Researchers have been studying the effects of stress on health, and they’ve known for decades that physical and emotional stress can trigger a host of serious health problems, including heart attacks. People who have chronic stress is something many of us have in our daily lives, but learning how to successfully manage life’s unavoidable stresses is essential to avoiding disease and illnesses.
Researchers have long suspected that the stressed-out, type A personality has a higher risk of high blood pressure and heart problems. We don’t know why, exactly. Stress can directly increase heart rate and blood flow and causes the release of cholesterol and triglycerides into the bloodstream. It’s also possible that stress is related to other problems — an increased likelihood of smoking or obesity — that indirectly increase the heart risks.
Many studies have shown that stress can worsen asthma. Some evidence suggests that a parent’s chronic stress might even increase the risk of developing asthma in their children. One study looked at how parental stress affected the asthma rates of young children who were also exposed to air pollution or whose mothers smoked during pregnancy. The kids with stressed-out parents had a substantially higher risk of developing asthma.
Excess fat in the belly seems to pose greater health risks than fat on the legs or hips — and unfortunately, that’s just where people with high stress seem to store it. “Stress causes higher levels of the hormone cortisol,” says Winner, “and that seems to increase the amount of fat that’s deposited in the abdomen.
Diabetes. Stress can worsen diabetes in two ways. First, it increases the likelihood of bad behaviors, such as unhealthy eating and excessive drinking. Second, stress seems to raise the glucose levels of people with type 2 diabetes directly
Stress is considered one of the most common triggers for headaches — not just tension headaches, but migraines as well.
Depression and anxiety
It’s probably no surprise that chronic stress is connected with higher rates of depression and anxiety. One survey of recent studies found that people who had stress related to their jobs — like demanding work with few rewards — had an 80% higher risk of developing depression within a few years than people with lower stress.
Here’s one thing that stress doesn’t do — it doesn’t cause ulcers. However, it can make them worse. Stress is also a common factor in many other GI conditions, such as chronic heartburn (or gastroesophageal reflux disease, GERD) and irritable bowel syndrome (IBS), Winner says
One animal study found that stress might worsen Alzheimer’s disease, causing its brain lesions to form more quickly. Some researchers speculate that reducing stress has the potential to slow down the progression of the disease.
There’s actually evidence that stress can affect how you age. One study compared the DNA of mothers who were under high stress — they were caring for a chronically ill child — with women who were not. Researchers found that a particular region of the chromosomes showed the effects of accelerated aging. Stress seemed to accelerate aging about 9 to 17 additional years.
A study looked at the health effects of stress by studying elderly caregivers looking after their spouses — people who are naturally under a great deal of stress. It found that caregivers had a 63% higher rate of death than people their age who were not caregivers.
Damaged Brain Structure and Connectivity
Neuroscientists at the University of California, Berkeley, have found that chronic stress triggers long-term changes in brain structure and function.
Cortisol Can Trigger Stem Cells to Malfunction
The ‘stress hormone’ cortisol is believed to create a domino effect that hard-wires pathways between the hippocampus and amygdala in a way that might create a vicious cycle by creating a brain that becomes predisposed to be in a constant state of fight-or-flight.
Chronic stress has the ability to flip a switch in stem cells that turn them into a type of cell that inhibits connections to the prefrontal cortex, which would improve learning and memory, but lays down durable scaffolding linked to anxiety, depression, and post-traumatic stress disorder.
Unfortunately, in a modern world, chronic stress can hijack the fight-or-flight system and backfire in a daily life in which you are not in physical danger.
Stress and Cardiac Arrhythmias
The importance of psychological factors in the genesis of cardiac arrhythmias is well recognized. Among the emotional factors, anger is strongly associated with triggering of ventricular arrhythmias . Negative emotions like anger and hostility increase the risk of atrial fibrillation .
Factors and symptoms of atrial fibrillation
Psychic stress was the most common factor triggering arrhythmia (54%). Atrial fibrillation (AF) is nowadays divided into three different forms; paroxysmal, persistent and permanent. Even if the pathological, electrical and physiological phenomena leading to AF have been described in ever more detail.
Most of the patients in a group being treated at a hospital for PAF consider psychic stress to be the factor triggering their arrhythmia.
