if they took 200 milligrams of L-theanine beforehand. You can get that much L-theanine from green tea, but you'll have to drink many cups—as few as five, as many as 20.

A small trial in Japan showed that a combination of two amino acids -- 2.64 grams each of L-lysine and L-arginine daily -- helped to reduce stress and anxiety. Both amino acids are available in tablets and capsules. Amino acids are generally considered safe in pregnancy. L-lysine is encouraged in pregnancy, in fact, at a higher dose.

Taurine:

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