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Social Anxiety


#1

I'm a new acupuncture student and I'm only working on patient diagnosis (not needling yet) but I'm curious about this one case: I have a patient who seems to have social anxiety, however she's not afraid to be talking to people. She suffers from extreme blushing, sweating and hives when in one-on-one interactions (these all occured as I was questioning her....which she said is usually the case). She said she's not afraid of the situation, but her body seems to act nervous even though she doesn't feel nervous emotionally. She said it began after using Xenadrine (which contained Ephedra) and she describes it as "I feel like my nervous system just doesn't work anymore". She said she had been seeing another acupuncturist for it but it hasn't helped. The points she showed me she was needled seem to be anxiety points...SP 6, KD6, PC7. Any suggestions?


#2

Social phobias are certainly an interesting case as many times people can rationally think through the situation and tell themselves to be calm, yet it still will not happen. Cognitive behavioral therapy is often very helpful along with acupuncture treatment. This patient, however, having a symptom that started after taking an herbal formula is a little different. From a practitioner perspective your goal is to figure out whether some damage happened to her system from the formula or whether this just simply brought out something that was already in her just not to as strong of a degree. The way to do this is by questioning, of course, but also your sense and matching up her other signs and symptoms, tongue, pulse, palpation, etc.


Certainly high doses of ephedra can cause damage to the adrenals which would lead to some of these sensations. Why they are brought out around people is anyones guess, as you would expect them to be experienced more often. Treatment wise from that perspective would be to focus on the Kidneys - either yang or yin depending on other symptoms.


If this brought out something that was already in her psyche, then the treatment may still involve the kidneys, but could also involve other symptoms. Personally I would start by following our protocol for anxiety/adhd and adding in points such as KD 3, SP 6, and others based on her overall tcm diagnosis to stabilize her energy.


#3

maybe she need a psychologist to treat her.


Thank you


Regards


Feng Mei


#4

I treated a patient a year or so ago who had very similar symptoms. Of course, you need to do a full Chinese diagnosis and treat on the basis of that, but there is clearly some heat there, and in the case of my patient I diagnosed Yin deficiency. Points such as Kid3, Sp6, Ht7 would be useful to nourish Yin. Also Kid1 to draw down Yang from the head and calm the mind.


Although she says she is not afraid of the situation I wonder if there is some underlying psychological or enmotional issue which she isn't aware of? Some kind of psychological therapy would probably help in this case.


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