Acupuncture for Anxiety: Part 1 – Yin and Yang

By Corey Bacon

Acupuncture for Anxiety: Part 1 – Yin and Yang

As an acupuncturist that sees a lot of Veterans, anxiety is one of the main symptoms I treat as a support for PTSD and CPTSD treatment. However, anxiety is much more prevalent than people know. So many people think anxiety is all about panic attacks or extreme unexpected responses to normal stimuli that they don’t recognize they are anxious. I see people for fertility, chronic pain, digestive issues, depression, and autoimmune disorder with anxiety as a big player in whatever problem they’re facing.

It used to be taught (and still is sometimes) that there were two branches of the nervous system: the Sympathetic Nervous System (SNS) that dealt with stress and created the Fight or Flight Response, and the Parasympathetic Nervous System (PSNS), that dealt with non-stressful situations and created the Rest and Digest Response. We are finding that’s not entirely accurate. The SNS is the Yang (heating, raising, increasing) aspect, and the PSNS is the Yin (cooling, lowering, decreasing) aspect of the nervous system. Like Yin and Yang, the two parts of the nervous system are separate AND work together. In addition, they both have stress and non-stress responses.

The Yang Response + Anxiety

We all know about Fight or Flight, where your blood pressure and heart rate go up, and your chest gets tight, as in a classic panic attack. The Yang/SNS, Fight or Flight response, is the same thing that triggers a veteran of the war to dive for cover when they hear a balloon pop or some other loud unexpected stimulus. Fight or Flight can look like a panic attack but can also cause more subtle signs of chronic anxiety like:

  1. elevated heart rate
  2. night sweats
  3. fidgeting (as the body tries to rid itself of excess energy)
  4. chronic high blood pressure/high heart rate
  5. nervous tics
  6. restless legs


In my experience, there’s another Yang stress response I call “Think.” In this response, the body shunts its energy to the head for problem-solving. Some signs of anxiety with this response are: overthinking 

  1. worrying
  2. circular thinking that doesn’t seem to end
  3. obsessions


There are other signs of anxiety that we don’t think of. As I mentioned, this Yang response raises energy to the head, so in addition to overthinking, we also get extra Qi in the head, causing:

  1. congestion and tension giving rise to tight neck and shoulders
  2. tension headaches
  3. migraines
  4. vertigo from excess
  5. intense loud tinnitus


These are all excess Yang responses to fear. Also, it’s important to note that excess Yang means less Yin. Since the Yin governs Rest and Digest, it is difficult for your body to listen to that part of the nervous system when you are in the excessive Yang fear response. You might experience:

  1. insomnia
  2. night sweats
  3. increased anxiety at night
  4. acid reflux
  5. diarrhea
  6. constipation
  7. nausea
  8. low appetite
  9. inability to relax


Yes, all the above symptoms can indicate other things as well, but they are all common symptoms of what I would call anxiety, or the body’s attempts to cope with FEAR. 


The Yin Response + Anxiety

The Yin also has its own responses to fear. These days, in addition to Fight or Flight, the Freeze or Fawn response has been added for overwhelming fear. In the Freeze response, the body shuts down. Yes, this can look like temporary paralysis, but more commonly seen with milder symptoms, including those of depression (one of the many reasons why anxiety and depression are diagnosed together), like:

  1. chronic fatigue
  2. oversleeping with great difficulty
  3. waking up
  4. isolation and antisocial behavior


Fawn is the response where the person tries to appease their attacker. Chronically this looks like:

  1. people pleasing
  2. hyper caretaking (think of an overbearing mother)
  3. excessive house cleaning and cooking


Yin also has other fear responses that we don’t think about. The PSNS is tied to digestion and elimination, so we might see:

  1. overeating
  2. excessive urination
  3. frequent bowel movements


Yang is warming and increases blood pressure and heart rate, so people stuck in Yin-type anxiety responses might experience:

  1. very cold hands and feet
  2. the core of their body may get chilled easily, making it difficult to warm up
  3. low blood pressure
  4. dizziness/vertigo
  5. low heart rate with low energy


Another common anxiety response from Yin is excessive emotions of sadness. Crying can get you out of a speeding ticket, but being trapped in a cycle of crying because you’re trapped in the hyper Yin mode of protecting yourself from fear can be exhausting. People stuck here get overwhelmed to the point of tears by very minimal stressors.

Like Yang responses, with extreme Yin responses to fear, the Yang system shuts down. Since Yang is related to Fight or Flight, a person with Yin anxiety might be unable to stand up for themselves or set reasonable boundaries. Also, there might not be much physical energy for anything.

As I said above, these symptoms can all come from other causes, but I see them often relating to anxiety. 

The situation is often more complex, especially when trauma, PTSD, and CPTSD are involved. The patient will experience both Yin and Yang-type anxiety symptoms with this complexity. A common example is during the day, the person might feel tired and groggy but suddenly, at bedtime, get a burst of energy with a racing mind and night sweats. Another common example is digestion; it’s very common to see someone with high anxiety alternating between constipation and diarrhea as the digestive system goes from being off to hyper-function or, conversely, from a cold sluggish state to a hot and irritated state. Sometimes these things happen because the person is vacillating between Yin and Yang responses to fear. Other times it’s a sign that a person has been functioning in a Yang-type response for so long that their body is running out of energy to keep them in that state, so they hyper-function in the Yang/SNS state and then crash into a Yin/PSNS state.

The first goal of acupuncture for anxiety treatment is to balance Yin and Yang, a crucial tenant of Chinese Medicine. In part 2, I will discuss a simplified version of treating these types of anxiety, including some suggestions patients might use at home.

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