Anxiety - Wokingham, Berkshire

On this page

1. Overview
2. Types of anxiety
3. Symptoms
4. Causes
5. Anxiety in Chinese medicine
6. Acupuncture for anxiety
7. Chinese herbal medicine for anxiety
8. Self-care
9. Treatment at my clinic
10. Frequently asked questions
11. References

1. Overview

Anxiety disorders are the most common mental health conditions worldwide, affecting an estimated 284 million people globally and ranked 24th in terms of disability-adjusted life years (DALYs). Anxiety is characterised by excessive, persistent worry or fear that is disproportionate to the actual threat, and which is difficult to control. When anxiety is sustained and interferes significantly with daily functioning, it is classified as an anxiety disorder. The prevalence of anxiety disorders has increased significantly since the COVID-19 pandemic, with global prevalence estimated at 26% in 2020.

Conventional treatment relies primarily on antidepressant medication (particularly SSRIs and SNRIs) and cognitive behavioural therapy (CBT). While these are effective for many people, a significant proportion do not respond adequately, and medication carries side effects including sleep disruption, sexual dysfunction, weight changes and a high relapse rate on discontinuation. Acupuncture and Chinese herbal medicine offer evidence-based alternatives and adjuncts to conventional treatment, working through the nervous system, neuroendocrine axis and the framework of traditional Chinese medicine (TCM) to calm the mind and address the root causes of anxiety without significant adverse effects.

2. Types of anxiety

Anxiety presents across a spectrum of clinical subtypes, each with distinct features that guide both conventional diagnosis and TCM pattern differentiation:

1. Generalised anxiety disorder (GAD) — persistent, excessive worry about multiple everyday concerns (work, health, finances, relationships) that is present more days than not for at least six months and is difficult to control. The most common anxiety disorder in adults
2. Panic disorder — recurrent, unexpected panic attacks characterised by sudden surges of intense fear accompanied by physical symptoms (racing heart, chest tightness, breathlessness, dizziness), often triggering avoidance behaviours and anticipatory anxiety
3. Social anxiety disorder — marked fear of social or performance situations where the person fears embarrassment, humiliation or negative evaluation, leading to avoidance of social situations
4. Health anxiety (hypochondria) — preoccupation with having or developing a serious illness despite medical reassurance, frequently accompanied by body-checking and healthcare-seeking behaviours
5. Perioperative and procedure-related anxiety — acute anxiety triggered by upcoming medical procedures, surgery or investigations. Auricular acupuncture has particularly strong evidence in this clinical context
6. Anxiety secondary to other conditions — anxiety associated with chronic illness, hormonal changes (including menopausal symptoms), chronic stress, insomnia and fertility concerns

3. Symptoms

Anxiety manifests in psychological, physical and behavioural dimensions. Common symptoms include:

1. Persistent excessive worry, rumination and difficulty switching off the mind
2. Restlessness, feeling on edge or easily startled
3. Physical symptoms: racing or pounding heart (palpitations), chest tightness, shortness of breath, trembling, sweating and dizziness
4. Muscle tension, aching and headaches
5. Difficulty sleeping — either getting to sleep or waking with the mind racing in the early hours
6. Gastrointestinal symptoms including nausea, IBS-type symptoms and changes in appetite
7. Fatigue and difficulty concentrating
8. Avoidance behaviours — withdrawing from social situations, work commitments or activities that trigger anxiety
9. In severe cases, panic attacks and an inability to leave the house, use public transport or engage in normal daily life

4. Causes

Anxiety arises from a complex interplay of biological, psychological and environmental factors:

1. Dysregulation of the stress response — anxiety reflects a state in which the body’s fight-or-flight response is chronically activated, with elevated cortisol and sympathetic nervous system arousal that does not switch off. The amygdala, which registers threat, and the prefrontal cortex, which provides rational context, become dysregulated
2. Neurotransmitter imbalances — reduced GABA (the brain’s primary calming neurotransmitter), disruption to serotonin and dopamine signalling, and excess noradrenaline drive the neurochemical basis of anxiety
3. Chronic stress and overactivation — sustained psychological pressure from work, relationships, financial pressures or existential concerns sustains the anxiety state. Modern life’s non-stop information environment — constant news, social media and digital stimulation — trains the mind into a state of hypervigilance and difficulty resting
4. Blood and Yin deficiency — in TCM terms, anxiety often arises when the Heart and Liver fail to hold and anchor the Mind (Shen) due to insufficient Blood or Yin. Women are particularly susceptible around their menstrual cycle when they lose Blood, and this physiological depletion can directly worsen anxiety
5. Genetic and constitutional factors — a family history of anxiety, a naturally sensitive temperament and prior adverse experiences all increase vulnerability
6. Sleep deprivation — poor sleep and anxiety are mutually reinforcing: anxiety disrupts sleep, and sleep deprivation increases cortisol and amygdala reactivity, worsening anxiety
7. Physical health conditions — thyroid disorders, hormonal imbalances, chronic pain and certain nutritional deficiencies can all generate or worsen anxiety symptoms

