Stress – part 2: the diagram

stress drivers

Please note: the above diagram does not refer to any specific research, it is the product of my own experiences and knowledge of what stress is and does to people.  The result is an activity cycle diagram, a technique used in systems thinking.  I have used a program called Vensim to draw the diagram.  Feel free to leave a comment or question.

 

Workplace stress – insights into its consequences

Stress exerts more than one effect. Its consequences can be felt sometimes long after the event that caused it in the first place.

Making sense of stress and its causes is not always straightforward, especially for those experiencing traumatic events or pressures that turn their lives upside down.

Workplace stress is an example where some of the longer term consequences can be avoided if sufficient control can be exerted soon enough.  Working longer hours is possibly an understandable response to a threat of losing your job but if sustained beyond a point where it puts a consistent strain on the individual, it will probably result in loss of health.

I hope the diagram (see link below) I have added below helps at least a few to understand the consequences of workplace stress on an individual and how stress can set in train feedback loops that once they have gained some momentum can be difficult to control.

Stress_drivers

Herbal medicine can help people suffering from stress, as it can provide remedies that help the individual to [a] cope with stress (e.g. licorice root) , [b] sleep better (valerian, lemon balm), [c] digest food more efficiently (dandelion, agrimony), and [d] relax (chamomile, skullcap).   It can also help people to recover more quickly from disease (many herbs but for colds and other short term viral infections, astragalus and andrographis).  Finally, working with a trained herbalist can provide someone who is experiencing a lot of workplace stress new perspectives and insights in how to cope better and regain control not only of their health but their working environment.

 

Quality shines through in the end with herbal medicines

This story illustrates why it is better to consult a knowledgeable herbalist than leave it to suppliers’ marketing and sales information.

Some years ago when I first got interested in medicinal plants and had begun a course of study, I purchased a bottle of Ginkgo extract.  Inside the bottle were dry capsules containing extract of leaves of the plant species Ginkgo biloba, also known as the maidenhair tree.  I had read somewhere that Ginkgo was a student’s special remedy, as it would boost brain power and memory, and as I had begun to feel somewhat sluggish some mornings, a remedy that could provide a boost to my cognitive state was worth considering.  Furthermore, I had begun to find strong coffee – the usual morning remedy – had a sting in its tail in that it could make me feel somewhat reactive and could also slightly unsettle the stomach. 

I took one of these Gingko capsules one morning after breakfast and waited for it to take effect.  A student friend told me I probably wouldn’t feel a thing, as herbs like that took several weeks to ‘kick-in’.  “Really?”, I said, more than a little disappointed that this wonder herb could not deliver an instant boost to a waning attention span and sluggish early morning, short term memory.  Not long after this, a piercing pain struck through my forehead and right temple.  Was this the healing action of a medicinal plant I asked myself – or a head cold about to explode through my sinuses? 

The head cold never erupted and a few days later I took another Ginkgo capsule, and suffered a similar pain in my forehead.  I repeated it a third time and although the pain was not as severe the first time it was there and sufficiently for me to conclude that it was the Gingko extract and not anything else. I left the bottle to collect dust and even tried a capsule again some years later from that same bottle and sure enough the same ‘side effect’ got me.  Not surprisingly, I came to the conclusion that Gingko and I did not mix too well. I did not write the herb off completely, however, as I had read plenty about it and knew it could help thousands if not millions of people who have poor circulation.  It had also occurred to me that the high dose of the dry extract might have been too high for my particular case.

Now, as a qualified practising herbalist, I have given people tincture of gingko and mixed it with other liquid herbal extracts to provide combinations that fitted their particular individual requirements. For example, Gingko is useful in combination with Cayenne for Raynaud’s disease, where small arterioles shut down in the hand, causing them to turn blue with cold. These two herbs can also people with weak peripheral circulation in their legs.

I had also learnt that the quality of an extract matters, in that contaminants can spoil preparations, and the source plant itself may have grown on a plot where it could not generate the active constituents in sufficient qualities to make an effective herbal drug, or it might be a sub-species or variety that does not contain the active constituent chemicals to the same degree that the medicinal type does. 

At a seminar, I was also reminded that the dose of Gingko extract needs to be high to achieve the benefits for the circulation to the brain and elsewhere. I was told that a concentrated dry extract in either a tablet or capsule was the best way to achieve such a high dosage, as with tinctures you would have to swallow too much alcohol (though in theory these could be made with vinegar or glycerine, in practice liquid extracts are usually made with alcohol).  Each capsule recommended by the seminar contained the equivalent of 3 grams of dry weight of leaf, standardized to 3.6 mg of gingkolides (important active constituents) and the top dose was three of these taken three times daily. 

