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  • Alison Dalziel

Lockdown - Anxiety or FEAR?

If the easing of Lockdown restrictions has affected you, or made you feel more anxious...you’re not alone.



During the past few months I have been able to treat patients with many different complaints in my clinic but in the last few weeks there has been a noticeable rise in the number of patients seeking help with symptoms of anxiety and depression. This may seem counter intuitive to the fact that lockdown restrictions are being eased. You'd even be forgiven for assuming that most people would be excited about planning days out, trips to see friends, going to the pub etc. But it seems that the reality may be somewhat different.


It appears that feeling like you haven’t achieved enough; having concerns over meeting people again; worrying over what to say in a social situation; feeling anxious about going out and wanting to just stay at home are all fairly common emotions right now. But how do these emotions affect us and what can we do about it?



The link between Anxiety and fear


Anxiety seems to creep up on us when we aren't looking and often people don’t realise that anxiety is at the root of their particular complaint. Western and Chinese medical viewpoints coincide when considering fear and anxiety and both approaches recognise that they are linked in their physiological responses. The two disciplines also appear to agree that anxiety has its root in fear.

Fear is defined as “the unpleasant emotional state consisting of psychological and psychophysiological responses to a real external threat or danger”, whereas anxiety is defined as a “multi-system response to a perceived threat or danger” (Dorland’s Medical Dictionary for Health Consumers, 2007).

The clear defining difference between the two is whether the threat is real or perceived.


The “stress response” is controlled by the Hypothalamus-Pituitary-Adrenal (HPA) axis which prepares the body to protect itself from danger and occurs alongside a feeling of fear. (We know it as “fight or flight”). However, recent literature suggests that sustained perception of threat (in other words, continuous worry), has the same effect on the physiology as the stress response, but with potentially harmful consequences. Problems arise when this perception of threat becomes the norm, resulting in a chronic stress response within the body and a steady release of the hormone cortisol. The immune system becomes suppressed by the high levels of cortisol in the blood, possibly resulting in disorders such as irritable bowel syndrome, hypertension, rheumatoid arthritis, depression and an increased risk of chronic disease development.


There is a subtle difference between fear and anxiety, in that anxiety is regarded as something which occurs prior to a stressful stimulus, whereas fear occurs after a stressful stimulus, resulting from an identifiable provocation.


So...is our worry based on something which has happened or on something which might happen? Most of the time you can probably identify with the second option. But you’ll notice that these two are inextricably linked in that the reason we worry is because we are afraid (fear) of something happening/not happening. We believe that if we cover every option or possible outcome, then we’ll be safe, as we will have a plan on how to deal with things. This is how we develop a craving for certainty. Dr Lissa Rankin has written a book about this called 'The Fear Cure' and I highly recommend it.


Acupuncture and Chinese Medicine


Chinese medicine differs somewhat from Western Medicine in that it considers the emotions as causes of internal disease and within that, fear is given a high-ranking position. The Kidneys and the emotion of fear are associated with the element of Water. Fear manifests itself in many ways including yin responses such as constant obsessive vigilance; diminished drive and will; focussing on phobias and becoming paranoid; and yang responses such as excessive drive and need to win; superiority complexes and bullying or intimidating behaviour. Consequently, it can be seen how many different types of behaviour may have their root in fear. This corresponds to observations made by Elizabeth Rossi, who links fear with the most profound yin and believes it to be the root of all other pathological emotions.

There appears to be a general consensus (in Chinese medicine literature) that fear makes the qi descend (just think about what happens when you’re really scared!), whilst anxiety makes it rise, perhaps alluding to their yin and yang interconnectedness and complementary but opposing qualities.


Acupuncture has helped many cases of anxiety and recently I have been fortunate to help people who have responded well to treatments for this debilitating condition. If you or someone you know is experiencing difficulties with anxiety, acupuncture may be worth considering.


The British Acupuncture Council states -

Research has shown that acupuncture treatment may specifically benefit anxiety disorders and symptoms of anxiety by:

  • Acting on areas of the brain known to reduce sensitivity to pain and stress, as well as promoting relaxation and deactivating the 'analytical' brain, which is responsible for anxiety and worry.

  • Regulating levels of neurotransmitters (or their modulators) and hormones such as serotonin, noradrenaline, dopamine, GABA, neuropeptide Y and ACTH; hence altering the brain's mood chemistry to help to combat negative affective states.

  • Stimulating production of endogenous opioids that affect the autonomic nervous system. Stress activates the sympathetic nervous system, while acupuncture can activate the opposing parasympathetic nervous system, which initiates the relaxation response.

  • Reversing pathological changes in levels of inflammatory cytokines that are associated with anxiety.

  • Reversing stress-induced changes in behaviour and biochemistry.

Acupuncture can be safely combined with conventional treatments such as medication or psycho-educational therapy, possibly enhancing their beneficial effects and reducing unwanted side-effects.





References:


Kirkwood, J. (2016) The Way of the Five Seasons. London: Singing Dragon


Rossi, E (2007) Shen. Psycho-emotional Aspects of Chinese Medicine. London: Churchill Livingstone.


Rankin, L (2015) The Fear Cure. Cultivating courage as medicine for the body, mind and soul. London: Hay House


The British Acupuncture Council (2021) a-z of conditions.

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