By Dr. Yoon Jeon. MChiro, MB, BSc, Dip.TCM, PGCert.
Case Presentation
A 39-year-old accountant presented with chronic anxiety and stress symptoms, which had progressively worsened over a period of approximately 12–18 months.
The patient reported recurrent episodes of anxiety characterised by palpitations, chest tightness, shortness of breath, and a persistent sense of internal tension or unease. Intermittent panic attacks were also present, typically occurring without a clearly identifiable trigger, although more frequently during periods of increased occupational stress.
Sleep disturbance was a prominent feature, including difficulty initiating sleep, frequent nocturnal awakening, and early morning waking. The patient described persistent cognitive hyperarousal, excessive rumination, and difficulty disengaging from work-related thoughts.
Additional symptoms included fatigue, irritability, and reduced stress tolerance, which were beginning to affect occupational performance and overall quality of life.
Prior management strategies (including conventional approaches) provided only partial or temporary symptom relief. The patient subsequently sought an integrative treatment approach for anxiety management in Southampton.
Clinical Assessment & Biopsychosocial Considerations
From a clinical perspective, the presentation was consistent with dysregulation of the stress-response system, commonly associated with increased sympathetic nervous system activity and reduced parasympathetic tone.
Within a Traditional Chinese Medicine (TCM) framework, the pattern was interpreted as a combination of:
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Heart Shen disturbance (emotional and cognitive overactivity)
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Liver Qi stagnation (stress-related tension and irritability)
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Underlying deficiency affecting stress resilience
This dual biomedical and TCM interpretation is commonly used in integrative practice for chronic anxiety presentations.
Treatment Approach
A structured, individualised treatment plan was implemented using a combination of acupuncture and herbal medicine.
Acupuncture for Anxiety
Acupuncture was applied with the objective of:
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Modulating autonomic nervous system activity
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Reducing sympathetic overactivation (“fight-or-flight” response)
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Enhancing parasympathetic tone and relaxation response
Research suggests acupuncture may influence limbic system activity and regulate neuroendocrine stress pathways, including modulation of cortisol levels and autonomic balance (Lee et al., 2009; Hui et al., 2010).
Herbal Medicine for Stress & Anxiety
A personalised herbal prescription was provided based on pattern differentiation.
The treatment aimed to:
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Support nervous system regulation
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Improve sleep quality and continuity
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Reduce emotional volatility and cognitive hyperarousal
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Enhance long-term stress resilience
Formula composition was adjusted over time according to clinical response.
Clinical Outcome
Over the course of treatment, the patient demonstrated progressive improvement:
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Reduction in baseline anxiety severity
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Decreased frequency and intensity of panic episodes
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Improved sleep initiation and maintenance
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Reduction in palpitations and chest tightness
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Improved emotional regulation and stress tolerance
Overall, the patient reported improved functional capacity and quality of life over time.
Discussion (Evidence-Informed Perspective)
Anxiety disorders are commonly associated with dysregulation of the hypothalamic–pituitary–adrenal (HPA) axis and autonomic nervous system imbalance, contributing to both psychological and somatic symptoms.
Emerging evidence suggests that acupuncture may have modulatory effects on:
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Autonomic nervous system balance
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Limbic system (emotion regulation pathways)
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Neurotransmitter regulation (e.g. serotonin, GABA activity)
A systematic review by Pilkington et al. (2007) reported potential benefit of acupuncture in anxiety-related conditions, although highlighted the need for further high-quality trials.
Similarly, Errington-Evans (2012) noted that acupuncture may influence stress physiology and has been used as an adjunctive treatment in anxiety disorders.
Herbal medicine approaches in TCM have also been studied for their anxiolytic effects, particularly in relation to sleep and stress modulation, though outcomes vary depending on formulation and diagnostic accuracy.
Conclusion
This case illustrates an integrative clinical approach to chronic anxiety and stress, combining acupuncture and personalised herbal medicine within both biomedical and Traditional Chinese Medicine frameworks.
While not a replacement for conventional psychiatric care where indicated, this approach may offer a useful adjunct for patients with persistent or partially responsive anxiety symptoms.
References
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Hui, K.K.S. et al. (2010). Acupuncture modulates the limbic system and subcortical gray structures of the human brain: evidence from fMRI studies.
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Lee, S.Y. et al. (2009). Acupuncture and autonomic nervous system regulation in stress-related disorders.
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Pilkington, K. et al. (2007). Acupuncture for anxiety and anxiety disorders – a systematic review. Journal of Alternative and Complementary Medicine.
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Errington-Evans, N. (2012). Acupuncture for anxiety: a review of clinical research and neurophysiological mechanisms.
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World Health Organization (WHO). (2010). Benchmarks for training in acupuncture.
