Lavender Essential Oil and Anxiety Management: A Case Study

A case-based examination of oral lavender essential oil as a non-pharmaceutical intervention for generalized anxiety disorder in a patient seeking evidence-informed, integrative care.

Dr. Jennifer Brusewitz ND

Abstract

This case study explores the use of a standardized oral lavender essential oil supplement in the management of moderate generalized anxiety disorder. It reviews proposed mechanisms of action, supporting clinical evidence, and patient-reported outcomes in the context of integrative, non-pharmaceutical care.

Introduction

Generalized anxiety disorder (GAD) affects up to 20% of adults and is one of the most common mental health disorders.1 The main psychological manifestations of GAD are excessive and persistent fear and worry about everyday aspects of life. Though transient anxiety can be a normal human emotion, when it lasts more than 6 months and hinders social or occupational functioning, an anxiety disorder is likely. Other aspects of anxiety disorders can include restlessness, fatigue, difficulty concentrating, irritability, muscle tension, and sleep disturbance.1 In addition to the psychological aspects, anxiety disorders can also lead to negative physical health consequences. Anxiety has been shown to be correlated with higher rates of depression, smoking, and substance-use – all of which raise the risk of cardiovascular disease.2 In addition to these psychological manifestations and their health consequences, emerging neurobiological evidence highlights the role of altered amygdala function. Specifically, disruptions in processing fear and regulation of emotional responses have been linked to generalized anxiety disorder. Dysregulation of neurotransmitter systems, particularly the gamma-aminobutyric acid (GABA) pathway further contributes to abnormal amygdala activity and the development of GAD.3 Research shows that many genes are implicated in the development of GAD, but given the increased prevalence in recent decades, it’s likely that the development of GAD is multifactorial.3 

Standard treatment for generalized anxiety disorder includes cognitive behavioral therapy (CBT), anxiolytic medication, or both. While CBT does show effectiveness for GAD, it isn’t a perfect solution. In a systematic review of 87 studies reporting response rates to CBT for various anxiety disorders, the response rate showing clinically significant improvement for GAD was 47% and 48% at post treatment and follow-up, respectively.4 As for pharmaceutical intervention, a meta-analysis including 89 trials and over 25,000 individuals with GAD compared treatment with over 20 active drugs versus placebo, with most agents modestly improved anxiety with reductions ranging from one to four points in the Hamilton Anxiety Rating Scale (a 14-item, 56-point scale).5 The data shows that there is still a large subset of the population that will not obtain meaningful benefit from these interventions alone. This case paper investigates a non-pharmacologic approach to anxiety treatment, focusing on the use of an evidence-supported herbal supplement.

Presenting Concerns

This case report describes the use of a lavender oil-based supplement for the management of anxiety in a 37-year-old male. His history was significant for opioid and stimulant use – including heroin, fentanyl, and methamphetamine, and he was in early recovery at the time of presentation. He reported persistent anxiety and mild residual auditory hallucinations following his last methamphetamine use a few weeks prior. The patient describes his anxiety as disruptive to his work, sleep, and interpersonal relationships, and he expressed a strong preference for non-pharmaceutical approaches to symptom management.  

Clinical Findings and Diagnostic Assessment 

At the initial visit, the patient’s GAD-7 score was 11, consistent with moderate anxiety. Given his recent substance use and the significant life changes associated with entering a treatment program, the presence of anxiety is not unexpected. Physical examination findings and recent laboratory results were unremarkable. Based on his clinical presentation, the notable impact of symptoms on daily functioning and duration of symptoms, and his validated screening score, a diagnosis of moderate generalized anxiety disorder was made. Differential diagnoses included substance-induced anxiety, early withdrawal effects, and mood or psychotic spectrum disorders. However, because these alternatives were less consistent with the overall presentation and because the patient wished to avoid pharmaceutical interventions, the treatment approach would not differ substantially. For these reasons, managing his symptoms as generalized anxiety disorder was deemed appropriate.

