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From worry to wellness: How to treat anxiety with Chinese medicine

What will be covered in this article?

  • Background on anxiety and current medical treatments
  • Chinese medicine perspective on anxiety disorder
  • Example Chinese Herbal formulas used in the clinic to address anxiety
  • Suggested acupressure points which can be stimulated at home to manage the symptoms
  • A brief introduction to NADA protocol for anxiety, insomnia, addictions and withdrawal symptoms
  • Lifestyle suggestions for managing anxiety
  • The benefits of magesium glycinate and its potential in anxiety disorder

What is anxiety?

Anxiety disorder is a common psychiatric condition affecting approximately 3 million Australians. Most people have experienced bouts of anxiety at times, however someone might be diagnosed with Generalised Anxiety Disorder (GAD) when their anxiety becomes chronic, recurring and affects their ability to function in life. GAD is categorised as a group of psychiatric conditions which may include fear, nervousness, panic or apprehension, phobias, Post-Traumatic Stress Disorder (PTSD), and ritualistic behaviours often seen in obsessive compulsive disorder (OCD) [1].

What are the current treatments?

Current conventional treatments for anxiety are primarily focused on psychotherapy and counselling, Cognitive Behavioural Therapy (CBT) and medications such as Selective Serotonin Re-uptake Inhibitors (SSRI’s) or Benzodiazepine’s [2]. Although medications are often prescribed in the primary care setting for anxiety disorders, there are also some concerns regarding potential adverse reactions, which is based on patient self-reporting and ongoing clinical research. The most commonly reported adverse reactions are, arrhythmias (heart palpitations), chronic dry mouth, nausea, vomiting, diarrhoea, weight gain, loss of libido, night-sweats, insomnia, and even suicidal thoughts for some individuals [3].

Chinese medicine & anxiety:

Chinese medicine diagnoses anxiety disorder based on specific symptoms and the persons presenting pulse and tongue diagnosis. The collection of these signs and symptoms will lead to a Chinese medicine diagnosis and an individual treatment plan. Example patterns in Chinese medicine include Liver Qi Stagnation, Heart-Kidney disharmony, Heart Blood and Spleen Qi deficiency, Kidney Yin deficiency, and Phlegm-Heat harassing the mind. Based on these these patterns, a specific acupuncture treatment or Chinese herbal formula is used to correct the internal imbalance, which is leading to the symptoms of anxiety. So let’s delve into some of the common treatment strategies used.

Chinese herbal medicine for anxiety:

Chinese herbs and anxiety

In the clinic, Chinese herbal formulas are nearly always prescribed for patients suffering with anxiety. The prescribed formulas all come from the ancient Chinese medical text ‘The Essential Prescriptions of the Golden Cabinet’, which addresses symptoms commonly associated with anxiety disorder. Example symptoms include panic, heart palpitations, insomnia, shortness of breath, chest pains, restlessness and agitation, feeling hot and vexed, and a lump sensation in the throat.

Below are listed some of the most common herbal formulas used in practice for anxiety, however it must be understood that these formulas are not to be used without first receiving a proper diagnosis from a qualified practitioner of Chinese Medicine. All formulas are based on the person’s unique signs and symptoms, and often herbal modifications are required.

Chai Hu Jia Long Gu Mu Li Tang:

Probably my favourite formula in clinic for anxiety and insomnia, this is one that I have personally taken many times as well. Chai Hu Jia Long Gu Mu Li Tang (CHJLGMT) is very useful for modern day mental-emotional symptoms. It is often prescribed to address chronic insomnia, anxiety, restlessness and agitation, hot flushes, night sweats, constipation issues, headaches, a feeling of stuffiness in the chest, and lots of tension in the muscles and pulse. In Chinese medicine, CHJLGMLT is used to sedate and calm the Spirit, unblock the bowels and move the Liver Qi to relieve the associated symptoms. It is also very commonly used in menopausal induced anxiety, insomnia and hot flushes.

