Melatonin supplements, commonly taken to help you fall asleep, were recently a subject of a review published in the International Journal Of Molecular Sciences as a potential anxiety treatment as it's "freely available, economically undemanding and has limited side effects" .
This article will summarize the review's main points in a much easier-to-understand format and answer general questions about melatonin supplements and CBD for anxiety.
First Off, What Exactly Is Anxiety? And What Do Anxiety Symptoms Look Like?
Feelings of anxiousness and fear naturally arise from stressors like upcoming final exams, a tight deadline work deadline, or moving to a new country.
While anxiety symptoms can manifest differently in individuals, some of the common symptoms can include the following:
Increased blood pressure
In times of stress, these feelings are completely warranted.
The feelings we get when we experience stress and anxiety are designed to serve as a warning sign to prepare the body for a fight-or-flight response in a healthy manner.
They're supposed to help deal with potential threats by increasing alertness and physical preparedness. However, fight-or-flight is only designed to be a short-term response.
When anxiety symptoms persist (especially without evident stressors) and interfere with daily life, it may indicate an anxiety disorder.
Anxiety disorders can present in various ways, including phobias, social anxiety disorder (SAD), obsessive-compulsive disorder (OCS), post-traumatic stress disorder (PTSD), or generalized anxiety disorder (GAD).
All of these mental health disorders are characterized by excessive fear with symptoms that are so severe that they interfere with leading a healthy life.
Feelings of anxiousness getting in the way of leading a healthy life is a key factor.
This means that the friend that just likes to keep their house clean doesn't have OCD.
OCD is a serious condition where one's repetitive thoughts (obsessions) and behaviors (compulsions) interfere with leading a healthy and productive life.
According to Our World In Data, the commonness of anxiety disorders worldwide varies from 2.5–7% by country.
The World Health Organization found that 301 million people were living with an anxiety disorder, including 58 million children and adolescents, in 2019, making it the most pervasive mental health disorder, with 63% (179 million) females in that group relative to 105 million males .
How Is Anxiety Treated?
Treating anxiety almost always involves a multifaceted approach through therapy, medications, and lifestyle changes for reducing stress.
People presenting with more severe anxiety disorders may be prescribed antidepressants and anti-anxiety medications.
These drugs are designed to increase neurotransmitters such as serotonin and norepinephrine levels in the brain to regulate mood and emotions.
Commonly prescribed anti-depressants for treating anxiety include:
Selective Reuptake Inhibitors (SSRIs): block the reabsorption of serotonin by the nerve cells, allowing for higher serotonin levels to remain active in the brain to regulate mood disorders.
Benzodiazepines: work by increasing the effects of GABA in the brain, calming the stress response to alleviate anxiety symptoms quickly.
With lifestyle changes, therapy, and guidance, prescription medications for treating anxiety symptoms have helped many people regain their lives.
But a large group of people may not have access to these medications or are much more sensitive to the side effects.
Additionally, with benzodiazepines, long-term use may result in tolerance and dependence, which means stopping its use can lead to nasty withdrawal symptoms and other complications.
This isn't ideal for anyone, so there has been a growing interest in finding more accessible and less risky options for supporting people suffering from anxiety.
One health supplement that has garnered some attention as a potential treatment for anxiety symptoms is melatonin. And another very popular compound that many people use to address stress and anxiety is CBD.
What Is Melatonin?
You may be familiar with melatonin from your local health store or pharmacy.
Maybe you've even used to get over jet lag or bouts of insomnia.
But what is melatonin exactly? How does it help with sleep? And what does the research review say about its use for treating anxiety symptoms?
For starters, the body naturally produces melatonin in the pineal gland in the brain.
Melatonin is a hormone that regulates the sleep-wake cycle in the body as part of the circadian rhythm, which has earned it the nickname the "sleep hormone."
While the pineal gland is the main source of melatonin, the stomach and the immune system also produce melatonin.
How Does Melatonin Work?
The human body is hard-wired to respond to light, and as the daylight fades, the pineal gland starts to release melatonin to promote drowsiness, preparing the body for sleep. While it's released, melatonin suppresses the wakefulness-promoting hormones, cortisone, and adrenaline (norepinephrine).
This seems like a pretty straightforward system for diurnal (day-time) creatures — wake up by sunlight and fall asleep as the sun fades — but the modern world isn't as simple as it used to be.
