Anxiety disorders impact approximately 40 million adults, are the most prevalent mental health-related diagnosis, and cost the United States healthcare system over 42 billion dollars annually. Additionally, anxiety can mimic many other health problems (e.g., shortness of breath, chest pain, nausea and vomiting), thus adding to the burden on patients and healthcare systems. Current anxiety treatment consists of pharmacotherapy, cognitive behavioral therapy, and some complementary therapies, but not aromatherapy. Pharmacological approaches to reduce anxiety primarily include the administration of benzodiazepines, but may also include SSRIs, and beta-blockers. These pharmacological approaches come with a myriad of potential side effects including dry mouth, confusion, constipation, fatigue, headaches, nausea, weight gain, and sexual dysfunction. Aromatherapy is understood as aroma from essential oils eliciting psychological or physiological responses via the limbic system in the brain. The following essential oils were reviewed: Angelica archangelica (Angelica Root), Citrus x aurantium (Bergamot), Elettaria cardamomum (Cardamom), Lavandula angustifolia (Lavender), Citrus aurantium (Petitgrain), and Origanum marjorana (Sweet Marjoram). The purpose of this project was to present a clinical aromatherapy case study and review the literature as a foundation for future research investigating the effectiveness of clinical aromatherapy in reducing adult anxiety instead of or in addition to standard treatment.
Methods:
The adult anxiety case study was conducted over a three week period, following guidelines of the National Association for Holistic Aromatherapy, by a registered nurse and certified clinical aromatherapy practitioner. CINAHL, Medline (via Ovid and PubMed), ProQuest, and TRIP databases were searched for peer-reviewed journal articles in English with the following keywords: angelica, bergamot, cardamom, generalized anxiety disorder, lavender, marjoram, and petigrain. Results were further filtered by inhalation, and human studies. No publication date limitations were used.
Results:
The case study demonstrated efficacy of the aromatherapy blend in reducing generalized anxiety with nausea and vomiting after both the initial, and each subsequent use. The literature review found significant evidence-based knowledge of the use of lavender essential oil for reduction in generalized anxiety via oral administration and inhalation. One animal study was found that demonstrated bergamot essential oil efficacy compared to diazepam in a rat model. No information was found regarding the use of angelica, cardamom, marjoram, or petigrain for anxiety, despite their use in clinical aromatherapy. No studies were found assessing the effect of these essential oils' chemical constituents for anxiety either.
Conclusion:
The anxiety-reducing efficacy of essential oils in humans has yet to be explored beyond clinical aromatherapy case studies with the exception of lavender which recently completed clinical trials and is now available as an over-the-counter product. Aromatherapy has the potential to reduce generalized anxiety without the adverse effects of prescription medications. Other essential oils may also reduce generalized anxiety, but warrant further research.