Transcription:

Melanie Cole (Host): Most of us feel stress and anxiety from time to time, and you may have wondered about some of the herbal supplements on the market that say that they can help soothe you and calm you down and help with your anxiety. Well here to tell us about them today is Dr. Sylvia Dennison. She’s a psychiatrist and the Medical Director of Behavioral Health at Aspirus Health System. Dr. Dennison, let’s start out with sort of a working definition to kind of set the stage. What is stress and the physiological and psychological affects of anxiety and stress on our bodies?

Sylvia Dennison, MD (Guest): Okay. Well stress and anxiety go hand in hand. All of us feel stress. Stress, a little bit of stress is actually a very good – can be a very good thing. For example, you have got final exams coming up, so you are studying more. You feel stressed, but that stress keeps you going and keeps you studying. So, it can be healthy. But when stress gets to be overwhelming, when we don’t seem to be able to deal with it well and we are suffering from chronic anxiety and that’s a feeling of your heart rate picks up, maybe I can’t breathe, maybe I can’t concentrate; that’s when it starts becoming overwhelming and negative for us. So, stress and anxiety are a normal part of life, but when it becomes consuming, when we can’t do other things in our lives; that’s when it’s a problem.

Host: So, before we get into specific recommendations and discussions about herbal supplements and things we have seen; what are some warning signs about natural treatments and interactions with other substances that you would like the listeners to know about before we begin?

Dr. Dennison: Alright, I appreciate that. I’m going to mention the National Center for Complimentary and Integrated Health. That is a big term for an institute with the National Institutes of Health. The National Institutes of Health have a huge, huge repository of information and research from around the world. That particular institution, the Center for Complimentary Health has a great deal of worldwide information regarding herbal treatments for a variety of conditions. I recommend that anyone who is interested in getting acquainted with or using herbals, they refer to that site first. They will tell you what the good, the bad, and the ugly is and what you should be looking for. One of the biggest problems when we talk about complimentary medications, when we talk about herbs and spices and vitamins and so forth; is it’s not – that industry is not controlled. When you get a medication, for example, penicillin, if I prescribe that for you and you get it at a pharmacy, you know what’s in it, you know that it has been approved by the Food and Drug Administration and that it’s considered safe and effective if used as prescribed.

When we talk about an herbal medication, the same doesn’t apply. Those are not regulated. So, you don’t really know what’s in them. Now, that sounds like I’m going to say don’t do it, in fact, I believe very strongly in recommending herbals and complimentary medicine to patients, because we want to take care of ourselves. A lot of people would like to take their care into their own hands and this is one way to do it. If you are going to go with an herbal, please get it from a reputable source, someone you trust. Just because something is “natural” doesn’t mean it’s safe. If you think about it, poisons are around us everywhere. Nightshade is – grows on everybody’s fence post, but it’s also deadly. It can kill you if you consume it. So, just because it’s herbal, just because it’s natural; doesn’t mean it’s safe. So, you need to be looking at what exactly are you getting and try to be sure that it’s not something that’s going to interfere with medications that you may be taking.

If you look online with the National Institutes of Complimentary Health; if you are on a medication, it can tell you what substances, what herbal substances or vitamins or otherwise, spices would interfere with your medications and you should avoid them. So, the takeaway there is, read up on it from a reputable source such as the National Institutes of Complimentary Medicine, get your product from a reliable source and make sure that you check if you are on medications that this medication will not interfere with it.

Host: That’s great information. What a wonderful summary Dr. Dennison. So, as we stand there at our reputable sort of health food store; there are essential oils, there are pills, there are liquids in eye droppers, there are tinctures, there are teas, there are creams, there are – I mean it’s dizzying, Dr. Dennison. So, if we want to start looking to things for anxiety and let’s start with some of the more well-known ones like lavender and chamomile and jasmine and rose and things that we’ve heard, and even melatonin can help us to relax a little bit. What forms should these be taking?

Dr. Dennison: Well the safest form obviously would be something that’s inhaled and some of the inhaled substances are extremely effective. In fact, in some of our pain clinics; our practitioners are beginning to use the inhaled substances to help calm patients before procedures. Some of the substances that are really effective as inhalants are lavender, which is my personal favorite, lemon balm which is a form of mint. It’s a member of the mint family. Those are two of the most effective and simply having it around you and inhaling can have a very calming effect.

Host: Do you mean by like a candle? Do you mean such as a candle or if you diffuse oil in a diffuser and have the little candle kind of, so you want it in the air just so that we can smell it?

Dr. Dennison: So, you are breathing it in.

Host: Breathing it in.

Dr. Dennison: You are actually breathing it in. I like the diffusers because they are pretty direct. You don’t have to have a burning candle. This can be something that just sprays some of the scent into the environment around you. And that in itself can be very calming and especially the lemon balm has been demonstrated to be effective that way. Chamomile, I happen to – I mean lavender I happen to love, but the lemon balm has had the best amount of research supporting it.

Host: Lavender is my favorite as well and even when my kids were little Dr. Dennison, I would keep a diffuser around the house to keep a rather calmer type house and my kids while they are older now, even like to drink chamomile tea before bed because that helps to calm them down. But now what about some of the other ones that people hear that they can try that may be ingested?

Dr. Dennison: Alright. Chamomile is certainly one of the most well-known and you mentioned chamomile tea. In fact, I have a lot of patients that I recommend if they can’t relax for bedtime, if they can’t sleep; they could go ahead and try chamomile tea. Some of the other substances that are very good for relaxation and anxiety; lemon balm I mentioned, passion flower is another one that’s been shown repeatedly to be very, very helpful. It should not be used in pregnancy. Again, please look it up on the National Institutes of Complimentary Medicine’s website. We are not sure that it’s safe for a fetus, but it tends to be helpful. One of the problems with taking passion flower is it can cause drowsiness more than you’d want. For example, if you are taking an exam later on and needed something to calm down with.