As a result of attending this seminar, decided to trial the recommended Gingko tablets.  I have taken just one tablet a day for the past week and have already noticed small improvements. But the most important discovery has been that a high dosage Gingko extract does not necessarily give me a headache!  Despite the fact these latest tablets were of a higher dosage than the ones I had taken all those years ago, there was no headache, rather I felt better. 

So, what are the lessons from this story?  Number one is that the quality of the herbal extract is most important if you are going to obtain the benefits you seek. The supplier of the latest tablets I have taken is a high quality manufacturer of herbal medicines that carries out many chemical tests to ensure the extracts it makes contain what they should to deliver efficacy without side effects.  Secondly, you can’t conclude that a plant is no good to you on the basis of one sample from one supplier, especially if their quality may not be of the highest.  A third lesson is that a high dosage can deliver clinical benefits more or less straightway, even if folklore or tradition says that the plant’s medicinal extract takes weeks to “kick-in”.  Lastly, if you are going to take a high dosage, you need to be sure that the herbal medicine you are taking is not contaminated and contains the beneficial constituents it is meant to, and therefore you need to rely on a herbal manufacturer of the highest quality and reputation.  To obtain this you are best consulting a qualified medical herbalist, who will not only advise you on the best dose for you, commensurate with your clinical requirements, but also know the best supplier to order from.  The quality supplier I have referred to does not supply to the public, only to qualified practitioners.

 

Headaches and Betony

This time of year headaches I find can sometimes happen when the atmosphere is heavy and thunder and lightening threaten.  They drain you of energy and give you a burdensome ache in the forehead or at the back of the head.  Unless an effective and rapid remedy is found an afternoon’s work can be consigned to the pending tray.  Sometimes all that is required is a loosening of the muscles at the back of the neck and shoulders and some breathing exercises, but if the source of the headache is nervous in origin, a remedy that acts on the central nervous system is required.

There are many possible causes of headache. Primary headaches may be tension headache, migraine or cluster headache.  There can also be over lap and tension headaches can be a factor in migraine, though the latter has a circulatory factor in its origin, with dilation of blood vessels playing a role.  Secondary headaches, on the other hand, are caused by traumas or pathologies to the head or brain. But the commonest form of headache is probably the tension headache and this is caused by a number of factors, including stress, anxiety and lack of sleep. 

One of the plants the Celts revered and used as a remedy for headaches such as these is betony or wood betony (Stachys officinalis or Stachys betonica).  In fact, the Anglo Saxons had 29 uses for it and a physician to Augustus found forty seven diseases it could ‘cure’.  As well as being a ‘nervine’ tonic, betony is a digestive remedy and cleanser. It gently stimulates the cerebral circulation, making it an alternative to rosemary in that respect.  Betony is not an especially well known medicinal plant these days and it is curious to speculate as to why this should be.  Perhaps, it is because it contains a few alkaloids, a category of compound that is poisonous, but at the level found in betony you would have to consume a lot to come to any harm.  Other plants are generally mentioned before betony for headaches these days, such as skullcap, German chamomile, and lavender.

I was lucky enough to come across this close relative of the mints the other day and it is always a pleasant surprise to finally see a plant in the wild that you know from books and illustrations. It was growing in a small clump under tree cover, not far from a pathway.  It is quite similar to another plant in the same family, hedge woundwort (Stachys sylvatica), a common weed with a harsh odour that grows on roadsides but betony produces purplish flowers in a very spiky spike at the top of each stem.

 

With headaches, sometimes just a very small dose can be sufficient to ward off a dull pain.  For example, 1ml of a 1:3 tincture in a beaker with some water can produce swift results, giving lie to the notion that herbal remedies do not act quickly.  But beware that optimum dosages can vary between individuals and some people can need a lot more than others, and vice versa.

Betony is generally a very safe herb. Nonetheless, you need to respect these medicinal plants and treat them as you would a medicine you can buy across the counter from a chemist. Start with a very low dose (such as a few drops of a tincture), if you have not taken it before.  If you are allergic to any of the constituents, a low dose is not likely to produce as much of a reaction as a larger dose. Also, betony can stimulate the uterus and is therefore best avoided if you are pregnant.  The plant contains a range of different secondary metabolite substances, including alkaloids, tannins, flavonoids and volatile oils. These compounds give rise to several medicinal actions, including a mild, relaxing sedative effect on the central nervous system, a bitter stimulus to digestion and possibly an effect on the vascular system to lower blood pressure. This article, though, can only scratch the surface and if you wish to know more about this remarkable plant, you will need to search the literature and available data that there is on this somewhat neglected species.

