Anxiety disorders
Also known as: anxiety disorder, generalised anxiety disorder, generalized anxiety disorder, panic disorder, panic attacks, social anxiety disorder, specific phobia, agoraphobia, separation anxiety disorder, health anxiety, excessive worry
Anxiety disorders are mental health conditions involving excessive fear, worry, apprehension or avoidance that persists, is difficult to control or significantly interferes with daily functioning. They include generalised anxiety disorder, panic disorder, social anxiety disorder, agoraphobia, specific phobias and separation anxiety disorder. Symptoms may include persistent worry, restlessness, irritability, muscle tension, poor concentration, disturbed sleep, palpitations, sweating, trembling, nausea, breathlessness, dizziness and a sense of impending danger. Panic attacks are sudden episodes of intense fear accompanied by physical symptoms, but chest pain, breathing difficulty, fainting and palpitations must not automatically be assumed to be anxiety. Medical conditions, medicines and substances can produce or worsen anxiety, including thyroid disease, cardiac arrhythmia, asthma, hypoglycaemia, anaemia, vestibular disorders, stimulant use, alcohol withdrawal and medication effects. Assessment should consider symptom pattern, functional impairment, physical health, trauma exposure, depression, bipolar disorder, obsessive-compulsive symptoms, substance use and suicide risk. Evidence-based treatment commonly includes psychoeducation, cognitive behavioural therapy, exposure-based interventions, other appropriate psychological therapies and, for some patients, medicines such as selective serotonin reuptake inhibitors or serotonin-noradrenaline reuptake inhibitors. Benzodiazepines are generally unsuitable as routine long-term treatment because of tolerance, dependence, withdrawal and impairment risks. Acupuncture may be considered as adjunctive support for selected symptoms such as tension, sleep disturbance or autonomic arousal, but it must not replace psychological treatment, medical assessment or prescribed medicine. TCM patterns commonly include Liver Qi stagnation, Heart and Gallbladder Qi deficiency, Heart-Spleen deficiency, Yin deficiency with Empty Heat, Phlegm-Heat disturbing the Heart, Heart-Kidney disharmony and Blood stasis. [1][2][3][4][5][6]
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Lifestyle & Diet
- •Seek professional assessment when anxiety persists, causes avoidance or interferes with work, relationships, sleep, study or self-care.
- •Evidence-based psychological treatment, particularly cognitive behavioural and exposure-based approaches, can be effective.
- •Take prescribed medicines consistently and discuss adverse effects with the prescriber.
- •Do not stop antidepressants or benzodiazepines suddenly unless directed by a clinician.
- •Benzodiazepine withdrawal may be dangerous and should be medically supervised.
- •Limit excessive caffeine, energy drinks, nicotine and stimulant products.
- •Avoid using alcohol, cannabis or non-prescribed sedatives to manage anxiety.
- •Maintain regular sleep and waking times.
- •Engage in regular physical activity appropriate to health and ability.
- •Eat regular balanced meals and maintain hydration.
- •Use slow, comfortable breathing rather than repeated deep over-breathing, which may worsen light-headedness.
- •Practise grounding, mindfulness or relaxation as complements to treatment.
- •Avoid repeatedly checking pulse, oxygen levels or bodily sensations when this reinforces health anxiety.
- •Reduce reassurance-seeking gradually with therapeutic guidance.
- •Approach feared situations through a planned, graded strategy rather than indefinite avoidance.
- •Do not use unplanned exposure during severe distress or trauma-related instability.
- •Develop a written plan for panic symptoms and emergency warning signs.
- •Seek urgent care when symptoms are new, unusually severe or different from previous panic episodes.
- •Discuss anxiety during pregnancy or breastfeeding with maternity and mental-health clinicians before medicine or herb changes.
- •Parents should seek professional support when anxiety causes school refusal, sleep disruption, restricted eating or developmental impairment.
- •In Australia, call Lifeline on 13 11 14 for crisis support or triple zero on 000 for immediate danger.
- •Recovery commonly involves gradual practice and does not require eliminating every anxious sensation.
Cautions & Contraindications
- •Do not treat chest pain, severe breathlessness, collapse, neurological symptoms or dangerous palpitations as anxiety without appropriate medical assessment.
- •Do not use acupuncture or herbs instead of suicide-risk intervention, psychiatric care or emergency treatment.
- •Do not advise abrupt cessation of antidepressants, benzodiazepines, antipsychotics, mood stabilisers or beta blockers.
- •Do not diagnose anxiety solely through tongue or pulse examination.
