Can herbal medicine help people with anxiety, panic & PTSD? - Ask the Herbalist - post-traumatic stress disorder

Townsend Letter for Doctors and Patients, August-Sept, 2002 by Andrew Gaeddert

Everyone experiences fear and anxiety. Fear is a response to an external threat, whereas anxiety can erupt from external events and a person's own thoughts. Anxiety is a stress response that can arise suddenly as in panic, or can occur gradually.

According to the American Heritage dictionary, anxiety is a state of apprehension, uncertainty, and fear resulting from the anticipation of a realistic or fantasized threatening event or situation, often impairing physical and psychological functioning. Panic is a sudden overpowering terror.

Generalized Anxiety Disorder pertains to persistent daily anxiety or worry that interferes with one's life. In addition, there may be three or more of the following symptoms: restlessness, fatigue, concentration problems, irritability, muscle tension, and insomnia. Three to five percent of adults have general anxiety disorder during a given year. Women are twice as likely as men to have this disorder. It has not been proven that repressed conflicts or chemical imbalances cause anxiety although these are popular theories among mental health professionals.

Panic attacks are acute and extreme anxiety in response to a specific situation. Symptoms of panic attack includes a sudden appearance of shortness of breath, a feeling of smothered, or "closed in," heart palpitations, shaking, fear of going crazy or losing control, feeling detached from the environment, dizziness, sweating, and chest pain. It is not uncommon for people to worry that they have a dangerous medical problem. Although panic attacks themselves are not dangerous, it makes sense to seek a physician to rule out other disorders.

Post-traumatic stress disorder (PTSD) is an anxiety disorder caused by exposure to an overwhelming traumatic event experienced by combat veterans, and victims of violent acts, whereby the person repeatedly re-experiences the event. Sometimes a person's symptoms don't begin until months or years after the traumatic event took place. Symptoms include intense fear, hopelessness, and horror. The person reexperiences the trauma in nightmares or flashbacks. The person may have difficulty sleeping or be easily startled. Oftentimes PTSD becomes less severe over time.

Conventional Treatments

Conventional therapies include behavior modification, where the person is exposed to the situation, which causes the fear, panic, and worry. Cognitive behavioral therapy, which emphasizes self help assignments and examining one's thoughts, can be very effective for anxiety, panic and PTSD. (Beck, Judith. Cognitive Therapy: Basics and Beyond. Guilford Press: New York, NY.) Psychiatrists typically recommend drugs such as SSRI's, MAO inhibitors, or trycylic antidepressants alone or in addition to counseling or behavioral therapy. Typical side effects of medications include anxiety, fatigue, gastrointestinal symptom's changes, insomnia, headaches or migraine and sexual dysfunction.

Herbal Approaches

There are several reasons why clients want herbal approaches. Some individuals are afraid of being on antidepressants and other medications for long periods of time, and therefore try herbs first. Other people have not had satisfactory results with typical conventional medications or treatment. Finally, some men and women try conventional drugs, but find their side effects intolerable.

The best way to take herbs is having them administered by a trained herbalist. You may obtain the name of an herbalist from a friend or see resource list. For example, an herbalist trained in Traditional Chinese Medicine (TCM) will note the symptoms of anxiety and panic but will also determine the other symptoms such as nightmares, sweating during the day and at night, mood swings, digestive symptoms, muscle aches, joint pain, sensations of hot and cold. Women may be asked about their period, as well as hormonal changes. ATCM practitioner may examine the patient's face and determine if the client seems especially fearful, timid, or angry. Qualities of the pulse and the tongue are measured. Clinicians may also pay attention to the individual's body type, and speed of movement.

According to TCM, certain lifestyle habits and constitutional factors would predispose one to suffer from panic disorders more than another person. For example, without adequate sleep and mind rest such as Tai Qi, and meditation, one might be more likely to suffer from panic attacks. A poor diet may lead to symptoms such as hot sensations and confusion. Although herbal anti-depressants or sedatives can be administered, well trained herbalists keep in mind constitutional factors when they select herbs. The following examples demonstrate how different patients with panic disorder and PTSD are treated differently by Chinese medicine.

Bob has a hot energetic pattern. He suffers from PostTraumatic Stress Disorder. He feels explosive rage at times; this by itself creates heat. Heat symptoms include his face becoming red, and migraine. Furthermore Bob is always thirsty so he drinks sodas to quench his thirst however, they contain sugar which is warming, and caffeine which removes water which is cooling; thus over time, he is getting dehydrated. In addition, Bob drinks alcohol at night to help him relax and go to sleep. Alcohol is both warming and also a diuretic. Alcohol is known to interfere with sleep so that the rest Bob gets is less than satisfactory, and no wonder he wakes up irritable and groggy and needs plenty of coffee, which is heating, to get going and the whole cycle begins again. During the day, Bob eats fast food, many fried foods, excessive amounts of meats, and sweets. Bob's pulse was rapid and his tongue was red and peeled. These all contributed to heat. In addition to drinking more water and fresh vegetables, we recommended that Bob reduce his alcohol, sweets and fast food intake. We recommended Coptis Purge Fire (Coptis Root Huang Lian, Lophatherum Herb Dan Zhu Ye, Bupleurum Root Chai Hu, Rehmannia Root Sheng Di Huang, Tang Kuei Root Dang Gui, Peony Root Bai Shao, Akebia Trifoliata Root Mu Tong, Anemarrhena Rhizome Zhi Mu, Phellodendron Bark Huang Bai, Gentiana Root Long Dan Cao, Alisma Rhizome Ze Xie, Plantago Seed Che Qian Zi, Scute Root Huang Qin, Sophora Root Ku Shen, Forsythia Fruit Lian Qiao, Gardenia Fruit Zhi Zi, Licorice Root Gan Cao), 2 tablets QID to clear heat and Calm Spirit (3 tablets contain: Magnesium Aspartate (75 mg), Taurine (100 mg) Enzymes: (300 mg) - Amylase, Cere Calase, Protease, Catalase, Alpha-Galactosidase, Lipase, Glucoamylase, Cellulase, Malt Diatase, and Herbs (1,800 mg) -- Biota Seed Bai Zi Ren, Peony Seed Bai Shao, Tang-kuei Root Dang Gui, Fu-shen Sclerotium Fu Shen, Polygala Root Yuan Zhi, Zizyphus Seed Suan Zao Ren, Ophiopogon Tuber Mai Men Dong, Codonopsis Root Dang Shen, Succinum Resin Hu Po ), 2 tablets QID for its heart yin nourishing and stress reducing effects.