Handling Anxiety and Stress with Botanical Medicine

By Anne Salazar RH (AHG), Clinical Herbalist

  These two topics (stress and anxiety) are major sources of interest and inquiry in my practice. They definitely go hand in hand. The more ongoing unaddressed stress one encounters, the more anxiety becomes a part of the picture. It is basically an over-reaction of the endocrine system (6), that has been in fight or flight for extended periods of time. This can lead to digestive issues, sleep challenges, panic attacks, eventual depression, etc.  In other words, it often accompanies other physiological challenges. This needs to be addressed in most protocols, as it is foundational. There are definitely ways to prevent and to treat chronic stress and anxiety. Obviously, the preventative approach is the ideal and the easiest, but this often does not happen. 

What Causes Anxiety?

  The core underlying issue around anxiety is an endocrine system (HPA Axis to be exact) that has been stressed for long periods of time, and/or has undergone trauma, or both. We have all heard of adrenal fatigue (cortisol imbalance), but it is often more than just the adrenals. This is mainly due to the fact that the endocrine system is a ‘highway’ of interconnected glands that oversee, direct, and support all hormonal activity in the body. When one gland is struggling, the whole system is not functioning at its best. This can throw many bodily functions off that are dependent on this very important network. 

  Fortunately, the world of botanical medicine has a plethora of options that have been utilized successfully for millenia (humans have always needed this support!). The following thoughts are general, and I hope they are helpful. Always keep in mind that each of us is an individual, and recognizing this and addressing this is KEY to regaining balance. There are similarities along the pathway of healing, but there are also important differentiations for each person.

  There are two main prongs in the herbal medicine toolbox for these issues; One is the amazing category of adaptogenic plants. The other is a category called nervines. They work differently but quite synergistically (1). The nervous system needs to be addressed along with the endocrine system. Quieting and supporting the nervous system allows for better and quicker results altogether. 

What are Adaptogens Exactly?

  Adaptogen is a particularly appropriate name considering the powerful amphoteric (balancing) actions these botanicals exert.  Adaptogens are essential to improving resilience to stress and increasing vitality by nourishing various systems in our bodies (2). For example- Ashwagandha, Rhodiola, Ginseng, and Shisandra are some adaptogens to name a few, but there are hundreds! Formulating (compounding) them appropriately is the ‘magic’ of well made, individualized medicine. This is the art and skill of the experienced clinical herbalist. These herbs work synergistically and potentize one another (thru their individual strengths), while allowing for lower dosing of each herb. Balance! Adaptogens can and should be taken long term as they have a beneficial effect for stress, immunity, degenerative disease, vitality, energy, longevity, etc. In other words, they are not only great for acute challenges, but also important for ongoing maintenance. I frankly cannot think of anyone who wouldn’t benefit from adaptogens in one form or another.

  To give some further context, 50 years ago the Western world “discovered” that adaptogens were extremely beneficial for elite athletes.  Eleuthero (formerly known as Siberian Ginseng), Schisandra, and Rhodiola  were and are still used extensively in this category, as are many other adaptogens (3). 

Nervines- A Synergistic Partnership with Adaptogens

  This is a category of botanical medicine that calms and supports the nervous system. Examples of nervines would be chamomile, lemon balm, oatstraw (and milky oats), gotu kola, passion flower, etc (4). These can often be used as a tea, but can also come in other forms. These herbs are mineral rich, very grounding, and quick acting. The combination of nervines  paired with adaptogens helps to improve overall resilience to stress and enhance physical and mental health.

  Nervines can certainly be taken alone for those times when you need quick calming. Unlike adaptogens, nervines will kick in quickly. For instance, if you are needing quick relief from anxiety you can take Calm Restore which is a great formula with medical grade lavender (5) with other excellent nervines. Another very effective combination of nervines is Tranquility by one of my overall favorite companies, Natura. 

  The easiest way to understand the difference between nervines and adaptogens is this: adaptogens, taken over time, heal and rebuild endocrine imbalance. Nervines will assist with this process, but don’t necessarily correct the foundational imbalances of endocrine dysfunction. While the adaptogens do their healing work over time, known as “slow medicine”, you can add nervines to help in the moment with symptoms that arise in the meantime. Although nervines will heal and support the nervous system, it’s the adaptogens that do the deep work with endocrine function.  You will find that the need to take nervines will lessen as the adaptogens do their healing and rejuvenating work.