Ban Xia Xie Xin Tang:

Often used as a follow-up formula to CHJLGMLT, Ban Xia Xie Xin Tang is used for anxiety which is accompanied by insomnia and chronic digestive disorders. This is for the person who has constant digestive symptoms or constipation issues. They will often complain of insomnia with difficulty falling asleep and feeling hot and restless. Other symptoms include irregular timing in opening the bowels, alternating constipation and loose stools, chronic bloating, reflux, or nausea.

Ling Gui Zhu Gan Tang:

Ling Gui Zhu Gan Tang (LGZGT) is more common with female patients due to their physiology and is regularly combined with Chai Hu Jia Long Gu Mu Li Tang or Ban Xia Xie Xin Tang, depending on the patient’s pulse, symptoms and overall presentation. This formula is used for anxiety symptoms which accompany heart palpitations, brain fog, lack of thirst with frequent urination, muscle or eye twitches, or postural dizziness. LGZGT is also used a lot for patients who habitually drink excessive amounts of water, eat a lot of cold or raw food based diets, and have a history of repeated antibiotic use.

Bai He Di Huang Tang:

Another prescription which is often combined with other formulas, Bai He Di Huang Tang (BHDHT) is a beautiful formula containing Lily Bulb and Rehmannia Root. BHDHT has been classically used for anxiety and an unbalanced mental-emotional state which can comprise many subjective symptoms. These may include unstable emotions, poor focus, restlessness and agitation, being unclear in what the person wants or needs, alternating between feeling hot or cold, dizziness, and a metallic taste in the mouth.

Zhi Gan Cao Tang:

Zhi Gan Cao Tang (ZGCT) is a quintessential ‘Blood tonifying’ formula and is used for anxiety which is accompanied by heart palpitations, in particular skipping heartbeats. Other symptoms include feeling hot and irritable, insomnia and mental restlessness. This formula has been used clinically for post-partum anxiety and exhaustion due to its function to quickly nourish Blood.

Acupressure:

Now that we’ve covered example Chinese herbal formulas, what are some of the acupuncture points that can be stimulated at home? The following points are only a very small fraction of acupuncture points which can be used to ease symptoms of anxiety. These points are easily found on the body and can be stimulated for 2-5minutes 2-3 times a day or when in an acute stage of anxiety or panic attack. These are some of my favourite points to use in clinic for their quick effect on calming the nervous system and helping the body to come back into balance.

Heart 5 & Pericardium 6:

Heart 5 (HT5) and Pericardium 6 (PC6) are conveniently located next to each other on the inner wrist. PC6 is approximately 3 centimetres from the central wrist crease, and HT5 is 2 centimetres from the inner wrist crease. Apply moderate pressure into these points for 5mins when experiencing anxiety or panic. The trick with self-acupressure is to press into the region where the points are approximately located and try and find a slightly more tender or dull-achey spot. Once you’ve found this, continue to press. You can either do small circular pressure or press into the points using an intermittent pulsing rhythm. Heart 5 and Pericardium 6 are used for acute anxiety, chest stuffiness, insomnia, and also help with digestive symptoms like bloating or nausea. PC6 is also a favourite for morning sickness!

Heart 5 and pericardium 6 acupuncture points for anxiety
Kidney 1 acupuncture point and anxiety

Kidney 1:

Another fantastic point to stimulate on yourself is Kidney 1. This point is located on the bottom of the foot approximately 1/3 down from the base of the second toe towards the heel. Similar to Heart 5 and Pericardium 6, press around until you find a more tender area and then stimulate this spot. In Chinese medicine, Kidney 1 helps to harmonise the heart, calm anxiety, open the chest and improve sleep quality. It is also used in clinic to help with high blood pressure, chest pain or headaches.

Yintang:

Yintang is another favourite used for most mental-emotional symptoms including anxiety, stress, depression and insomnia. Sometimes referred as the ‘third eye’ point, Yintang helps to pacify the mind, calm the heart and settle the nervous system. It is also the point which is most highly requested in clinic!

