| Conditions:

Stress

Stress is mental or emotional tension. It can be short or last a long time. It can also lead to health problems, such as high blood pressure, anxiety, and problems sleeping. It can also lower the body's ability to fight off infection, such as the cold or flu.

It can be treated with lifestyle changes, such as healthy eating, exercise, and taking breaks. Some people turn to natural therapies to further ease stress.

Natural Therapies

Likely Effective

These therapies are likely to help ease stress:

• Cognitive behavioral therapy is a way of reframing problems. It is likely to ease stress related to anxiety disorders.^L1-L4 
• Emotional freedom techniques are likely to ease stress from post-traumatic stress disorder.^N1 
• Lycium barbarum is a shrub that is native to China. It is likely to ease stress.^T1 
• Mindfulness meditation is a method used to pay attention to the present moment. It is likely to promote resilience.^K1-K6 
• Multivitamins and minerals —A blend of B vitamins, vitamin C, and minerals (one study included probiotics) is likely to ease stress and anxiety.^A1-A6 
• Probiotics are healthy microorganisms that are likely to ease stress.^O1 

May Be Effective

Therapies that may help ease stress are:

• Biofeedback is a method used to take control over functions in your body that work automatically such as your heart rate.^B1-B2 
• Guided imagery is visualizing mental images of scenes or actions.^C1-C5 
• Hypnotherapy combines heightened attention with deep relaxation and openness.^D1 
• Music therapy may ease stress from anxiety during pregnancy.^M1 
• Qigong is a martial art that uses poses, breathing, and meditation to strengthen and balance the body’s energy. ^S1 
• Tai Chi with or without yoga) is a martial art that uses poses, breathing, and meditation to strengthen and balance the body’s energy.^E1-E3 
• Yoga is a form of exercise uses poses and breathing.^F1-F2 

Supplements that may ease stress are:

• Ashwagandha is a plant in the nightshade family. ^G1-G2 
• Rhodiola is a flowering plant. ^H1-H2 

Unlikely to Be Effective

These therapies are unlikely to ease stress:

• Eleutherococcus senticosus is a species of small, woody shrub.^I1 
• Exercise^J1 
• Homeopathic medicine is the use of therapies to help the body heal itself.^U1 

Not Enough Data to Assess

• Acupoint stimulation^P1 
• Aromatherapy^R1 
• Self-performed foot reflexology^Q1 

Editorial process and description of evidence categories can be found at EBSCO NAT Editorial Process.

Herbs and Supplements to Be Used With Caution

Talk to your doctor about any supplements or therapy you would like to use. Some can interfere with treatment or make conditions worse, such as:

• Ashwagandha—Don’t use this herb if you have hyperthyroidism.
• Multivitamins and minerals—Generally safe, but don’t take more than the recommended dose.

References [ + ]

A1. Carroll D, Ring C, et al. The effects of an oral multivitamin combination with calcium, magnesium, and zinc on psychological well-being in healthy young male volunteers: a double-blind placebo-controlled trial. Psychopharmacology (Berl). 2000;150(2):220-225.

A2. Schlebusch L, Bosch BA, et al. A double-blind, placebo-controlled, double-centre study of the effects of an oral multivitamin-mineral combination on stress. S Afr Med J. 2000;90(12):1216-1223.

A3. Kennedy DO, Veasey R, et al. Effects of high-dose B vitamin complex with vitamin C and minerals on subjective mood and performance in healthy males. Psychopharmacology (Berl). 2010;211(1):55-68.

A4. Allaert FA, Courau S, et al. Effect of magnesium, probiotic, and vitamin food supplementation in healthy subjects with psychological stress and evaluation of a persistent effect after discontinuing intake. Panminerva Med. 2016;58(4):263-270.

A5. McCabe D, Lisy K, et al. The impact of essential fatty acid, B vitamins, vitamin C, magnesium and zinc supplementation on stress levels in women: a systematic review. JBI Database System Rev Implement Rep. 2017;15(2):402-453.

A6. Long SJ, Benton D. Effects of vitamin and mineral supplementation on stress, mild psychiatric symptoms, and mood in nonclinical samples: a meta-analysis. Psychosom Med. 2013 Feb;75(2):144-153.

