JIANG XUE FENG—Senior Physician
Anxiety disorder
Anxiety disorder (psychoneurosis) is a mental illness that’s characterized by a sense of distress. Those who suffer from it experience fear and anxiety for no apparent reason, and may also have headaches, chest fullness, palpitation, difficulty breathing, dry mouth, urinary urgency, sweating, and tremor.
TCM divides anxiety disorders into 3 types:
The phrase “anxiety disorder” does not exist in TCM terminology. However, it’s signs and symptoms are similar to those of “visceral inflammation”, “panic attack”, “palpitation”, and “insomnia” in TCM. It is generally due to Qi and blood deficiency, emotional trauma and inflammation of the “liver system” that lead to fluid stagnation and malnourishment of the “heart system”. The disorder is associated with multiple visceral systems, including heart, liver, gallbladder, spleen, and kidney. Treatment needs to bring the visceral functions back to balance based on the differential diagnosis.
TCM categories
Type
|
Signs and symptoms
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Other concomitants
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Heart and spleen deficiency
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Racing thoughts, palpitation, weakness
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Dizziness, forgetfulness, sleeplessness, excessive dreaming, reduced appetite, bloating after even a small meal, pale facial complexion
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Liver congestion and spleen deficiency
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Attention deficit
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Depressed mood, chest fullness, sleeplessness, reduced appetite, bloating, loose stool
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Heart and gallbladder deficiency
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Palpitation, fearfulness, easily startled, irritability, brain fog, mood swings, restlessness
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Sleeplessness and excessive dreaming
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Liver and kidney Yin deficiency
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Untrusting, easily startled, irritability
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Dizziness, tinnitus, low back and lower extremity weakness, sleeplessness, excessive dreaming, bitter taste in the mouth, dark yellow urine
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Inflammation and phlegm retention
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Irritability, racing thoughts, restlessness, talks a lot
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Excessive dreaming, headaches, dizziness, bitter taste in the mouth, dry mouth
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Blood stasis
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Palpitation, irritability, untrusting
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Restless sleep, headaches, sharp chest pain, chest fullness, dark circles around the eyes, bluish color of the lips
|
TCM treatment for anxiety disorder
See the table above for specific TCM treatment for each type of anxiety disorder. Tranquilizers used by medical doctors are more effective, yet long-term use of high dosed medications lead to dependency, and side effects, such as hormonal dysfunction and weight gain. Combining medication with herbal medicine can potentially reduce the side effects and increase efficacy. When appropriate, acupuncture is included in the treatment protocol. Acupuncture mainly focuses on the neurological and mental mechanisms. It is advised to continue the medication for up to 1-2 years after remission. This rule of thumb applies to all types of anxiety disorder. Please seek medical advice to tapper off your medication to avoid relapse.
Case study:
Mr. C, 33. He first visited the clinic in 2012. He recalls that he was in Hong Kong in February 2012. One day, he suddenly had palpitation and trouble breathing, and was not able to sleep. When I saw him, he had thin white coating on his tongue, and his pulse was thin, yet taut and fast. I diagnosed him with anxiety disorder, the liver congestion and heart and gallbladder deficiency type. He continued TCM treatment by using Chinese medicine and acupuncture all the way up to November 2013, and we started tapering off his treatment frequency, as he was very stable. He completed all treatments in October 2014. He has not had any relapse.
It is common for patients to experience relapses during the initial period of treatment. For that reason, you should always follow your doctor’s advice. Do not discontinue treatment halfway, or reduce the dosage of medication. It typically requires one to two years of continued treatment to stabilize anxiety disorder.