What Self-Help Treatments Are Helpful For Anxiety Disorders?

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Anxiety disorders are mental illnesses that involve overwhelming fear or persistent anxiety that interferes with daily life. They include panic disorder (with or without agoraphobia), generalized anxiety disorder, specific phobia, social phobia, obsessive-compulsive disorder, post-traumatic stress disorder and acute stress disorder.

Anxiety disorders are very common (eg about 10% of people will have one in any year). Recommended treatments for anxiety disorders including medication (eg selective serotonin reuptake inhibitors) and psychological treatment (eg cognitive behavior therapy). Although these treatments are effective, studies show that many people do not seek treatment from health professionals. However, many people self-treat their anxiety symptoms with complementary and alternative therapies that often do not involve a professional.

This article will give an overview of what self-help treatments are effective for anxiety disorders as shown by scientific research. Although anecdotal evidence or personal testimonials are intuitively convincing, this type of evidence is not a good guide to a treatment’;s effectiveness. This is because other factors may have caused the improvement, such as the passage of time, other outside events, or other treatments the person was using. Improvement or changes should also be measured accurately and systematically. Evidence is much more convincing than scientific studies that compare a treatment with some sort of control (eg a placebo), have many participants, randomly assign participants to the treatments, and keep participants unaware of whether they are using the treatment or the placebo. These studies are called randomized controlled trials (RCTs). Only these types of studies were examined in this review of what self-help treatments work for anxiety. Keep in mind that these studies are expensive to conduct, so there are fewer studies of self-help treatments than for standard treatments.

Helpful treatments

Bibliotherapy

Bibliotherapy is the use of structured books that contain a treatment program that the reader works through on their own. They are usually based on psychological treatments such as cognitive behavior therapy. Several studies show that bibliotherapy can be helpful for anxiety disorders, but that some contact with a health professional improves outcomes, or may even be necessary for improvement.

Computer-based CBT

This is similar to bibliotherapy, except the treatment program is on a computer or the internet, rather than in a book. Many studies have shown they are helpful for anxiety disorders. Support from a health professional may improve outcomes.

Relaxation training

Relaxation training (eg progressive muscle relaxation) teachers physical relaxation, through tensioning and relaxing muscles, using mental imagery, or breathing exercises. Studies generally show it is helpful for anxiety disorders, except for specific phobias.

Promising treatments

These treatments show promising evidence, but more studies are needed to be sure.

5-hydroxy-tryptophan (5-htp)

5-htp is an amino acid. It can sometimes be purchased over-the-counter as a dietary supplement. One good study showed it may be useful for a range of anxiety disorders, but more studies are needed to be sure.

Exercise

Many studies have shown exercise can reduce anxiety, but only one good study has looked at exercise as a long-term treatment for anxiety disorders. It showed exercise was better than placebo, but not as good as medication, for panic disorder.

Ginkgo biloba

Ginkgo biloba is a type of tree. Leaf extracts are sold as a dietary supplement. One good study of the extract EGb-761 showed promise for generalized anxiety disorder, but more studies are needed to be sure.

Inositol

Inositol is a compound similar to glucose. It is present in food and is available as a supplement. Inositol has been tested in studies of panic disorder and obsessive compulsive disorder, with encouraging results.

Kava

Kava is a herb from the South Pacific. Products containing kava are banned in many countries due to concerns over damage to the liver. Several studies indicate that kava may be effective for anxiety disorders, but not all studies agree.

Withania somnifera

Withania somnifera is a plant used in India for centuries. One study found it was better than placebo for anxiety disorders, but more studies are needed to be sure.

Yoga

Yoga exercises the mind and body through physical postures, breathing techniques and meditation. Three studies showed positive results, but most were not very good studies.

Unclear

For these treatments it is hard to draw conclusions because they have not been evaluated in good studies.

  • Autogenic training
  • Homeopathic remedies
  • Meditation
  • Passionflower
  • Valerian

Not encouraging but too early to tell

These treatments do not show promise, but more studies are needed to be sure they are not helpful.

  • Bach flower remedies
  • Omega-3 fatty acids
  • St john’;s wort

There are many other self-help treatments, but these were not reviewed because they have not been studied in RCTs.

Conclusions

The best self-help treatments appear to be bibliotherapy, computer-based CBT, and relaxation training. A few others show promise but have less convincing evidence. Even though some self-help treatments may be helpful, it is still recommended that you try them under supervision from a health professional.

Reference

Morgan, AJ and AF Jorm (2009). "Outcomes of self-help efforts in anxiety disorders." Expert Review of Pharmacoeconomics & Outcomes Research 9 (5): 445-459.