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If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Health Guide are underpinned by peer-reviewed research and information drawn from medical societies and governmental agencies. However, they are not a substitute for professional medical advice, diagnosis, or treatment.
Plant extracts marketed as essential oils have been touted to calm nerves, soothe souls, and cure any number of diseases throughout human history. Whether they help with your anxiety may depend on how individuals react to aromatherapy. A scent that’s pleasant and soothing for one person might conjure negative memories in someone else, or it could just smell noxious or even induce breathing problems.
Science suggests essential oils, which are unregulated and not thoroughly studied, can be good for anxiety, but proof remains elusive. Because most of the popular essential oils are generally considered safe (with exceptions), aromatherapy perhaps epitomizes the mantra “if it feels good, do it”.
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What are essential oils and are they safe?
Often used for aromatherapy aiming to have a calming effect, essential oils are squeezed or steamed out of flowers, leaves, fruit, or other parts of plants. The oils are highly concentrated—it takes some 220 pounds of lavender flowers to make a pound of essential oil (National Center for Biotechnology Information, 2019).
Essential oils are often pumped into a room with a small appliance called a diffuser, in which drops of oil are added to water that’s turned into a vapor. Among several other ways of deploying them, the oils can also be added to a bath or applied directly to the wrist or other areas of skin, creating a more individualized experience. Essential oils are often incorporated with other less aromatic oils for use in massage (Johns Hopkins Medicine, n.d.).
There is nothing “essential” about essential oils in terms of human health. They are called “essential” simply because they contain the essence of a plant’s fragrance (National Cancer Institute, n.d.). Also, don’t be tricked by claims of “therapeutic grade,” which is nothing more than an essential oil marketing term (Johns Hopkins Medicine, n.d.).
Essential oils marketed as cosmetic products or to make you smell good are not reviewed for safety or effectiveness by the Food & Drug Administration, and they don’t need to gain FDA approval before they’re brought to the market and sold to consumers. The agency has no definitions or regulations for the terms “natural” or “organic” as they apply to such products (FDA, 2020).
But if essential oils are marketed with claims they can treat or prevent disease, they can be subject to FDA regulation as a drug. “For example, claims that a product will relieve colic, ease pain, relax muscles, treat depression or anxiety, or help you sleep are drug claims,” the agency states (FDA, 2020).
The reality is that essential oils are brought to market without FDA approval, the agency is chasing the tail of a huge industry with billions of dollars in sales, in stories, online and through multi-level marketing strategies. More recently, the FDA and the Federal Trade Commission have sent numerous warning letters to smaller companies that marketed essential oils as Covid-19 treatments (Federal Trade Commission, 2020).
Even if you’re buying essential oils from reputable sources, keep in mind that it does not mean that they’re safe in all concentrations and applications. Ingredients in the products, and how diluted the oils are, can vary greatly from one brand to another, and the ingredients may not all be stated on the label (Johns Hopkins Medicine, n.d.).
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Do essential oils actually relieve anxiety and stress?
Research suggests lavender is one of the best essential oils for relieving anxiety. Several small studies have suggested lavender extracts, taken orally or inhaled in aromatherapy, can help calm anxiety. But most of the studies have serious limitations or flaws, ranging from their very small number of participants to lack of a placebo for comparison to inconsistencies in the identification of oil ingredients (Koulivand, 2013).
Here is some of the specific research:
- Aromatherapy may help as a complementary therapy to reduce anxiety when a woman is in the early stages of labor when inhaled or used in a massage, according to a review of a handful of studies on the topic (Ghiasi, 2019).
- A review of 33 studies, mostly in Iran, found evidence to suggest aromatherapy can relieve pain and anxiety during labor. The most common essential oil used was lavender, but in many of the studies, it was mixed with other oils (Tabatabaeichehr, 2020).
- Lavender and rosemary essential oils reduced test-taking anxiety among graduate nursing students, based on readings of their pulse rates and their self-evaluation of anxiety levels (McCaffrey, 2009).
- A reduction in anxiety and an increase in sleep quality was linked to the use of lavender essential oils by people with coronary artery disease (Karadag, 2015).
- Inhalation of linalool, a chemical in lavender extracts, reduced anxiety in mice. Rodents are often used in medical studies, but results do not necessarily translate to humans (Harada, 2018)
There’s extensive anecdotal evidence for the calming effect of lavender, and aromatherapy may play a complementary role in lowering anxiety and even treating diagnosed anxiety disorders, but scientists advise caution given the inconclusiveness of the research (Malcolm, 2018).
Several other essential oils have been touted for anxiety relief, including orange, lemon, chamomile, and rosemary, each with some supporting evidence from mostly small studies (Sowndhararajan, 2016).
