Anxiety can be experienced in many different ways such as OCD, PTSD, panic attacks, and phobias. For this blog, I will discuss acupuncture for anxiety as it relates to general anxiety. Giovanni Maciocia, a world-renowned expert and Chinese medicine practitioner, describes general anxiety as "an excessive, uncontrollable worry about everyday things. [A] constant worry [that] affects daily functioning and can cause physical symptoms." From a Chinese Medicine perspective, anxiety can derive from imbalances in emotional stress, constitution, irregular diet, loss of blood and overwork. Imbalances in the above etiology lead to approximately nine different patterns of disharmony that acupuncturist use to diagnose and appropriately treat the cause of a patients anxiety. As an acupuncturist, I want to know how my patient explicitly experiences "anxiety" since treatments are not all one size fit all.
Before discussing some causes of anxiety through a more holistic approach, let's discuss yin. Yin is the opposite of yang. At the most fundamental level, everything can be broken down into yin and yang. Yin is associated with energies such as cold, moon, dark, rest while yang is associated with hot, sun, light, and activity. If a person is deficient of yin, they may experience night sweats, constipation, and dry skin. If someone is deficient of yang they may feel cold, have poor circulation, or feel fatigued. We need both yin and yang to be balanced. When thinking of yin and yang through the lens of anxiety, a deficiency of yin means the yang energy may rise, feel uncontrolled, or not be anchored. In addition to acupuncture, yin activities such as meditation, yoga, baths, and walking can support those who experience anxiety and help bring balance.
In general, anxiety tends to be a result of blood, yin, and/or qi deficiency as well as qi stagnation. A variety of emotions can affect anxiety too, not just worry and fear. Excess joy, shock, guilt, shame, sadness, and pensiveness are also contributing emotions to anxiety. Emotions become a problem when they become stuck and stagnate. In balance, an emotion should rise, peak, and fall like a wave. It's when emotions keep rising, spin over and over, or drops off suddenly, that imbalance and disease occur. Out of balance emotions may cause qi stagnation and stagnation over time leads to heat in the body. The heat then damages the blood and yin (fluids) in the body and begins to agitate the mind. (Think about how disturbing a hot summer day can feel when all you want to do is cool off). In Chinese Medicine, the blood is said to house the mind. Therefore, blood deficiency may lead to anxiety because the mind has no home, anchor, or place to rest. People may feel anxiety after significant traumas such as an accident, surgery, or childbirth because of the loss of blood as well.
Poor diet contributes to anxiety similarly to emotional stress. According to Maciocia, irregular eating causes a deficiency of qi and yin of the stomach. If irregular eating continues over time, the lack of qi and yin of the stomach will eventually no longer nourish the heart and lead to what's called heart-yin deficiency. In more advanced cases, a patient may be consuming too many damp foods like dairy, alcohol, and sugar. Too much damp may lead to phlegm which in turn obstructs the mind and causes more severe anxiety such as panic disorders (think about after eating poorly for a few days how foggy the brain feels). Too much alcohol may also contribute to anxiety due to the amount of heat it brings into the body. Remember, for some, too much heat may agitate the mind.
Constitution can play a significant role in a persons experience of anxiety. It is essential to look at family history when working with an anxiety disorder because anxiety can be inherited. A person's constitution in regards to their elemental type may also contribute to how they experience anxiety. More on this in the next week.
Lastly, overworking may deplete kidney yin and lead to anxiety. The kidneys are associated with the water element and winter. The water element in balance is related to adequate rest, having enough reserves and resources, skillfulness, and deep listening. As a result, depletion of the water element and kidney yin may result in chronic anxiety which may or may not affect the heart. In addition, the water element controls the fire element via the ko cycle. If the water element is deficient one may experience anxiety due to their fire element not being adequately controlled.
As a review, anxiety may be a result of qi, blood, and/or yin deficiency. Qi stagnation is a common precursor to anxiety as it relates to emotional stress. It is important to note that deficiency can cause stagnation and stagnation can cause a deficiency. Emotional stress, constitution, irregular diet, blood loss, and overwork are all contributing factors. Next week we will discuss how anxiety shows up specifically within each of the five elements.
Maciocia, G. (2009). The psyche in Chinese medicine: Treatment of emotional and mental disharmonies with acupuncture and Chinese herbs. Edinburgh: Churchill Livingstone/Elsevier.