Therapeutic Intervention 

The patient was participating in an immersive substance use program with concurrent mental health counseling and expressed a preference for non-pharmaceutical approaches to managing anxiety.  We recommended a well-researched lavender essential oil-based supplement, with instructions to take one 80 mg capsule twice daily. Lavender has long been valued in traditional medicine for its calming, pain-relieving, and antimicrobial properties. Earliest documented uses date back over 2,500 years and include Egyptian, Greek and Roman civilizations. While ancient cultures used preparations and infusions of the plant, steam distillation was used to extract concentrated essential oil and was documented in Europe in the 16th century*. Once distillation methods were established, the essential oil became popular in European folk medicine.

The benefits of lavender are thought to come from its effects on various structures in the brain, including the limbic system, the amygdala, and hippocampus.6 Much of the research on the medicinal effects of lavender is on the standardized oral preparation. The mechanism of action is theorized to be that it can increase the density of 5-HT1A receptors, leading to increased extracellular serotonin levels, as well as inhibiting voltage-dependent calcium channels, contributing to stress-relieving effects in the central nervous system.7 Lavender essential oil has shown promising evidence for its use in managing some of the most common mental health related disorders, including anxiety, depression, and substance use.6 

In one systematic review and network-meta analysis, it was found that a standardized preparation called Silexan 160 mg produced greater reductions in Hamilton Anxiety Rating Scale scores than Silexan 80 mg, placebo, and paroxetine; and no significant difference was found between the effectiveness of Silexan and lorazepam for anxiety.8 As for depression, several studies have found that using oral lavender essential oil in conjunction with an antidepressant drug (TCA or SSRI) is more effective than using the drug alone.6 It has also been noted that the benefit for oral lavender essential oil is not found if used less than one week duration,6  as was demonstrated in this case. It is well established that individuals with mental health disorders have higher rates of substance use and tobacco smoking compared to the general population. Tobacco use is a major risk factor for numerous adverse health outcomes, including cardiovascular disease and cancer. In a study evaluating the effectiveness of herbal therapies for smoking cessation, the use of lavender essential oil was associated with a significantly higher continuous abstinence rate compared to control groups.9 In addition to mental health disorders, lavender supplementation has also shown promise in treating other common complaints, including sleep disturbance and pain measures. In one meta-analysis looking at the effect of lavender essential oil on subthreshold anxiety, 10 weeks of administration led to significant symptom reduction compared to placebo.10 As for pain, a different meta-analysis showed that there was a clinically meaningful effect on multiple bodily pain measures.11 

Timeline 

Follow-up and Outcomes 

At the second visit one week later, the patient reported no noticeable change in anxiety, although his GAD-7 score had improved from 11 to 8. Given that compounds that modulate the nervous system often require time to achieve full effect, he was encouraged to continue taking the supplement as prescribed. By the third and fourth visits, the patient reported significant improvements in anxiety, with his GAD-7 score decreasing to 2 at the final visit one month later. Given the absence of side effects and the favorable safety profile of the supplement, he was advised to continue as needed to support his mental health.

Discussion and limitations 

This case demonstrates the potential role of evidence-based herbal therapies in the management of mental health disorders. Accessible and well-researched complementary therapies, such as standardized lavender oil preparations, may serve as valuable adjuncts or alternatives, particularly for patients seeking non-pharmaceutical options.  The literature on lavender essential oil reflect clinically meaningful reductions in anxiety symptoms, positioning these agents as a reasonable consideration in cases where conventional treatments such as CBT or pharmacotherapy are inaccessible, poorly tolerated, or declined by the patient. In this case, the patient’s preference to avoid pharmaceutical anxiolytics made the use of such an herbal intervention especially appropriate.

However, important limitations must be acknowledged. Lavender essential oil–based supplements remain dietary supplements rather than FDA-regulated pharmaceuticals, which raises issues regarding standardization, quality control, and consistency across brands. In addition, these products are typically not covered by insurance, creating potential financial barriers for patients with limited resources. The evidence base, while promising, is relatively small and long-term safety and comparative effectiveness data remain limited.  Overall, this case highlights the need for expanded access to a wider range of mental health treatments, including herbal options, to better meet patient needs as well as continued research into their effectiveness and safety, and improved provider education on their appropriate use.