Because essential oils are not regulated, there can be significant differences in two separate products marketed as having the same ingredients. This contributes to uncertainty in the research. Importantly, when positive links are found, it’s often not clear if essential oils alone caused the effects or if something else might be at work, such as controlled breathing (Schmidt, 2018). Controlled breathing, which involves deep breaths and/or slow breathing exercises, has been found in many studies to reduce stress and anxiety (Harvard Health Publishing, 2020).
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How do essential oils work?
Our sense of smell is powerful, warning of danger, offering a pleasurable experience, may even help us find a partner. The things we smell can affect the brain in many ways. Aromas and fragrances can alter everything from cognition to mood and social behavior. This has prompted humans throughout history to use essential oils and other scents in their efforts to treat numerous physical and mental health conditions (Sowndhararajan, 2016).
Without question, our sense of smell has powerful effects. The nose has a direct connection to the brain’s processing centers for memory and emotion, so smells can evoke strong thoughts and feelings, positive or negative. But genetics, culture, and upbringing all play a role in whether certain smells are pleasant or repulsive. One person’s stinky cow manure is another person’s pleasant memory of the farm they grew up on (Weir, 2011).
In a nutshell, the olfactory system that starts with your nose contains hundreds of receptors that sense odors, good or bad, converting them to electrical signals that zip to the brain. These signals are known to trigger the release of hormones and other chemicals that modulate functions in the brain, including emotions, thoughts, and memories.
These modulations can cause immediate changes to the body, from blood pressure to skin temperature. Collectively, aromatherapy and smells, in general, are thought to “play a major role in the psychophysiological functions of human beings” (Sowndhararajan, 2016).
Nonetheless, exactly how essential oils might affect our moods, and if they do at all, remains largely mysterious.
Essential oils side effects and and concerns
No matter how they are deployed, all essential oils emit so-called volatile organic compounds (VOCs)—chemicals that make it into the air we breathe—and some of these can potentially be hazardous. A study of 24 different essential oils found each emitted one or more potentially hazardous VOC, such as acetaldehyde, acetone, and ethanol. (Nematollahi, 2018).
It’s important to keep in mind that using an oil diffuser means everyone in your home will be inhaling the essential oils. The problem is, not everyone thinks any given oil smells nice or seems soothing, and some oils can cause allergic reactions. Also, applying essential oils at full strength directly to the skin can cause skin irritation. (Johns Hopkins Medicine, n.d.). In rare cases, the growth of breast tissue in prepubescent boys has been linked to the topical application of lavender extract (Diaz, 2016).
If you use essential oils, make sure your kids are safe. The oils should never be ingested. There were more than 17,000 calls to U.S. poison centers in 2018 related to exposure to essential oils among children under age 5 (American Academy of Pediatrics, 2020). The U.S. Consumer Product Safety Commission issued several recalls of essential oils in 2020 due to a lack of child-resistant packaging (CPSC, 2020).
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The upshot: Essential oils may help reduce anxiety
Essential oils should be viewed as just one possible way to deal with the complex causes and effects of anxiety.
Physical activity, a healthy diet, and good sleep are also keys to keeping anxiety at bay. But if your anxiety is chronic and seems to get the best of you on a daily basis, or if it causes disabling anxiety attacks, it’s time to talk to your healthcare provider to learn if you might have an anxiety disorder that’s treatable with medication or behavioral therapy (National Institute of Mental Health, 2016).
However, if you’re feeling a little anxious now and then—and who isn’t nowadays?—essential oils could be a way to soothe your mind and cut down on the angst in your soul. It probably won’t hurt that you’re simply slowing down to do some self-care, getting your mind off your worries.
And hey, as you inhale those soothing scents, consider leveraging a scientifically proven anxiety reliever: Take a few deep breaths.