Atrial fibrillation and managing stress
Stress can contribute to causing heart rhythm disorders (arrhythmias) such as atrial fibrillation. Some studies suggest that stress and mental health issues may cause your atrial fibrillation symptoms to worsen. High levels of stress may also be linked to other health problems.
Several limited studies suggest that psychological distress may be linked with AF symptom severity.
demonstrates the consequence of psychological distress on AF-specific symptom severity
Stress-induced cardiac arrhythmias: The heart-brain interaction
There exists a complex and dynamic interaction between the heart and brain especially in the setting of negative emotions. Stress, anger, and depression have all been shown to have a significant impact on cardiac arrhythmogenesis.
Not only does negatively charged emotion result in coronary ischemia, platelet activation, vasoconstriction, alteration in hemodynamics and catecholamine release but it also has a significant effect on atrial and ventricular electrical indices 
Even in the setting of a structurally normal heart, we can identify changes in the neuro-cardiac axis in response to stress and anger but it appears when there is a substrate for arrhythmia these effects can be detrimental . There clearly is a difference between some people being more susceptible to the effects of ANS activation, irrespective of whether a structural abnormality is present .
Stress and anger not only impact ventricular arrhythmias but also atrial arrhythmias. Many studies in relation to stress events and arrhythmias are subject to recall bias. A prospective study demonstrating that negative emotional triggers were identified as triggers of atrial fibrillation.
Interestingly, not only does stress increase the frequency of cardiac arrhythmias but also the lethality of ventricular arrhythmias . So focussing on prevention or treatment of stress, anger, and depression could be paramount to the electrophysiologists’ management of their patients.
In humans, chronic stressors have long been linked to cardiac morbidity. Altered serotonergic neurotransmission may represent a crucial pathophysiological mechanism mediating stress-induced cardiac disturbances.
Psychological Stress and Cardiovascular Disease
There is an enormous amount of literature on psychological stress and cardiovascular disease. This report reviews conceptual issues in defining stress and then explores the ramifications of stress in terms of the effects of acute versus long-term stressors on cardiac functioning.
According to James Wilson (author of “Adrenal Fatigue: The 21st Century Stress Syndrome”), chronic stress and lifestyle affect the body’s ability to recuperate from physical, mental or emotional stress.
Because of the vast influence of the adrenals on the body, symptoms of adrenal fatigue can mimic a number of disorders and isn’t always easily recognizable.
Most sources agree that adrenal fatigue symptoms include extreme fatigue, brain fog, weight gain, insulin resistance and others (more on that below).
While the mere fact you feel fatigued is not necessarily indicative of adrenal fatigue, and adrenal fatigue tests aren’t always straightforward, there is evidence that high cortisol levels found in saliva are associated with a reduced immune function, increased blood pressure, increased heart rate and delayed growth in children. (21)
These symptoms and more can be indicative of a few different disorders and are often overlooked by doctors, but more and more people are starting to realize that a combination of these could indicate the onset of adrenal fatigue.
Some people at high risk for the symptoms of adrenal fatigue include busy new parents, students in college or post-graduate studies and caregivers, such as nurses or family members caring for invalid relatives.
If you have adrenal fatigue, it can also be a major cause of excess fat storage and low energy levels. Luckily, you can heal adrenal fatigue with three simple steps: start an adrenal fatigue diet, take supplements and reduce stress.
An Angry Heart Can Lead To Sudden Death
Before flying off the handle the next time someone cuts you off in traffic, consider the latest research that links changes brought on by anger or other strong emotions to future arrhythmias and sudden cardiac arrests, which are blamed for 400,000 deaths annually.
New research published in the March 3, 2009, issue of the Journal of the American College of Cardiology finds that anger-induced electrical changes in the heart can predict future arrhythmias in patients with implantable cardioverter-defibrillators (ICDs).
While previous studies have demonstrated an increased incidence of sudden cardiac death during times of population stress such as earthquake and war, this study provides the first evidence that changes brought on by anger and other strong emotions can predict arrhythmias and may link mental stress to sudden cardiac arrest–which accounts for over 400,000 deaths each year.
“It’s an important study because we are beginning to understand how anger and other types of mental stress can trigger potentially lethal ventricular arrhythmias, especially among patients with structural heart abnormalities,” says Rachel Lampert, M.D., F.A.C.C., associate professor, Yale University School of Medicine.
