7 Ways To Treat Anxiety Without Medication
Written by Jessica Kettell, Board-Certified Psychiatric Mental Health Nurse Practitioner (PMHNP-BC).
Disclaimer: While I love sharing freely about my experience with my own and my clients’ mental health and health, this content is for information purposes only and should not be used as diagnosis or in place of seeing a licensed mental health or healthcare professional. Before starting new supplements or protocols, you should talk with a professional, especially if you take other medicines or have existing health conditions.
I’ve shared before how I have dealt with all kinds of anxiety. Growing up, I never really felt safe in my body. And then things really escalated during the pandemic when I worked super long hours in intensive care under extreme stress. Anxiety and panic attacks started happening so frequently that I was worried I wouldn’t be able to keep doing my job.
Like a lot of people, my first thought was to see a traditional psychiatrist. But I couldn’t get an appointment for THREE MONTHS. So I decided to take my mental health into my own hands. By the time my appointment finally rolled around, I didn’t even need it because I had found holistic ways to treat anxiety without medication.
This kicked off my journey into holistic psychiatry. Now, as a mental health nurse practitioner, I know that there are many contributing factors to your anxiety that can range from nutrient deficiencies to imbalances in your body. That’s why my approach to treating anxiety starts with identifying your root cause(s) and then using natural, effective tools to treat it.
Let’s dive into how you can feel better and finally be free from anxiety, (without medication!).
Anxiety and Medication
First, a bit about anxiety and medication as a treatment.
The conventional approach to treating anxiety starts from the premise that your anxiety symptoms originate in your brain, with an imbalance of neurotransmitters. So, the treatment is a medication that influences those neurotransmitters.
There are a few different types of standard anxiety medicines to manage symptoms, including:
Selective serotonin reuptake inhibitors (SSRIs): These medicines are usually the first line of treatment and include drugs like Prozac (fluoxetine) and Zoloft (sertraline). They raise the brain's serotonin levels, which may reduce anxiety and improve mood.
Serotonin-norepinephrine reuptake Inhibitors (SNRIs): These are similar to SSRIs and include medicines like Effexor (venlafaxine). They increase brain levels of norepinephrine and serotonin levels.
Azapirones: This is a class of drugs shown to reduce anxiety, like the medication buspirone (brand name Buspar).
Beta-blockers: Typically used for physical anxiety symptoms, medicines like propranolol can help with things like a rapid heart rate.
Antihistamines: Antihistamine medications (yes, like for allergies!) like hydroxyzine can sometimes reduce anxiety.
Benzodiazepines: These medications have an addiction potential, so they're typically used only for the short-term management of acute anxiety symptoms. Benzodiazepines like Xanax (alprazolam) enhance the effects of GABA, a neurotransmitter that reduces anxiety and induces relaxation.
As a medical professional, I’ve seen how medications can be incredibly effective for some people to treat anxiety. But the problem is they also come with potential side effects:
weight gain
sexual dysfunction
emotional blunting
increased risk of bleeding
low sodium levels
bone density loss
sleep disturbances
increased blood pressure
cognitive impairment
suicidal thoughts
And some have a risk of dependency if they're used long-term, meaning your body could have worse anxiety if you forget to take your medication on time.
The ways to treat anxiety without medication that I highlight below can be used on their own or with other treatment approaches, depending on your unique needs.
7 Ways To Treat Anxiety Without Medication
I love people who do their own research into their mental health — it’s what I did. But my aim is for you to read the suggestions below as information, not as a guidebook of what you should absolutely do on your own. Everyone's body and mind are different, and what works for one person might not work for another. The best and safest way to approach your mental health is to partner with a functional doctor or practitioner who can help you create a personalized plan that suits your unique needs.
Identify the root cause
I don’t believe that some people “just have anxiety” and therefore will always need medication and that’s that. There’s usually an underlying issue in your body or environment causing your anxiety symptoms. The tricky part, though, is identifying what your underlying issue is. Below, I’m sharing some of the root causes I see most often in my practice:
Poor gut health
Have you ever felt nauseous because of nerves? Our digestive system is SO connected to anxiety and our nervous system. So it’s not surprising that gut imbalances would lead to anxiety symptoms. Everything from a messed up microbiome to a parasitic infection could throw your entire nervous system out of whack and lead to persistent anxiety.
Genetics
Unfortunately, anxiety can literally “run in your family” because it may be genetic! That’s why I often test my patients for specific traits that make them more likely to have anxiety. Once we know for sure your anxiety is genetic, we can personalize your treatment with targeted supplementation, diet changes, and lifestyle changes. For example, if you have the MTHFR gene, we can treat this with a methylated folate supplement.
HPA axis issues
HPA stands for hypothalamic-pituitary-adrenal axis. This is a fancy medical term for the system in your body and brain that helps you respond to stress (think about how your heart races when you’re scared — that’s the HPA axis at work, telling your heart to pump more blood in case you need to run or fight).
