Does Melatonin Help With Anxiety

Anxiety rates are at an all-time high, leading to panic attacks, poor sleep and a host of symptoms that impact the quality of life. If you are looking for natural solutions to feel calmer and at ease with life and the events of the world, a little-known option is melatonin. 

Sure, we are familiar with melatonin supplements for sleep; it is the sleep hormone after all. But melatonin has a lot more to offer, including support for a healthy metabolism, strong immunity and even a better mood. Low melatonin levels are linked with higher rates of anxiety, and melatonin supplements help with sleep problems related to anxiety and anxiety itself. 

Keep reading to learn more about:

• Anxiety – definitions, symptoms, and treatments
• The science of melatonin
• Melatonin supplements for anxiety 
• Tips for improving anxiety symptoms, naturally and effectively 

Let’s get started! 

Understanding Anxiety

Anxiety is defined as the fear felt when faced with a threatening or stressful situation. While anxiety, fear, and worry are normal human responses to anticipated danger, when symptoms become extreme or ongoing, it may signify a clinical condition. (Source 1)

In 2019, over 19 percent of Americans, nearly 50 million people, experienced mental illness, and the numbers increased during the Covid-19 pandemic. (Source 2, 3) 

Anxiety disorders are the most common classification of mental health disorders, including generalized anxiety disorder, panic disorder, post-traumatic stress disorder, and social anxiety disorder. Pre-pandemic anxiety disorders were estimated to affect one in ten people and more women than men. Many with anxiety go undiagnosed in the healthcare system. (Source 1,  4) 

Anxiety disorders may be comorbid with other mental health disorders, including depression, and interfere with daily life. (Source 4)

Symptoms of anxiety may include:

• Disproportionately worrying and overthinking 
• Difficulty relaxing
• Poor concentration and cognitive function
• Indecisiveness
• Avoidance of certain situations
• Nervousness and irritability 
• Restlessness
• Heart palpitations and chest tightness
• High blood pressure
• Changes in bowel habits
• Insomnia or sleep problems

Sleep disorders, including insomnia and circadian rhythm disorders, are found frequently in those with mood disorders, including anxiety. (Source 5)

Treatment for anxiety disorders in a western medicine model often includes psychotherapy and prescription medications, like antidepressants or anxiolytic (anti-anxiety) medications. One standard class of anxiolytics is benzodiazepines; Alprazolam, commonly known as Xanax, is an example. 

In functional medicine, we want to understand the root causes of anxiety from a biochemical and lifestyle perspective. While therapy and medication have their place, drugs are not without side effects, and there may be other supportive strategies to consider. One such strategy is the use of melatonin. 

What Is Melatonin?

Melatonin, known as the sleep hormone, is produced primarily in the brain by the pineal gland. Melatonin is involved in the daily regulation of the sleep-wake cycle and supports seasonal body rhythms. For example, melatonin helps some animals reproduce during the right season. Melatonin also plays a role as an immune system stimulant and antioxidant, supports mitochondrial function, and protects against neurodegenerative disease. (Source 6, 7)

The amino acid tryptophan converts into the neurotransmitter serotonin, which makes melatonin. Melatonin production is suppressed by natural sunlight during the day and rises in the evening as it gets dark out. As melatonin levels increase, it promotes drowsiness and sleepiness. (Source 6)

Melatonin levels decline with age, explaining why some older adults experience a decline in sleep quality and duration. (Source 7)

Exposure to artificial light, including light from laptops, televisions, and phone screens, has been shown to suppress melatonin production. This light exposure may be particularly problematic in the evening time before bed. (Source 8)

Melatonin Supplementation For Anxiety

The most common use of melatonin supplements you’ll see are for sleep disturbances, insomnia, and jet lag. In a large meta-analysis of melatonin supplements’ effect on sleep, melatonin helped people fall asleep more quickly, increase total sleep time and improve sleep quality. (Source 9) 

Poor sleep often results from anxiety or sleep issues, like insomnia, occur alongside anxiety. Melatonin supplements may offer symptomatic relief to this aspect of anxiety disorders. Beyond supporting sleep, melatonin may provide specific support for anxiety itself. 

