Anxiety

Talking therapies such as CBT are the first-line treatment for anxiety, then medicine if needed. Among holistic options, mindfulness, relaxation, acupuncture and some herbal products show small or limited benefits, and kava carries a liver-injury warning.

When to see a medical doctor first

• A mental health crisis or thoughts of self-harm: call or text 988 to reach the 988 Suicide & Crisis Lifeline, free and available 24 hours a day, or chat at 988lifeline.org. 988 also helps people worried about a family member or friend. If someone is in immediate danger, such as a suicide attempt in progress or a suspected overdose, call 911.
• Anxiety with tiredness or other physical symptoms: anxiety can overlap with thyroid problems and anemia, which the NHS checks with blood tests.
• Ongoing worry without a crisis: the NHS advises seeing a doctor if you think you might have generalized anxiety disorder, or if treatment for diagnosed generalized anxiety disorder is not helping.
• Before starting kava or other herbal products, especially alongside prescription medicines, talk to a doctor or pharmacist.

What a medical workup usually checks first

The NHS recommends talking therapies first, such as CBT, one-to-one or in a group, and then medicine, usually an SSRI antidepressant. It also advises self-help, exercise, good sleep, and cutting down on caffeine and alcohol. Physical causes such as thyroid problems and anemia are checked when symptoms suggest them.

What the evidence says about holistic options

Therapy	Evidence	Notes
Mindfulness	Mixed/limited	Some evidence for anxiety, with small to modest, short-term benefits (NCCIH).
Relaxation	Mixed/limited	CBT is the better long-term option for generalized anxiety disorder (NCCIH).
Acupuncture	Mixed/limited	NCCIH calls the evidence limited and low quality. A 2022 review of 27 trials (1,782 people) found better relief than comparators, mostly drugs, for generalized anxiety disorder, but its authors call for better trials. Serious harms can occur when acupuncture is done poorly.
Massage	Mixed/limited	Mixed results in people with medical conditions; little research in anxiety disorders.
Kava	Mixed/limited	Short-term benefit, but the FDA has warned about liver injury.
Chamomile; lavender oil	Mixed/limited	Preliminary evidence.
Melatonin	Mixed/limited	Mainly studied for anxiety before medical procedures.
Chiropractic or spinal manipulation	Unconfirmed	No source found.
Naturopathic or functional medicine	Unconfirmed	No source found.

Unconfirmed means we found no source in this review. It is not a verdict either way.

Who people see for anxiety on this site

• Mental health services. In New York, licensed mental health counselors (LMHCs) do not prescribe; psychiatrists, who are MDs or DOs, can. New York licenses psychologists under Education Law Article 153 (NYSED) and licensed clinical social workers under Article 154 (NYSED).
• Acupuncture clinics and massage therapists.
• Integrative medicine doctors, who are licensed MDs or DOs.
• Naturopathic doctors in our directory, who are not licensed in New York.

You can check a New York license on the NYSED verification search.

Questions to ask a practitioner

• Does your approach replace or sit alongside CBT or medication, and what is the plan if symptoms become severe?
• If you suggest kava or another herbal product, how do you check for liver risk and drug interactions?
• How do you measure progress, for example with the GAD-7 questionnaire, and when do you refer to a therapist or psychiatrist?

Last reviewed: October 2026

Sources

• SAMHSA, 988 frequently asked questions (updated 16 December 2025)
• NHS, Anxiety (reviewed 22 October 2024)
• NHS, Tiredness and fatigue (reviewed 2 June 2023)
• NCCIH, Anxiety and complementary health approaches (August 2020)
• NCCIH, Meditation and mindfulness: in depth (June 2022)
• NYSED Office of the Professions, online license verification; psychology license requirements and clinical social work license requirements (checked 10 October 2026)