Integrating Tibetan and Western Medicine in the Treatment of Anxiety

At the present time, more anxiety disorders are seen in the clinic than any other mental health disorder. In the United States, anxiety affects about 15 percent of adults, most of whom are women. Anxiety worsens during stress, yet it is ignored and is not recognized by our health care professions. In the Western medical profession, the manifestation of anxiety is categorized under “non-specific complaints.”¹ As a result, the care given is often lacking in attention, nurturing, and appropriate treatment methods for patients.

Anxiety is defined as a feeling of apprehension, worry, uneasiness, dread (especially pertaining to the future), or fear that lingers. The alternative names for anxiety are feeling uptight, stress, tension, jitteriness, and/or worry. The source or the cause for this uneasiness is not always known or recognized in biomedical science.³ It is true that if we have a small amount of worry or anxiousness, it creates more enthusiasm for dealing with different experiences and supports better preparation than not having any stress at all. However, if this exceeds the normal range, our body, mind, and spiritual life are disturbed. In severe cases, some people will end up in emergency care situations because of losing control of their behavior and speech, and a lack of mental clarity leading to a paralysis of their ability to manage daily life.

Anxiety in Tibetan medicine is only one of the symptoms of rlung, or air disorder. rLung, or air, is one of three important fundamental energies in the body. In this context, however, we are specifically referring to a subdivision of rlung called life-sustaining rlung,⁴ which has various effects in our body. In general, rlung is the vital force or source of energy for our body, speech, and mind because it travels throughout the body with the blood to promote and sustain our health when it is in balance. If it gets disturbed, our body, speech, and mind will suffer because the out-of-balance rlung energy will then bring about a disease state as well.⁵ According to Dr. Rapgay, a Tibetan psychiatrist, “rLung is most intimately related to our mental and physical health, it serves as a basis for nerve, skeletal and smooth muscle, vascular, hormonal, and membrane transport activity. On a subtle level, it serves as a foundation of sensory consciousness. Thus, rlung encompasses the mind.”⁶ Because of this reason, the life-sustaining rlung controls any mental activities and reflects the status or condition of the flowing of rlung energy.

Specifically, the life-sustaining rlung (LSR) is located at the crown of the head and travels or circulates between the chest and head through the throat. The main functions of LSR are: to facilitate respiration and swallowing of food and drink, promote blood and rlung energy circulation throughout the body, control the spitting out of mucus and phlegm, control sneezing, clarify our mind and five sensory organs, and provide the physical basis for the mind.⁷ Therefore, according to Tibetan medicine, since the mind rests on it, LSR is directly involved in the cause of anxiety, regardless of anxiety disorders or neurosis described in Western medicine. In short, when the LSR is disturbed, the mind gets agitated and feels pain,⁸ and anxiety appears with a prolonged progression.

Although there are many related causes and risk factors for anxiety in Western medicine, the most common one is stress occurring from early childhood, current environmental conditions, or from emotional attacks.⁹ Likewise, according to Tibetan medicine, the anxiety or disturbances of the life-sustaining rlung disorders are also related to stress. This can be caused by many factors: for example, improper diet such as too much junk food, improper behaviors such as excessive physical or mental exertion, excessive talking and having sex (especially when the stomach is empty), a large amount of blood loss, malnourishment, a history of anemia, and long-term fasting or continuing hunger. In short, these risk factors actually contribute to stress, anxiety, or other mental disturbances in daily life.

As explained in Western medicine, anxiety manifests in both physical and mental symptoms. Examples of physical symptoms include: twitching or trembling, muscle tension, headaches, sweating, dry mouth or difficulty swallowing, dizziness, a rapid or irregular heart rate, fast respiration, diarrhea or frequent urination accompanied with anxiousness, fatigue, insomnia, nightmares, and sexual problems. Mental symptoms include: irritable mood, jumping mind, decreased concentration, excessive sighing, restlessness, stress, and a feeling of emptiness.¹⁰

Similarly, according to Tibetan medicine, all of the above symptoms are the major manifestations of physical, speech, and mental level disturbances of life-sustaining rlung. Stress is the most relevant symptom connected to anxiety because it is an actual mild or early form of anxiety. If it is not managed appropriately in time or if it is ignored at an early stage, it will eventually progress to full-blown anxiety. The symptoms and manifestations depend on their severity, especially in the early stages: an uptight feeling, apprehension, worry, uneasiness, dread or fear that lingers, stress, tension, shortness of breath, difficult inhalation, and palpitation.