 

Herbal medicine for Candida and fungal infections

Herbal medicine has never been more important in the fight against persistent infections.  Drug resistant forms of bacteria and fungi are on the increase and pose a particular threat to immunocompromised people.  Drug resistant fungi are perhaps not so well known but are posing a challenge in addition to drug resistant bacteria like MRSA.  Studies of Candida albicans the yeast like organism that infects the gut and other areas of the body, causing thrush and even systemic illness, are revealing how herbal medicines can help people to win against this opportunistic bug.

Did you know that Candida has more than one form? A gene has been discovered that switches the relatively harmless yeast-like entity into pathogenic hyphal form with invasive filaments.  The Hgc1 gene is switched on by a ‘peptidoglycan’ (a mixture of protein and carbohydrate) molecule produced by gut bacteria.

Interestingly, a naturopath who treats people with Candida says that 80% of his patients have a Candida infection in their guts.  He uses a diagnostic called Biological Terrain Assessment Analysis to test for intestinal Candida infection, testing blood, urine, and saliva for their pH, redox and resistivity.

The story gets more intriguing though because the mycelial or hyphal form of Candida releases toxins that interfere with the body’s normal physiological functioning. The toxins can compete with hormone receptors and cause endocrine deficiency disease, such as hypothyroidism or hypoestrogenism. They can also damage the immune system.  Equally, damage to the immune system can lead to unchecked anti-body production and auto-immune disease.  Immunocompromised individuals are especially at risk from Candida.  People who get run down may start to succumb to an infection.  If left unchecked and untreated, it can proliferate and invade any tissue. Symptoms can affect not only the gastro-intestinal and genitourinary tracts but also the endocrine and nervous systems.  In addition to autoimmune disease there can also be allergy.

There are a number of herbs that research has found to possess ant-fungal properties. Examples include common thyme, tea tree, neem tree and holy basil. But treating someone with Candida is more than simply giving them anti-fungal herbal medicines.  It makes sense to boost their immune systems in a way to maximise their infection fighting potential. With an intestine resident pathogen, it also makes sense to modify the diet to reduce the pathogen’s strength and to provide herbal actions that will improve digestion, re-balance gut flora and assist healing processes. With patients who have taken anti-biotics and had their gut flora disturbed this is especially important. If the patient also has hormonal imbalances it is important to address these too. There are many herbs that can provide these therapeutic actions and it is impossible to cover all the possibilities here.

However, it is useful to mention two examples of herbal agents that can help in the fight against drug resistant forms of Candida. Glabridin is a constituent of liquorice root, and is a strong anti-fungal agent against amphotericin B resistant Candida albicans.  An alcohol extract of liquorice root was found to have a wide spread of activity against various C. albicans strains and several filamentous fungi.  In another study, thyme oil strongly inhibited the growth of a range of fungi, including Candida and, of twenty oils tested against three Candida albicans strains, provided the greatest measured effect.  And in another study, multi-drug resistant strains of Candida albicans were found to be sensitive to three of five plants tested – Acacia nilotica, Syzygium aromaticum and Cinnamum zeylanicum.

References

Fatima A et al. Phyto Res 2009;23:1190-1193

Kamble VA, Patil SD, J Herbs, Spices, Med Plants 2008;14(3-4):129-143

Both of the above references courtesy of Greenfiles -   www.greenfilesjournal.com

Khan R, et al.  Molecules 2009 Feb 4;14(2):586-97.

 

Why use Ginkgo – can it help prevent diseases of ageing?

Ginkgo is a widely researched medicinal plant with many clinical applications, mainly for circulatory disorders but also for dementia and a range of other conditions including hearing loss, vertigo, glaucoma, macular degeneration and diabetes.

The maidenhair tree, Ginkgo biloba, is a remarkable and ancient species that was the only member of its kingdom to survive the Hiroshima bomb.  Traditional herbalists have long used the leaf for medicinal purposes but most clinical trials have relied on a standardized extract of 50:1 concentration with levels of key constituents assured (24% flavonoid glycosides and 6% terpenoids).

