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An Alternative Approach to Recognizing and Treating Anxiety Disorders According to the Anxiety Disorders Association of America, about 20 million Americans currently suffer from some form of anxiety disorder. Some sub-categories of anxiety disorders are panic disorder, generalized anxiety disorder (GAD), post-traumatic stress disorder, phobic disorder, social and simple phobias, and the most severe form, agoraphobia. Many of the above mentioned syndromes may overlap and coincide, however for most TCM practitioners these western differentiations are not useful in determining the most appropriate treatment. The differentiations may, however, serve as a way of discerning the degree of severity of a given patient’s case. Most patients experiencing anxiety disorders have a clean bill of health, yet present with a myriad of complaints. Despite being told he is healthy, the anxious patient is certain that something is just not right… that perhaps the doctor missed something. Indeed, the list of symptoms may often seem paradoxical, unusual and difficult to pinpoint. Usually there is a strong physical and emotional component – anxiety is the ultimate example of the mind-body interweave. For many patients, it is difficult if not impossible to see the connection between their lifestyle and their list of symptoms. In addition, people with anxiety disorders are often well educated, of higher than average intellect, and highly sensitive. Their inability to control the way they feel frightens them, confuses them, and causes them to seek externally for reasons why they feel so out of sync. Most patients have a hard time taking responsibility for their condition and, unfortunately, there is a large genetic component. However, it is crucial that the practitioner inform the patient that his etiology is far less significant than his own ability to regain control over his life. Anxiety disorder is an emotional disorder (not a mental illness), and is the most treatable and most common form of psychological distress. Unfortunately, many MDs and Western approaches use medications when there is a growing body of knowledge indicating that patients can learn to reduce the overwhelming symptoms and discomfort. This can be accomplished through relaxation training, biofeedback, and learning coping skills. Acupuncture can play a significant role. Many theorists state that anxiety disorders stem from psychological trauma or repression of emotional conflicts. Others claim it is a purely physical problem stemming from imbalances in the brain chemistry. It is the heartfelt theory of the author that it is not necessary to give too much power to the patient’s etiology. Focusing on the etiology often sends patients on a goose chase trying
to find where they went wrong in their life, and a great deal of guilt
and improperly placed blame may ensue. In addition, the financial burden
of seeking the root of their problem is another major source of strain
and anxiety for the sufferer. And, as far as brain chemistry is concerned,
the human brain is still a mystery. Yet, it has been shown that thoughts
have the ability to alter a person’s brain chemistry, so if one
learns new, more calming ways of thinking, this could have as profound
an effect as a medication that artificially does the same thing. This
is not to discredit medicine in treating anxiety disorders, but it is
crucial that the patient reestablish his own sense of power and control
in his life in order to truly become free of this disorder. The patient
must learn to nourish his body with the proper foods, and his soul with
the proper thoughts and beliefs. Symptomology
There may be many other symptoms, ranging from instant headaches to stiffness of muscles, overwhelming waves of fatigue, etc. Once possible physiological disorders have been ruled out, it is up to the practitioner to diffuse the patient’s fear of his or her symptoms. It is often helpful to explain that a rapid release of adrenaline is what brings on the symptoms, that they are not dangerous, and that they should be seen as a signal to make some lifestyle adjustments. Alternative Approaches to Treatment It is also helpful for the practitioner to advise the patient to cut out stimulants. Studies have shown that anxiety-prone individuals can set off the “emergency response” that causes panic attacks by ingesting even small amounts of coffee, chocolate, sugar and salt. It is beyond the scope of this article to go into great detail on dietary guidelines, but in general it is important to avoid stimulants, eat a well balanced diet and perhaps include a good multi-vitamin and mineral supplement. Controlling one’s diet is just another way the patient can maintain an active involvement in his own healing process. As far as TCM is concerned, there is a great deal Oriental medicine can offer anxiety patients. But first, it is essential - as with any disease - that we look at the differentiations. The classics say that joy can cause a “shaking of the heart.” This type of anxiety is related to the Heart and is defined as repressed excitement. Many other common Heart meridian symptoms accompany this pattern, such as a tendency toward being easily startled, restlessness, dry mouth, lightheadedness, or dizziness, plus of course chest pains. Most resources are in agreement that anxiety is primarily related to the Heart and Lungs, and with general systemic hyperactivity. The symptomology in these two organ systems often coincide. For sake of comparison, a few approaches and theories will be discussed. Of course, it is most important to look at each individual case and treat it accordingly. According to Jeremy Ross (Acupuncture Point Combinations; Churchill
Livingston, 1995), anxiety is linked with the Heart and Kidney systems.
He states that Heart anxiety is rooted in Kidney fear, with marked feelings
of apprehension and the fear that something terrible is going to happen.
If there is an element of anger along with extreme tension, then there
is also Liver-Gallbladder involvement. This case would include feelings
of uncertainty, indecision, irritability, and hypersensitivity, along
with headaches and pain, plus stiffness or tremors in the muscles of
the face, neck shoulders, back and limbs. Ross divided the anxiety into
the types of disturbance, such as excess, deficiency, or stagnation:
In all cases, the treatment of anxiety should first calm fear, anxiety,
panic or worry, and second tonify the underlying deficiency. Ross notes
that the Shu points have less of an immediate effect for calming and
are best used for tonifying the underlying deficiency when the acute
anxiety has reduced.
Herb formula: Gui Pi Wan
Points: Liv 14, 3, 13, Sp 4 and St 36. Herb formula: Modified Si Ni
San These differentiations reflect the author’s theory that anxiety stems from deficiency, even if there is a resulting excess that occurs. Accompanying this article is a description of alternative therapeutic strategies that practitioners may consider in treating cases of anxiety. Many patients with anxiety seek quick fixes and are often drawn into the Western treatment protocol of medication. Should this be the case, it is advisable to not try to convince the patient to eliminate the medications. The patient must first feel comfortable with the new treatment protocol before undertaking a gradual elimination of medication. In addition, there should be communication with the prescribing MD, who will want to manage the patient through the process. Aside from acupuncture, TCM practitioners can help the patient help himself by assigning an at-home exercise program that focuses on relaxation and breath awareness. Breathing exercises and simple Qi Gong movements are a good way to get the patient more active in his own healing process by teaching him to relax himself. Good relaxation therapies that may be helpful include walking, painting, stamp collecting, and meditation. Clearly, there are many factors that influence the development of such a condition. Yet, no matter the cause, the important thing is that a person learns how to adjust his or her lifestyle and nourish not only the body but also the spirit. As practitioners of Traditional Chinese Medicine, we are in a very unique place in that we can strongly influence the healing process of our patients by helping them regain the vital balance in their lives.
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