What We Carry and Love at Remedy

  There are some variations in the way adaptogenic formulas are made.  This is predicated by how acute the stress issues are. For someone who is beginning to experience symptoms of stress and/or anxiety, Stress Ease is a great choice. If you are having sleep issues (waking up and not being able to get back to sleep), regular anxiety challenges, or other acute stress issues,  then StressCare would be the appropriate formula for you. These formulas can take up to six weeks to create obvious changes, depending on how deep the challenge is. Both contain nervines in their formulas for that synergy that was discussed earlier. 

  If you prefer a liquid adaptogenic formula, I would recommend Vital Adapt by Natura. It can work for moderate to severe stress; up-dosing to twice a day would help with a more acute situation.

  Don’t forget, by scheduling an herbalist consultation, a custom made tincture can be created for you and your particular needs and challenges, right here in our apothecary.

How to Mitigate Stress in Our Lives

  Certainly it's best to prevent the negative effects of stress. Stress is a given in our lives, no matter your situation or circumstances, but it doesn’t have to become pathological.

  • Regular sleep hours- Sleep helps rejuvenate our bodies. 

  • Regular moderate exercise- Cues the body to rebuild and heal, and aids in getting a good night’s sleep.

  • Whole food diet- Minimize simple carbs, sugar, and processed foods.

  • Remember to breathe (deeply)

  • Meditation (in multiple forms)

  • Social Connection

  • Better time management

  • Limit screen time

  • Spending time in Nature

  • Volunteer 

  • Limit alcohol

  • Hydrate properly

  • Utilizing adaptogens regularly to help maintain overall balance

  As always, we are here to help. Speaking with a clinically trained herbalist can make the difference between success and failure when it comes to your health. I hope it goes without saying that social media is NOT the place to find personal health guidance. Always get your supplements and herbs from reliable sources!  A private consult is an effective and efficient way to access and address your personal needs.


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1.Burns J. Common herbs for stress: The science and strategy of a botanical medicine approach to self-care. J Interprof Educ Pract. 2023 Mar;30:100592. doi: 10.1016/j.xjep.2022.100592. Epub 2022 Dec 10. PMID: 36530213; PMCID: PMC9737923.

2.Panossian A, Wikman G. Effects of Adaptogens on the Central Nervous System and the Molecular Mechanisms Associated with Their Stress-Protective Activity. Pharmaceuticals (Basel). 2010 Jan 19;3(1):188-224. doi: 10.3390/ph3010188. PMID: 27713248; PMCID: PMC3991026.

3.Todorova V, Ivanov K, Delattre C, Nalbantova V, Karcheva-Bahchevanska D, Ivanova S. Plant Adaptogens-History and Future Perspectives. Nutrients. 2021 Aug 20;13(8):2861. doi: 10.3390/nu13082861. PMID: 34445021; PMCID: PMC8398443.

4.Saadatmand S, Zohroudi F, Tangestani H. The Effect of Oral Chamomile on Anxiety: A Systematic Review of Clinical Trials. Clin Nutr Res. 2024 Apr 23;13(2):139-147. doi: 10.7762/cnr.2024.13.2.139. PMID: 38784853; PMCID: PMC11109927.

5.Koulivand PH, Khaleghi Ghadiri M, Gorji A. Lavender and the nervous system. Evid Based Complement Alternat Med. 2013;2013:681304. doi: 10.1155/2013/681304. Epub 2013 Mar 14. PMID: 23573142; PMCID: PMC3612440.

6.Herman JP, McKlveen JM, Ghosal S, Kopp B, Wulsin A, Makinson R, Scheimann J, Myers B. Regulation of the Hypothalamic-Pituitary-Adrenocortical Stress Response. Compr Physiol. 2016 Mar 15;6(2):603-21. doi: 10.1002/cphy.c150015. PMID: 27065163; PMCID: PMC4867107.