So how does it work? It is an anti-oxidant herb that stimulates circulation right round the body, so that the extremities receive sufficient blood and oxygen. In doing so it promotes healing. It also exerts a protective effect on nerves, which may be associated with enhanced attention and aspects of memory. When given in sufficient dose (in standardized extract form) to people with tiny plaques (atherosclerosis) forming in their arteries, active constituents reduce the size of those plaques. It also significantly lowers the quantity of a special protein called lipoprotein[a], which is an important constituent of the plaques that form to clog up arteries.  In fact, the so called ‘bad cholesterol’, LDL-cholesterol, is also reduced in people taking Ginkgo. Studies have also found that other key constituents are affected by taking the extract: for example, the anti-oxidant enzyme superoxide dismutase – thought to have a role in slowing down ageing – is increased.

The lipoprotein[a] finding is very interesting because lipoprotein[a] is implicated in many diseases and conditions.

So, what does Ginkgo treat well?  The answer is a wide number of conditions, mostly those affected by weak peripheral circulation.  Here’s a list:

°         Impaired peripheral and cerebral circulation

°         Atherosclerosis

°         Arterial occlusive disease

°         Raynaud’s disease

°         Ischaemic ulcer and leg ulcers

In addition, there is evidence from trials of benefit for a number of other conditions including: tinnitus, dizziness, sudden hearing loss, altitude sickness, hypoxia, multiple sclerosis, diabetes, stress, normal tension glaucoma, and age-related macular degeneration. Moreover, there is evidence that Ginkgo may improve concentration, cognitive function and memory.

Is standardized Ginkgo extract safe? For the most part, the herb is indeed safe. Although Ginkgo acts on the anti-platelet activating factor agent, the effect on clotting time is viewed as insignificant, as the anti-PAF agent is not very influential. However, if you are taking blood thinning medication – or indeed any medication – you should consult a professional herbalist or your doctor.

In summary, Ginkgo extract can provide many benefits, some of which help to prevent or treat diseases associated with getting older.

 

Hawthorn for the cardiovascular system

 

Hawthorn is a great medicinal plant and a superb remedy for the heart and circulation – the cardiovascular system.  It flowers at this time of year, in early May, when hedgerows are covered in “May blossom”.

One of the main health risks over 40s men face is high blood pressure and thickening of the arteries.  Indeed, if the process of atherosclerosis is left unchecked it is likely to affect the coronary artery, which leads to heart trouble and the risk of a heart attack. The reason blood pressure tends to rise with age is that the arteries harden and become less flexible and so less able to widen when the heart is working harder or when there is a greater volume of blood in the system (though there are other reasons why blood pressure can rise, to do with the control exerted by the nervous and hormonal systems).  

Unfortunately, some people have a much greater risk than others, simply because of inherited factors or genes. It is quite easy to tell if you are likely to be one of these types because at least one of your parents will have had cardiovascular or heart disease, especially if it surfaced in their 30s or 40s.  But even if you are not one of the people who face heart disease early on in middle age, you will want to reduce your risk long before you reach retirement age.  The sooner you take steps to keep your arteries clear, the greater will be your chances of living healthily beyond retirement.

These days doctors have very organised methods for assessing your cardiovascular risk and dispense helpful advice covering lifestyle.  This advice is likely to cover diet and exercise in the main, which is fine being the bedrock of good health.  Incidentally, if you read that red wine is a good remedy for the heart and circulation, I advise caution for two reasons. One is that a statement like that says nothing about the dose required and it is so easy to drink too much: the harmful effects of excess alcohol would cancel out the beneficial effects of medicinal constituents in the red wine.  The other reason is that many of the cheaper red wines contain preservatives, which makes them unsuitable for medicinal purposes. 

Despite the great amount of good advice given out by medical people and in the media some natural methods for keeping your heart and circulation ticking over well and maintaining blood pressure within normal limits are not so well known.  Why is this?  I don’t know. It might be because some natural ways to improve your health lack the scientific evidence required by medical people.  

By contrast, hawthorn is a medicinal plant about which much has been written by the scientific community.  Its positive effects on heart circulation are well documented.  It contains two key sets of constituents – cyanidins and flavonoids – that mainly contribute to its vessel wall improving and anti-inflammatory effects.  Why, then, isn’t it more popular as a remedy?  Perhaps it is in some circles.  Certainly, amongst herbalists and natural healers it is widely used. And herbal supplements containing extracts of hawthorn berries or flowering tops are available in health stores. 