- •Do not claim acupuncture or Chinese herbal medicine cures anxiety disorders.
- •Do not promise that treatment will eliminate panic attacks or prevent relapse.
- •Do not encourage avoidance of feared situations as a permanent coping strategy.
- •Do not perform forced exposure, trauma processing or psychotherapy outside professional competence.
- •Do not interpret mania, psychosis, withdrawal or delirium as Phlegm-Fire without urgent biomedical assessment.
- •Avoid alcohol-containing tinctures in patients with alcohol-use disorder, pregnancy, liver disease or interacting medicines.
- •Sedating herbs require caution with antidepressants, benzodiazepines, antipsychotics, antihistamines, opioids, sleep medicines and alcohol.
- •Gān Cǎo may contribute to hypertension, oedema and hypokalaemia.
- •Bàn Xià must be correctly processed because the raw herb is toxic.
- •Dān Shēn, Dāng Guī, Chuān Xiōng, Táo Rén, Hóng Huā and Niú Xī require bleeding, pregnancy and anticoagulant review.
- •Yuǎn Zhì and stimulating herbs may aggravate gastrointestinal symptoms or interact with medicines.
- •Mineral sedatives require contamination and heavy-metal quality assurance.
- •Screen every herbal prescription for pregnancy, breastfeeding, bipolar disorder, epilepsy, liver or kidney disease and medicine interactions.
- •Do not interpret worsening agitation, insomnia, suicidal thinking or behavioural activation as a healing response.
Frequently Asked Questions
What is an anxiety disorder?+
An anxiety disorder involves excessive fear, worry or avoidance that persists or significantly interferes with daily functioning [7].
What symptoms can anxiety cause?+
Symptoms may include worry, restlessness, poor sleep, muscle tension, palpitations, sweating, trembling, nausea, dizziness and breathlessness [7].
Can physical illness resemble anxiety?+
Yes. Cardiac, respiratory, endocrine, neurological and metabolic conditions, medicines and substance withdrawal can resemble or worsen anxiety [7].
Are panic attacks dangerous?+
Panic attacks themselves are not usually physically dangerous, but first-time, severe or unusual chest, breathing, fainting or neurological symptoms require medical assessment [7].
What treatments are effective?+
Evidence-based options include cognitive behavioural therapy, exposure-based treatment and, for some patients, antidepressant medicines [7].
Are benzodiazepines suitable for long-term anxiety treatment?+
They are generally not preferred for routine long-term treatment because tolerance, dependence, withdrawal, falls and cognitive impairment may occur [7].
Which TCM patterns may be considered?+
Patterns may include Liver Qi stagnation, Heart-Gallbladder Qi deficiency, Heart-Spleen deficiency, Yin deficiency, Phlegm-Heat and Qi-Blood stasis [7].
Can acupuncture cure anxiety?+
No cure can be guaranteed. Acupuncture may provide adjunctive symptom support but must not replace psychological or medical care [7].
Can Chinese herbs interact with anxiety medicines?+
Yes. Sedating, stimulating and Blood-moving herbs may interact with antidepressants, benzodiazepines, antipsychotics and other medicines [7].
When is urgent help required?+
Urgent help is required for suicidal risk, psychosis, mania, severe withdrawal, collapse, chest pain, severe breathlessness or new neurological symptoms [7].
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Sources & Further Reading
Clinical guidance, red flags and safety notes on this page draw on the following current sources alongside the classical references above.
- Healthdirect Australia · 2026
Australian overview of anxiety symptoms, diagnosis and treatment using lifestyle measures, psychological therapy and medicines.
- Healthdirect Australia · 2026
Australian information on persistent excessive worry and impairment caused by generalised anxiety disorder.
- Healthdirect Australia · 2026
Australian information on panic symptoms, assessment and treatment.
- Healthdirect Australia · 2026
Information on antidepressants and other medicines used for anxiety.
- World Health Organization · 2025
International overview of anxiety symptoms, suicide and substance-use risks, CBT-based psychological treatment and medicine considerations.
- National Institute for Health and Care Excellence · 2020
Stepped-care recommendations for generalised anxiety disorder and panic disorder, including CBT and medicine.
- World Health Organization · 2008
Standardised acupuncture-point nomenclature and anatomical-location methodology.
- World Health Organization · 2020
International benchmarks for acupuncture competency and safety.
Educational reference for licensed practitioners. Not a substitute for individual clinical assessment. Refer to conventional care for any red-flag or undiagnosed presentation.