Biofeedback

B1. Ratanasiripong P, Park JF, et al. Stress and anxiety management in nursing students: biofeedback and mindfulness meditation. J Nurs Educ. 2015;54(9):520-524.

B2. Goessl VC, Curtiss JE, et al. The effect of heart rate variability biofeedback training on stress and anxiety: a meta-analysis. Psychol Med. 2017;47(15):2578-2586.

C1. Nilsson S, Forsner M, et al. Relaxation and guided imagery do not reduce stress, pain and unpleasantness for 11- to 12-year-old girls during vaccinations. Acta Paediatr. 2015;104(7):724-729.

C2. Beck BD, Hansen ÅM, et al. Coping with work-related stress through guided imagery and music (GIM): randomized controlled trial. J Music Ther. 2015 Fall;52(3):323-352.

C3. Flynn TA, Jones BA, et al. Guided imagery and stress in pregnant adolescents. J Occup Ther. 2016;70(5):7005220020p1-7.

C4. Giacobbi P Jr, Long D, et al. Guided imagery targeting exercise, food cravings, and stress: a multi-modal randomized feasibility trial. J Behav Med. 2018;41(1):87-98.

C5. Hadjibalassi M, Lambrinou E, et al. The effect of guided imagery on physiological and psychological outcomes of adult ICU patients: A systematic literature review and methodological implications. Aust Crit Care. 2018;31(2):73-86.

Hypnotherapy

D1. Fisch S, Brinkhaus B, et al. Hypnosis in patients with perceived stress – a systematic review. BMC Complement Altern Med. 2017;17(1):323.

Tai Chi

E1. Wang F, Lee EK, et al. The effects of tai chi on depression, anxiety, and psychological well-being: a systematic review and meta-analysis. Int J Behav Med. 2014;21(4):605-617.

E2. Zou L, Sasaki JE, et al. Effects of mind-body exercises (tai chi/yoga) on heart rate variability parameters and perceived stress: a systematic review with meta-analysis of randomized controlled trials. J Clin Med. 2018;7(11).

E3. Wang C, Bannuru R, et al. Tai Chi on psychological well-being: systematic review and meta-analysis. BMC Complement Altern Med. 2010 May 21;10:23.

Yoga

F1. Li AW, Goldsmith CA. The effects of yoga on anxiety and stress. Altern Med Rev. 2012;17(1):21-35.

F2. Pascoe MC, Thompson DR, et al. Yoga, mindfulness-based stress reduction and stress-related physiological measures: A meta-analysis. Psychoneuroendocrinology. 2017;86:152-168.

Ashwagandha

G1. Chandrasekhar K, Kapoor J, et al. 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 J Psychol Med. 2012;34(3):255-262.

G2. Choudhary D, Bhattacharyya S, et al. Body weight management in adults under chronic stress through treatment with ashwagandha root extract: a double-blind, randomized, placebo-controlled trial. J Evid Based Complementary Altern Med. 2017;22(1):96-106.

Rhodiola

H1. Lin JC, Fisher DL, et al. Evaluation of graft patency during minimally invasive coronary artery bypass grafting with Doppler flow analysis. Ann Thorac Surg. 2000;70(4):1350-1354.

H2. Cropley M, Banks AP, et al. The effects of Rhodiola rosea L. extract on anxiety, stress, cognition, and other mood symptoms. Phytother Res. 2015;29(12):1934-1939.

Eleutherococcus Senticosus Root Extract

I1. Schaffler K, Wolf OT, et al. No benefit adding eleutherococcus senticosus to stress management training in stress-related fatigue/weakness, impaired work or concentration, a randomized controlled study. Pharmacopsychiatry. 2013;46(5):181-190.

Exercise

J1. Nigdelis MP, Martínez-Domínguez SJ, et al. Effect of programmed exercise on perceived stress in middle-aged and old women: A meta-analysis of randomized trials. Maturitas. 2018 Aug;114:1-8.

Mindfulness Meditation

K1. Joyce S, Shand F, et al. Road to resilience: a systematic review and meta-analysis of resilience training programmes and interventions. BMJ Open. 2018 Jun 14;8(6):e017858.

