6 Tips For Managing Anxiety Without Drugs


As a holistic psychiatrist practicing in New York City, I see a lot of anxiety. A lot. And I’m disheartened to see so many of my patients on loads of psychiatric medications that are not necessarily helping and may even be causing harm. Meanwhile, these highly medicated folks are still suffering from anxiety! This is because we’re going about it all wrong. Anxiety is not a Xanax-deficiency disorder. The mind, body and spirit are all involved in anxiety, but I think anxiety is first and foremost a physiologic disorder; that is, it’s a disorder of the body, not just the mind. The good news is that shifting our body’s physiology is relatively easy to do. There is so much we can do with diet and lifestyle to manage anxiety, and much of it is safer and more effective than medication.

Here are 6 tips for managing anxiety naturally:

1. Maintain Stable Blood Sugar

    • “It isn’t disrespectful to the complexity of existence to point out that despair is, often, just low blood sugar and exhaustion.” – Alain de Botton
    • The American diet promotes a blood sugar roller coaster, and every time we’re on the ride down, we can feel anxious.
    • When our blood sugar crashes, our body responds with a stress response. We secrete stress hormones, cortisol and adrenaline, which tell our liver to make more blood sugar to keep us alive. The good news: We stay alive. The bad news: This hormonal stress response feels identical to anxiety.
    • By stabilizing blood sugar, you can avoid this stress response and decrease your anxiety.

Here’s how to maintain stable blood sugar:

    • Eat more protein and healthy fats (e.g., olive oil, coconut oil, butter and ghee from pasture-raised animals).
    • Avoid sugar and refined carbohydrates.
    • Eat 3 meals and 2 snacks daily; don’t skip meals.
    • Take a spoonful of coconut oil upon waking, in the afternoon and right before bed; this will serve as a blood sugar safety net throughout the day.
    • Always have a snack handy (e.g., nuts, hard-boiled egg, dark chocolate, Epic™ jerky, Vital Choice wild salmon jerky, almond butter).

2. Do a Trial Off Caffeine

    • Don’t underestimate the relationship between caffeine and anxiety.
    • Think of it like this: When we’re caffeinated, our nervous system is ready for a fight. Introduce a stressor, and you have an all out anxiety response.
    • If you suffer from anxiety, you owe it to yourself to do a trial off caffeine.
    • I know, I know, the idea of going off caffeine is giving you anxiety right now. If you reduce your intake gradually (coffee -> half-caf -> black tea -> green tea -> herbal tea) over the course of a week or two, you’ll avoid withdrawal symptoms. After a few weeks, you may be surprised to see that your anxiety has decreased, your sleep has improved, your energy is stabilized, and you even tolerate stress better.
    • If you had a successful trial off caffeine, but you want to go back to having that morning ritual, consider making green tea your go-to beverage, rather than a “Venti Skinny Vanilla Latte.”

3. Sleep

    • Getting adequate good quality sleep is your best protection against anxiety.
    • There’s a 2-way street between anxiety and sleep–anxiety causes insomnia and sleep deprivation makes us vulnerable to anxiety.
    • The best way to address this is to set ourselves up for better sleep. Conveniently, the way to do this overlaps with the overall approach to anxiety.
    • Here’s how:
      • Reduce or eliminate caffeine
      • Even if you have no trouble falling asleep, caffeine decreases sleep quality.
      • Maintain stable blood sugar
      • Blood sugar fluctuations disrupt your sleep, causing middle of the night awakening.
    • Be strategic about light:
      • Let your eyes see bright light in the morning and dim light at night.
      • If your room isn’t completely dark when you sleep, wear an eye mask or get blackout curtains.
      • Wind down and unplug before bed

4. Heal the Gut

    • Perhaps you’ve seen some of the recent articles about the relationship between gut flora and mood.
    • The bugs in our digestive tract have a profound impact on how we feel and play an integral role in anxiety disorders.
    • Here’s how to promote healthy gut flora and heal the gut:
      • Avoid what irritates the gut:
        • Food: Gluten, sugar, industrial vegetable oils, artificial sweeteners, alcohol.
        • Certain medications: Antacids, antibiotics, oral contraceptives (only make changes under close supervision from your doctor).
      • Add in what soothes the gut:
        • Fermented foods: Sauerkraut, kimchi, beet kvass, miso paste, apple cider vinegar, kombucha, kefir (if you tolerate dairy).
        • Starchy tubers: Sweet potatoes, white potatoes, plantain, taro, yucca.
        • Bone broth:
        • Supplements:
      • Create the conditions for the gut to heal:
        • Squatty Potty can be life-changing.
        • Get enough sleep.
        • Manage stress with yoga, meditation, breathing exercises, unplugging, acupuncture, being in nature.
        • Treat gut infections. If you suspect you may have a chronic gut infection, get evaluated by an integrative or functional medicine practitioner.

5. Exercise

    • Exercise is the best anti-anxiety medicine.
    • If you struggle to exercise regularly, forget the boot camps and triathlons. Get in the habit of mini workouts. Do small amounts of exercise in your living room or take a brief walk outside. Sustainability is key.
    • In general, stand more, sit less, walk whenever possible, and lower your standards for exercise.
    • Yoga and Tai Qi are particularly beneficial for anxiety, but the most important thing is to find something you enjoy.