Yintang is very easy to locate directly in the centre between the eyebrows. For acupressure, it is advised to perform slow circular motions for approximately 2-5minutes when experiencing acute stress or anxiety. This point can also be stimulated when going to sleep to help with insomnia or for a mind that ruminates and overthinks.

Yintang acupuncture point for anxiety

Ear acupuncture & NADA protocol:

Ear acupuncture NADA protocol

Auricular acupuncture involves stimulating specific points on the ear using press seeds that can be left on for several days and re-stimulated using gentle pressure. An example protocol is the National Acupuncture Detoxification Association protocol (NADA), which was developed in the mid-1970s at the Lincoln Detoxification clinic, through a community process of experimentation and feedback. NADA was initially used as an experimental adjunctive treatment for heroin addiction and symptoms of withdrawal, but became applicable for various mental health conditions in the primary care setting [4]. In clinical research trials, NADA has shown to significantly reduce cravings, depression, anxiety, anger, body aches/headaches, poor concentration, and low energy levels [5]. It is for this very reason that NADA and other specific ear points are often used in the clinic to help manage symptoms of anxiety.

What else can you do to help anxiety?

When addressing symptoms of anxiety, it is important to take a holistic approach to treatment. Much of the following suggestions relate back to a term called ‘Yang Shen’ which translates as ‘nourishing life’. Therefore, these suggestions are applicable to most people and cases. If you have any concerns or underlying health conditions, it is always best to consult your general practitioner or trusted allied health professional before making any significant dietary or lifestyle changes.

Optimise your sleep:

Sleep is vital for the body’s restoration and regulating the nervous system. Here’s some suggestions to optimise your sleep quality:

  • Aim for at least 7 hours per night
  • Create a regular sleep routine by going to bed and waking up at the same time each day. In the autumn and winter periods, aim to sleep a little earlier at night.
  • Have complete blackout in your room when sleeping
  • Try to avoid screen use at least 1 hour prior to sleep – instead listen to gentle music or an audiobook
  • Avoid sleeping under an open window or with a fan facing directly towards you. It is understood in Chinese medicine that external wind and cold are considered two of the primary causes of colds, flu’s and flare-ups in physical or mental-emotional symptoms.

Exercise regularly:

According to Chinese medicine, the Heart is connected to the mind and spirit. The Heart also corresponds to the fine liquids in the body, including sweat. By exercising and inducing a light sweat, you can assist the Heart to release stagnant heat and Qi, which has accumulated due to chronic stress and anxiety. This allows the Heart Spirit to become quiet and descend into the Kidney’s below, allowing for a calmer mind.

  • It is advisable to exercise and move the body for at least 20-40 minutes a day. This could be any form of exercise such as walking, running, swimming, weight lifting, pilates or yoga. The important thing is to find a form of exercise which you enjoy and then stick with this.
  • Yoga, Taichi and Qigong are also valuable forms of exercise as these movements concentrate on breath work and slow deliberate movements. This can be wonderful to help calm the mind and ground the nervous system. If you are inclined to practice yoga, a yin-style might be more suitable in the initial stages.

Diet:

The following suggestions are considered general in nature but come from deep ancient Chinese medicine principles.

  • Try to eat foods which are grown in season.
  • Eat your meals at regular times every day and ideally in a calm and quiet environment.
  • Avoid excess intake of water and instead focus on consuming fluids when your body naturally feels thirsty.
  • Avoid the overconsumption of cold, raw of damp causing foods. This includes fruit, dairy, grains, raw salads and smoothies. During Spring, you can incorporate a bit more fresh salads, but always try to combine with warm cooked foods and warming spices.
  • For chronic digestive complaints, you an incorporate daikon raddish into your cooking. You can read more about daikon radish here.
  • For weak digestion, fatigue or recovering from illness, consume rice congee. You can read more about congee here
  • For Blood deficiency individuals who are prone to anaemia, cold hands and feet, aversion to cold, fatigue, pale complexion and low mood, it is best to consume more lamb, beef, pate’ and red coloured foods such as beetroots, cherries and tomatoes.
  • Keep alcohol consumption to a minimum.

