Q: I get very anxious when I have to fly or give a speech. I know my fear is irrational, but I can't seem to combat the overwhelming sensation that I could die or collapse. I've tried Valium and Xanax, but I don't feel right on these drugs, and I'm concerned about their addiction potential. Help!
-GD, Kake, Alaska
A: The reasons prescription tranquilizers aren't the answer is because they do not address the cause of your anxiety. Many people have imbalances or deficiencies in their basic neurotransmitter production. Deficiencies or imbalances in the essential brain chemicals serotonin and dopamine are a major cause of many psychological and neurological diseases (including migraines, depression, eating disorders, and attention deficit disorders). You can't just eat serotonin or dopamine. You have to synthesize them in your brain. The only way to promote production is by ingesting the precursors to these brain chemicals. The amino acids 5-HTP (5-hydroxytryptophan) and tyrosine are the immediate biochemical precursors to serotonin and dopamine, respectively. People with neurological disorders, including anxiety, are almost invariably helped by supplementing with these precursors (about 100 mg of 5-HTP and 500 mg tyrosine 2 to 3 times daily) as well as other basic nerve nutrients. NeuroResearch Clinics has a good Web site (neuroassist.com) to learn more about amino acid therapy for neurological challenges.
All brains also need good quality fats, such as fish oil-free of heavy metals or other toxic residues-and high in the important omega-3 oils EPA and DHA. About 3 g daily of a good quality fish oil is essential for your mental and emotional well-being if you suffer from chronic anxiety. And don't forget a high-potency B vitamin with at least 50 mg of all the B's and at least 1,000 mcg of B12. It's best taken in the morning because sometimes B vitamins are a bit stimulating.
If your anxiety is specific to certain situations and relatively mild, you may get the support you need from kava root in liquid or capsule form. Kava (Piper methysticum, related to the black pepper plant) has been used as a relaxant and "transformative" herb for more than 3,000 years in the Pacific Islands. Look for a product that contains 60 mg of kavalactones per serving, and that is not wild-harvested, if possible. It's much better to support farmers working with sustainable agriculture methods than to pilfer increasingly rare wild medicinal plants. The traditional way to use kava is to brew a strong tea and take several cups daily. Otherwise, the prepared extracts are good substitutes.
Another option for intermittent or nondebilitating anxiety is L-theanine, an amino acid that occurs naturally in green tea. Human research has shown that L-theanine creates a sense of relaxation approximately 30 to 40 minutes after ingestion. Two different mechanisms have been revealed. First, this amino acid directly stimulates the production of alpha brain waves, creating both deep relaxation and mental alertness similar to what is achieved through meditation. Second, L-theanine is involved in the formation of the inhibitory neurotransmitter, gamma-aminobutyric acid (GABA). GABA influences the levels of the two other major neurotransmitters, dopamine and serotonin, which together produce the desired relaxation effect. About 200 mg of straight GABA 2 to 3 times daily is a good choice for relatively mild anxiety that also presents with a rise in blood pressure. If, however, your anxiety is more constant or chronic, or can develop into panic attacks, then steady neurotransmitter support as described above, will be required.
Q: I pull out my hair, even my eyebrows and eyelashes-I don't want to but I can't help it. I sometimes do it for half an hour before realizing what I'm doing. I feel like a freak, and wish I could stop. I've tried various medications, but nothing has worked. I'm only 16, but I feel old and lonely.
-MH, Cheltenham, England
A: You have what has been labeled trichotillomania, a type of obsessive compulsive disorder (OCD). The amino acid therapy I mention in the previous reply will likely help you also. You will need to find a doctor who is familiar with the therapy to guide you. However, on your own, you could try high-dose inositol, which is a kind of fat-based B vitamin. You need at least 3 g and can take as much as 5 g or more twice daily-this is a big dose, but there are no side effects. You can buy inositol at any health food store, usually in lecithin granule form. This is generally derived from soy, so look for a non-GMO product. Inositol mixes quite well with juice, applesauce, or yogurt. Several studies have shown that inositol works better than pharmaceutical-grade antidepressants (such as Prozac, Effexor, or Lexapro) for OCD. Because inositol is a fat-based molecule, it can get into the nerve cell, through the fatty cell wall, and exert a more direct action on the nucleus of the cell than all the selective serotonin reuptake inhibitors, which only work in the spaces between the nerve cells. This is where real change can happen: in the nucleus of the cell where your genetic material is stored.
The other challenge with OCD besides the actual behavior, which needs to stop, is the work it will take to "reintegrate" you into "normal" life with friends and family, all of which can be anxiety-producing and cause you to retreat into the behavior. So it's important to work with a compassionate and experienced therapist (skilled in behavioral therapy) as well as get the brain chemical support to "switch off" the behavior.