An Ayurvedic Approach to Anxiety

Anxiety is an extremely common problem, affecting approximately 23.4 percent of females and 14.3 percent of males. In fact, it is the most common mental disorder worldwide. Data from the National Institute of Mental Health suggest that around 31 percent of adults can expect to experience some type of anxiety disorder in their lifetime. Only about one-third of those who experience anxiety seek formal treatment, but anxiety is one of the most common reasons that people use holistic and alternative modalities.

From an Ayurvedic perspective, anxiety is an imbalance in the Vata dosha. Vata is the “air” principle. It is light, dry, and mobile. An imbalance of Vata, mentally, is associated with an overabundance of lightness or movement—erratic thoughts, worries, obsession, confusion, and difficulty focusing. Vata imbalance is also associated with a hyper-excitable nervous system and trouble sleeping. If you’ve ever heard someone say they feel “ungrounded,” that’s a classic description of Vata imbalance. It’s too much energy in the mind, not enough at the feet.

Thus, when Vata is disturbed, you feel ungrounded—disconnected from the earth. To treat anxiety/Vata imbalance, you have to stabilize your energy—calm the nervous system, relax the mind, release obsessive thoughts, connect to your body and to the earth, and ultimately surrender to the flow of the Universe.

Role of Meditation in Healing Anxiety

Meditation is a wonderful, evidence-based tool for healing anxiety. It is an ancient technology for gaining mastery over the mind. Meditation involves diligent practice letting go of thoughts, regulating the breath, and surrendering to the open space of the current moment. Meditation could be considered training for the rest of life. If you become skilled at controlling your mind while seated on the meditation cushion, you can more easily manage your mind during the rest of the day. In meditation, you become humbled by the strength of your thoughts. You learn to be compassionate to the struggle—the struggle to have a moment of stillness and the struggle to have peace in the rest of your life. The gift of struggle is surrender. It is the ultimate antidote to resistance. And, it is also a key in the healing of anxiety.

Surrender allows you to become less attached to what could happen, is happening, or did happen and helps you focus instead on finding your way to your heart in every moment. To heal anxiety at its roots you want to try to find a way to be loving in the face of fear.

It is important for you to learn to have compassion for yourself for the vulnerability that is life on earth. It is hard to be out of control here. It is scary to face your mortality or know that you could be hurt in a variety of ways at almost any time. This is why anxiety is so common! But, if worry is consuming, then it does suggest that you are holding on too tightly, trying to control, hoping for a specific outcome, and not trusting or surrendering to the greater intelligence and design of the whole.

Lifestyle Factors to Stabilize Vata and Release Anxiety

1. Eat warm, nourishing food (steamed veggies, homemade soups, and baked squash) for most meals of the day (until anxiety improves significantly and stays that way). Continue this diet more long-term if your primary dosha is Vata or Kapha.
2. Create a relatively solid structure for your day. Follow a routine. Avoid erratic lifestyle choices. This means: eat at generally regular times, work at regular times, exercise regularly (and at regular times), sleep at regular times, and spend some time outdoors every morning and evening. Routine helps stabilize Vata, ground restless energy, and calm chaotic minds.

Time in nature is grounding and inherently harmonizing. Try to put your bare feet on the earth or touch a tree for at least a few minutes (or much longer) every day. Get into wild nature at least once a week for a walk, hike, or picnic if your anxiety is severe. The restorative role of nature is a part of ancient Ayurveda, and it is also backed by science!

3. Meditate 20 or more minutes per day (20-plus minutes is best but even 10 minutes helps). This, too, is best built into a routine (such as first thing every morning). Look into Deepak Chopra’s and Oprah’s 21-Day Meditation Program if you need some instruction (and structure) for beginning a meditation practice. You could also consider doing a meditation retreat at the Chopra Center or another established meditation center. A retreat is a wonderful way to develop solid proficiency in meditation.
4. Do 15-plus minutes of yoga every single day. Yoga has been proven by multiple good quality scientific studies to be helpful for anxiety. It is soothing for the nervous system, which is agitated when Vata is out of balance and/or you are anxious. Yoga increases glutathione, a natural antioxidant (helps you look young and radiant, prevents illness, and detoxifies the body). It is also much easier to meditate after doing yoga, so consider doing 10–15 minutes of yoga followed by meditation first thing in the morning (and/or later in the afternoon as a work break, especially if feeling stressed or anxious).
5. Take a nightly bath in sea salt and ginger powder while also drinking ginger tea. Ginger is very warming. Vata is considered to be a cool or cold energy, so warm temperatures are balancing for this cool, chaotic energy. Too much ginger can be a bit irritating to the Pitta dosha long term, but when stressed or anxious the Vata dosha is temporarily out of balance and needs treatment. So, even a Pitta can handle a little heat temporarily to help stabilize a Vata imbalance.

As a holistic psychiatrist who is also a trained herbalist, I regularly use Ayurvedic herbal remedies, in addition to the above behavioral approaches, to help people improve anxiety, ground Vata, and regulate stress levels. These Ayurvedic approaches have a long history of use in India and have passed the test of time. Many of them have also more recently passed the test of scientific analysis.