But your HPA axis can become too reactive, triggering stress responses too frequently or too intensely when they’re not warranted. This can cause a bunch of health and mental health issues, including anxiety.
Nutrient deficiencies
My clients are always surprised when I tell them that their chronically low B12, magnesium, iron, copper, or vitamin D (or a number of other nutrients and minerals) could be the reason they’ve been dealing with anxiety. Even if you’re “eating well,” it’s pretty common to not be getting enough of certain nutrients.
For example, as much of 50% of adults in the US are showing less than optimal vitamin D levels! Risk factors for low Vitamin D are more common than you might think: having IBS, not getting enough sun exposure, taking medications like spironolactone, having a darker skin tone, being overweight, simply being older, and more….
I always run blood tests for my clients to check for nutrient deficiencies because if this is a contributing factor, it’s SO easy to fix (just a matter of increasing sunlight, certain foods, and taking a supplement or two when necessary).
Side note: certain medications can cause nutrient deficiencies! You can check to see if any medications you’re on could be causing nutrient deficiencies (and, in turn, worsening your anxiety), on Mytavin’s curated search tool.
Blood sugar regulation
Conventional medicine might tell you that your blood sugar is “fine” as long as you don’t have diabetes. But there are a CRAZY amount of studies that show us how even mildly dysregulated blood sugar can affect your health and mental health way earlier than developing diabetes.
I’ll go into this topic in way more detail in a future blog post, but for now, one thing to know is that hypoglycemia (low blood sugar) has particularly been associated with anxiety. Low blood sugar is typically caused when you eat too much sugar or carbohydrates (especially without any fiber or protein), which spikes your blood sugar … causing an increase in your insulin levels and a sudden drop in blood sugar. If this happens a lot, you’ll be left riding the “blood sugar roller coaster” which feels an awful lot like anxiety.
High histamine
You’re probably familiar with antihistamine medications used to treat allergies, like Benadryl and Claritin. Histamine is the name for a chemical released in the body and brain in response to allergens or inflammation. Typically, an overload of histamine creates those tell-tale allergic reaction symptoms that have us reaching for the Benadryl, like itching, flushing, and wheezing. But other times, the symptoms can be physiological, like anxiety.
It’s possible that your chronic anxiety could be stemming from chronically elevated histamine levels in your body and brain due to eating foods you’re mildly allergic to or are just high in histamine (like fermented and preserved foods).
Lyme disease
Lyme disease, a bacterial infection that you can contract from a tick bite, has been known to cause anxiety in affected patients. Worse — you might not know you have Lyme disease at all unless you test for it. If you spend time outdoors in an area known to have ticks, you should be tested for Lyme disease.
Thyroid disease
Thyroid disease develops when your thyroid gland is over or underactive. Both conditions have been documented to cause anxiety, along with trouble sleeping, weight loss or gain, restlessness, and more. Specific thyroid marker testing is required to determine if you have thyroid disease, but it can be worth it if you suspect this!
2. Aim for Regular Exercise
Exercise is one of the few things I can confidently tell you to GO DO without you ever stepping foot in my office or meeting with any practitioner. There are SO many health benefits and the drawbacks are practically non-existent.
So if you have anxiety and you’re not already exercising, PLEASE make it priority number one to build in some form of physical movement every single day. Even just taking a walk outside and looking at your surroundings — in the city or in nature — reduces the fear response!
Also, when you participate in physical activities, you naturally increase your endorphin production, boosting your mood, WHILE it reduces your cortisol levels (that’s your stress hormone!). There’s even some fascinating new research that has identified the link between your mood and your physical activity: “Hope molecules” — it’s worth a deep dive into this topic if you’re curious.
3. Therapy
I know therapy isn’t for everyone, but it could be for you. Therapy, especially cognitive-behavioral therapy (CBT), is one of the most effective anxiety treatments out there.
When you participate in CBT, you work with your therapist to identify and challenge your negative thought patterns and behaviors, especially when they contribute to anxiety. You’ll also work together to understand your anxiety triggers and develop coping strategies to manage them. Techniques like exposure therapy can help desensitize you to those triggers over time, making them less overwhelming.
Here's the thing: when you constantly focus on negative thoughts, those neural pathways get stronger—they literally 'fire and wire' together. That's why it's so important to shift your focus to more positive thoughts like gratitude, love, and acceptance, helping to strengthen those healthier pathways instead.
Along with CBT, other therapy approaches that can help you manage and reduce anxiety:
Dialectical behavior therapy (DBT): As a therapy approach, DBT focuses on teaching skills to cope with stress and regulate emotions. You also learn how to improve relationships. It combines acceptance and change strategies so you can manage those intense emotions that can fuel anxiety. You can get free DBT therapy here!
