Generalised Anxiety Disorder (GAD)

The DSM-V stated that generalised anxiety disorder is characterised by excessive worry that is hard to control and is accompanied by three or more symptoms including restlessness, becoming easily tired, finding it hard to concentrate, irritability, muscle tension and sleep difficulty, experienced more often than not in the past 6 months.

Commonly used treatments for anxiety include massage, acupuncture, Psychology, meditation, Bach flower remedies, aromatherapy and herbal medicine, along with diet and lifestyle changes.

Kava kava (Piper methysticum) is an herbal medicine used in the Pacific that is a widely used for the treatment of anxiety, insomnia, and stress (Wang, et al., 2019) but it is not a replacement for prolonged anti-anxiety use (Smith & Leiras, 2018). Kava kava was found to be an effective alternative for those more prone to natural therapies or lifestyle approaches over pharmacological treatment for anxiety, and it safe and well tolerated (Ooi SL, 2019).

Although it is well tolerated, some may experience liver toxicity due to forming metabolites in the liver when kava kava undergoes the cytochrome P450 liver detoxification pathway, highlighting the common misconception that all natural therapies must be safe because they are natural, and how important it is to speak to a suitably qualified practitioner before starting any herbal medicine treatments.

My advice with regards to anxiety and natural therapies is to consult your Naturopath for a thorough discussion around your symptoms. A Naturopath has ingestive medicine training and is able to complete a thorough consultation with you that will look at all areas of your life and the functional impact that anxiety has on it, a crucial process to determine which treatment approach to take. For example, there are many different herbal approaches for treating sleep disturbances that are indicated depending upon how the symptom manifests, with a different herb indicated for insomnia due to excessive thoughts keeping you awake that would be indicated for a person with insomnia that manifests as not being able to maintain sleep.

Warmest regards,

                             Penelope Espinoza Hallett, Naturopath

BHsc (C.M.) AdvDip. Nat/N.D, Dip. Aroma, Dip. C.H., Cert. R.M., Cert. R.M., Cert. SBM, mNHAA



Ooi, S. L., Henderson, P., & Pak, S. C. (2018). Kava for Generalized Anxiety Disorder: A Review of Current Evidence. The Journal of Alternative and Complementary Medicine, 24(8), 770-780. doi:10.1089/acm.2018.0001

Wang, P., Zhu, J., Shehu, A. I., Lu, J., Chen, J., Zhong, X., & Ma, X. (2019). Enzymes and Pathways of Kavain Bioactivation and Biotransformation. Chemical Research in Toxicology. doi:10.1021/acs.chemrestox.9b00098

Smith, K., & Leiras, C. (2018). The effectiveness and safety of Kava Kava for treating anxiety symptoms: A systematic review and analysis of randomized clinical trials. Complementary Therapies in Clinical Practice, 33, 107-117. doi:10.1016/j.ctcp.2018.09.003