Calming Herbs for Anxiety: A Galenic Guide

Worry is as old as humanity, and so is the search for calming herbs for anxiety. The Hippocratic physicians gave it one of its oldest definitions: “If fear and despondency last a long time, it is melancholia.”¹ In their view, persistent anxiety was not simply “in the mind.” It was a disturbance of the whole person, body and temperament together, and it called for gentle, steady correction rather than force.

That is still how I think of the calming herbs. They are not a substitute for good medical care, and anyone with severe or lasting anxiety deserves professional help. But for ordinary worry, tension and restless nights, they are among the kindest allies we have.

Table of Contents

The Galenic Reading: Two Kinds of Anxiety

The humoral tradition distinguished two quite different pictures, and they call for different herbs.

Melancholic anxiety (cold and dry): fear, brooding, low spirits, waking at 3 a.m. with a heavy heart, a sense of foreboding without cause. This person needs warming, moistening, cheering herbs, the old “cordials” that gladden the heart: lemon balm, borage flowers, rose, and holy basil simmered in milk.
Choleric anxiety (hot and dry): irritability, racing thoughts, a short fuse, tension in the jaw and shoulders, difficulty falling asleep. This person needs cooling, relaxing herbs: chamomile, passionflower, lavender in small amounts, and cool infusions of rose and lemon balm.

Many people are a mixture. A good starting point is to notice whether your worry feels heavy and cold or hot and wired, and choose accordingly.

The Calming Herbs

Chamomile

The gentlest and best-studied of the calming teas. In a long-term trial in people with generalized anxiety disorder, chamomile extract produced a significant reduction in symptoms, and those who stayed on it tended to relapse less often.² Cooling and relaxing, it suits the choleric picture best. See chamomile.

Lemon Balm

The old herbalists’ favourite cordial, said to make the heart merry. A single dose of lemon balm reduced the effects of laboratory-induced stress and improved calmness in healthy volunteers.³ It suits both pictures, and is one of the best herbs for a nervous stomach. Fresh leaves make the best tea.

Lavender

Lavender is warm and drying. As an aroma it soothes almost everyone; taken by mouth, a standardised lavender oil capsule was found as effective as the drug lorazepam for generalized anxiety in a six-week trial, without sedation.⁴ As a tea, use only a pinch; it is strong and slightly bitter.

Passionflower

A cooling, quieting herb for the racing mind that will not switch off at night. In a small trial, passionflower extract worked about as well as the tranquilliser oxazepam for generalized anxiety, with less impairment of work performance.⁵

Ashwagandha

An Ayurvedic root, warming and nourishing, best suited to the depleted, exhausted, cold melancholic person rather than the hot, wired one. In a placebo-controlled trial, ashwagandha root extract reduced stress scores and cortisol levels in stressed adults over sixty days.⁶ Because of its warmth and its effects on thyroid hormones, I use it more cautiously than the gentle teas above.

Borage and Rose: The Old Cordials

“I, borage, bring always courage,” went the old saying. Borage flowers, rose petals and lemon balm were the classic heart-cheering cordials of the European herbals, given for melancholy and low spirits. Use borage flowers in salads and summer drinks rather than every day; see the borage monograph for the cautions.

Two Calming Blends

For hot, wired anxiety (choleric): 2 parts chamomile, 1 part passionflower, 1 part lemon balm, a pinch of lavender. Steep covered 10 minutes. Drink warm in the evening, or cool by day.
For cold, heavy anxiety (melancholic): 2 parts lemon balm, 1 part rose petals, a few borage flowers in season, and a thin slice of fresh ginger. Steep covered 10 minutes. Drink warm, with a little honey.

Beyond the Teacup

No herb works alone. The Galenic physicians would have advised regular sleep and rising, gentle daily movement, warm, easily digested food, time outdoors in daylight, and good company alongside any herb. Modern research agrees: regular exercise, steady sleep and practices that calm the breath all reduce anxiety.

Safety

Seek help: if anxiety is severe, lasts more than a few weeks, causes panic attacks, or stops you living normally, please see your doctor. If you ever have thoughts of harming yourself, contact emergency services or a crisis line straight away.
Medications: calming herbs can add to the effect of sedatives, sleeping pills and some antidepressants. Never stop or replace medication your doctor has given you.
Ashwagandha: avoid in pregnancy, with thyroid medication or thyroid disease, and if you have liver problems; rare cases of liver injury have been reported.
Kava: I do not use it. It has been linked to liver injury and is restricted in several countries.
Chamomile: avoid if you are allergic to daisy-family plants.
Driving: passionflower, valerian and strong lavender can cause drowsiness in some people.

