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Looking for a formula to help with anxiety + insomnia


Hello. I am currently seeing a TCM practitioner for some rather nasty chronic health issues. I’ve made impressive progress but recently I started experiencing some more acute problems that seem to be difficult to budge. I recognize that self-treatment and diagnosis is utterly impossible, but if advisable I thought I would perhaps try something to help with these more immediate problems and maybe even gain some information to report. The symptoms are as follows:

  • anxiety (last night I had my first panic attack)
  • insomnia (trouble going to sleep)
  • uncomfortable tightness in my throat around the base of the neck
  • reflux (no burning, but during the panic attack in particular I was burping and tasting stuff I ate a while ago)
  • general feeling of being unable to relax
  • Mood leaning towards irritation can be present as well, though it feels that the anxiety is the more “core” symptom.

A quirk of the anxiety in particular is that it seems to be worse at night, assuming I’m reading things correctly.

Next I suppose I’ll list my more chronic issues. Again, I’m not looking to even attempt to address these myself but thought I’d list them in the off case the information is relevant to the above problems.

  • severe fatigue
  • stomach problems (main symptom is epigastric pain that can be flaired by diverging from a strict diet. Worse at night. This used to be my #1 complaint but my current practitioner has helped tremendously)
  • head problems: brainfog. Sense of mild distension in the head w/o headaches. Dizziness but not in the sense of vertigo but rather like feeling woozy or lightheaded. Makes physical exertion difficult. When severe I feel “detached”, as if I’m in a dream of sorts.

If a formula recommendation to try isn’t possible any general thoughts would be greatly appreciated. Thanks for your thoughts and time!


Before I try to break this down a little bit, could you clarify by what exactly is involved with your statement:

How long have you been seeing your current practitioner with what frequency of treatments - just acupuncture, or acupuncture and herbal formulas and if herbal formulas, then which ones - over what duration, at what doses and with what specific effects?

Basically, what has resolved or improved and how long has that taken to take place.

Ultimately, however, the best person to ask these questions to is your current practitioner and if they are stumped or feel like they have reached their limit in helping you, then, it would be easiest if they would reach out to us and ask questions. Part of this would be they could describe your issues in more pure TCM terms which is helpful to us as the symptoms are a somewhat less significant detail as they can come from any number of causal factors - as you seem to already understand.

Everything you are describing seems fairly straightforward to treat with acupuncture and Chinese herbal medicine - in general terms. From what you are describing it sounds a lot like damp heat of some nature (liver/spleen) - which can be a layered condition to resolve completely and has to be done in the appropriate order (which is why your practitioner reaching out to us if they feel limited would be much easier; so we can discuss it in more practitioner level terminology).


Firstly, thank you so much for your time and help!!!

To begin with I think I should fill in some blanks. To summarize my health history: I was diagnosed with autoimmune hepatitis about 15 years ago -> put on immunosuppressant drugs -> condition rapidly deteriorated -> Lyme disease suspected and treated -> dramatic improvement -> relapse (currently here).

Over the course of my life I’ve taken an obscene amount of antibiotics, which presumably lead to my former #1 complaint: severe epigastric pain that doctors could not help. The severity could get to the point I didn’t want to live anymore and the only thing that (sometimes) helped was pain management (tramadol, hydrocodone).

When I state that “I’ve made impressive progress” I refer to the fact that this pain is now much improved.

It has been roughly a year.

Treatment involves herbal formulas taken via decoction x2 a day.

Unfortunately I don’t have a list of herbs and the formula is tweaked every week. However, I do know that one of the goals of my treatment is to “gently supplement Yin”. I believe that stomach Yin is a priority here. I do know that some herbs are very common, though this list is not comprehensive:

  • Sha Shen
  • Mai Men Dong
  • Wu Mei (I have thirst issues)
  • Sha Ren

Some others I have taken include:

  • Chen Pi
  • Dan Shen
  • Mai Ya
  • Shan Zha
  • Fu Ling
  • Ban Xia

And so on. More recently Dai Zhe Shi and Xuan Fu Hua (I think?) were added for reflux but only brought temporary relief.

My epigastric pain is much improved and I can eat a wider variety of foods now. This process took around 7-9 months. Only recently have other symptoms become my #1 concern. Fatigue and brainfog have remained constant.

OK! I cannot thank you enough for taking the time to help. My mind is more clear now and I think I know what to talk to my practitioner about. I try really hard but with my fatigue/brainfog it can be difficult to communicate well, so this week I’m going to try to restate what is currently happening and go from there.

I’ve taken note that your clinic is just within driving distance, so that may be something to consider if I have further difficulty getting over the current plateau. I’d be more than happy to hear any other thoughts/advice you have, though I feel I’ve already taken up enough of your time.

Thanks again!

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