Melatonin, and its connection with anxiety, have been studied extensively in animals. In one mouse study, mice lacked melatonin receptors and therefore didn’t receive the benefits of this critical hormone, showed anxiety, decreased attention, and increased sociability. Interestingly, the female mice showed increased anxiety, where male mice became more social. (Source 10)

In humans, low levels of melatonin correlate with anxiety. (Source 11) And melatonin supplementation may offer some relief. 

In a recent systematic review including 27 randomized controlled trials and other clinical trials, scientists evaluated melatonin administration in preoperative and postoperative anxiety where acute anxiety is prevalent. The effects of melatonin in this short-term setting showed a reduction in anxiety before surgery, immediately after surgery and six hours after surgery with melatonin compared to placebo. Melatonin supplements showed similar effects as benzodiazepine medication but were better tolerated, with fewer side effects. (Source 12)

Another review article looked at 41 studies where melatonin was used as an intervention in psychiatric disorders, including mood disorders like anxiety. The study showed melatonin taken before bed improved insomnia symptoms or comorbid insomnia in those with psychiatric disorders. (Source 5)

Melatonin supplementation has minimal side effects, the most common being drowsiness if taken at the wrong time. However, melatonin may interact with certain medications, so please consult with your healthcare provider if you take medication (including over-the-counter medicines and supplements) or have a medical condition. 

When considering doses of melatonin, more isn’t always better. Too much may contribute to anxiety and irritability, the exact symptoms we are using melatonin to address. Typical melatonin dosages are between 0.5 and 5mg, taken in the evening. I recommend starting with a low dose, 0.5mg. You can then increase by 0.5mg every few days until you achieve the desired effect. If you are already taking a higher amount, you can reduce it to the lowest possible dose that achieves the same results. 

Tips For Improving Anxiety And Sleep, Naturally 

We all want a quick fix and popping a pill when we feel anxious seems like the easiest solution, but targeted lifestyle change works miracles when it comes to calming the body and mind over the long term. Here are some natural ways to support anxiety and associated symptoms:

1. Calm the nervous system. When you are anxious or stressed, the nervous system is on overdrive. The brain senses danger, and the body responds just as it would if you happened upon a bear in the woods. To counter this fear response, we need to teach the body that it is safe regularly. 
   
   Some ideas for calming the nervous system include mindfulness practices, meditation, yoga, joyful movement, spending time in nature, gardening, massage, energy work, and more. Find what works for you and make it a regular part of your routine. 

2. Create a regular daily rhythm. We have a lot of influence over the circadian rhythm through our lifestyle habits. Set a regular bedtime and prioritize getting enough sleep to support a healthy circadian rhythm. Eating at normal mealtimes throughout the day helps too. Try stimulating things, like exercise or taking a multivitamin, in the morning, while creating a relaxing ritual at night. For more circadian rhythm and sleep tips, please read my article Better Sleep. 

3. Work with your functional medicine provider. A functionally trained doctor will be able to help you look at your stress response (HPA-axis), gut health (gut-brain axis), nutrient status, and other underlying factors that may contribute to anxiety. They can even test your melatonin levels through simple saliva or urine collections. It’s good to have someone you trust in your corner to help you navigate supplements, medication, therapy, and other medical needs. 

4. Support anxiety and sleep with supplements. GABA, magnesium, melatonin, lavender are just a few nutrients and herbs that help calm the body, reduce anxiety, and healthy promote sleep. To learn more about these supplements, and more, please read A Guide to Sleep Supplements. 
   
   Core Med Science’s Liposomal Sleep Formula is a gentle and incredibly effective solution for anxiety and anxiety-related sleep issues. The formula contains melatonin, GABA, the body’s primary calming neurotransmitter, and glutathione, the body’s master antioxidant. The liposomal liquid formula offers superior absorption and bioavailability. You can easily adjust the dose to your individual needs. Start with just one pump before bed and increase up to six as needed.

If you struggle with an anxiety disorder or just feel anxious, getting better sleep can make all the difference. You’ll have more energy for self-care and be able to experiment with some of these tools for relaxation and addressing the root causes of anxiety. Melatonin is a tiny molecule but powerful, and it may be worth experimenting with as part of your holistic care plan. Don’t forget to check with your doctor to make sure it’s right for you. 