Our circadian rhythms can be thrown off-kilter with artificial lighting, shift work, and blue-light screens. This constant exposure to light can inhibit the signalling for the body to produce enough melatonin, causing sleep disturbances.
The Evolution Of Melatonin
One of the most intriguing parts of the International Journal Of Molecular Sciences article on melatonin for anxiety was the evolution of the melatonin molecule, which has been around for millions of years, virtually unchanged, found in single-celled organisms to multi-cellular ones (like humans).
Researchers believed that melatonin was created as a way to protect the organism from damage caused by oxygen. Now, it serves many functions, including regulating the sleep-wake cycle, supporting metabolism (mitochondrial protection), and heart health.
Melatonin can accomplish these tasks by connecting to different proteins in the body, such as receptors on cell membranes, or by binding to proteins within cells. There are different types of melatonin receptors, and they work in unique ways to produce effects in the body.
The Connection Between Melatonin, Sleep, and Anxiety
So, how does a natural sleep aid help with anxiety?
Sleep and anxiety have a complex relationship.
For instance, a lack of sleep can lead to increased anxiety — but anxiety can also keep us up at night, interfering with sleep and causing a vicious cycle.
But this also means that getting enough sleep can help to improve anxiety symptoms. This is because sleep is necessary for the body to mentally and physically repair and rejuvenate.
There's plenty of research to show that even short bouts of sleep deprivation can negatively impact our cognitive function, mood, and ability to handle stress .
According to the International Journal Of Molecular Sciences review on melatonin for anxiety, melatonin has anti-anxiety effects by directly regulating sleep patterns .
It's also been observed to reduce the activity of the hypothalamic-pituitary-adrenal (HPA) axis, which is directly involved in producing the stress response (increasing heart rate, breathing rate, and mental alertness).
What The Research Says On The Anti-Anxiety Effects Of Melatonin
It's not exactly clear why melatonin has anti-anxiety effects, but it's reasonable to believe that it's because it works so closely with sleep patterns. However, specific melatonin receptors in the brain are also directly linked to anxiety.
The International Journal Of Molecular Sciences review points to these intriguing studies with animals and humans on the effects of melatonin on anxiety.
Scientists found that removing the pineal gland (which produces melatonin) made the rat subjects more anxious (as they exhibited anxious behaviors). Melatonin administration did help to make them less anxious and calm [4, 5].
That study can't be replicated in humans, but some clinical studies are looking at the effects of melatonin on stress.
In people, taking oral melatonin before surgery was shown to reduce preoperative and postoperative anxiety with similar effects to benzodiazepines. The good news is that melatonin is much safer, with few and mild side effects [6, 7].
CBD For Anxiety Symptoms
The review also mentions how CBD could be used to treat anxiety symptoms.
Here are some insights worth diving into related to cannabinoids and anxiety:
CBD has the potential to slow down the stress response by increasing GABA activity in the brain .
In this study, individuals with a generalized anxiety disorder were given 400 MG of oral CBD with positive results in reducing their anxiety symptoms .
Some tests are being done to investigate CBD's effects for reducing anxiety, but more research is needed.
Frequently Asked Questions About Melatonin Supplements
1. What is melatonin, and how does it work for anxiety?
Melatonin is a naturally occurring hormone produced in the pineal gland that helps the body fall asleep and plays an important role in regulating the body's circadian rhythm.
While how it works for anxiety isn't exactly clear, it's believed that melatonin supplements may help with anxiety symptoms by slowing down the stress response and improving sleep quality overall.
2. Is Melatonin safe for anxiety treatment?
Melatonin is sold as a supplement, and it's not FDA-approved to treat any mental disorders. However, high-quality melatonin supplements are considered safe for short-term use and have helped many people manage anxiety and sleep problems.
With that being said, you should speak with your doctor before experimenting with a melatonin treatment or any other medication for anxiety or depressive symptoms, as it may interact with certain medications or might not be suitable for certain conditions.
3. How does melatonin compare to other anxiety medications in terms of effectiveness?
Melatonin isn't classified as an anxiety medication but rather a natural supplement to support a good night's sleep, which may inadvertently help with anxiety levels. However, its effectiveness as an anxiety treatment hasn't been studied in depth.
4. How does melatonin interact with other anxiety medications and substances?
Melatonin might interact with other anxiety medications, such as benzodiazepines and other anti-depressants, by potentially increasing their risk of side effects.
