Taking an Holistic Approach
In my last article on anxiety, I explained what anxiety was: the causes, symptoms, common Western Medicine and Traditional Chinese Medicine (TCM) approaches, and some simple tips on what you can do to help reduce anxiety.
In this article, I thought I would expand on this topic to give you a clearer understanding of how we approach anxiety from a Chinese medicine perspective, including herbal prescriptions.
In many Western schools of thought, anxiety disorders are considered to be dysfunctions in a person’s brain chemistry. An acupuncturist does not view anxiety as a brain dysfunction, but rather as an imbalance in a person’s organ system.
In TCM, this imbalance is called Shan You Si (“anxiety & preoccupation”) and is believed to affect the main organs: the Heart, Lung, Spleen, Liver, and Kidneys. Each organ is related to a different aspect of a person’s emotion. For instance, worry is said to affect the Spleen, grief affects the Lungs, anger the Liver, fear the Kidneys, anxiety the Heart – the Heart stores the Shen (spirit). If a person experiences one or more of these emotions over a long period of time due to lifestyle, dietary, hereditary or environmental factors, it can cause an imbalanced emotional state and lead to various anxiety disorders.
The role of an acupuncturist is to investigate the underlying causes of the anxiety by carrying out a thorough diagnostic evaluation to determine which organ system has been affected and is out of balance. The acupuncturist will then seek to restore the imbalance by tailoring a treatment program directly correlating to the presenting organ pattern of dysfunction.
The main treatment tools of TCM are acupuncture and Chinese herbal medicine. Some conditions are best treated with one or the other, or the two in combination. Anxiety is one condition where I usually recommend both acupuncture and herbal medicine combined. Either modality can be used as a stand-alone treatment, however best results come from a combined approach.
The effects of acupuncture are usually cumulative, so initially, the effects tend to be short lived. Then as you progress through a treatment course the period of relief following each treatment should become increasingly more extended.
A regular review allows us to stay on top of any changes that may be needed as you progress through the treatment course.
Herbal medicine prescriptions will vary according to which organ system is out of balance and can be reviewed and refined as treatment progresses.
The most common Chinese herbal formulas I use when working with anxiety in clinic are:
Bupleurum and Dang-gui formula (Xiao Yao san)
• This formula is for a Liver pattern disharmony
• Liver disharmony can manifest in a range of emotional responses, i.e. inability to give vent to feelings, depressed mood, crying easily
• Key signs and symptoms for this formula are a sense of frustration, stress, emotional strain and depressed mood
• A systematic evaluation and meta-analysis was conducted in 2021 on the clinical efficacy and safety of TCM Xiao Yao San in insomnia combined with anxiety. The results showed that Xiao Yao San combined with Western medicine or Xiao Yao San alone was beneficial for improving sleep quality and relieving anxiety.1
Ginseng and Longan formula (Gui Pi Wan)
• This formula is for a Heart and Spleen pattern disharmony
• It is traditionally used for the combined symptoms of palpitations, anxiety and forgetfulness due to the effects of prolonged worry or excessive mental activity
• Heart and Spleen disharmony frequently occurs in students, for example, due to the added stresses of examinations
Ginseng and Zizyphus formula (Tian Wang Bu Xin Wan)
• This formula is for a Kidney and Heart pattern disharmony
• Most common symptoms are irritability, extreme anxiety, insomnia, palpitations and night sweats
Wheat and Jujube combination (Gan Mai Da Zao Tang)
• It is used for a range of mental and emotional problems, with the principal feature of overwhelming or uncontrollable emotional responses
• A meta-analysis of the efficacy and safety of TCM formula Gan Mai Da Zao decoction for depression was conducted in 2014. It revealed that Gan Mai Da Zao has few side effects and the potential as an antidepressant. In addition, it found that adding Gan Mai Da Zao to antidepressants reduces the side effects and enhances efficacy of antidepressants.2
Zizyphus combination (Jin Gui Suan Zao Ren Tang)
• This formula is for a Liver and Heart pattern disharmony
• It has a tranquilising action that is specifically directed towards insomnia and mental unrest. Key signs, in addition to anxiety, are restlessness and irritability
Zizyphus and Polygala formula (An Shen Ding Zhi Wan)
• This formula is specifically for a Heart pattern disharmony
• Insomnia, sleep disturbance and forgetfulness are key symptoms
If you’re interested in finding out more, or if you would like to talk to me about how I can support you in your mental health journey, please do not hesitate to get in touch.
Dr. Juanita Fuchs (Acupuncture)
Morningside Acupuncture & Natural Therapies Healing Sanctuary
1. Clinical efficacy and safety of traditional Chinese medicine Xiao Yao San in insomnia combined with anxiety (nih.gov)
2. A meta-analysis of the efficacy and safety of traditional Chinese medicine formula Ganmai Dazao decoction for depression – PubMed (nih.gov)