Anxiety: I Want to Stop Thinking, but My Body Tenses First

There is a question: “I want to stop thinking, but my body tenses up first, could this be anxiety?” When I assess mental and physical symptoms in the clinic, the first thing I ask about is not how severe they are, but how much time these symptoms have taken away. These are the situations I encounter in the clinic. Some people find that worry has disrupted their sleep and concentration, leading them to repeatedly check and search for information. Others become even more anxious because of palpitations, trembling, or stomach discomfort. The goal of treatment is to reduce physical suffering that has been dismissed as being “all in the mind” and help patients resume sleeping, eating, going out, and working. Before focusing on test names, let’s look at where these symptoms actually interrupt your day.

Before focusing on test names, let us first look at where this symptom actually disrupts your day. An anxiety disorder is a condition in which anxiety persists across various situations beyond temporary worry, disrupting sleep, concentration, relationships, and causing bodily tension. Palpitations, trembling, and gastrointestinal discomfort can have other causes, so we first check the thyroid, heart, low blood sugar, and the effects of medications and caffeine. Rather than waiting for the anxiety to disappear completely, we expand the range in which you can continue necessary conversations, travel, and sleep. The name of a symptom alone does not clearly show what the patient experiences in a day. We will look in sequence at when it began, what it made you give up, and how you recover.

The first thing to examine is “it started for the first time and the cause is unclear.” Important clues include “physical illness, medications being taken, and changes in sleep,” followed by “the necessary evaluation first.” Next is “it has repeated for a long time and daily life has become more limited.” The items to check during the consultation are “activities avoided, recovery time, and treatment response,” and what is needed is an “integrated care plan.” Finally, there is “physical burden remaining during existing treatment.” Here, we check “sleep, heart rate, digestion, and energy,” followed by “a consultation on goals for concurrent care.” By looking at the three axes of mind–body symptoms together, we can distinguish what to reduce first and which recovery to wait for.

We first check the heart, thyroid, low blood sugar, caffeine, and the effects of medications being taken. Even while continuing mental health treatment, Korean herbal medicine care has a treatment goal when anxiety repeatedly causes tension in the heartbeat, breathing, digestion, body heat, and sleep. Write down in chronological order the day the symptoms first appeared and whether changes in medication, illness, work, or relationships came beforehand. Choose one or two activities among sleeping, going to work, traveling, eating, and talking that you actually gave up or delayed.

When deciding on a treatment direction for mind–body symptoms, I look at both the order in which they begin and the order in which they recover. This is because the flow of a patient’s mind–body symptoms, from the first change to the aspect of daily life that returns last, needs to be reflected in the prescription. I explain Korean medicine treatment, which regulates physical hyperarousal and supports recovery of sleep and digestion to create more room to tolerate anxiety before trying to persuade the emotions. I look not only at the content of the worries but also at the order in which palpitations, breathing changes, tension in the upper abdomen, and shoulder stiffness begin. In this process, Korean medicine terms used to describe mind–body symptoms should not be decorative wording; they should serve as criteria for choosing the first focus of treatment among sleep, digestion, cold and heat, and tension.

After treatment, I look at 3 things: “the time it takes for tension to ease,” “recovery of digestion and sleep after anxiety,” and “the time it takes to start an activity.” I prescribe based on what actually changes together with anxiety on difficult days among sleep, appetite, sensations of heat or cold, and fatigue. Korean herbal medicine prescriptions for mind–body symptoms are determined by looking at how sleep and digestion, cold and heat, and fatigue are connected. Acupuncture treatment for mind–body symptoms is also planned by looking beyond stimulating only the uncomfortable area to how quickly the body relaxes after movement and tension. Rather than focusing on a single best day, we will look at whether the number of days when you are less disrupted under similar conditions and recover more quickly is increasing.

Chest pain, fainting, difficulty breathing, thoughts of self-harm, or a state of being unusually elevated despite getting almost no sleep require immediate care from the appropriate service. If you cannot eat or drink, or if it is difficult to maintain safety while driving or working, get the necessary help right away. Safety signals for mind–body symptoms are easiest to remember when kept short and clear. If none of these changes are present, the treatment focus can shift to recurring mind–body symptoms and recovery of daily life.

The record I recommend is simple: 1. the time it takes for tension to ease, 2. recovery of digestion and sleep after anxiety, 3. the time it takes to start an activity. Try recording only these 3 things. In mind–body records, we will look together at the indicators that change first and the aspects of daily life that return last. What the record shows is the daily life regained, rather than numbers. The last item to look at is “the time it takes to start an activity.” This change gives much clearer guidance for the next direction of mind–body treatment.