Melatonin for Anxiety | Effects & How it Works

One of the biggest struggles for those dealing with anxiety and depression is the overwhelming feeling of “aloneness.”

It seems like everyone else is carrying on with life while we fight an inward battle.

You might think to yourself, “no one understands what I am dealing with.” Statistically, however, you are far from alone. Anxiety disorders are (and have been) the most common mental illness in the U.S, affecting an estimated 40 million adults in any given year.

While it’s true that one common symptom of anxiety is insomnia, sleep deprivation itself can also cause such a nervous disorder. This correlation prompts a never-ending cycle of sleeplessness and anxiety. In fact, those who suffer from chronic insomnia are at the highest risk of developing an anxiety disorder.

This conundrum prompts a question: Could better sleep help anxiety? More specifically, can a sleep aid like melatonin be used as an alternative or supplemental treatment?

What is Melatonin?

Melatonin is a hormone that is produced at night by the pineal gland in the brain to synchronize circadian rhythm, the 24-hour cycle in the biological processes of living beings, including humans, animals, fungi and even cyanobacteria. While circadian rhythms are generally internal processes, they can be prompted by sunlight and temperature, and are important to the creation of regular patterns of sleeping and eating.

As a part of this process, the hormone, melatonin is produced by the body more at night than during the day. Essentially, it works while you sleep.

As Rebecca Park, a registered nurse and founder of RemediesForMe, put it: “Melatonin tells your body when to get ready for sleep and balances the sleep-wake cycle. Melatonin production increases when the sun goes down and decreases as the sun rises.”

There are many causes for someone to experience low melatonin levels, including stress, low levels of direct sunlight, increased exposure to blue (fake) light (computer screen, cellphones, TV), working night shifts, change in time zones, jet lag, poor sleep quality or deficiencies in nutrients.

If your melatonin levels are low, you may experience symptoms such as insomnia, fatigue, or sleep disturbances. Naturally, a melatonin deficiency will cause symptoms associated with sleep deprivation, including high levels of stress or changes in mood.

Luckily, for times when your body does not naturally produce enough of this natural hormone, there are melatonin supplements available to help you sleep. In the United States, an estimated 3.1 million adults take or have taken melatonin to help them get a better night’s rest.

This supplement is particularly valuable for those who suffer from insomnia or other sleep disorders, as well as other medical conditions where sleep disturbance is a symptom. Because sleep disorders are commonly connected to mental health disorders, it makes sense that melatonin treatment might actually help with them, too, in its own way.

Melatonin and Anxiety: More Than a Sleep Aid?

Sleep disorders like insomnia are closely linked with anxiety and depression, so it stands to reason that using this sleep aid could lessen anxiety, improve cognitive function, and boost overall mood.

“Melatonin may be able to help with anxiety. If your body does not produce enough melatonin, it can cause you to feel sleepless, restless and anxious,” Park said. “Taking melatonin for anxiety can promote better sleep quality, regulate your circadian rhythm, and ease negative feelings.”

She added that melatonin can help different types of this nervous disorder, including generalized anxiety, as well as age-related and surgical anxiety.

There was even a placebo-controlled trial where melatonin administration was used to reduce pre-surgery anxiety. When compared with patients in the placebo-controlled group, there was a significant 13‐point reduction in anxiety for the patients who took melatonin before surgery.

When asked if she had ever recommended melatonin to patients dealing with anxiety or depression, Dr. Wendy Kirby, a psychiatrist with more than 25 years of experience, explained that she has done so in the context of coexisting sleep problems.

While melatonin may not directly reduce anxiety, Dr. Kirby agreed that it could “indirectly” lessen it by helping to regulate that sleep/wake cycle and increasing the quality of sleep.

“We know that poor sleep can increase anxiety and depression,” Dr. Kirby said. “By regulating the sleep/wake cycle and helping the body and brain stay on a regular routine, melatonin should lessen anxiety and also help people feel more energy to seek out other ways to deal with anxiety, like exercising, meditating, or seeking therapy.”

How Melatonin Compares to Anxiety Medication

So at its most basic use as a sleep aid, melatonin treatment can indirectly lessen anxiety. But could there be other ways that this naturally occurring hormone could contribute to the reduction of anxiety?

A 2017 study published in the American Journal of Translational Research found strong evidence that melatonin administration displayed the ability to reduce anxiety-like behavior caused by sleep deprivation in rats. In the placebo-controlled trial mentioned earlier, where melatonin was administered prior to surgery, it showed such a significant reduction in anxiety, that researchers concluded that melatonin administration “offers an atoxic alternative to benzodiazepines,” particularly sedatives such as Midazolam or Xanax.

In another controlled trial focused on pre-surgery anxiety, researchers compared six milligrams of oral melatonin to Alprazolam and discovered that the oral melatonin dosage was an effective alternative. The conclusion held that, as a premedication, melatonin could also lessen anxiety, but with less sedation and cognitive dysfunction.

