Stress, anxiety and insomnia have become synonymous with life in the 21st century. These elements exist across every socioeconomic strata, negatively impacting health and well-being, and serve as potential precursors to numerous health issues. Although stress is a normal and natural reaction to everyday pressures, it can become unhealthy when it upsets day-to-day functioning. A stress response involves changes that affect almost every system of the body, causing mind-body changes that influence how people feel and behave, ultimately affecting their mental and physical health, and resulting in a reduction in the quality of life. A persistent state of stress may contribute to the development of complicated health issues such as cardiovascular disorders, hypertension, anxiety, depression, digestive disorders, impaired memory and cognition, fatigue, and autoimmune disorders.1,2

ACUTE STRESS VERSUS CHRONIC STRESS

According to The American Institute of Stress, many people over the course of their lives have experienced acute stress, which involves a dramatic physiological and psychological reaction to a specific event. Acute stress is a very short-term type of stress that can either be positive or more distressing; this type of stress is most often encountered in day-to-day life. On the other hand, chronic stress is a long-term persistent type of stress that can induce serious health issues.3,4 Stress is associated with altered hormonal secretions of cortisol, adrenaline, and norepinephrine. Chronic stress is known to deviate the normal sleep-wake cycle by impacting the level of circadian cortisol.

Although there is a large group of pharmaceutical medications dedicated as a potential solution to persistent stress and anxiety, a review of the medical literature continues to document the limitations, side effects, withdrawal symptoms, and the potential for addiction due to the altered or adaptive behavior of the subject.5,6 As a result, there is a growing number of patients who are using evidence-based complementary and integrative therapies (CITs) that have been shown to be effective in relieving symptoms of stress and anxiety.

INTEGRATIVE HEALTH CONSIDERATIONS

An Integrative Health approach to stress and anxiety involves supporting the patient with a nutrient-dense diet, neuro-nutrient supplementation, physical activity, movement therapies, the incorporation of mind-body techniques such as mindfulness-based stress reduction (MBSR), yoga, breath exercises, as well as other evidence-based therapies that include full-spectrum, standardized phytomedicines and acupuncture.

Traditional Ayurvedic medicine provides a remarkable time-tested solution for addressing stress and anxiety with Ashwagandha (Withania somnifera), a revered phytomedicine known worldwide for its numerous health benefits. Pharmacological studies have confirmed that Ashwagandha is a multipurpose herbal medicine with anti-inflammatory, neuroprotective, adaptogenic, memory-enhancing, sleep-inducing, and anxiolytic properties.7,8

ASHWAGANDHA

A phytomedicine adaptogen

Ashwagandha (Withania somnifera) belongs to the Solanaceae plant family and is commonly known as Indian winter cherry. It is one of the most important medicinal plants in Ayurvedic medicine and has been used for more than 3000 years. In Ayurveda, the herbal preparation is referred to as a rasayana (rejuvenator), a medicinal agent that functions in a nonspecific manner to increase human health and longevity. It is also considered an adaptogen, a nontoxic agent that normalizes physiological functions, disturbed by chronic stress, through correction of imbalances in the neuroendocrine and immune systems. Ashwagandha is used in Ayurvedic medicine for stress management, elevation of energy and improved cognitive health,9-11 and decreasing inflammation, blood sugar and cortisol levels, anxiety, and depression.12,13 The leaves, roots, stems, and flowers contain an array of more than 50 therapeutic active metabolites; however, it is the "withanolides," a group of steroidal lactones found in the leaves and roots, that are considered to be the most important constituents and serve as marker compounds in high-quality standardized extracts.14,15

Ashwagandha is the most researched adaptogen, a special category of phytomedicines, that serves to increase our ability to deal with stress, boost energy, and improve our general well-being. Adaptogens have demonstrated their ability to help regulate the balance of several hormones and neurotransmitters involved in the stress response, including cortisol. Translated in terms of their biochemical actions as metabolic regulators, the wide range of medical benefits and physiological actions of adaptogens may be explained by their effects on the immune, hormonal, central nervous system, cardiovascular system, muscular regulatory system, and other body systems. Research has shown that adaptogens reduce damage from stressors by mediating the organism's defense system, more specifically the hypothalamic-pituitary-adrenal (HPA) axis and the efferent sympathoadrenal system.

THERAPEUTIC EFFECTS

Sleep-enhancing effects

Sleep quality has a tremendous impact on our overall health and well-being. It is well established that a lack of sleep can induce multiple disease conditions in an individual. Stress, anxiety, and sleep have an intrinsic relationship. A better sleep experience helps in reducing stress and anxiety, whereas poor sleep quality may induce anxiety and stress. Therefore, supporting sleep quality is a primary therapeutic consideration in relation to stress management.

Several studies have shown that Ashwagandha helps improve overall sleep quality by reducing the time required to get to sleep along with reduced nighttime awakenings and improved sleep duration.

Anti-stress and antianxiety effects

Ashwagandha is of benefit to individuals experiencing acute or chronic stress in their life. It exerts its beneficial effects on sleep quality and adrenal function and reduces feelings of anxiety, while enhancing resistance to stress. It has been used historically to restore vitality and increase energy, improve mental and physical performance, prevent the negative effects of stress, and increase the body's response to stress. Ashwagandha improves the stress response by lowering the adrenal stress hormone cortisol, while increasing the level of the adrenal anti-stress hormone dehydroepiandrosterone (DHEA).

CONTRAINDICATIONS

Ashwagandha should not be taken by pregnant or lactating women.

POTENTIAL SIDE EFFECTS

Ashwagandha is very well tolerated with no significant side effects.16

SUMMARY

Ashwagandha (Withania somnifera) is a phytomedicine adaptogen that has demonstrated its remarkable impact on regulating the stress response. Research studies have confirmed that Ashwagandha is a multipurpose herbal medicine with anti-inflammatory, neuroprotective, adaptogenic, memory-enhancing, sleep-inducing, and anxiolytic properties. These benefits support the use of Ashwagandha as a therapeutic agent to help restore a normal lifestyle with reduced stress and prevent the onset of several life-threatening disease conditions.

REFERENCES