Does anyone have any recommendations for severe anxiety? Besides benzos and SSRIs. Beyond sedating supplements like valerian, passionflower, lavender, theanine. Besides opiates. And please don’t confuse anxiety with stress. Stress is exogenous; anxiety is endogenous. Stress can make anxiety worse, but it is possible to have little stress and lots of anxiety. The answer is pharmacological, an overactive amygdala. Does anything work?
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Long term psychotherapy? Exercise? Yoga and meditation?
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I’ve seen studies where they used lithium for anxiety, but that was in rats.
From the CR list, I’ve come across several anecdotal cases where CR eliminated anxiety, but again, anecdotes. Here is a diet centered review:
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All superficial modalities; anxiety erupts from the inner recesses of one’s neurochemistry. And psychotherapy is also useless. The solution, if there is one, is pharmacological. Think of severe anxiety like severe depression, without the suicidal ideation.
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“Analysis revealed an association between less anxiety and more fruits and vegetables, omega-3 fatty acids, “healthy” dietary patterns, caloric restriction, breakfast consumption, ketogenic diet, broad-spectrum micronutrient supplementation, zinc, magnesium and selenium, probiotics, and a range of phytochemicals.”
I do just about everything on this list. Not CR but I do intermittent fasting (eating all calories in just six hours each day). I do take 5 mg of lithium a day. But what would be the therapeutic dose?
I placed my question about anxiety seeking non-conventional suggestions.
You tried any Ayurvedics like Bacopa and / ashwagandra ?
What’s your current daily exercise routine ?
Well, I cited the diet study, because I wanted to highlight CR as an anti-anxiety intervention, but unfortunately there are very few human CR studies, so this was the next best thing.
Meanwhile there are a lot of CR studies in rodents, but that is obviously a limitation:
I was looking for a way to validate the anecdotal reports from the CR list, but unfortunately it’s all rodents.
I’ve done CR for many years, and I found it had interesting psychological effects, increased alertness, sharper senses (especially smell), and a sense of calm. This has been reported by many people on CR (on the CR list) but it’s complicated, because one has to distinguish between short term and long term CR - the effects are very different, in fact opposite. Short term CR results in increased hunger, aggression, lack of focus, irritability, food obsession. Long term CR resulted in much diminished aggression, a strong sense of calm, much increased focus, and for many (myself included), lack of hunger.
I have a tendency to being short tempered (which I regret and struggle against), but it was completely eliminated with long term CR. When I quit CR, the problem returned, unfortunately, though with age it is getting better. And let me add: IF and time restricted feeding are in no way comparable to the effects of long term CR - incomparable. I eat within an 18-20 hour window daily, and on two days out of the week do one small (500 calories) meal a day, and can tell you it has zilch to do with long term CR effects, totally different ball game.
However this is all personal examples, so not scientific. My wife, who has anxiety, feels chamomile helps, but again, anecdotal, although you can find many papers that find camomile effective,
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I would start with a 5 day water fast, then change diet to vegetarian.
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Full Spectrum CBD -oil? I personally suffer from anxiety caused by insomnia and am currently testing CBD oil; it’s still too early to say anything for sure about its effectiveness, but it seems promising.
EDIT: As a clarification, the THC content must be below 0.2% for the product to be legal where I live. To my understanding, chronic THC use can worsen anxiety and insomnia, whereas CBD has the opposite effect.
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At the mental hospital a low dose of loxapine works quite well. Definitely not a health-promoting substance but it can helps if needed sometimes
I’ve personally noticed some long-term/delayed benefits on mild anxiety from canagliflozin. This is consistent with its documented effect of increasing parasympathetic tone. Consistent exercise is also very helpful.
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I am limited in the exercise I can do because of chronic pain and tendonitis – but I have had anxiety since I was a young child. So my lack of exercise is not relevant. I consume Ashwagandha every day. I have never heard of Bacopa. I will look it up.
I took CBD oil some years ago with no effect. My wife also suffers from anxiety and found no effect from long-term CBD use. BUT, CBD oil is not standardized and it’s difficult to know what you are getting in any one formulation. Plus, a lot of CBD is hype to sell products. But CBD is still on my list of things to eventually investigate with a psychopharmacologist. If you have any CBD brand recommendations, please let me know.
I will investigate canagliflozin. It seems promising.
-Supplements: ashwagandha, rhodiola rosea
-Pharma: ssri (generally suck for men), wellbutrin/bupropion, trazodone, glp-1s
-Exercise
-more/better sleep
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I have had rhodiola rosea on my list of things to try. Thank you.
I used to have much more anxiety—not crippling but definitely a mainstay of being me. Now I just don’t. Not even sure what I did to change it. But the answer isn’t necessarily pharmacological. The sauna makes me completely relaxed, especially with a good book in hand. If you can get one, I’d strongly recommend it. Vagal nerve stimulation with devices like Pulsetto can also help. Prioritizing sleep and good sleep hygiene, blue blocking glasses in the PM, can also help.
Dapagliflozin work in the same way:
https://www.ahajournals.org/doi/abs/10.1161/CIRCRESAHA.124.324708
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When I say the solution is pharmacological, I mean that the issue is neurochemical. And I am skeptical that any exogenous treatment, like a sauna, can do more than a superficial job. But I have heard about the vagal nerve, and that seems more promising. I will investigate Pulsetto.
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Sounds like you’re already doing a lot. If I was working with you, I’d probably do baseline checks, like how is your vitamin D, magnesium, b12 (correct forms), folate, etc, to make sure you weren’t running a deficit somewhere, and make sure you weren’t taking something that was unexpectedly causing anxiety. There are such things.
As for lithium orotate (LiO), assuming you have normal kidney functioning, it might be worth trying more than your current 5mg. If I were you, I’d double that and see if that makes any difference. It might not.
Also, you mention having tried CBD, but have you tried CBD Isolate? I have found little upside to CBD, but CBD-I (non-psychoactive, and legal enough to get mail order from any state) has been system-changing for me, seeming to normalize some biochemical functions that were mysteriously atypical. (I’m being vague only because it’s not relevant except for the ability to change how my body worked, which might be what you need.)
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