In contrast to exercise, mental stress doesn’t elevate one’s heart rate much, suggesting that changes seen with mental stress may be due to a direct effect of adrenaline on the heart cells. Therefore, mental stress testing could provide an alternative to atrial pacing for patients unable to exercise, according to Dr. Lampert.
More research is needed, but these data suggest that therapies focused on helping patients deal with anger and other negative emotions may help reduce arrhythmias and, therefore, sudden cardiac death in certain patients.
Supplements for Anxiety and Adrenal Fatigue
Ashwagandha is an adaptogen herb that is often used as a natural remedy for anxiety because it helps to stabilize the body’s response to stress. In a systematic review that assessed data on the effectiveness of ashwagandha as a treatment for anxiety, researchers found that most studies concluded with significant improvement in anxiety symptoms with ashwagandha therapy. (7)
However, ashwagandha is not only a stress reliever. It also protects the brain from degeneration and it works to improve anxiety symptoms by destroying free radicals that cause damage to the brain and body. Research shows that Ashwagandha helps to improve focus, reduce fatigue and fight anxiety without the side effects of most anti-anxiety medications. (8)
5. Kava Root
Research shows that kava root can be used to treat anxiety because it’s a nonaddictive and non-hypnotic anxiolytic. Kava is used to improve mood, ease anxiety and boost sociability. It works by stimulating dopamine receptors and inducing euphoria. In fact, a randomized controlled trial conducted in Australia found that kava can be considered a first-line therapy for generalized anxiety disorder and it’s shown to be safe for people undergoing treatment. (9)
A meta-analysis reported by Cochrane, which involved 7 trials, suggests that there are significant effects from kava treatment for anxiety with few side effects, which are all considered mild. (10)
Take kava under the guidance of your health care provider, as it can interact with certain medications. Also, do not consume alcohol if you are using kava and be aware of the most common side effects, including a headache, drowsiness, and diarrhea.
6. 5-HTP (5-hydroxytryptophan)
Supplementing with 5-HTP, which is synthesized from tryptophan (an essential amino acid that acts as a mood regulator), can help to treat a number of issues that are associated with anxiety, including trouble sleeping, moodiness and headaches. 5-HTP increases serotonin, which is a calming neurotransmitter that transmits signals between the nerve cells and alters brain functions that regulate your mood and sleep patterns.
Studies show that 5-HTP therapy is associated with a significant reduction in anxiety due to its calming effects. However, it’s important that you do not take 5-HTP with any prescription anti-anxiety or antidepressant medications. (11, 12)
7. GABA (Gamma-aminobutyric acid)
GABA is an amino acid that is responsible for decreasing anxiety in the nervous system, and it also helps to relax your muscles. It’s used for a number of conditions, in addition to relieving anxiety, including reducing PMS, relieving insomnia, stabilizing blood pressure, treating ADHD, burning fat and relieving pain.
GABA is also an inhibitory neurotransmitter that can cause a sedative effect, helps regulate nerve cells and calms anxiety. Anti-anxiety drugs, like Xanax and Valium, work to increase the amount of GABA in the brain. There are GABA supplements available in your local health food or vitamin store. Or, another option is to use valerian root, which naturally increases your brain’s GABA level and helps to calm anxiety. (13)
Magnesium plays many important roles in the body, and magnesium deficiency is one of the leading deficiencies in adults. So if you’re struggling with anxiety, you may want to try taking a magnesium supplement. (14) Magnesium helps to relax your muscles and calm the nervous system.
Also, it’s vital for GABA function and for regulating certain hormones that are crucial for calming the brain and promoting relaxation.
Magnesium is commonly used to combat anxiety, poor digestion, muscles aches and spasms and trouble sleeping. Look for magnesium in citrate, chelate and chloride, which are forms that the body absorbs better.
However, be aware that too much magnesium can cause diarrhea, so be careful with the dose. Because of this, start with smaller amounts of magnesium and work your way up to a dose that’s effective for you.
9. Vitamin B Complex
B vitamins help to combat stress and stabilize your mood. Vitamin B6, in particular, serves as a natural remedy for anxiety because it works to boost mood, balance blood sugar levels and maintain a healthy nervous system.
In fact, symptoms of a vitamin B6 deficiency include anxiety, irritability, depression, changes in mood, muscle pains and fatigue. In addition, Vitamin B12 is also important for fighting chronic stress, mood disorders and depression.