In a randomized clinical trial on patients presenting with ST-segment-elevation myocardial infarction (STEMI), pharmacists evaluated melatonin against oxazepam, which is a short-to-intermediate-acting benzodiazepine, to determine its ability to decrease anxiety and improve overall sleep quality. Benzodiazepines are effective at treating anxiety and insomnia, but they are also responsible for adverse side effects or negatively impacting the side effects of other prescription medications when taken together.

During the trial, the natural supplement showed a significant advantage over the oxazepam, in both lessening anxiety and improving sleep quality. For this reason, melatonin treatment is largely considered more favorable (and possibly more effective) than oxazepam for these types of patients.

Melatonin has also shown promise as a treatment for depression as well. A 2006 study conducted by researchers at Oregon Health & Science University (OHSU) suggested that low doses of melatonin may be more beneficial for seasonal affective disorder (SAD), which is a type of depression that follows a seasonal pattern and occurs in many people during the colder months when days are shorter.

In 2018, another study found that melatonin helped reduce symptoms of depression for some people.

All in all, the evidence overwhelmingly shows that melatonin has some benefits to offer to those who suffer from anxiety and/or depression.

How to Use Melatonin for Anxiety

A typical dose of melatonin for the treatment of anxiety is around 3-10 milligrams per day, but you don’t want to go overboard. Most experts recommend starting at a dose of three milligrams and working your way up once you see how it affects you.

There are four ways you can take melatonin:

1. Orally: This is, by far, the most common dosing method because melatonin supplements are readily available over the counter.
2. Sublingually: Tablets that dissolve under your tongue
3. Topically: Apply to the skin as a cream or lotion, typically used to treat androgenetic alopecia or hair loss
4. Intravenously: An uncommon method that should only be used with assistance from medical professionals

Can You Take Melatonin During the Day?

While melatonin can certainly help calm your thoughts and the nighttime jitters, anxiety can strike at any time of the day or night. Park advised against taking it during the day, but she offered suggestions for alternative natural supplements that could be valuable:

• (gamma-aminobutyric acid) GABA supplements
• kava
• passion flower
• L-theanine
• lemon balm (melissa officinalis)
• chamomile tea
• lavender tea
• catnip tea
• vitamin B-complex
• magnesium
• vitamin D3
• omega-3 (fish oil)

Can Melatonin Cause Anxiety?

Technically, according to the Mayo Clinic, one proclaimed side effect of melatonin is actually mild anxiety. However, according to Dr. Kirby, this is a side effect that doesn’t normally occur.

“I have never seen melatonin cause anxiety, so I think that is rare. But, as with any medication, it’s possible,” she said.

So, this appears to be a fairly general warning that is attached to a variety of different medications. However, it is highly unlikely that melatonin supplements will cause anxiety for people who take it.

Melatonin Side Effects: What Are the Risks?

As with any supplement or medication, there are always certain side effects you should know about.

There are some potential minor side effects to melatonin use, including dizziness, headache, nausea, drowsiness and agitation. Overall, no matter the dosage, these supplements are generally safe when taken on a short-term basis. However, long-term consumption may reduce the body’s ability to naturally produce this hormone.

Park explained that there have been a few studies that focused on the safety of melatonin, but none have produced evidence of harmful side effects.

For pregnant women and children, research regarding the effects or risks of melatonin is just amping up. Melatonin supplements are generally accepted as safe for children over the age of four, and some research suggests that it has a number of benefits for children who have autism or ADHD.

Regarding pregnant women, the research is mixed. Some research has shown that taking melatonin helps protect the fetus’ brain, but an animal study connected the use of melatonin to low birth weight. Pregnant women should talk to their doctor about the possibility of taking any supplements.

Although melatonin is a natural hormone, some may wonder how it interacts with other medications, particularly anti-anxiety or antidepressants. For instance, one common question is whether you can take melatonin and Xanax together?

Dr. Kirby explained that she has seen melatonin prescribed along with antidepressants, anxiety meds and sleeping meds, without complication.

On the contrary, Park warned that melatonin may interact with certain medications, particularly diabetic medications, immunosuppressants, contraceptives, anticonvulsants, anticoagulants and anti-platelet drugs.

Either way, if you’re taking any type of medication, you should always consult your doctor before taking melatonin supplements.

Melatonin for Anxiety: Don’t Sleep On It

It’s clear that melatonin certainly has value in the treatment of anxiety, as indirect as this value may be. Lack of quality sleep and anxiety go hand-in-hand and can create a vicious cycle. The only way to get out of the cycle is to break it.

First and foremost, getting quality sleep is a crucial step in treating your anxiety naturally and improving your overall well-being. At the very least, good rest will give you the energy you need to seek out other ways to deal with your anxiety (exercise, meditate, therapy, etc.) that work for you.