6. Magnesium

    • Magnesium is mothernature’s Xanax.
    • Many of us are deficient in magnesium, since our food is grown in magnesium-depleted soil.
    • You can supplement with magnesium in a few different ways:

Anxiety has a significant impact on quality of life. Maintaining stable blood sugar, reducing caffeine, getting enough sleep, healing the gut, getting some exercise and filling the body with magnesium are safe tactics that go a long way toward reducing anxiety. If your anxiety does not respond to these lifestyle interventions, I recommend having a consultation with a qualified mental health provider.

  • Sofia Coelho

    Great article! When should we take a magnesium supplement if we need to sleep better? Before bedtime? At dinner? I heard that magnesium citrate keeps us awake if taken at bedtime – is there a scientific basis? Many thanks.

  • laurakraber

    Hi Sofia – we recommend our buffered chelate form of magnesium before bed or in the evening to help with sleep. I have not heard that it keeps people awake, and is generally relaxing. An epsom salt bath is also full of magnesium and a good night-time ritual… best of luck to you. – Health Coach, laura

  • Sara

    You can get a highly concentrated spray at Whole Foods or Ancient Minerals spray from Amazon. It’s really good for calming sleep. I think it’s way better than an epsom salt bath.

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  • Angela

    Hello! I am posting because i am in DESPERATE need of some help. Ive fought with anxiety for years now. I use to be on a daily i eventually came off of it because i hated feeling like i did. Then i wemt to xanax always has been a low dose of .5 but within the last couple months it has gotten waaay worse and the docotors are telling me its probably hormones because i changed my birth control for a month then my first cycle after is when it got really bad. Im going to have hormones ckd in a few wks until then i need some help. My xanax now is more a day then ever before and it still doesnt always work and its affecting my daily life now. My job my marriage. ..alll of it. Please tell me if you’ve ever heard of hormones doing this and if i need to get back on a daily or if these things will really help. Im desperate.

  • Loren

    Hi Angela. I hope things got better since you have posted. I was prescribed 1 mg of estrace and letrozole 5 mg x 5 days for my fertility treatment. Two weeks after the treatment, i started to feel sick. I just woke up one day and felt that something was wrong with me. My biggest symptom was my mood swings and anxiety. I would cry, laugh, be upset, sad, and all these feelings came really out of the blue. With that, the nausea, light headed, vomiting, and loss of appetite came in. I was so taken back. I didn’t have the desire to get out of bed and no motivation to do anything! It did get worse and i went to the ER. Since my estrageon was doubled up- my hormones were out of wack. I believe its called “hormonal anxiety”. I was told that i need to wait one month until the medication clears up or when i get my period that my hormones should go back to normal. I never had this in my life and it really threw me for a loop. I didn’t know how to handle the situation and started to do more research on anxiety, hormones, and natural ways of reducing anxiety and mood swings because of this. I hope all goes well for you and that your find the right tools to help you! Best of luck and stay strong!

  • Melissa

    I probably suffered with mild anxiety for years. Not enough to bother me or even really notice until one day, out of the blue, I had my first panic attack. I ended up in the ER sure that I was having a heart attack. I had another one a few months later. After eliminating every possible physical issue (heart, etc), it was concluded that I had anxiety, which I kind of already knew. Wanting to prevent more panic attacks, I went on Prozac (20 mg). I only took 6 doses before I had the most horrible reaction ever. Never been that sick in my life. I discontinued the Prozac, obviously, but it was weeks before I was even functional again. Needless to say, neither me nor my doc want me to go on any kind of SSRI or SSNI again. I had to take Klonopin (low dose) until all the Prozac was out of my system, then taper off of it. Right now I’m not taking anything for anxiety and so far, so good. I do have Xanax to take if I ever do get another full-blown attack. I will say that I have found acupuncture to be the absolute best thing for me. Aside from being very relaxing, I truly feel physical relief from it. I was kind of skeptical going into it but desperate to try anything. I can now say that it really does work. I’m not a huge fan of yoga, but I have started meditating, and it helps too. I just bought a CD that I play that walks you through about a 20 minute meditation session. Don’t be afraid to try anything. You never know which one will work.

  • Memewars2000

    I do not take any drugs but i do go through anxiety. i get paranoid about people laughing at me, and i have trouble talking to people my age. some people i have no problem with. i always blame it on my looks. in my eyes, i look fine, till something ruins my day (practically everyday) then i look at myself like “ew gross”
    im always paranoid about the way i look. and im always paranoid about dating as well.
    im paranoid all the time. D: im never chill

  • Taylor

    I have never responded to any board before but I have been through a similar situation. I got pregnant with my daughter 18 months ago and just a few months in and my anxiety that I had been free of for so long was back. Long story short, I highly recommend a natropath. I had my neurotransmitters (hormones too) tested and I was able to fix my anxiety with supplements. I also was introduced to Lavela. It changed my life. Lavela is just a lavender oil pill but has been study up against anti anxiety pills and sleeping pills and has been proven to be just as affective. It can be found on amazon and is safe , non habit forming. It’s amazing for sleep! It can be taken 1 to 3 a day. I take one to start and one to end my day.