ModerateGBS: 81 (High Risk)mental health

Anxiety & Panic Protocol (Non-Benzo)

Developer: Various integrative psychiatrists

2-4 weeks for supplements, 8-12 weeks for therapy/lifestyle changes

Protocol Overview

Natural and integrative protocol for anxiety using supplements, lifestyle, and therapy. Avoids benzodiazepines (addictive, cognitive impairment, withdrawal).

Conditions Treated

Generalized anxiety disorder

panic disorder

social anxiety

Protocol Steps

Rule out medical causes: Hyperthyroidism (TSH, free T3/T4 - even subclinical hyper causes anxiety), caffeine excess (eliminate or reduce), hypoglycemia (blood sugar dysregulation), anemia, cardiac arrhythmias (especially if palpitations), sleep apnea, POTS (dysautonomia), medication side effects (stimulants, steroids, decongestants)

L-theanine: 200-400mg 1-3x daily (amino acid from green tea, promotes relaxation without sedation, increases alpha waves, reduces anxiety within 30-60 min - fast-acting, safe, no tolerance)

Magnesium: 400-800mg daily (calming, GABA modulation, most people deficient - glycinate or threonate forms best absorbed, calming)

Inositol: 12-18g daily in divided doses (second messenger, affects serotonin receptors, RCTs show reduces panic attacks and anxiety - high dose needed, well-tolerated, powder form)

Omega-3: 2-3g EPA/DHA daily (anti-inflammatory, reduces anxiety in studies, higher EPA ratio)

GABA: 500-750mg daily (inhibitory neurotransmitter, calming - controversial if crosses blood-brain barrier but many report benefit, possibly via gut-brain axis)

Ashwagandha: KSM-66 600mg 2x/day (adaptogenic, reduces cortisol 27% in studies, reduces anxiety significantly in RCTs)

Rhodiola rosea: 340-680mg daily (adaptogenic, reduces anxiety and fatigue, improves stress resilience)

Passionflower: 500mg extract daily or tea (GABA-ergic, reduces anxiety comparable to benzos in some studies but without addiction/impairment)

Lavender oil: Silexan 80-160mg daily (oral lavender oil capsule, RCTs show anxiolytic effects comparable to lorazepam, well-tolerated - not aromatherapy, specific German product studied)

Lemon balm: 300-600mg daily (GABA-ergic, calming, reduces anxiety, improves sleep)

Valerian: 400-900mg before bed (sedating, GABA-ergic - for nighttime anxiety, improves sleep, not daytime use due to sedation)

Vitamin D: Optimize 60-80 ng/ml (low D associated with anxiety)

B-vitamins: Methylated B-complex (stress depletes B-vitamins, needed for neurotransmitter synthesis, calming)

Probiotics: Psychobiotics - Lactobacillus helveticus + Bifidobacterium longum (gut-brain axis, reduces anxiety in studies)

CBD oil: 25-75mg 2x daily (anxiolytic, well-tolerated, non-intoxicating - helps generalized anxiety and social anxiety in studies)

Exercise: 30-60 min daily (burns off cortisol/adrenaline, releases endorphins, reduces anxiety - aerobic or yoga/tai chi)

Breathing exercises: Critical - hyperventilation drives panic, slow breathing activates parasympathetic: Box breathing (4-4-4-4: inhale 4 counts, hold 4, exhale 4, hold 4), 4-7-8 breathing (inhale 4, hold 7, exhale 8), practice 5-10 min 2-3x daily and during anxiety spikes

Meditation/Mindfulness: Daily practice reduces anxiety over time (MBSR - Mindfulness-Based Stress Reduction has strong evidence, 8-week programs)

CBT: Cognitive-behavioral therapy for anxiety - gold standard, challenges catastrophic thinking, exposure therapy for phobias/panic, teaches coping skills

Avoid: Caffeine (stimulant, triggers anxiety, panic - eliminate or limit to AM only <100mg), alcohol (rebound anxiety after temporary relief, worsens long-term), sugar (blood sugar swings cause anxiety spikes), excessive news/social media (information overload increases anxiety)

Sleep: 7-9 hours (sleep deprivation increases anxiety dramatically - prioritize sleep hygiene)

Reduce stress: Identify and reduce stressors (work, relationships, finances - therapy addresses), boundaries, say no more, schedule downtime

Vagal nerve stimulation: Cold water face immersion, gargling, singing, humming (activates vagus nerve - shifts from sympathetic to parasympathetic, calms anxiety)

Acupuncture: Some evidence for anxiety reduction

Progressive muscle relaxation: Tense and release muscle groups (reduces physical tension associated with anxiety)

Limit stimulants: Decongestants (pseudoephedrine), energy drinks, pre-workout supplements (stimulants trigger anxiety)

Blood sugar stability: Eat regular meals with protein (hypoglycemia causes anxiety-like symptoms - shakiness, palpitations, panic)

SSRIs if needed: If natural approaches insufficient, SSRIs (Lexapro, Zoloft) are non-addictive anxiolytics (take 4-6 weeks to work) - much better long-term than benzos