It helps to improve your concentration, improve energy levels and allow your nervous system to function properly. (15)
10. Lavender Oil
Lavender oil has been shown to reduce anxiety and help relax the body. A multi-center, double-blind, randomized study conducted in Germany found that Silexan, an oral lavender oil capsule, was just as effective as benzodiazepine, an anti-anxiety medication that usually induces sedation and had a high potential for drug abuse. (16)
Research also shows that using lavender oil topically or inhaling lavender can help to induce calmness and relieve symptoms of anxiety-like nervousness, headaches, and muscle pain. (17) Put 3 drops of lavender oil in your palm and rub it onto your neck, wrists, and temples. You can also diffuse lavender oil at home or at work, inhale it directly from the bottle for immediate relief, and add 5–10 drops to warm bath water to fight anxiety naturally.
11. Roman Chamomile
Roman chamomile essential oil is used to calm nerves and reduce anxiety because of its mild sedative and relaxation-promoting properties. Inhaling roman chamomile works as an emotional trigger because the fragrance travels directly to the brain to help fight anxiety symptoms.
A study published in Alternative Therapies in Health and Medicine found that when chamomile oil is taken orally, it causes a significant reduction of anxiety and depression symptoms when compared to a placebo. (18) Diffuse 5 drops of Roman chamomile oil at home or at work, inhale it directly from the bottle or apply it topically to the neck, chest and wrists. Roman chamomile is also gentle enough for children to use as a natural remedy for anxiety.
Reduce Adrenal Fatigue Stress
The key to restoring your adrenal function is to heed your mind and stress needs. Pay attention to your body!
- Rest when you feel tired as much as possible.
- Sleep 8–10 hours a night.
- Avoid staying up late and stay on a regular sleep cycle — ideally, in bed before 10 p.m.
- Laugh and do something fun every day.
- Minimize work and relational stress however possible.
- Eat on a regular food cycle, and reduce your caffeine and sugar addiction.
- Exercise (even moderate exercise and walking can help). Yoga, in particular, can help to improve quality of life and reduce stress responses. (32)
- Avoid negative people and self-talk.
- Take time for yourself (do something relaxing).
- Seek a counselor or support group for any traumatic experiences.
How to Heal Adrenal Glands
Supplement with vitamin D3, a B complex that’s got extra B5, a fatty acid supplement with DHA and EPA, a good multivitamin powder, and a liquid mineral formula.
Get the diet right. No stimulants like coffee, caffeinated teas, energy drinks, tobacco, etc. In fact, no drugs period. Eat more fresh raw vegetables than anything else, and eliminate refined and processed foods like white rice, HFCS, and even that bag of organic, super healthy, ancient grain, non-GMO quinoa chips.
Adaptogens like ashwagandha, eleuthero, holy basil, maca, Panax ginseng, Rhodiola rosea, and Schisandra, as well as glandulars (desiccated glands), are generally used for naturopathic healing of the pituitary.
(Growth Hormone Production Nutrition). When someone is matched with the right supplements, the right formula can increase IGF-1 levels by 20 percent or more. A good alternative to HGH injections, these supplements are amino acid-based precursor formulas that contain ingredients such as glutamine, tyrosine, GABA, arginine, and lysine.
Let’s talk about “self-talk” for a minute. Our bodies are made to heal. However, the words we say have a great impact on our body and our ability to heal. Regardless of what diet and supplements you take, your environment is one of the most important components.
So, be kind to yourself. Try to avoid saying negative things about yourself and others. It’s important to choose to be around positive people and stay positive about yourself as well.
Many people roll their eyes at such advice, but it’s scientifically proven that it’s possible to reduce pathological worry by practicing “thought replacement,” a positive self-talk practice that involves verbally reciting positive outcomes to stressful situations. (33)
Signs of When to Go to the Endocrinologist for Adrenal Fatigue
Many people go for some time without consulting their general physician or endocrinologist about some of the symptoms of adrenal fatigue. However, experiencing high cortisol symptoms over a long period of time can really take a toll. In addition, some symptoms can be indicative of more serious conditions.