Common Questions

Which herb is best for anxiety?

For most people, start with chamomile or lemon balm tea. They are gentle, safe and well studied. Choose cooling herbs if your anxiety feels hot and wired, warming cordials if it feels cold and heavy.

How quickly do calming herbs work?

Lemon balm and lavender can help within an hour. Chamomile and ashwagandha work best taken daily for several weeks.

Can I take herbs with my anxiety medication?

Only with your doctor’s agreement. Several calming herbs can add to the effects of medications.

What is a “cordial” herb?

In the old herbals, a cordial (from the Latin cor, heart) was a preparation that gladdened and strengthened the heart, used for melancholy and low spirits. Lemon balm, borage and rose were the classic cordials.

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Notes

Hippocrates, Aphorisms 6.23, in Hippocrates, vol. 4, trans. W. H. S. Jones, Loeb Classical Library 150 (Cambridge, MA: Harvard University Press, 1931). ↩
Jun J. Mao et al., “Long-Term Chamomile (Matricaria chamomilla L.) Treatment for Generalized Anxiety Disorder: A Randomized Clinical Trial,” Phytomedicine 23, no. 14 (2016): 1735–42. ↩
D. O. Kennedy, W. Little, and A. B. Scholey, “Attenuation of Laboratory-Induced Stress in Humans after Acute Administration of Melissa officinalis (Lemon Balm),” Psychosomatic Medicine 66, no. 4 (2004): 607–13. ↩
H. Woelk and S. Schläfke, “A Multi-Center, Double-Blind, Randomised Study of the Lavender Oil Preparation Silexan in Comparison to Lorazepam for Generalized Anxiety Disorder,” Phytomedicine 17, no. 2 (2010): 94–99. ↩
S. Akhondzadeh et al., “Passionflower in the Treatment of Generalized Anxiety: A Pilot Double-Blind Randomized Controlled Trial with Oxazepam,” Journal of Clinical Pharmacy and Therapeutics 26, no. 5 (2001): 363–67. ↩
K. Chandrasekhar, Jyoti Kapoor, and Sridhar Anishetty, “A Prospective, Randomized Double-Blind, Placebo-Controlled Study of Safety and Efficacy of a High-Concentration Full-Spectrum Extract of Ashwagandha Root in Reducing Stress and Anxiety in Adults,” Indian Journal of Psychological Medicine 34, no. 3 (2012): 255–62, https://doi.org/10.4103/0253-7176.106022. ↩

Bibliography

Akhondzadeh, S., H. R. Naghavi, M. Vazirian, A. Shayeganpour, H. Rashidi, and M. Khani. “Passionflower in the Treatment of Generalized Anxiety: A Pilot Double-Blind Randomized Controlled Trial with Oxazepam.” Journal of Clinical Pharmacy and Therapeutics 26, no. 5 (2001): 363–67.

Chandrasekhar, K., Jyoti Kapoor, and Sridhar Anishetty. “A Prospective, Randomized Double-Blind, Placebo-Controlled Study of Safety and Efficacy of a High-Concentration Full-Spectrum Extract of Ashwagandha Root in Reducing Stress and Anxiety in Adults.” Indian Journal of Psychological Medicine 34, no. 3 (2012): 255–62. https://doi.org/10.4103/0253-7176.106022.

Hippocrates. Aphorisms. In Hippocrates, vol. 4, translated by W. H. S. Jones. Loeb Classical Library 150. Cambridge, MA: Harvard University Press, 1931.

Kennedy, D. O., W. Little, and A. B. Scholey. “Attenuation of Laboratory-Induced Stress in Humans after Acute Administration of Melissa officinalis (Lemon Balm).” Psychosomatic Medicine 66, no. 4 (2004): 607–13.

Mao, Jun J., Sharon X. Xie, John R. Keefe, Irene Soeller, Qing S. Li, and Jay D. Amsterdam. “Long-Term Chamomile (Matricaria chamomilla L.) Treatment for Generalized Anxiety Disorder: A Randomized Clinical Trial.” Phytomedicine 23, no. 14 (2016): 1735–42..

Woelk, H., and S. Schläfke. “A Multi-Center, Double-Blind, Randomised Study of the Lavender Oil Preparation Silexan in Comparison to Lorazepam for Generalized Anxiety Disorder.” Phytomedicine 17, no. 2 (2010): 94–99..