The treatments for anxiety in Western medicine are counseling, cognitive-behavior changes, and anti-anxiety drugs for short-term relief at the onset of anxiety. However, these anti-anxiety drugs can make patients suffer from many undesirable effects. The drugs utilized are in the family called benzodiazepines. This family causes a variety of side effects, for example, “sleepiness and drowsiness, impaired coordination, slow reaction or sluggishness.” Benzodiazepines contribute to drug dependence. People who have alcohol dependency problems are very sensitive to them. and can develop dependency to the drugs in general.¹¹ Because of these uncomfortable side effects, many patients are seeking an alternative medical approach to deal with this condition.

The Tibetan approach

Tibetan medicine, as an alternative medical approach, provides appropriate care, management, and treatment methods, especially from the side of prevention, without undesirable effects. Approaches in Tibetan medicine include diet, behavioral changes, herbs, and accessory therapy.

1. Diet and nutrition

First, in terms of diet and nutrition, increased amounts of protein (meats, grains, green leafy vegetables, dairy products, nuts, seeds, brown sugar, garlic, fennel) are recommended. Health care practitioners are especially sensitive to the needs of vegetarians in helping them to understand that they need proper amounts of vitamins, minerals, and other supplements in their daily diets. Otherwise, according to Tibetan medicine (Gyushi, the original and main study text), they can be susceptible to malnourishment, which can then lead to weak and sensitive emotions, mental stress, and agitation.

2. Behavioral changes

Second, in terms of behavior, meditation and breathing exercises are a very useful and effective approach.¹² In addition, there are some accessory behavior therapies that are recommended to prevent, help, or treat stress or anxiety problems, such as color therapy, spending time with friends, and environmental therapies. It is through these different therapies that the circulation of life-sustaining rlung is regulated and disorders are treated. Normally, a special environment or atmosphere is recommended with a quiet, cozily decorated room with darker subdued colors, where one can listen to birds singing or other pleasant sounds such as smooth and soothing music. Such an environment tends to pacify, resettle, and redirect anxiety’s direction and ground the mind. A close and trusted friend can soothe a patient with very supportive motivations and a gentle voice. This provides a safe environment so the patient can expel his or her congested or accumulated negative energy and/or emotions.

3.Herbal remedies

Third, many herbal formulas are recommended, the most important ones being Aquilaria (Eagle-wood, Aloe-wood) and related formulas such as Aquilaria 8, 15, 20, 24, 31, and 35. Different herbal combinations of Aquilaria can reduce stress or anxiety at different levels either by tonifying, nourishing, or regulating the life-sustaining rlung. Different formulas are selected for different people based on individual constitutions and health conditions. The number of each formula represents different numbers of ingredients contained therein. Most are taken orally except Aquilaria 31, which comes in an incense stick or powder form. It is used twice a day at dawn and late in the evening.

4. Massage

Lastly, ku nye (Tibetan massage) and moxa are applied to regulate life-sustaining rlung. The most common and effective type of massage technique for this condition is called hor-mey. It is a unique and simple technique to apply either on others or on oneself.

Conclusion

I believe that through the integration of Tibetan medicine, a rich and enduring tradition of healing and medical science from ancient Tibet, and Western medicine, the fastest developing, advanced, and modern medical science, we can successfully and effectively help patients who are suffering from anxiety. The major methods are to increase awareness of one’s own body, to develop the art of listening to one’s body, and to take care of the discomforts and problems at an early stage by regulating and modifying one’s diet, behaviors, and life style.

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