Alcohol and caffeine may also interfere with your natural melatonin production and metabolism. It's important that you follow the instructions and warnings of your melatonin supplement and speak to your doctor first.
5. What are the side effects of taking melatonin?
While taking a high-quality melatonin supplement for sleep support is generally safe, it should only be taken for short-term use unless discussed with your health care professional.
Some side effects of melatonin include:
6. Can Melatonin be taken with other vitamins and supplements for anxiety?
The effect of melatonin on anxiety hasn't been well established, but many people believe one of the best pairings for melatonin for reducing anxiety and supporting sleep is CBD.
7. Is a prescription needed to take melatonin for anxiety?
You don't need a prescription for melatonin supplementation. Oral melatonin is available at most health food stores, pharmacies, and grocery stores at fairly inexpensive prices.
That being said, these melatonin supplements aren't intended to ease anxiety. As we've stated throughout the article, there's some evidence pointing to its use for potentially decreasing stress-related symptoms, but more research is needed.
8. What is the recommended dosage of melatonin?
The typical recommended dosage of oral melatonin supplements for sleep aid is 1–3 mg, taken 30 minutes before bedtime.
People may have different sensitivities to the supplement, but it's generally best to start on the lower end of doses and work your way up.
Taking too much melatonin at once could result in adverse effects like drowsiness the next morning, headaches, dizziness, and nausea.
9. Are there any food or lifestyle changes that can affect melatonin levels in the body?
Research suggests that dietary habits, including intake of vegetables, caffeine, vitamins, and minerals, could modify melatonin production. Still, it doesn't have as big an impact as light exposure .
Exposure to blue light from phones, tablets, and TV screens can suppress melatonin production. If you're trying to get a wrap around your sleep issues, it's best to limit screen time in the evenings and dim the lighting in your home before bed.
Repova, K., Baka, T., Krajcirovicova, K., Stanko, P., Aziriova, S., Reiter, R. J., & Simko, F. (2022). Melatonin as a Potential Approach to Anxiety Treatment. International Journal of Molecular Sciences, 23(24), 16187.
Institute of Health Metrics and Evaluation. Global Health Data Exchange (GHDx), (https://vizhub.healthdata.org/gbd-results/, accessed 30 January 2023).
Killgore, W. D. (2010). Effects of sleep deprivation on cognition. Progress in brain research, 185, 105-129.
Simko, F., Reiter, R. J., Pechanova, O., & Paulis, L. (2013). Experimental models of melatonin-deficient hypertension. Frontiers in Bioscience-Landmark, 18(2), 616-625.
Golus, P., & King, M. G. (1981). The effects of melatonin on open field behavior. Pharmacology Biochemistry and Behavior, 15(6), 883-885.
Caumo, W., Levandovski, R., & Hidalgo, M. P. L. (2009). Preoperative anxiolytic effect of melatonin and clonidine on postoperative pain and morphine consumption in patients undergoing abdominal hysterectomy: a double-blind, randomized, placebo-controlled study. The Journal of Pain, 10(1), 100-108.
Patel, T., & Kurdi, M. S. (2015). A comparative study between oral melatonin and oral midazolam on preoperative anxiety, cognitive, and psychomotor functions. Journal of anaesthesiology, clinical pharmacology, 31(1), 37.
Hasler, G., van der Veen, J. W., Grillon, C., Drevets, W. C., & Shen, J. (2010). Effect of acute psychological stress on prefrontal GABA concentration determined by proton magnetic resonance spectroscopy. American Journal of Psychiatry, 167(10), 1226-1231.
Wong, H., & Cairns, B. E. (2019). Cannabidiol, cannabinol and their combinations act as peripheral analgesics in a rat model of myofascial pain. Archives of oral biology, 104, 33-39.
Russo, E. B. (2008). Cannabinoids in the management of difficult to treat pain. Therapeutics and clinical risk management, 4(1), 245-259.
Crippa, J. A. S., Derenusson, G. N., Ferrari, T. B., Wichert-Ana, L., Duran, F. L., Martin-Santos, R., ... & Hallak, J. E. C. (2011). Neural basis of anxiolytic effects of cannabidiol (CBD) in generalized social anxiety disorder: a preliminary report. Journal of psychopharmacology, 25(1), 121-130.
Peuhkuri, K., Sihvola, N., & Korpela, R. (2012). Dietary factors and fluctuating levels of melatonin. Food & nutrition research, 56(1), 17252.