It is possible that many people are simply unaware of the scientific evidence in favour of hawthorn as an efficacious remedy for atherosclerosis, heart disease and high blood pressure.

Hawthorn’s safety record is very good and it can be taken beyond a few weeks. But if you are starting to take it, it is best to commence with a very small dose to test how you are with it.  This is especially important if you are prone to allergies or reactions with plants.  I would also avoid rich or spicy food, to begin with, as this could intensify any reactions. 

However, one important point about hawthorn should not escape your attention and may have contributed to its modest use. This is that it may interact with heart medicines such as digoxin and beta-blockers or with blood pressure medication.  For this reason, it is essential that if you are taking medication you should consult your doctor if you are contemplating taking hawthorn and also consult a professional medical herbalist, who can advise on a dosage regimen, if indeed it is appropriate for you to take hawthorn.

Nonetheless, hawthorn is an excellent remedy for the heart and circulation.  It can be taken either as an infusion of the leaves and flowering tops or a decoction of the berries or as a tincture of either the flowering tops or berries.  It can also be purchased as capsules or tablets.  A maintenance dosage for people who are taking it to prevent cardiovascular disease, would be between 1 and 3 grams a day of dried flowering tops or berries or 3 to 6ml a day of a tincture (of either 1:2 or 1:3 strength). Start with only 0.5 gram at first to see how you get on with it.

 

Turmeric is as effective as ibuprofen for osteoarthritis

Turmeric is known to be quite strongly anti-inflammatory – there has been quite a lot of research on it and it is useful for reducing the risk of damage to arteries from fatty deposits (atherosclerosis). Inflammation in joints arising from wear and tear (osteoarthritis) affects many people and non-steroidal anti-inflammatory drugs (NSAIDs) are consumed by many sufferers. As NSAIDs can damage the stomach wall lining, there would be an advantage from any effective remedy that can avoid this. However, turmeric is difficult to absorb through the gut wall and ideally needs to be taken with oil or fat based foods (curcumin, one of the main active constituents, is insoluble in water). A recent trial found that taking 500 milligrams of the root extract (as two 250mg capsules) four times daily provided as much relief from pain as well as improved mobility during walking as the NSAID ibuprofen, and fewer side effects. Turmeric of course can also be added to cooking, as in curries and stews. Although turmeric has ‘generally regarded as safe’ status in the US, it is not without its risks. It should not be taken by women wishing to conceive and those on anti-platelet or anticoagulant medication, such as warfarin. There is also a risk of hair loss. Moreover, there was a suggestion (from an Indian journal in 2006) that stopping consumption of turmeric was a factor in repigmentation of skin in several patients with vitiligo (depigmented skin) – apparently the constituent curcumin may have contributed to the ‘oxidative stress’ of acute vitiligo. 

If you haven’t eaten turmeric before and you want to use it for culinary purposes, use a little to see if you are ok with it, and when you are comfortable with it don’t over do it. If you buy the tincture, I would avoid high doses and if taking it long term give yourself a break from it every now and then.  Nonetheless, this medicinal plant is a winner, not only in its value for osteoarthritis but for a whole range of conditions owing to its anti-inflammatory, anti-oxidant and anti-infective actions.

 

More on natural remedies for gout sufferers…

Gout is very painful and can be very tricky to deal with. Ordinary painkillers can be fairly useless.  The uric acid that builds up and forms crystals in joints has to be removed in some way. If you have an inherited tendency to produce more uric acid than normal, you need to find a way to reduce this and eliminate it faster than average. The good news is that research is beginning to catch up with this disease that afflicts quite large numbers of people, particularly men in middle age and beyond.

Firstly, there are certain foods that are complete “no-no’s”, such as offal (liver, kidneys, etc), oily fish (sardines, anchovies, etc), shellfish and asparagus. Alcohol, of course, especially port and red wine, is off limits. Strangely, scientists have now found that some fruits are not a good idea for gout sufferers. This came as a surprise to me, as I frequently say to people “up your intake of fresh fruit and vegetables”, for conditions like this. In fact, generally, if you have any kind of inflammatory condition, you want to reduce inflammation and a good way to help this by adopting a non-inflammatory diet that is rich in fresh fruit and vegetables. But with metabolic conditions like gout you have to tread carefully with dietary adjustments.