It’s probably time to visit the endocrinologist if:
- You experience one or a combination of adrenal fatigue symptoms for an extended period of time
- Your symptoms have begun interfering with normal life relationships and/or activities, such as work, family time or school
- Dietary and lifestyle judgments have not significantly improved your symptoms
- Your sleeping patterns have shifted into insomnia and/or you are no longer able to get restful sleep, no matter how long you’re in bed
- You experience hyperpigmentation or patches of darker skin on your body
- You are a woman who has ceased menstruating
- You experience dizziness and/or overall weakness for multiple consecutive days with no explainable cause (such as flu, concussion or excessive exercise)
- You are unsure of how or unable to study adrenal fatigue supplements to safely take them, or unsure of how to structure an adrenal fatigue diet
Because of the controversial nature of this condition, you may need to seek out a naturopath who will help you treat adrenal fatigue with a combination of dietary advice and supplement recommendations, as well as any hormonal or other medications necessary.
Manage your stress
The stress hormone, cortisol, is public health enemy number one. Scientists have known for years that elevated cortisol levels: interfere with learning and memory, lower immune function and bone density, increase weight gain, blood pressure, cholesterol, heart disease.
Chronic stress and elevated cortisol levels also increase the risk for depression, mental illness, and lower life expectancy. This week, two separate studies were published in Science linking elevated cortisol levels as a potential trigger for mental illness and decreased resilience—especially in adolescence.
Cortisol is released in response to fear or stress by the adrenal glands as part of the fight-or-flight mechanism. The fight-or-flight mechanism is part of the general adaptation syndrome defined in 1936 by Canadian biochemist Hans Selye of McGill University in Montreal. He published his revolutionary findings in a simple seventy-four line article in Nature, in which he defined two types of “stress”: eustress (good stress) and distress (bad stress).
Both eustress and distress release cortisol as part of the general adaption syndrome. Once the alarm to release cortisol has sounded, your body becomes mobilized and ready for action—but there has to be a physical release of fight or flight. Otherwise, cortisol levels build up in the blood which wreaks havoc on your mind and body.
Regular physical activity and mindfulness meditation are two effective ways to reduce stress and lower cortisol. Although this study doesn’t focus on the benefits of reducing cortisol, other research suggests that making lifestyle choices that reduce stress and lower cortisol can improve brain structure and connectivity.
Finding ways to manage your stress may help improve your health and manage your condition.
Stress management ideas
Simply taking a few deep breaths engages the Vagus nerve which triggers a signal within your nervous system to slow heart rate, lower blood pressure and decreases cortisol. The next time you feel yourself in a stressful situation that activates your ‘Fight-or-Flight’ response take 10 deep breaths and feel your entire body relax and decompress.
Setting aside 10-15 minutes to practice mindfulness or meditation will fortify a sense of calm throughout your nervous system, mind, and brain. There are many different types of meditation.
Social connection with family and friends
Close knit human bonds—whether it be family, friendship or a romantic partner—are vital for your physical and mental health at any age. Recent studies have shown that the Vagus nerve also responds to human connectivity and physical touch to relax your parasympathetic nervous system.
The “tend-and-befriend” response is the exact opposite to “fight-or-flight”. The “tend-and-befriend” response increases oxytocin and reduces cortisol. Make an effort to spend real face-to-face time with loved ones whenever you can, but phone calls and even Facebook can reduce stress and cortisol if they foster a feeling of genuine connectivity.
Regular physical activity
Kickboxing, sparring, or a punching bag are terrific ways to recreate the “fight” response by letting out aggression (without hurting anyone) and to reduce cortisol.
Any aerobic activity, like walking, jogging, swimming, biking, riding the elliptical… are great ways to recreate the ‘flight’ outlet and burn-up cortisol. A little bit of cardio goes a long way. Just 20-30 minutes of activity most days of the week pays huge dividends by lowering cortisol every day and in the long-run.
Fear increases cortisol. Regular physical activity will decrease fear by increasing your self-confidence, resilience, and fortitude—which will reduce cortisol.
Laughter and Levity
Having fun and laughing reduces cortisol levels. Dr. William Fry is an American psychiatrist who has been studying the benefits of laughter for the past 30 years and has found links to laughter and lowered levels of stress hormones. Many studies have shown the benefits of having a sense of humor, laughter and levity. Try to find ways in your daily life to laugh and joke as much as possible and you’ll lower cortisol levels.