Avoid benzodiazepines long-term: Xanax, Ativan, Klonopin addictive, tolerance develops, cognitive impairment, dangerous withdrawal. Short-term rescue OK (rare panic attacks) but not daily use

Key Resources

The Anxiety and Phobia Workbook by Edmund Bourne, Lavender oil (Silexan) anxiety RCTs, inositol panic disorder studies, CBT anxiety evidence

Contraindications & Risks

Avoid combining multiple GABA-ergic herbs (excessive sedation), don't combine with benzodiazepines, valerian sedating (don't drive), lavender oil can cause eructation (burping)

Important Notes

Anxiety disorders affect 40+ million Americans - most common mental health condition. Types: Generalized anxiety disorder (chronic worry), panic disorder (panic attacks), social anxiety, phobias, OCD. Conventional treatment: SSRIs (take weeks), benzodiazepines (fast but addictive). Natural approaches have evidence and avoid benzo addiction. L-theanine: Fast-acting (30-60 min), promotes alpha waves (relaxed alertness), doesn't cause sedation, safe, no tolerance. Dose 200-400mg as needed. Green tea contains L-theanine but need 5+ cups for therapeutic dose. Inositol: Multiple RCTs show reduces panic attacks and anxiety (high dose 12-18g daily needed - powder form). Well-tolerated, minimal side effects. Mechanism: Affects inositol phosphate second messenger system, serotonin receptor sensitivity. Ashwagandha: Adaptogenic, reduces cortisol 27% in RCT, significantly reduces anxiety scores. KSM-66 extract studied (600mg 2x daily). Calming and energizing paradoxically. Lavender oil (Silexan): Specific German oral lavender oil product (Lasea/CalmAid). RCTs show anxiolytic effect comparable to lorazepam (Ativan) without addiction or impairment. 80-160mg daily. Not aromatherapy - oral capsules. Magnesium: Deficiency causes anxiety, muscle tension. Supplementation calming. GABA modulation. Most Americans deficient. CBD: Multiple studies show anxiolytic effects (generalized anxiety, social anxiety, public speaking anxiety). Dose 25-75mg. Non-intoxicating (no THC high). Well-tolerated. Mechanism: 5-HT1A serotonin receptor agonist, other pathways. Breathing: Hyperventilation drives panic (low CO2 causes symptoms - tingling, lightheadedness, chest tightness). Slow breathing (box breathing, 4-7-8) raises CO2, activates parasympathetic, stops panic. Simple, powerful, free intervention. Teach all anxiety patients. CBT: Gold standard - challenges catastrophic thoughts ("I'm dying" → "it's just anxiety, uncomfortable but not dangerous"), exposure therapy for phobias, teaches coping skills. As effective as medications. MBSR (Mindfulness-Based Stress Reduction): 8-week program, reduces anxiety significantly, teaches present-moment awareness. Caffeine: Huge anxiety trigger - stimulant, increases cortisol/adrenaline, can trigger panic attacks. Many anxious people consume coffee (self-medicating fatigue from poor sleep due to anxiety) - vicious cycle. Eliminate or limit to AM <100mg. Blood sugar: Hypoglycemia causes anxiety-like symptoms (shakiness, palpitations, sweating, panic) - eat regular meals with protein, avoid sugar crashes. SSRIs vs benzos: SSRIs (Lexapro, Zoloft) take 4-6 weeks but non-addictive, effective for long-term anxiety management. Benzodiazepines (Xanax, Ativan, Klonopin) work immediately but addictive, tolerance, cognitive impairment, dangerous withdrawal (seizures). Benzos should be avoided for chronic anxiety (short-term rescue OK - rare panic attacks, acute crisis). Benzos are "borrowing calm from tomorrow" - rebound anxiety. Natural approach addresses root causes (nutrient deficiencies, blood sugar, hyperventilation, catastrophic thinking, chronic stress). Combination works best: L-theanine/magnesium for acute relief, ashwagandha/inositol for daily support, breathing exercises, CBT, lifestyle changes. Many can avoid or taper off medications.

Key Supplements & Herbs in This Protocol

Supplements

L-Theanine

Herbs

Ashwagandha

Withania somnifera

Rhodiola

Rhodiola rosea

Lemon Balm

Melissa officinalis

Valerian

Valeriana officinalis

Passionflower

Passiflora incarnata

Lavender

Lavandula angustifolia

Critical Safety Warning

This protocol is documented for educational purposes only. The Gabriel Bullshit Score (GBS) of 81 reflects significant institutional response and controversy. Some alternative health protocols have resulted in serious harm or death.

Always consult with qualified healthcare professionals before beginning any treatment. Do not delay or forego proven medical care.

Quick Overview

Evidence LevelModerate

GBS Score81 / 100

Categorymental health

DeveloperVarious integrative psychiatrists

Duration2-4 weeks for supplements, 8-12 weeks for therapy/lifestyle changes

About GBS Score

The Gabriel Bullshit Score reflects the magnitude of institutional response, controversy, and documented concerns. Higher scores indicate greater institutional pushback, not necessarily inefficacy. This is a research tool, not medical advice.