SNS(Sympathetic Nervous system) Dominent Type - Due to hypersensitive
SNS
Elizabeth(pseudonym) has been stressed from relationships between her
co-workers lately. She often feels heat flaring up to her face and
palpitation during meetings, which makes her hard to converse
normally. Even after she comes home, it is hard for her to calm down
and it takes her 1-2 hours before she falls asleep. She also
experiences frequent heartburn and occasional abdominal pain
Elizabeth is currently showing typical symptoms of SNS (sympathetic
nervous system) hyperactivity. SNS comes into action when we have the
flight-or- flight response (aka acute stress response.) For example,
we confront a bear in the woods. To fight or flight, we require a
large amount of blood supply to the muscle tissues, and our heart rate
goes up to pump more blood. Thus the patient experiences palpitation.
Increased blood flow to the muscle tissues naturally reduces blood
supply to the gastrointestinal system, because digesting food matters
very little when we are in life or death situation. Thus, digestive
issues arise such as loss of appetite, heartburn, bloating and acid
reflux altogether with sleep problem from being very alert to changes
(confronting stress or a bear) to her surroundings.
Certainly, not everyone rapidly reacts to stress like Elizabeth. We
know that there is always one friend who can sleep through a fire
alarm without a problem. Thus, those who are hot-tempered, strongly
opinionated easily develop symptoms like Elizabeth. Of course,
patients who are introverted can also suffer from hyperactivity of
SNS, but they will not show skin sensitivity or red face (heat flare
up to the face.) Three herbs were mainly used to treat Elizabeth:
Huang Lian (Rhizoma Coptidis), Ban Xia (Rhizoma Pinelliae Tematae) and
Gua Lou Shi (Fructus Trichosanthis Kirlowil). Huang Lian is an
extremely bitter herb that is often used calm down the hyperactivity
of SNS. Ban Xia is an effective herb for nausea and acid reflux by
regulates secretions of mucosal tissues. Lastly, Gua Lou Shi is an
excellent herb for relieving chest tightness and pain. Combination of
these main herbs and other supplementary herbs greatly reduced the
symptoms that Elizabeth had and after three months of weekly
continuous acupuncture and herbal treatments, all of her symptoms
disappeared.
SNS(Sympathetic Nervous System) Dominent Type – Due to hyposensitive
PNS(Parasympathetic Nervous System)
Jessica(false name), in her early 30’s, has been suffering from
anxiety disorder for two years. When she is stressed or nervous, she
gets palpitation, breathless and especially, digestive issues in which
she experiences bloating and nausea frequently. Daily errands such as
getting groceries can be difficult for Jessica because she feels
nauseous and gets palpitations when she is in a crowded area, She gets
cold easily, frequent urination and severe menstrual cramps. Moreover,
she is introverted and prefers quiet places where she can spend her
time alone. Jessica has a hard time falling asleep, and caffeine
intake interferes her sleep even more. She has a slender body with
fatigue and low stamina.
Anxiety is typically caused by hyperactivity of Sympathetic Nervous
system(SNS). SNS hyperactivity occurs in two situations. First, there
is an exaggeration of the sympathetic nerve itself due to external
stimuli such as stress. Second, the function of the parasympathetic
nervous system(PSNS) that suppresses the sympathetic nervous system,
is declined, and the SNS is relatively hyperactive. Sympathetic
hyperactivity is easy to understand when we imagine confronting a bear
in the woods. To fight or flight, we require a large amount of blood
supply to the muscle tissues, and our heart rate goes up to pump more
blood. Increased blood flow to the muscle tissues naturally reduces
blood supply to the gastrointestinal system, because digesting food
matters very little when we are in a life or death situation.
Immediate judgment continues to be asked where to run.