Exposure therapy: If you struggle with social anxiety or specific phobias, exposure therapy might be your go-to. This technique involves gradually confronting the situations or objects you fear, helping you become desensitized over time. It’s a safe, structured way to reduce anxiety responses in real-life scenarios.
Acceptance and Commitment Therapy (ACT): In ACT, you're encouraged to accept your thoughts and feelings instead of fighting them or feeling guilty. Instead of trying to change them, you focus on mindfulness and aligning your actions with your values. This reduces anxiety's grip on your life while keeping you grounded in the present. A great low-cost therapy option can be found here!
4. Deep Breathing & the Physiological Sigh
Let me tell you about one of my favorite quick-fix hacks for those moments when anxiety hits hard: mastering your breath.
Any breathing pattern where your exhale is longer or more forceful than your inhale will automatically slow your heart rate and activate calm in your body. This makes it a great “emergency strategy” during moments of high anxiety (as well as something I recommend building into your routine every day).
Specifically, neuroscientist Andrew Huberman swears by a technique called the physiological sigh to quickly reduce anxiety and stress. The method is rooted in his research on the neural mechanisms that underlie stress, breathing, and emotional regulation.
This is a natural breathing pattern that both people and animals use to calm down. All it takes is a double inhale through your nose, followed by a long exhale through your mouth. Not only does this feel super satisfying, but it also works by lowering carbon dioxide levels in your blood, which helps calm your nervous system almost instantly.
The physiological sigh is the fastest way to activate your parasympathetic nervous system (basically the “relax button” for your body!).
5. Journaling
I absolutely love journaling before bed as a way of slowing my thoughts down (you can only write so fast!). It’s backed by research that journaling is an effective approach to treating anxiety without medication. You can organize your thoughts and emotions, reduce your mental clutter, and it gives you a space to release negative thoughts, which can help you get a sense of control over your mental state.
There are so many different ways to approach journaling, and here are a few of my favorites:
Daily journaling: Writing about your thoughts, feelings, and experiences daily allows you to express and process emotions. It can help you understand and manage your internal state, reducing anxiety. You can also use journaling to learn more about your anxiety triggers and patterns.
Gratitude journaling: Take time every day to write down things you're grateful for. Focusing on positive elements of your life can take your mindset away from thoughts that induce anxiety and give you a more optimistic outlook.
Expressive writing: Write about your feelings, especially when stressful or emotionally challenging. This can help you make sense of complex emotions.
6. Non-Deep Sleep Rest (NDSR) Protocols
A term coined by Andrew Huberman, these practices help your brain and body enter deep rest without actually sleeping. Options for NSDR protocols include:
Yoga Nidra: Often called yogic sleep, this guided meditation practice brings you deep relaxation, but you stay conscious. It helps minimize stress and anxiety and can enhance focus and cognitive function by allowing your brain to recover and reset.
Self-Hypnosis: You enter a state of focused relaxation and become more suggestible to achieve deep rest or work on personal goals. Self-hypnosis lets your mind relax deeply, and it can be used to reinforce positive thinking and behaviors.
Progressive Muscle Relaxation: PMR involves systematically tensing and relaxing different muscle groups in your body. It releases physical tension and promotes deep relaxation, a great way to calm your nervous system.
Guided Imagery: This involves visualizing scenes that are peaceful and relaxing. It's a way to treat anxiety without medication because it shifts your focus away from worries and toward something calming.
Non-Deep Sleep Rest Protocols activate your parasympathetic nervous system and lower stress hormones like cortisol. Regular practice can also improve brain plasticity for better cognitive function, learning, and memory. These practices can also improve your sleep quality. Here’s a link to a sample video guiding you through a NDSR protocol!
7. Limit Alcohol and Substance Use
Alcohol and other substances can make your anxiety symptoms worse for many reasons including interfering with your ability to sleep well.
I always advise reducing or eliminating substance use as an initial step for helping manage mental health symptoms.
To learn more about the mental health risks associated with alcohol consumption and for tips on reducing those risks, check out this article by Dr. Robin Berzin.
Final Thoughts
There’s a reason I put “Identify the root cause” as the very first item on this list: no amount of self-help strategies (even the holistic ones!) will truly solve your anxiety until you know what exactly is causing it.
That’s why I strongly recommend working with an integrative or functional medical practitioner who takes that approach. When I work with clients, I always order thorough lab tests to uncover underlying physical causes like gut imbalances, parasites, nutrient deficiencies, and more. Then I create a protocol to address it to make sure you’re doing the MOST effective things for faster results.
If you’re interested in working with me to get free from anxiety through a root-cause approach, you can get in touch with me here. If you’re not quite ready, you can also order your own lab tests to take charge of your health. Download my free PDF and bring it to your doctor to request the appropriate tests, or order your own labs through Rupa health.