Other helpful tips:

Aromatherapy:

Essential oils have demonstrated to be effective in reducing stress and anxiety in preliminary human trials. Current clinical research indicates that Lavender and Sweet Orange are particularly effective in reducing anxiety symptoms [6]. A personal favourite blend used in clinic includes essential oils Lavender, Sweet Orange and Geranium. Its creates a gently uplifting but calming blend which is fantastic for settling the nervous system.

Essential oils for anxiety

Mindfullness meditation:

Mindfullness meditation is a mental practice that involves focusing your attention on the present moment without judgement. It is simply being aware of your thoughts, feelings, body sensations, sounds or objects in your direct surroundings as they arise. My recommendation is to perform mindfullness for 10-15 minutes a day and preferably when in a more calm space. As your body attunes to mindfulness, you can use this to help navigate anxieties which arise and gently move away from it. If you’re interested in starting a mindfulness practice, Sam Harris’s Waking Up App is a great place to start and also includes a free introductory trial.

Magnesium Glycinate: A special mention

I believe magnesium glycinate deserves a special mention here for its use in anxiety disorders. Regarded as the 4th most abundant mineral in the body, magnesium is essential for over 300 enzymatic processes and is involved in ATP/energy production, nerve function, blood sugar control and heart health [7]. Further to this, promising clinical research has revealed that supplementation with magnesium is beneficial for various psychiatric disorders, including depression, anxiety and possibly OCD symptoms [8]. Magnesium glycinate is a particular form of magnesium which naturally forms with the amino acid glycine. It is often used for its high absorbability and use in anxiety disorders, as glycine has demonstrated to gently ‘slow down’ the brain and calm the nervous system. It is for this very reason that magnesium glycinate is often prescribed in the clinic for numerous mental-emotional symptoms, especially in the case of recurring anxiety or chronic insomnia.

Summary:

In conclusion, Chinese medicine offers a holistic approach to anxiety, addressing both the physical and mental aspects of this common condition. Utilising Chinese herbs, acupressure, and specific acupuncture techniques, such as the NADA ear acupuncture protocol, and dietary and lifestyle adjustments, individuals can find a sense of balance and inner peace. If you would like to book in for a consultation and treatment, please don’t hesitate to reach out and see if this ancient holistic medicine is right for you.

[1] Martin P. (2003). The epidemiology of anxiety disorders: a review. Dialogues in clinical neuroscience, 5(3), 281–298.

[2] Parker, E.L., Banfield, M., Fassnacht, D.B. et al. Contemporary treatment of anxiety in primary care: a systematic review and meta-analysis of outcomes in countries with universal healthcare. BMC Fam Pract 22, 92 (2021).

[3] Wang SM, Han C, Bahk WM, Lee SJ, Patkar AA, Masand PS, Pae CU.   Addressing the Side Effects of Contemporary Antidepressant Drugs: A Comprehensive Review.   Chonnam Med J. 2018 May;54(2):101-112.

[4] Stuyt, E. B., & Voyles, C. A. (2016). The National Acupuncture Detoxification Association protocol, auricular acupuncture to support patients with substance abuse and behavioral health disorders: current perspectives. Substance abuse and rehabilitation7, 169–180.

[5] Carter K.O., Olshan-Perlmutter M., Norton H.J., Smith M.O (2011). NADA acupuncture prospective trial in patients with substance use disorders and seven common health symptoms. Medical Acupuncture, 23, 131–135.

[6] Hur MH, Song JA, Lee J, Lee MS. Aromatherapy for stress reduction in healthy adults: a systematic review and meta-analysis of randomized clinical trials. Maturitas. 2014;79(4):362-369.

[7] Schwalfenberg, G. K., & Genuis, S. J. (2017). The Importance of Magnesium in Clinical Healthcare. Scientifica2017, 4179326.

[8] Botturi, A., Ciappolino, V., Delvecchio, G., Boscutti, A., Viscardi, B., & Brambilla, P. (2020). The Role and the Effect of Magnesium in Mental Disorders: A Systematic Review. Nutrients12(6), 1661.

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