5. Anxiety in Chinese medicine

In traditional Chinese medicine, anxiety is understood primarily as a disturbance of the Shen — the Mind — which is housed in the Heart. When the Heart has sufficient Blood and Yin to anchor the Shen, the mind is calm, clear and able to rest. When Blood or Yin are deficient, the Shen becomes restless, floating and unanchored, manifesting as anxiety, worry, rumination and insomnia. The main TCM patterns seen in anxiety are:

1. Heart Blood deficiency — the most common pattern in anxiety, particularly in women. Insufficient Heart Blood means the Shen has no firm resting place and becomes agitated. Signs include palpitations, poor memory, light and unrefreshing sleep, pale complexion, fatigue and a tendency to be easily startled. Often seen in women who worry excessively and feel run down
2. Heart and Kidney not communicating (Heart & Kidney Yin deficiency) — Kidney Yin fails to rise and cool the Heart, leaving Heart Fire unanchored. Signs include insomnia with vivid dreams, palpitations, hot flushes, night sweats, anxiety that worsens in the evening, and a feeling of heat in the chest. Common in adults with chronic anxiety, particularly perimenopausal women
3. Liver Qi stagnation — the most common pattern in stress-related anxiety. When the Liver fails to ensure the smooth flow of Qi through the body, emotional tension builds. Signs include a sensation of chest tightness or throat constriction, sighing, irritability, premenstrual anxiety, and physical tension. This pattern directly corresponds to the fight-or-flight overdrive of modern life. Associated with digestive symptoms such as IBS
4. Liver Fire and Phlegm-Fire harassing the Heart — when Liver Qi stagnation generates Heat over time, or when a hot, rich diet generates Phlegm-Fire, the resulting pattern drives more intense anxiety, agitation, insomnia with nightmares, panic attacks, a bitter taste in the mouth and a feeling of heat. Corresponds to more severe, persistent anxiety with pronounced physical symptoms
5. Spleen and Heart deficiency — worry (the emotion associated with the Spleen in TCM) weakens Spleen Qi, which in turn fails to produce sufficient Blood to nourish the Heart. A pattern of pensiveness, overthinking, poor appetite, fatigue, loose stools and chronic low-level anxiety. Common in students, academics and people in intellectually demanding jobs

6. Acupuncture for anxiety

Acupuncture addresses anxiety through multiple, well-documented mechanisms: modulating the autonomic nervous system to reduce sympathetic (fight-or-flight) overdrive and enhance parasympathetic (rest-and-digest) tone; stimulating the release of endogenous opioids, serotonin and GABA; regulating the hypothalamic-pituitary-adrenal (HPA) axis to reduce cortisol; and, via auricular acupuncture, directly influencing vagal nerve activity. Key acupoints used for anxiety include PC6 (Neiguan), HT7 (Shenmen), GV20 (Baihui) and SP6 (Sanyinjiao), all of which have documented effects on reducing sympathetic hyperactivity and calming the nervous system. I have personally helped patients with severe anxiety — including those unable to leave the house, travel by public transport or return to work — regain a normal life through acupuncture treatment.

Research evidence

A systematic review and meta-analysis by Yang et al. (2021), published in Annals of General Psychiatry, included 20 RCTs on acupuncture for generalised anxiety disorder (GAD) and found that acupuncture was significantly more effective than control conditions, with a standardised mean effect size of −0.41 and no serious adverse events. A systematic review and meta-analysis of electroacupuncture by Hong et al. (2023), published in Frontiers in Psychology, confirmed significant reductions in anxiety as measured by the Hamilton Anxiety Rating Scale (HAMA) and the Self-Rating Anxiety Scale (SAS), and identified that points PC6, GV20, SP6 and HT7 were most frequently used and most clinically effective. A comprehensive systematic review by Cheng et al. (2025), published in Annals of General Psychiatry and covering the most rigorous and up-to-date evidence for acupuncture in GAD, found that acupuncture combined with medication significantly improved HAMA scores over medication alone (MD −2.26, 1,390 participants) with consistently better outcomes across different treatment courses. An earlier systematic review and meta-analysis by Wang et al. (2001) on auricular acupuncture confirmed its potential as a treatment for anxiety in the perioperative setting, supporting the original reference on this page.