Ayurvedic Herbs to Stabilize Vata and Release Anxiety

1. Holy Basil (Ocimum sanctum) is probably my number one herb of all time. Its name says it all: Holy basil. It has been revered as a sacred plant for centuries in India. Holy basil has numerous benefits, including anti-anxiety effects, mild anti-depressant effects, antioxidant effects, anti-stress/adrenal protective effects. It also has anti-viral properties, pain-relieving properties, blood glucose stabilization properties and more.

Holy basil, which is also called tulsi in Ayurveda, protects against chemical, emotional, and physical stress. I used it personally all day long (as a tea, which I kept in a thermos) to help myself get through residency training (after medical school). Holy basil was a great gift to me at that time and remains in my regular health routine to this day.

Tulsi is available as a tea, tincture, liquid gel, capsule, and powder. An average recommended dose is 500–1000 mg up to three times daily, as needed. I tend to use a full tea ball or two to three tea bags/cup one or more times per day. Tulsi tea is a wonderful alternative to alcohol for unwinding and calming the nervous and endocrine systems at the end of the day. Growing this plant at home will bring harmonious vibrations to your garden.

2. Ashwagandha (Withania somnifera) is one of the best Vata-balancing herbs out there. It is soothing, grounding, and warming. It boosts thyroid activity a bit (an action that is likely responsible for the warming effect), so it can often be a helpful herb for those with borderline or low thyroid function.

Because of this warming property, ashwagandha is not great for longer-term use by Pitta doshas (they are already warm). It can aggravate their heat and increase their irritability over time. A few weeks use when acutely anxious, however, is not usually a problem.

The presence of anxiety indicates a temporary imbalance of the Vata dosha. (Everyone has all three doshas within them, but one generally predominates in the constitution and is considered the “primary” dosha. Any of the three can fall out of balance, however, causing symptoms.) There is great scientific evidence for ashwagandha’s use as an anxiolytic. It also shows benefit for stress, insomnia, cognitive dysfunction, neurologic/nervous system conditions, PTSD, and more. A commonly used dose is 400–800 mg per day.

3. Jatamansi (Nardostachys jatamansi) has been used for hundreds (maybe thousands) of years in Ayurveda. It has a role in anxiety, depression, insomnia, and more. It is a very strong antioxidant, and it has even been found to be protective against gamma radiation exposure. More recently, it is being looked at as a cancer preventive or treatment. This herb is a little harder to find, as it is less well-known in the U.S., but it is worth the search. The dose is 500–1500 mg per day.
4. Gotu Kola (Centella asiatica) is a marvelous plant remedy that has been used in Traditional Chinese Medicine and Ayurveda for a variety of conditions—most notably those that have a neurologic component (memory issues, nerve damage, learning enhancement, epilepsy) or psychologic component (anxiety, depression, stress). It actually is a leaf that can be eaten as a salad! In America, it’s a bit harder to find the fresh leaf, but the supplement is widely available. The dose is 350–1400 mg per day. (I tend to start slowly and work my way up depending on symptom severity and the body’s unique response.)
5. Bacopa (Bacopa monnieri) is a traditional Ayurvedic herbal medicine that is sometimes known as “Brahmi.” (Gotu kola is also sometimes called Brahmi, which can be confusing. Both herbs have benefit for cognitive function as well as anxiety and can even be combined, if one is mindful and starts with a low dose.) Bacopa has benefits for anxiety, memory/mental acuity, and ADHD. In fact, it has even been scientifically studied as an alternative to prescription stimulants in children with ADHD (and performed well for this purpose). There is also quite a bit of scientific data supporting bacopa’s use in elderly adults or others with cognitive decline. The usual dose is around 750 mg per day (range: 500–900 mg).

In Summary

Anxiety is a complex problem and, thus, there are no simple solutions. The greatest improvements I have seen come with dedicated effort across multiple dimensions of life. I have seen people experience dramatic improvements in their anxiety levels if these suggestions are consistently and diligently practiced. Think: lifestyle change rather than one-time adjustment.

Also, don’t forget the supremely important role of compassion in all forms of healing. Some individuals truly are more sensitive and more prone to anxiety. (I am an astrologer as well as a physician, and I can actually see if someone is predisposed to anxiety in his or her birth chart!) This is probably perfect for their soul’s unique learning, growth, and function. So, realistic expectations are helpful, especially if you believe yourself to be a bit more vulnerable to stress and worry.

Even those who are naturally more sensitive can improve, however. I fall into this category! My own anxiety during medical school is what led me down the path of holistic medicine, and I am happy to say I have been able to radically improve my life with the perspectives, herbs, and practices described in this article. Your anxiety can be a great teacher—showing you how to best care for yourself and encouraging you to explore resources your unique mind-body-spirit system needs in order to thrive in this world.

The journey of self-discovery, taken with an open heart, inevitably leads to healing.

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