Listening to Music that you love, and fits whatever mood you’re in, has been shown to lower cortisol levels. I recently wrote about the wide range of benefits that come from listening to music in a Psychology Today blog title “The Neuroscience of Music, Mindset, and Motivation”. We all know the power of music to improve mood and reduce stress. Add reducing your cortisol levels as another reason to keep the music playing as a soundtrack of health and happiness in your life.
A healthy diet
Eating anti-inflammatory foods can be a natural remedy for stress and anxiety because they are important for neurotransmitters synthesizing and balancing your mood and stress response. In addition, it’s also important to eat healthy fats, unrefined carbohydrates, and lean protein. To improve anxiety symptoms, make sure to add vitamin B foods, magnesium-rich foods, foods high in calcium and omega-3 foods to your diet too.
- wild-caught fish (like salmon, mackerel, tuna, white fish and herring)
- grass-fed beef
- organic chicken
- nutritional yeast
- organic eggs
- yogurt or kefir from grass-fed animals
- organic leafy greens (like spinach, kale, chard and collard greens)
- organic fresh vegetables (like celery, bok choy, broccoli, beets and artichokes)
- organic fresh fruits (like blueberries, pineapple, banana and figs)
- sea vegetables
- healthy fats (like avocado, coconut oil and olive oil)
- beans (such as black beans, adzuki beans, chickpeas and fava beans)
- legumes (like lentils and peas)
- nuts (such as walnuts, almonds and cashews)
- seeds (including flaxseeds, chia seeds, hemp seeds and pumpkin seeds)
- unrefined grains (like farro, quinoa and barley)
Stress and Anxiety Quiz
To find out your ranking of stress and anxiety, take this quiz, adapted from a scale developed by Peter Lovibond at the University of New South Wales.
For the first 16 questions, please indicate how much each statement applied to you over the past week. Answer the questions as honestly as possible; there are no right or wrong answers.
The last five questions are about you, and they’ll be used by our research team to better understand how stress relates to factors like marriage and employment. We’ll report next month on what the scores suggest about the Greater Good community.
When you’re done, you’ll get your score, along with resources for combating stress.
Adapted from: Lovibond, P. F, & Lovibond, S. H. (1995). “The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories.” Behaviour Research and Therapy
- 10 Serious Health Problems Related to Stress
- Chronic Stress Can Damage Brain Structure and Connectivity
- Psychopathology and symptoms of atrial fibrillation: implications for therapy.
- Stress-induced cardiac arrhythmias: The heart-brain interaction https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4662914/
- An Angry Heart Can Lead To Sudden Death https://www.sciencedaily.com/releases/2009/02/090223221235.htm
- An Alternative Treatment for Anxiety: A Systematic Review of Human Trial Results Reported for the Ayurvedic Herb Ashwagandha (Withania somnifera) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4270108
- Naturopathic Care for Anxiety: A Randomized Controlled Trial http://journals.plos.org/plosone/article?id=10.1371/journal.pone.000662
- Kava for the treatment of generalised anxiety disorder (K-GAD): study protocol for a randomised controlled trial. https://www.ncbi.nlm.nih.gov/pubmed/2652753
- Kava extract for treating anxiety. http://www.cochrane.org/CD003383/DEPRESSN_kava-extract-for-treating-anxiety
- L-5-hydroxytryptophan in the treatment of anxiety disorders. https://www.ncbi.nlm.nih.gov/pubmed/3157735
- Hydroxytryptophan: a clinically-effective serotonin precursor. https://www.ncbi.nlm.nih.gov/pubmed/9727088
- GABA A receptors as in vivo substrate for the anxiolytic action of valerenic acid, a major constituent of valerian root extracts. https://www.ncbi.nlm.nih.gov/pubmed/18602406
- Association between magnesium intake and depression and anxiety in community-dwelling adults: the Hordaland Health Study. https://www.ncbi.nlm.nih.gov/pubmed/19085527
- The effect of methylated vitamin B complex on depressive and anxiety symptoms and quality of life in adults with depression. https://www.ncbi.nlm.nih.gov/pubmed/23738221
- A multi-center, double-blind, randomised study of the Lavender oil preparation Silexan in comparison to Lorazepam for generalized anxiety disorder. https://www.ncbi.nlm.nih.gov/pubmed/19962288
- Chamomile (Matricaria recutita) May Have Antidepressant Activity in Anxious Depressed Humans – An Exploratory Study, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3600408/
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