- American Academy of Pediatrics (2020) Health Alerts: Essential oils, hand sanitizers, OTC drugs, and more https://www.aappublications.org/news/2020/11/01/healthalerts110120
- ANSES (2020) ANSES calls for vigilance concerning essential-oil based sprays and diffusers. https://www.anses.fr/en/content/anses-calls-vigilance-concerning-essential-oil-based-sprays-and-diffusers
- Consumer Product Safety Commission, Recall List https://cpsc.gov/Recalls?combine=essential+oils&field_rc_date[date]=&field_rc_date_1[date]=
- Diaz A, Luque L, Badar Z, Kornic S, Danon M. Prepubertal gynecomastia and chronic lavender exposure: report of three cases. J Pediatr Endocrinol Metab. 2016 Jan;29(1):103-7. doi: 10.1515/jpem-2015-0248. PMID: 26353172. Retrieved from https://pubmed.ncbi.nlm.nih.gov/26353172/
- Federal Trade Commission. (2020). FTC, FDA Send Warning Letters to Seven Companies about Unsupported Claims that Products Can Treat or Prevent Coronavirus. Retrieved from https://www.ftc.gov/news-events/news/press-releases/2020/03/ftc-fda-send-warning-letters-seven-companies-about-unsupported-claims-products-can-treat-or-prevent
- Food & Drug Administration (2020) Aromatherapy https://www.fda.gov/cosmetics/cosmetic-products/aromatherapy
- Ghiasi A, Bagheri L, Haseli A. A systematic review on the anxiolytic effect of aromatherapy during the first stage of labor. J of Caring Sci 2019; 8(1): 51-60. doi: 10.15171/jcs.2019.008. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6428160/
- Harada H, Kashiwadani H, Kanmura Y, Kuwaki T. Linalool Odor-Induced Anxiolytic Effects in Mice. Front Behav Neurosci. 2018 Oct 23;12:241. doi: 10.3389/fnbeh.2018.00241. PMID: 30405369; PMCID: PMC6206409. Retrieved from https://www.frontiersin.org/articles/10.3389/fnbeh.2018.00241/full
- Harvard Health Publishing (2020) Relaxation techniques: Breath control helps quell errant stress response https://www.health.harvard.edu/mind-and-mood/relaxation-techniques-breath-control-helps-quell-errant-stress-response
- Johns Hopkins Medicine, Aromatherapy: Do Essential Oils Really Work? https://www.hopkinsmedicine.org/health/wellness-and-prevention/aromatherapy-do-essential-oils-really-work
- Karadag E, Samancioglu S, Ozden D, Bakir E. Effects of aromatherapy on sleep quality and anxiety of patients. Nurs Crit Care. 2017 Mar;22(2):105-112. doi: 10.1111/nicc.12198. Epub 2015 Jul 27. PMID: 26211735. Retrieved from https://pubmed.ncbi.nlm.nih.gov/26211735/
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- Malcolm BJ, Tallian K. Essential oil of lavender in anxiety disorders: Ready for prime time?. Ment Health Clin. 2018;7(4):147-155. Published 2018 Mar 26. doi:10.9740/mhc.2017.07.147. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6007527/
- McCaffrey R, Thomas DJ, Kinzelman AO. The effects of lavender and rosemary essential oils on test-taking anxiety among graduate nursing students. Holist Nurs Pract. 2009 Mar-Apr;23(2):88-93. doi: 10.1097/HNP.0b013e3181a110aa. PMID: 19258850. Retrieved from https://pubmed.ncbi.nlm.nih.gov/19258850/
- National Cancer Institute, Essential Oil https://www.cancer.gov/publications/dictionaries/cancer-terms/def/essential-oil
- National Center for Biotechnology Information. (2019). Aromatherapy With Essential Oils https://www.ncbi.nlm.nih.gov/books/NBK65820/
- National Institute of Mental Health. (2016). Generalized Anxiety Disorder: When Worry Gets Out of Control. Retrieved from https://www.nimh.nih.gov/health/publications/generalized-anxiety-disorder-gad
- National Institute of Mental Health. (2017). Any Anxiety Disorder. Retrieved from https://www.nimh.nih.gov/health/statistics/any-anxiety-disorder.shtml
- Nematollahi, N., Kolev, S.D. & Steinemann, A. (2018) Volatile chemical emissions from essential oils. Air Qual Atmos Health 11, 949–954. https://doi.org/10.1007/s11869-018-0606-0. Retrieved from https://link.springer.com/article/10.1007/s11869-018-0606-0
- New Yorker (2017) How Essential Oils Became the Cure for Our Age of Anxiety https://www.newyorker.com/magazine/2017/10/09/how-essential-oils-became-the-cure-for-our-age-of-anxiety
- Schmidt, M (2020) What Science Says About The Potential Healing Effects Of Essential Oils, Discover magazine https://www.discovermagazine.com/health/what-science-says-about-the-healing-potential-of-essential-oils
- Sowndhararajan K, Kim S. Influence of Fragrances on Human Psychophysiological Activity: With Special Reference to Human Electroencephalographic Response. Sci Pharm. 2016 Nov 29;84(4):724-751. doi: 10.3390/scipharm84040724. PMID: 27916830; PMCID: PMC5198031. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5198031
- Tabatabaeichehr M, Mortazavi H. The Effectiveness of Aromatherapy in the Management of Labor Pain and Anxiety: A Systematic Review. Ethiop J Health Sci. 2020;30(3):449-458. doi:10.4314/ejhs.v30i3.16. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7445940/
- The Washington Post (2019) Essential oils are potent, risky and promising https://www.washingtonpost.com/lifestyle/wellness/essential-oils-are-potent-risky-and-promising-heres-what-you-need-to-know/2019/12/10/1470d7c4-1623-11ea-8406-df3c54b3253e_story.html
- Weir, K (2011) American Psychological Association, Scents and sensibility https://www.apa.org/monitor/2011/02/scents
Dr. Mike is a licensed physician and the Director, Medical Content & Education at Ro.