Apparently, there is a possibility that fructoses – a kind of sugar – may raise serum (blood) purine levels. Research into sugar-sweetened beverages has indicated that these drinks are associated with an increased risk of gout (as well as raised blood pressure and diabetes). Fructoses are used to sweeten such beverages though the link from fructoses to raised uric acid levels is not clear. However, you may like to know that certain fruits such as apples and oranges contain fructoses.

Now, if apples and oranges are your favourite source of vitamin C, and you are contemplating giving those fruits up to avoid fructoses, you may need to find other sources of ascorbic acid (vitamin C). This is because a high dose of vitamin C reduces gout – but your intake may need to be as much as half a gram or more a day. In fact, a very intake of 1,500mg (1.5 grams) would reduce your chances of getting gout by quite a margin than if intake was 250mg or less each day. To obtain such high amounts of vitamin C probably requires supplements; however, note that high dose vitamin C intake can result in loose bowels: caution is the watchword.

Fresh produce that favour avoiding gout includes cherries, tomatoes and green leafy vegetables (cabbage, kale, brocoli), which are good examples of foods to include in a gout-avoiding diet. In fact, supplements with cherry, known as ‘tart cherry’ capsules are sold now as gout prevention remedies. Low fat dairy foods could also be included if you are not lactose or milk intolerant, as they are low in purines.  You may also want to consider how to obtain your essential fats, especially the omega-3 ones found in fish oils.  Flax seeds contain a plant form of an omega-3 fatty acid but there are also purified forms of omega-3 fatty acids available in capsules (though they are relatively expensive).

The herbalist’s approach to gout is to use plants that help to reduce uric acid levels, by dissolving the crystals and eliminating the uric acid via the kidneys, as well as advising dietary and lifestyle adjustment. For example, celery seed helps to eliminate uric acid from joints and nettle leaf promotes elimination. Other medicinal herbs may be used too, such as ones with an anti-inflammatory action. Intake of fluids often needs to be raised, to maintain elimination and prevent other risks such as kidney stones. The precise details depend on the individual as cases can vary.

 

Medicinal plants for anxiety

Anxiety strikes many people in our competitive and fast-paced world. It may be a sign of stress, though it could also be a psychological condition. Anxious people are fearful and this can affect how they are to others, seemingly either passive and hesitant or hostile and aggressive. It can also affect their bodies and give them cold sweats, being dry in the mouth and other symptoms of a lack of normal temperature control. They can be tense, restless and find it difficult to unwind. Continual anxiety can also give people indigestion and other aches and pains, such as back ache. If you have continual anxiety and symptoms that affect you on a daily basis you need to obtain a proper medical assessment. Fortunately, there are a number of medicinal plants that can help to remedy anxiety and to restore a person to a normal and relaxed state, without side effects. They are not all the same and each plant acts in a slightly different way. Plants that act on the nervous system may also act elsewhere in the body, such as on the digestive system or the liver, for example.

Chamomile is a useful mild relaxant that can help someone to be calm and soothe any digestive troubles, and it is useful if you are irritable. Also, it doesn’t interact with any medical drugs and can be tolerated by most people including children – though a very few people can experience an allergic reaction. There are two forms of chamomile: German and Roman. They are similar in action but differ in flower structure. The German is more bitter and stronger whereas Roman chamomile is even gentler on the stomach and lungs. The infusion can be drunk freely, though in strength or quantity it can help induce sleep, which won’t be so helpful during the day! If you obtain the medicinal form of chamomile flowers, check that they give off an aroma (almost apple-like in Roman chamomile) and if fresh it can be quite strong. Once boiled water has been added make sure the pot or cup is covered to preserve the blue volatile oil, which is medicinal (look for a blue tinge to the surface of the infusion).

Another plant that can help with anxiety is skullcap. (Please note that North American skullcap (Scutellaria lateriflora) is different to the Chinese skullcap (S. baicalensis), which is a herb for the digestive system.) Skullcap is useful if you work long hours and need help to relax and recharge your batteries. Unfortunately, there is very little published research available, as to its efficacy, on this widely used plant. Analysis of its constituents suggests it is antispasmodic and possibly anti-microbial, in addition to its relaxing effect on the central nervous system. It may also be combined with other herbs for sleeplessness (such as lemon balm, valerian or passionflower). If you wish to take the infusion, start with a small amount, such as half a teaspoon of the fresh or dried herb, and steep it for at least five minutes.

Two other medicinal plants that may be considered for anxiety are motherwort and hawthorn, as both help to maintain a steady heart beat, which can be accelerated by fear and worry. However, motherwort must not be taken by pregnant women.