Ashwagandha and Anxiety: Supporting the Stress Response System
Ashwagandha is an herbal extract traditionally used for stress resilience. In root cause psychiatry, it is considered when anxiety appears closely linked to chronic stress activation, sleep disruption, or persistent physiological tension despite appropriate treatment.
Ashwagandha Basics
Ashwagandha contains active compounds called withanolides. These compounds appear to influence the body’s stress regulation systems.
What Ashwagandha Influences:
Regulation of stress hormones such as cortisol
Support of calming neurotransmitter systems
Modulation of inflammatory signaling
Support of sleep quality
Stress resilience and recovery
Ashwagandha has been associated with reductions in perceived stress and measurable decreases in cortisol levels.
When the stress system remains chronically activated, anxiety can become persistent and physically uncomfortable. In these cases, the nervous system may not be deficient in serotonin alone. It may be overstimulated.
Ashwagandha is considered when anxiety appears driven by stress physiology rather than only cognitive worry.
Stress-Driven Anxiety Pattern
Not all anxiety looks the same.
Some patients describe:
Constant muscle tension
Feeling “wired but tired”
Light or fragmented sleep
Difficulty relaxing even when nothing is wrong
Fatigue combined with inner restlessness
Stress that lingers long after the trigger has passed
This pattern often reflects an overactive stress response system.
Chronic stress exposure can alter cortisol rhythms, increase inflammation, and reduce the brain’s ability to switch into a restorative state.
Ashwagandha may be considered when:
There is a pattern of chronic hyperarousal
Sleep disturbance is stress-related
Stress appears to be the dominant driver
Anxiety has persisted despite first-line medications
This does not mean stress is the only cause of anxiety.
It means stress regulation may be contributing in your case.
How Long Till I Feel Better?
Ashwagandha works gradually.
What to expect:
Subtle changes may begin within 2–4 weeks
Sleep improvements may occur earlier
Full benefit is typically assessed around 12 weeks
Some patients report:
Reduced physical tension
Improved stress recovery
More consistent sleep
A modest reduction in daily anxiety intensity
This is not an immediate calming agent. It supports regulation over time.
Why Traditional Psychiatry Misses This
Standard psychiatric treatment focuses primarily on neurotransmitters.
Stress-system regulation is not routinely measured unless there is a clear endocrine disorder.
What often goes unaddressed:
Chronic cortisol elevation
Long-standing stress exposure
Inflammation-related anxiety
Subclinical HPA axis dysregulation
Medication adjustments alone may not fully address physiologic hyperarousal.
What Root Cause Psychiatry Does Differently:
We do not automatically recommend supplements.
We evaluate:
Symptom patterns
Treatment history
Medical safet
Medication interactions
Stress physiology clues
The Importance of Expertise In Lab Reviews
Before starting, clinicians may review:
Thyroid function
Liver function
Medication profile
Autoimmune history
This is not a casual supplement recommendation.
Rare complications can include:
Thyroid overactivation
Liver inflammation
Autoimmune flares
Most side effects, when they occur, are mild and temporary.
However, expert oversight ensures safe use. This strategy requires individual review.
Safety Considerations:
Ashwagandha should be avoided or used cautiously in:
Pregnancy
Active thyroid instability
Autoimmune conditions
Significant liver disease
Use of certain sedatives or immunosuppressants
It is used alongside existing anxiety treatment, not instead of it.
Practical Takeaway:
Ashwagandha may be considered when anxiety includes:
Chronic stress activation
Physical tension
Sleep disruption
Fatigue with hyperarousal
Incomplete response to first-line medication
It supports stress regulation. It is adjunctive. It is selective. It requires monitoring.
Next Steps, If You’re Curious
If you are interested in this approach, please schedule an appointment with one of our prescribers. They will review your history, discuss your symptoms, guide testing, and create a personalised plan to support your mental health safely and effectively.
We are here to answer your questions and provide thoughtful, professional care every step of the way.
References
Fuladi S, Emami SA, Mohammadpour AH, Karimani A, Manteghi AA, Sahebkar A. Assessment of the Efficacy of Withania somnifera Root Extract in Patients with Generalized Anxiety Disorder: A Randomized Double-blind Placebo- Controlled Trial. Curr Rev Clin Exp Pharmacol. 2021;16(2):191-196. doi: 10.2174/1574884715666200413120413. PMID: 32282308.
Akhgarjand C, Asoudeh F, Bagheri A, Kalantar Z, Vahabi Z, Shab-Bidar S, Rezvani H, Djafarian K. Does Ashwagandha supplementation have a beneficial effect on the management of anxiety and stress? A systematic review and meta-analysis of randomized controlled trials. Phytother Res. 2022 Nov;36(11):4115-4124. doi: 10.1002/ptr.7598. Epub 2022 Aug 25. PMID: 36017529.
Lopresti AL, Smith SJ, Malvi H, Kodgule R. An investigation into the stress-relieving and pharmacological actions of an ashwagandha (Withania somnifera) extract: A randomized, double-blind, placebo-controlled study. Medicine (Baltimore). 2019 Sep;98(37):e17186. doi: 10.1097/MD.0000000000017186. PMID: 31517876; PMCID: PMC6750292.
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