Khoury B, Sharma M, et al. Mindfulness-based stress reduction for healthy individuals: A meta-analysis. J Psychosom Res. 2015 Jun;78(6):519-528.

Goyal M, Singh S, et al. Meditation programs for psychological stress and well-being: a systematic review and meta-analysis. JAMA Intern Med. 2014 Mar;174(3):357-368.

Khoury B, Lecomte T, et al. Mindfulness-based therapy: a comprehensive meta-analysis. Clin Psychol Rev. 2013 Aug;33(6):763-771.

Regehr C, Glancy D, et al. Interventions to reduce stress in university students: a review and meta-analysis. J Affect Disord. 2013 May 15;148(1):1-11.

Bohlmeijer E, Prenger R, et al. The effects of mindfulness-based stress reduction therapy on mental health of adults with a chronic medical disease: a meta-analysis. J Psychosom Res. 2010 Jun;68(6):539-544.

Cognitive Behavioral Therapy

L1. Joyce S, Shand F, et al. Road to resilience: a systematic review and meta-analysis of resilience training programmes and interventions. BMJ Open. 2018 Jun 14;8(6):e017858.

Carpenter JK, Andrews LA, et al. Cognitive behavioral therapy for anxiety and related disorders: A meta-analysis of randomized placebo-controlled trials. Depress Anxiety. 2018 Jun;35(6):502-514.

Parsons CE, Crane C, et al. Home practice in Mindfulness-Based Cognitive Therapy and Mindfulness-Based Stress Reduction: A systematic review and meta-analysis of participants’ mindfulness practice and its association with outcomes. Behav Res Ther. 2017 Aug;95:29-41.

Regehr C, Glancy D, et al. Interventions to reduce stress in university students: a review and meta-analysis. J Affect Disord. 2013 May 15;148(1):1-11.

Music-Based Interventions

M1. Corbijn van Willenswaard K, Lynn F, et al. Music interventions to reduce stress and anxiety in pregnancy: a systematic review and meta-analysis. BMC Psychiatry. 2017 Jul 27;17(1):271.

Emotional Freedom Interventions

N1. Sebastian B, Nelms J. The Effectiveness of Emotional Freedom Techniques in the Treatment of Posttraumatic Stress Disorder: A Meta-Analysis. Explore (NY). 2017 Jan – Feb;13(1):16-25.

Probiotics

O1. McKean J, Naug H, et al. Probiotics and Subclinical Psychological Symptoms in Healthy Participants: A Systematic Review and Meta-Analysis. J Altern Complement Med. 2017 Apr;23(4):249-258.

Acupoint Stimulation

P1. Gilomen SA, Lee CW. The efficacy of acupoint stimulation in the treatment of psychological distress: A meta-analysis. J Behav Ther Exp Psychiatry. 2015 Sep;48:140-148.

Self-Performed Stimulation

Q1. Song HJ, Son H, et al. Effect of self-administered foot reflexology for symptom management in healthy persons: a systematic review and meta-analysis. Complement Ther Med. 2015 Feb;23(1):79-89.

Aromatherapy

R1. Hur MH, Song JA, et al. Aromatherapy for stress reduction in healthy adults: a systematic review and meta-analysis of randomized clinical trials. Maturitas. 2014 Dec;79(4):362-369.

Qigong

S1. Wang CW, Chan CH, et al. Managing stress and anxiety through qigong exercise in healthy adults: a systematic review and meta-analysis of randomized controlled trials. BMC Complement Altern Med. 2014 Jan 9;14:8.

Lycium Barbarum

T1. Paul Hsu CH, Nance DM, et al. A meta-analysis of clinical improvements of general well-being by a standardized Lycium barbarum. J Med Food. 2012 Nov;15(11):1006-1014.

Homepathy

U1. Davidson JR, Crawford C, et al. Homeopathic treatments in psychiatry: a systematic review of randomized placebo-controlled studies. J Clin Psychiatry. 2011 Jun;72(6):795-805.

Last reviewed December 2019 by EBSCO NAT Review Board Eric Hurwitz, DC
Last Updated: 6/25/2020

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