I am a qualified and registered acupuncturist, a member of the British Acupuncture Council, and I use acupuncture alongside moxibustion where appropriate in the treatment of anxiety. To get the most from acupuncture treatment, always ensure you see a fully licensed and registered acupuncturist.

7. Chinese herbal medicine for anxiety

Chinese herbal medicine provides a daily therapeutic stimulus to address the underlying TCM patterns driving anxiety, and is particularly effective for chronic, persistent or severe anxiety where frequent acupuncture sessions alone may be insufficient. A major systematic review and meta-analysis published in 2025, covering 92 RCTs of Chinese herbal medicine (CHM) versus anxiolytic medication for generalised anxiety disorder and related conditions, found that CHM was significantly more effective than medication in reducing anxiety (Hamilton Anxiety Rating Scale Mean Difference −1.50 points) and produced dramatically fewer adverse events (incidence rate ratio 0.33, meaning the medication group had three times as many adverse events). This evidence base supports CHM as a first-line or adjunct treatment for anxiety, particularly for patients who cannot tolerate or do not wish to take pharmaceutical anxiolytics.

Key formulas used for anxiety in TCM include: Tian Wang Bu Xin Dan (Emperor of Heaven’s Special Pill to Tonify the Heart) for Heart and Kidney Yin deficiency with prominent insomnia, palpitations and night sweats; Gui Pi Tang (Restore the Spleen Decoction) for Heart Blood and Spleen Qi deficiency with worry-driven anxiety and fatigue; Xiao Yao San (Free and Easy Wanderer) for Liver Qi stagnation — the most commonly prescribed formula for stress-related anxiety, with a systematic review of 14 RCTs confirming its efficacy and safety for anxiety disorders (Wang et al., 2023); Long Dan Xie Gan Tang for Liver Fire and Phlegm-Fire patterns with more intense anxiety and agitation; and Suan Zao Ren Tang for Heart Blood deficiency with prominent insomnia alongside anxiety. Individual herbs with documented anxiolytic effects include Suan Zao Ren (Ziziphus/jujube seed), Bai Zi Ren (Biota seed), Fu Shen (Poria with wood), Yuan Zhi (Polygala root) and Long Gu (Dragon bone/fossil).

I prescribe pharmaceutical-grade Chinese herbal granules from Sun Ten (Taiwan), independently tested for purity and safety. For patients who cannot attend the clinic in person, online Chinese herbal medicine consultations are available with herbs dispensed by post.

8. Self-care

The following strategies support the effects of acupuncture and herbal treatment and address the lifestyle factors that sustain anxiety:

1. Mindfulness and meditation — regular mindfulness practice directly reduces amygdala reactivity, lowers cortisol and strengthens the prefrontal cortex’s ability to regulate anxious thoughts. Even ten minutes daily produces measurable neurological changes over weeks. In TCM terms, mindfulness calms the Shen and stills the overactive mind
2. Regular physical exercise — aerobic exercise is among the most evidence-supported interventions for anxiety, reducing cortisol, increasing GABA and serotonin, and providing a healthy outlet for the physical energy of sympathetic nervous system activation. A minimum of 30 minutes of moderate exercise three times per week is recommended
3. Reduce information overload — habitual checking of social media, news and devices trains the mind into a state of constant alertness and vigilance. Setting clear boundaries around screen use, particularly in the hour before bed, directly reduces anxiety. Reducing news consumption is beneficial, as most news content is designed to provoke threat-activation responses
4. Prioritise sleep — sleep deprivation directly worsens anxiety. A consistent bedtime before 10pm, a cool dark bedroom and a wind-down routine without screens supports the quality of sleep required to regulate anxiety the following day
5. Reduce stimulants — caffeine, alcohol and energy drinks all worsen anxiety. Caffeine directly increases cortisol and sympathetic nervous system arousal; alcohol initially reduces anxiety but generates rebound anxiety as it clears. Both should be reduced or eliminated where anxiety is a significant problem
6. Breathing practices — slow diaphragmatic breathing (extended exhalation, e.g. breathing in for 4 counts and out for 8) directly activates the vagus nerve and shifts the nervous system into parasympathetic mode. This can be used in the moment during anxiety episodes as well as as a daily practice
7. Time in nature — regular time outdoors, particularly in green or natural settings, reduces cortisol and activates the parasympathetic nervous system. In TCM terms, connecting with the natural world nourishes the Liver and allows Qi to move freely

9. Treatment at my clinic

I treat anxiety, generalised anxiety disorder, panic disorder and stress-related anxiety at my clinics in Wokingham, Berkshire. Online Chinese herbal medicine consultations are also available for patients who cannot attend in person.