References

1. Dean E. (2016). Anxiety. Nursing standard (Royal College of Nursing (Great Britain) : 1987), 30(46), 15. Abstract: https://pubmed.ncbi.nlm.nih.gov/27406490/ 
2. Mental Health America. The State of Mental Health in America. Accessed 3/7/22 at: https://mhanational.org/issues/state-mental-health-america 
3. Jia, H., Guerin, R. J., Barile, J. P., Okun, A. H., McKnight-Eily, L., Blumberg, S. J., Njai, R., & Thompson, W. W. (2021). National and State Trends in Anxiety and Depression Severity Scores Among Adults During the COVID-19 Pandemic - United States, 2020-2021. MMWR. Morbidity and mortality weekly report, 70(40), 1427–1432. Full text: https://www.cdc.gov/mmwr/volumes/70/wr/mm7040e3.htm 
4. Penninx, B. W., Pine, D. S., Holmes, E. A., & Reif, A. (2021). Anxiety disorders. Lancet (London, England), 397(10277), 914–927. Abstract: https://pubmed.ncbi.nlm.nih.gov/33581801/ 
5. Palagini, L., Manni, R., Aguglia, E., Amore, M., Brugnoli, R., Bioulac, S., Bourgin, P., Micoulaud Franchi, J. A., Girardi, P., Grassi, L., Lopez, R., Mencacci, C., Plazzi, G., Maruani, J., Minervino, A., Philip, P., Royant Parola, S., Poirot, I., Nobili, L., Biggio, G., … Geoffroy, P. A. (2021). International Expert Opinions and Recommendations on the Use of Melatonin in the Treatment of Insomnia and Circadian Sleep Disturbances in Adult Neuropsychiatric Disorders. Frontiers in psychiatry, 12, 688890. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8222620/ 
6. Hardeland, R., Pandi-Perumal, S. R., & Cardinali, D. P. (2006). Melatonin. The international journal of biochemistry & cell biology, 38(3), 313–316. Abstract: https://pubmed.ncbi.nlm.nih.gov/16219483/ 
7. Tan, D. X., Xu, B., Zhou, X., & Reiter, R. J. (2018). Pineal Calcification, Melatonin Production, Aging, Associated Health Consequences and Rejuvenation of the Pineal Gland. Molecules (Basel, Switzerland), 23(2), 301. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6017004/ 
8. Gooley, J. J., Chamberlain, K., Smith, K. A., Khalsa, S. B., Rajaratnam, S. M., Van Reen, E., Zeitzer, J. M., Czeisler, C. A., & Lockley, S. W. (2011). Exposure to room light before bedtime suppresses melatonin onset and shortens melatonin duration in humans. The Journal of clinical endocrinology and metabolism, 96(3), E463–E472. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3047226/ 
9. Ferracioli-Oda, E., Qawasmi, A., & Bloch, M. H. (2013). Meta-analysis: melatonin for the treatment of primary sleep disorders. PloS one, 8(5), e63773. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3656905/ 
10. Thomson, D. M., Mitchell, E. J., Openshaw, R. L., Pratt, J. A., & Morris, B. J. (2021). Mice lacking melatonin MT2 receptors exhibit attentional deficits, anxiety and enhanced social interaction. Journal of psychopharmacology (Oxford, England), 35(10), 1265–1276. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8521347/ 
11. Sundberg, I., Rasmusson, A. J., Ramklint, M., Just, D., Ekselius, L., & Cunningham, J. L. (2020). Daytime melatonin levels in saliva are associated with inflammatory markers and anxiety disorders. Psychoneuroendocrinology, 112, 104514. Full text: https://www.sciencedirect.com/science/article/pii/S0306453019312557?via%3Dihub 
12. Madsen, B. K., Zetner, D., Møller, A. M., & Rosenberg, J. (2020). Melatonin for preoperative and postoperative anxiety in adults. The Cochrane database of systematic reviews, 12(12), CD009861. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8092422/