Kava is another medication – is another substance that has had a lot of research done on it. This is one that’s a little bit more controversial. Kava is used, the leaves and some of the roots are made into extracts and capsules and drinks. And it has been shown to be helpful for calming, but it’s also been shown to cause some problems with the liver. And if you have had any tendency along that line, this probably one you’d want to avoid. I don’t recommend it to people, but you will find it in the health foods store as safe and effective and the safety is the issue that concerns me.

Another one is valerian. Valerian is a leaf – is a flower and it’s interesting in that this is a substance that you use the leaves, the roots and the flowers, all of them have been used to make tablets and extracts and teas. As an infusion – as a suffusion inhalant, it’s not been particularly as effective. It’s not as potent as thing like lavender and lemon balm. But in the extract form in a tea or tablets; it’s been found to have a very relaxing effect, and this is another substance that I often recommend to patients if you have problems getting to sleep or feeling very anxious; this can be helpful.

Now, in the grocery store, I routinely go through the tea section. There are a number of teas that are available over the counter and most of them are composed of a combination of such things as lavender, valerian and chamomile. And that’s another way that you can take it in and get the benefit of the substance itself.

Host: One of the ones we’ve heard about being used for depression, anxiety, during menopause, you know we hear for women especially, is St. John’s wort. Tell us a little bit about that.

Dr. Dennison: St. John’s wort is actually – there is good evidence that it can be helpful in mild depression or people we call it dysthymia, that’s where you just never are on top of things. You are always a little blue. There is good evidence that it can be very helpful. A couple of problems potentially with St. John’s wort is that oftentimes the dose that you need upsets people’s stomach and many people can’t tolerate it. Now, the folks in the health food stores will tell you that I can make it compact enough in capsular form that you won’t have that problem. But that’s one of the things that does make it a little less desirable for some people. Something else that’s very important to know. If you are already on an antidepressant, it’s not considered a good idea to start St. John’s wort. I would never recommend someone stop a prescription medication without talking to their provider, but I have had patients that I have helped get off a traditional antidepressant and on to St. John’s wort effectively. You don’t want to be on both of them at the same time.

Host: Really important and that’s great information. What a good tip. Dr. Dennison, before we wrap up or as you wrap up, speak about some of the other things that you as a psychiatrist would like people to try to help manage their anxiety, such as exercise, yoga, meditation, relaxation techniques, massage, taking a bath, all of these things and many of them can be combined with some of the herbs we’ve talked about today. A bath with lavender is lovely. So, speak about your recommendations and what you might want people to try.

Dr. Dennison: Well all of the things that you mentioned of course are very, very helpful. If I can get people up and moving more; we would probably have to use fewer medications and herbals. Exercise. Exercise can be a wonderful stress reliever. Sometimes I actually with adolescents I tell them go out and beat on a speed bag or fold up a towel in two and beat on the bed with it. Get that out. Get that tension out of your body physically. There are relaxation techniques that we have where we talk about breathing exercises, visualize something, a wonderful scene, something that’s comforting to you and breathe into it. Those are techniques that we teach our clientele every day of the week. I have people who love to swim and because swimming is such an all-consuming activity; you can’t be relaxing and do a decent swim. That can be a very relaxing – that can be a very soothing but distracting thing to get some of the tension out of your body and out of your mind.

Yoga. There are now hundreds of years of research looking at the therapeutic effect of yoga that it’s a mind body control and I’m not - I would not presume to pretend that I can teach someone yoga, but the folks that I refer to yoga find it very beneficial and again, the National Institutes of Complimentary Health speak very highly of yoga and similar techniques, Tia Chi for example as being among the best approaches to anxiety that there is, far and above any medications. I’m not as familiar with the literature on massage, but I can say personally that I find it rewarding.

Host: Then give us your best advice of the precautions we should take, what you would like us to know about the importance really, Dr. Dennison, of managing our anxiety so that we can take care of ourselves and especially women. We’re the caregivers of society and if we don’t take care of ourselves, we can’t take care of the ones we love. So, your best advice on managing our anxiety.

Dr. Dennison: Don’t be afraid to admit that you are feeling stressed. It’s a good idea to have a confidante, someone you can talk to. Sometimes just talking can help you put things into perspective and to help you think through the things that are most stressful to you and causing you the most anxiety. That, first and foremost, rather than carrying everything on your shoulders can be very, very beneficial.

If you decide that you need to try to take care of yourself, there are some very good programs online. I don’t have the references in front of me, I’m afraid right now. But there are some very good programs online that teach some of the breathing techniques and relaxation techniques that can be very, very beneficial. If you find that that’s not sufficient and you need a little more help but don’t want to seek professional help; there are again, some very beneficial substances that you can take as long as you research them and know that they are safe for you and whatever specific conditions you have. And finally, if things are feeling overwhelming, if you find that you are functioning less well; don’t be afraid to call us. That’s what we are here for.

Host: Wonderful. Thank you so much Dr. Dennison. Even your voice is so soothing. Thank you for such great information because anxiety really is a problem in this country today and it’s – the information you gave is so helpful. So, thank you very, very much. This is Aspirus Health Talk. For more information please visit www.aspirus.org, that’s www.aspirus.org. I’m Melanie Cole. Thanks so much for listening.