Treatment uses acupuncture and Chinese herbal medicine tailored to the individual’s specific TCM pattern, combined with lifestyle guidance. Most patients notice a significant reduction in anxiety symptoms within four to six weekly sessions, with deeper and more sustained improvements over the following two to three months of treatment. Treatment works safely alongside conventional medication and psychological therapy — there is no need to stop existing treatment to benefit from TCM. Anxiety often presents alongside depression, insomnia and stress, and TCM is well-placed to address these as a whole. Visit the prices page for treatment costs.

10. Frequently asked questions

Can acupuncture help with anxiety?

Yes. Acupuncture has a strong and growing evidence base for the treatment of anxiety. A systematic review of 20 RCTs found that acupuncture was significantly more effective than control conditions for generalised anxiety disorder, with no serious adverse effects. A 2025 systematic review confirmed that acupuncture combined with medication significantly outperformed medication alone in reducing anxiety scores across nearly 1,400 participants.

How many acupuncture sessions are needed for anxiety?

Most people notice meaningful improvement in anxiety symptoms within four to six weekly sessions. Deeper or more chronic anxiety typically benefits from a course of eight to twelve sessions, with ongoing monthly maintenance thereafter to sustain improvement. Combining acupuncture with Chinese herbal medicine accelerates improvement by providing a daily therapeutic stimulus.

Can Chinese herbal medicine help with anxiety?

Yes. A large systematic review covering 92 RCTs found that Chinese herbal medicine was significantly more effective than anxiolytic medication for GAD, and produced far fewer adverse events. Chinese herbal medicine addresses the specific TCM pattern underlying each person’s anxiety — whether Heart Blood deficiency, Liver Qi stagnation or Yin deficiency with Shen disturbance — making it a powerful and personalised anxiolytic treatment.

Is acupuncture safe to use alongside anxiety medication?

Yes. Acupuncture is very safe to use alongside SSRIs, SNRIs, benzodiazepines and other anxiety medication, and does not interfere with how these medications work. Many patients use acupuncture as an adjunct to help reduce the dose of medication they need, under medical supervision. There is no need to stop existing treatment to benefit from TCM.

Does acupuncture work for panic attacks?

Yes. Acupuncture reduces sympathetic nervous system overdrive and modulates the autonomic nervous system dysregulation that underlies panic attacks. Regular treatment reduces the frequency and intensity of panic episodes, and specific acupoints can be taught for self-use between sessions to support the parasympathetic response during a panic episode.

Can anxiety be treated without medication?

Many people manage anxiety effectively without medication, using a combination of acupuncture, Chinese herbal medicine, psychological therapy and lifestyle changes. Research shows that Chinese herbal medicine is more effective than anxiolytics for GAD with fewer side effects, making it a credible non-pharmaceutical option. Whether medication is appropriate depends on the severity of symptoms and is a decision to make with your GP or psychiatrist.

11. References

Wang SM, Peloquin C, Kain ZN. Auricular acupuncture: a potential treatment for anxiety. Anesth Analg. 2001 Feb;92(2):548–553. https://doi.org/10.1213/00000539-200102000-00049.

Yang XY, Yang NB, Huang FF, Ren S, Li ZJ. Effectiveness of acupuncture on anxiety disorder: a systematic review and meta-analysis of randomised controlled trials. 20 RCTs, generalised anxiety disorder. Ann Gen Psychiatry. 2021 Jan 30;20(1):9. https://doi.org/10.1186/s12991-021-00327-5. PMID: 33516258.

Hong WK, Kim YJ, Lee YR, Jeong HI, Kim KH, Ko SG. Effectiveness of electroacupuncture on anxiety: a systematic review and meta-analysis of randomized controlled trials. Front Psychol. 2023 Dec 19;14:1196177. https://doi.org/10.3389/fpsyg.2023.1196177. PMID: 38173848.

Wang Y, Chen X, Wei W, Ding Y, Guo R, Xing J, Wang J. Efficacy and safety of the Chinese herbal medicine Xiao Yao San for treating anxiety: a systematic review with meta-analysis and trial sequential analysis. 14 RCTs. Front Pharmacol. 2023 Oct 5;14:1169292. https://doi.org/10.3389/fphar.2023.1169292. PMC10613521.

Cheng X, et al. Efficacy of acupuncture for generalized anxiety disorder: a systematic review. Ann Gen Psychiatry. 2025;24. 92 RCTs, acupuncture plus medication superior on HAMA scores (MD −2.26, 1,390 participants). https://doi.org/10.1186/s12991-025-00614-5. PMC12664193.