Patient Perspective 

The patient reported substantial improvements in his anxiety symptoms following the introduction of the lavender oil-based supplement. He described feeling more consistently calm throughout the day, which positively influenced his interpersonal relationships, particularly with his romantic partner, and improved his general social interactions. Importantly, the patient noted that the reduction in anxiety allowed him to engage more fully in other health-promoting behaviors, including regular exercise and meditation suggesting a cascading benefit on overall well-being. From the patient’s perspective, his primary goal of managing anxiety through non-pharmaceutical approaches was largely met. He expressed satisfaction with the perceived effectiveness of the herbal intervention and appreciated the absence of sedative or habit-forming effects commonly associated with conventional anxiolytic medications. Additionally, the patient felt a greater sense of autonomy and control over his mental health, which reinforced his motivation to maintain sobriety and to continue integrating holistic strategies into his daily routine.

Dr. Jennifer Brusewitz, ND is a licensed naturopathic physician, clinical supervisor, and adjunct faculty member at the National University of Natural Medicine (NUNM) in Portland, Oregon. She earned her Doctor of Naturopathic Medicine degree from the National College of Naturopathic Medicine in 2000 and completed a two-year family practice residency at NUNM Health Centers, where she continues to serve as an attending physician. Dr. Brusewitz brings over two decades of primary care experience, emphasizing foundational naturopathic principles, nutrition, botanical medicine, lifestyle medicine, and individualized patient collaboration. In addition to supervising students in teaching clinics, she contributes to academic programs in nutrition and oriental medicine, mentoring future clinicians in evidence-informed, holistic practice.

References

1. Munir S, Takov V. Generalized Anxiety Disorder. In: StatPearls. StatPearls Publishing; 2025. Accessed November 14, 2025. http://www.ncbi.nlm.nih.gov/books/NBK441870/
2. Bonnet F, Irving K, Terra JL, Nony P, Berthezène F, Moulin P. Anxiety and depression are associated with unhealthy lifestyle in patients at risk of cardiovascular disease. Atherosclerosis. 2005;178(2):339-344. doi:10.1016/j.atherosclerosis.2004.08.035
3. Mishra AK, Varma AR. A Comprehensive Review of the Generalized Anxiety Disorder. Cureus. 2023;15(9):e46115. doi:10.7759/cureus.46115
4. Loerinc AG, Meuret AE, Twohig MP, Rosenfield D, Bluett EJ, Craske MG. Response rates for CBT for anxiety disorders: Need for standardized criteria. Clin Psychol Rev. 2015;42:72-82. doi:10.1016/j.cpr.2015.08.004
5. Slee A, Nazareth I, Bondaronek P, Liu Y, Cheng Z, Freemantle N. Pharmacological treatments for generalised anxiety disorder: a systematic review and network meta-analysis. Lancet Lond Engl. 2019;393(10173):768-777. doi:10.1016/S0140-6736(18)31793-8
6. Irwin T, Justice H, Roman K, et al. Effectiveness of lavender supplementation in treating the most common mental health conditions in primary care settings: a narrative review. J Herb Med. 2025;54:101050. doi:10.1016/j.hermed.2025.101050
7. Müller WE, Sillani G, Schuwald A, Friedland K. Pharmacological basis of the anxiolytic and antidepressant properties of Silexan®, an essential oil from the flowers of lavender. Neurochem Int. 2021;143:104899. doi:10.1016/j.neuint.2020.104899
8. Yap WS, Dolzhenko AV, Jalal Z, Hadi MA, Khan TM. Efficacy and safety of lavender essential oil (Silexan) capsules among patients suffering from anxiety disorders: A network meta-analysis. Sci Rep. 2019;9(1):18042. doi:10.1038/s41598-019-54529-9
9. Mitra R, Rai A, Kumar A, Mitra JK. Role of Herbal Medication in Tobacco Cessation Treatment: A Systematic Review and Meta-analysis. Addict Health. 2023;15(1):63-70. doi:10.34172/ahj.2023.1290
10. Möller HJ, Volz HP, Dienel A, Schläfke S, Kasper S. Efficacy of Silexan in subthreshold anxiety: meta-analysis of randomised, placebo-controlled trials. Eur Arch Psychiatry Clin Neurosci. 2019;269(2):183-193. doi:10.1007/s00406-017-0852-4
11. von Känel R, Kasper S, Bondolfi G, et al. Therapeutic effects of Silexan on somatic symptoms and physical health in patients with anxiety disorders: A meta‐analysis. Brain Behav. 2021;11(4):e01997. doi:10.1002/brb3.1997