Whether most of us know it or not, Generalized Anxiety Disorder (GAD) affects anywhere between 4% and 15% of Americans. This disorder is estimated to cost the United States as much as $ 46 billion a year. Oftentimes, patients suffering from GAD also have coexisting conditions such as major depressive disorder (commonly known as depression), obsessive-compulsive disorder, or a panic disorder. Conventional treatments for GAD normally include medication, psychological counseling or cognitive behavioral therapy, and even exercise. Sometimes, patients also opt to receive treatment with complementary or alternative medicine (CAM). There is a wide range of CAM treatments that are in use in the United States, yet only a few that have been shown to have positive benefits. This article discusses a few of the therapies that have been shown to be effective as well as some that have not yet been proven to provide any benefit.

Two alternative therapies shown to provide measurable benefit for GAD were kava (a type of plant), and relaxation techniques. Kava is a plant that grows naturally in the South Pacific; in traditional cultures of this region, the root of the kava plant is crushed or ground into a powder and the powder is mixed with either water or coconut milk to make a drink. Kava's active components are substances called kavain, dihydromethysticin, and methysticin. For the clinical trials performed on kava, standardized concentrations of the active ingredients are used (normally with a concentration of 100 mg). Surprisingly, kava was demonstrated to be effective at treating anxiety in more than a dozen randomized blinded trials, and was shown to have only mild side effects [1]. There have been reports of negative effects on the liver in vulnerable patients, however, so it is prudent to speak with a primary care doctor or psychiatrist before attempting to use kava supplements as a treatment for anxiety.

Relaxation techniques have also been shown to be effective in GAD patients. These methods train participants to recognize signs and symptoms of anxiety, and allow them to consciously relax the body in order to cope with stressful situations before a full-on panic attack ensues. Surprisingly, a 2007 study showed these techniques were equal in efficacy to cognitive behavioral therapy, meditation, autogenic training and biofeedback [2]. The study groups using relaxation therapies showed enough improvement over control groups (those not given any therapy) in the study so as to establish the effectiveness of the method. Since there are no substances ingested by the patient, this type of intervention is generally extremely safe and also effective.

Limited efficacy for treating GAD has been demonstrated for acupuncture, music, aromatherapy, and meditation. There is an important distinction to make in the case of acupuncture, however. While its efficacy has been shown for reducing anxiety in certain situations (such as before a dental procedure, or before an operation), only a few randomized trials exist that studied its effectiveness in patients with GAD. Due to the paucity of studies on its effectiveness for treating psychiatric conditions and their associated anxiety, it is most accurate to say that the current scientific evidence can neither confirm nor refute the clinical usefulness of acupuncture for GAD.

Although meditation has a reputation for aiding in stress reduction, there have been only two randomized clinical trials examining the effect of meditation on anxiety conditions. The general conclusion from these was that there is only limited evidence that meditation is useful for reducing anxiety symptoms among people who suffer from GAD. Other studies found that mediation was just as effective as relaxation therapies and biofeedback [3]. However, there have not been large randomized trials focused specifically on GAD and meditation. For now the most accurate statement is probably that it cannot be recommended as a proven therapy for GAD, but that further studies could change this if they were able to show clear benefits.

As new forms of complementary medicine continue to emerge for illnesses like GAD and other psychiatric aliments, it will be important for both patients and the medical community to study their effectiveness. Some may prove surprisingly useful - as in the case of kava - while others may not be as impactful as the average patient might assume. To learn more about the studies mentioned in this article, see the references below.

References
[1] Saeed SA, Bloch RM, Antonacci DJ. Herbal and dietary supplements for treatment of anxiety disorders. American Family Physician. 2007 Aug 15;76(4):549-56.

[2] Siev J, Chambless DL. Specificity of treatment effects: cognitive therapy and relaxation for generalized anxiety and panic disorders. Journal of Consulting and Clinical Psychology. 2007 Aug; 75(4):513-22.

[3] Jorm AF, Christensen H, Griffiths KM, Parslow RA, Rodgers B, Blewitt KA. Effectiveness of complementary and self-help treatments for anxiety disorders. Medical Journal of Australia. 2004 Oct 4;181(7 Suppl):S29-46.