Anxiety: A Chinese Medicine (CM) Perspective

Anxiety is a normal reaction to stress. In general, it helps one to cope. But when anxiety becomes an excessive, irrational dread of everyday situations, it has become a disabling disorder [1] and is high in prevalence, especially in the female population, whose incidence is approximately double that of the male population[2].

Anxiety disorders are the most prevalent of psychiatric disorders and afflict millions of people each year. Anxiety tends to be chronic, and the individual and social burden is high.

Under normal conditions (i.e. conditions that do not generate pathology) the stress response enables us to mobilise our resources effectively to meet an environmental challenge, following which the system returns to homoeostasis.

If the stressor is very intense, prolonged or occurs repeatedly, the individual exhibits the ‘General Adaptation Response’ (GAR). This is described as a continuum from a normal healthy response through to exhaustion and death if the effect of the stressor (or cumulative effect of combined stressors) is greater than the individual’s capacity to deal with it (Fig.1).

Figure 1 – Adopted from Human response to stress curve according to Nixon P Practitioner 1979 Yerkes RM

Stage one is the alarm reaction. This is followed by the stage of resistance, which is the stage where distress, both physical and mental, is experienced. This is followed by the stage of exhaustion, accompanied by overt pathology, which may readily lead to death if the stress continues and intervention is not sought.

Western medical science classifies anxiety disorders into the following:

Generalised anxiety disorder (GAD)
Panic disorder
Social anxiety disorder
Post-traumatic stress disorder (PTSD)
Obsessive-compulsive disorder (OCD)

All anxiety disorders involve excessive, irrational fear, worry and dread.

GAD is an excessive, uncontrollable worry about everyday things. This constant worry affects daily functioning and can cause physical symptoms.

A panic attack (Distress) is defined as the abrupt onset of an episode of intense fear or discomfort, which peaks in approximately 10 minutes and includes at least four of the following symptoms [1]:

a feeling of imminent danger or doom the need to escape
palpitations
sweating
trembling
shortness of breath or a smothering feeling a feeling of choking
chest pain or discomfort
nausea or abdominal discomfort
dizziness or lightheadedness a sense of things being unreal, depersonalisation
a fear of losing control or “going crazy” a fear of dying
tingling sensations
chills or hot flushes.

How Does Traditional Chinese Medicine (TCM) view Anxiety

The main aetiological factor in anxiety is obviously mental/emotional stress. In addition, constitutional and dietary factors also play an important role.

In TCM, psychiatric disorders such as anxiety, depression, post traumatic stress disorder and others, frequently relate to energetic disharmonies involving the so-called ‘Five Spirits’. These are the Hun (the eternal soul/spirit), the Po (the corporal spirit/consciousness), the Zhi (the will), the Yi (the intellect) and the Shen (the mind and the connecting spirit.) [3,4]

In TCM diagnosis, anxiety may be part of any of the following pathologies [3]:
Basically, the cost common TCM Patterns involving anxiety include the Liver, Heart, Spleen and Kidney. These may occur as single patterns or more commonly in complex patterns where there is more than 2-patterns interacting.

Liver constraint: Prolonged emotional strain (e.g. suppressed anger, inability to vent feelings) leads to Liver constraint.
Heart deficiency: Loss of emotional balance or control, too much thinking or mental work depletes the Heart (Qi, Blood or Yin).
Spleen deficiency: Excessive physical work, worrying or thinking  depletes the Spleen Qi.
Kidney deficiency: Prolonged fear reaction depletes the Kidney  (Qi, Yin or Yang)

TCM doctors will identify the specific pattern affecting their patient and prescribe personalised treatment approach using acupuncture and/or Chinese herbs.

At Kurrajong Natural Medicine Centre our highly qualified and experienced team of practitioners are happy to develop a personalised treatment programme with you. Simply call (02)4573 0784

What You Can Do to Help Yourself

1. Seek help:

Talking to someone you trust about what’s making you anxious could be a relief. It may be that just having someone listen to you and show they care can help in itself. If you aren’t able to open up to someone close to you may contact your healthcare professional or Beyond Blue: https://www.beyondblue.org.au/ or Black Dog Institute: https://www.blackdoginstitute.org.au/resources-support/anxiety/help-support/

2. Sleep, Diet & Exercise:

Try to get enough sleep. Sleep can give you the energy to cope with difficult feelings and experiences. See our page on coping with sleep problems for more information.
Think about your diet. Eating regularly and keeping your blood sugar stable can make a difference to your mood and energy levels. See our page on food and mood for more information.
Try to do some physical activity. Exercise can be really helpful for your mental wellbeing. See our pages on physical activity for more information.

3. Relaxation/Mindfulness/Meditation:

Relaxation/Mindfulness – taking time to be out in nature and have some ‘Me-Time’ away from the daily stressors is very important to maintain a balanced emotional state. Meditation is a learned tool that can help you gain insight into your mind-body state and recognise why you become anxious when exposed to certain triggers or stressors.

References

1. Marciocia, G. (1994) The Practice of Chinese Medicine: The Treatment of Disease with Acupuncture and Chinese Herbs, Edinburgh: Elsevier Churchill Livingstone.

2. Sniezek, D. P., & Siddiqui, I. J. (2013). Acupuncture for Treating Anxiety and Depression in Women: A Clinical Systematic Review. Medical acupuncture, 25(3), 164–172. https://doi.org/10.1089/acu.2012.0900

3. Maciocia G. Principles and strategies of treatment. In: The Foundations of Chinese Medicine. London: Elsevier; 2005:1115–1132

4. [21] Kaptchuk TJ. The fundamental textures: Qi, Blood, Essence, Spirit and Fluids. In: The Web That Has No Weaver. New York: McGraw-Hill; 2000:59–66

Kurrajong Natural Medicine Centre

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