The 5 Primary Types of Anxiety in Traditional Chinese Medicine

My anxiety began back when I was a teenager. Final year high school exams really took over my life, leaving me with a constant pounding in my chest, stomach issues and barely 3 hours of sleep per night. When I went to local GPs, they told me to stop stressing, and that I was working myself up too much. When I finally found Traditional Chinese Medicine, I couldn't believe how many questions my practitioner asked me, how interested they were in my body and the way it worked. They took the time to explain my symptoms and how I was feeling, and I felt actually seen for the first time by a medical Doctor. The following year, I was enrolled in University to study TCM, sleeping like a baby and still learning to manage my anxiety naturally.

In my clinical practice, I frequently meet patients who have been told their anxiety is simply a chemical imbalance that they cannot help, or something to be managed with medication and perhaps some generic stress-reduction techniques. While these approaches can be helpful (and even life-saving!), they often miss the nuanced way anxiety manifests differently in each person.

Traditional Chinese Medicine (TCM) offers a more personalised framework for understanding anxiety, recognising that what we collectively call "anxiety" can actually stem from imbalances in different organ systems. By identifying your specific anxiety pattern, we can develop targeted strategies that address the root cause, not just the symptoms.

Why One-Size-Fits-All Approaches Fall Short

Have you ever wondered why certain anxiety management techniques work wonderfully for some people but do nothing for you? Or why your anxiety presents with physical symptoms that seem unrelated in conventional medicine?

In TCM, this makes perfect sense. Your anxiety isn't just happening in your head—it's a whole-body experience involving specific organ systems and energy pathways. When we understand which systems are involved, we can choose interventions that specifically support those areas.

Have a look at my Instagram Reel below to find which acupressure point suits your anxiety type best!

The Five Primary Types of Anxiety in TCM

1. Heart-Type Anxiety

How it feels: Palpitations, insomnia (especially difficulty falling asleep), being easily startled, dream- disturbed sleep, and anxiety that spikes at night. You might experience a sense of emotional vulnerability or a "racing mind" that prevents sleep.

Root causes: In TCM, this pattern often stems from emotional shock, prolonged stress, blood deficiency (different from Western anemia), or constitutional factors. The Heart houses the Shen (spirit), and when disturbed, emotional equilibrium suffers.

Supportive approaches:

• Acupuncture points that calm the spirit

• Heart-nourishing formulas containing herbs like Suan Zao Ren (Sour Jujube Seed) and He Huan Pi (Albizzia Bark)

• Establishing bedtime rituals that signal safety to the nervous system

• Practices that nourish Heart yin, such as gentle yoga and meditation

2. Spleen-Type Anxiety

How it feels: Overthinking, rumination, digestive issues that worsen with stress, worry about health, and a tendency to "digest" experiences through excessive analysis. Physical symptoms often include bloating, loose stools, and fatigue after mental exertion.

Root causes: Poor diet (especially excessive sugar or cold foods), irregular eating habits, overwork, excessive mental labor, and situations requiring hypervigilance. The Spleen in TCM is responsible for transformation of both food and thoughts.

Supportive approaches:

• Regular, warming meals that support digestion

• Limiting raw and cold foods

• Acupuncture focused on strengthening the middle jiao (digestive center)

• Formulas containing herbs like Bai Zhu (White Atractylodes) and Huang Qi (Astragalus)

• Grounding practices that bring you out of the head and into the body

• Clear boundaries around work and mental exertion

3. Kidney-Type Anxiety

How it feels: Deep existential fear, adrenal fatigue, feeling "wired but tired," lower back weakness, and anxiety that worsens with exhaustion. This type often includes fear of the unknown or catastrophic thinking.

Root causes: Chronic stress depleting kidney energy, constitutional factors, fear, genetic predisposition, and overwork without adequate rest. In TCM, the Kidneys store our most fundamental energy and are associated with willpower and fear.

Supportive approaches:

• Prioritizing rest and sleep

• Gentle but consistent exercise like tai chi or qigong

• Kidney-supporting formulas containing herbs such as He Shou Wu (Fo-Ti) and Gou Qi Zi (Goji Berry)

• Acupuncture focusing on kidney meridians

• Practices that help you feel safe and secure in your body

• Addressing underlying fears with compassionate awareness

4. Liver-Type Anxiety

How it feels: Irritability, tension, headaches (especially at the temples or top of the head), sighing, tightness in the chest, PMS symptoms, and feeling emotionally "stuck." Anxiety often manifests as frustration or being easily triggered.

Root causes: Suppressed emotions (especially anger), irregular lifestyle, hormonal fluctuations, and lack of creative expression. The Liver is responsible for the smooth flow of Qi (energy) throughout the body.

Supportive approaches:

• Regular movement that expresses emotions (dance, martial arts)

• Liver-smoothing formulas containing herbs like Chai Hu (Bupleurum) and He Huan Pi (Albizzia Bark)

• Acupuncture focusing on moving stagnant liver qi

• Creative expression and emotional release practices

• Regular exercise to maintain smooth energy flow

• Addressing suppressed emotions with appropriate support

5. Lung-Type Anxiety

How it feels: Panic attacks with prominent breathing difficulties, shallow breathing even when calm, unresolved grief, skin issues, and a sensation of "not getting enough air." This type often includes themes of loss and difficulty letting go.

Root causes: Unresolved grief, respiratory conditions, boundary issues, and environmental factors. In TCM, the Lungs control the boundary between self and environment and are associated with the emotion of grief.

Supportive approaches:

• Breathing techniques that encourage full exhalation

• Lung-supporting formulas containing herbs like Bai He (Lily Bulb) and Wu Wei Zi (Schisandra)

• Acupuncture focusing on lung meridians

• Grief processing through appropriate therapeutic support

• Boundary work to strengthen sense of self

• Connection with nature, especially forests (forest bathing)

How to Identify Your Type

While proper diagnosis should be done by a trained TCM practitioner, you can start to observe patterns in your anxiety:

• When does it tend to occur?

• What physical symptoms accompany it?

• Which organs or areas of your body feel affected?

• What makes it better or worse?

• Are there emotional themes that frequently arise?

Many people have a primary type with aspects of secondary types. The beauty of this approach is that it's not about fitting perfectly into a single category, but about understanding the unique constellation of factors contributing to your experience.

Beyond Categorization: The Holistic Picture

While these categories provide useful clinical direction, in TCM we always look at the whole person. Your anxiety exists within the context of your constitutional makeup, lifestyle factors, environmental influences, and life history.

In my practice, I combine traditional Chinese diagnostics with functional medicine principles and nervous system support to create deeply nourishing, evidence-based treatments that address anxiety at multiple levels. The goal isn't just symptom management, but a renewed relationship with your body and emotions.

Taking the Next Step

Understanding the type of anxiety you're experiencing is the first step toward meaningful relief. Rather than seeing anxiety as an inconvenience to be suppressed, we can view it as important information— your body communicating its needs in the best way it knows how.

If you're curious about how TCM might help with your specific anxiety pattern, I invite you to book an initial consultation or a free 15 minute discovery call to discuss your options. Together, we'll explore the root causes of your symptoms and develop a personalized treatment strategy that helps you not just cope with anxiety, but truly transform your relationship with it.

Your anxiety has something important to tell you. Let's learn to listen.