When the bear leaves, the PSNS, which plays a role in restoring the
heart rate to normal and relieving the tension in the muscles, does
not function accordingly. Even when the bear is no longer around, our
body feels as if we are still in the presence of a bear. The smallest
sound, smell, stimulation, and stress will make your body react too
quickly. Naturally, Jessica is suffering the hyposensitivity of the
PSNS, the second type of Sympathetic hyperactivity. This type of
patients are often introverted and enjoys staying in a quiet place
where the patient can be alone because any form of stimulus can
aggravate the SNS. Jessica was prescribed a medicinal herb called “Fu
Ling(Poria/ Scierotium Poriae Cocos).” Fu Ling is a sclerotium that
grows like a lump on the root of pine trees that has been lumbered
several years back. It is found skewing around the stalks of pine
trees(20 to 50 centimeters deep.) Fu Ling has long been used as a
diuretic and mental stabilizer, but it also has a strong activating
effect when the PSNS is down. It nourishes all the cells in the body,
activates brain cells, and helps to stabilize the mind. After three
months of continuous acupuncture and herbal treatments, Jessica’s
symptoms due to the anxiety disorder have all disappeared.
Hyperactive Amygdala Type – Due to trauma-initiated hyperactivity of
sympathetic systems
Maggie(false name), in her early twenties, is experiencing a panic
disorder after a robbery incident a few years ago. She is fine in
general, but when she is stressed or alone in a quiet area, she starts
to feel breathless, palpitation and trembly. Since this doesn’t happen
very often, she thought it would get better eventually. Recently,
however, the panic attack became more frequent. Other than the panic
attack, Maggie has frequent urination, diarrhea and constipation that
alternate, and hands and feet that are cold and numb. She is scared
easily, has dry mouth and gets hot flash sometimes. A panic disorder
is one of PTSD(Post-traumatic Stress Disorder) that occurs after an
accident or incident that is not easily experienced in everyday life
like Maggie. Not only after a robbery, assault, hostage incident,
natural disaster, fire, motor accidents, war and similar traumas also
lead to PTSD where soldiers are especially vulnerable to the disorder.
Like Maggie, they often suffer insomnia, are terrified, startled
frequently. Sudden panic attacks trigger palpitation and
breathlessness, and reoccurring symptoms can lead to depression.
To understand the PTSD that Maggie is experiencing, we must take a
look at the function of the ‘amygdala’ in the brain. Amygdala is known
to detect fear and prepare for emergency events. For example, rabbits
will perceive life threats when they encounter wolves. At this point,
the amygdala is activated. It sends a danger signal to the
hypothalamus, and the sympathetic nerves in the affected area are
excited, accelerating the heart rate (chest pounding) and breathing
rate because of the extra oxygen needed to make more energy that
allows the rabbit to run away with all its strength. In modern
society, it is common for humans to encounter such situations that
activate the amygdala. Therefore, when an amygdala is overactivated
due to a traumatic experience, it becomes difficult to stabilize on
its own.
Meggie was in a quiet, deserted setting when the amygdala was
activated after being robbed, and then the memory of that experience
triggers her fear response (amygdala) automatically when she is in a
similar situation or surrounding, even when there is no danger on
sight. Eastern medicine in the treatment of PTSD focuses on
stabilizing the hyperactivity of this amygdala. The two herbs, Long Gu
(Fossilia Ossis Mastodi) and Mu Li (Concha Ostreae) are often used as
calcium medicines. Excitable cells such as neurons are susceptible to
changes in the concentration of calcium ions, and large amounts of
calcium ions activate the calcium channel in the amygdala, leading to
a marked change in the amygdala. Thus, maintaining calcium homeostasis
reduces the feelings of fear and anxiety. After taking a Long Gu and
Mu Li-based herbal medicine for two months, all of her symptoms have
disappeared.
Hyperactive Hepatic type – Due to hyper-metabolism of liver
In her early 20s, Emilie (false name) has been suffering from severe
depression for two years. Having trouble adapting to school and a new
environment, she sighs frequently, experiences stuffiness(tightness)
from the pit of her stomach to all around her chest, loss of appetite
when she is stressed, has indigestion and feels dizzy after eating.
She gets hot flashes and she has no energy when she is in a hot
environment. Emilie doesn’t have any problem falling asleep, but she
feels very tired when she wakes up in the morning no matter how long
she sleeps. She also tends to get constipated a little, has low
stamina, and all the symptoms worsen prior to menstruation. Nowadays,
there is often feelings of alexithymia beyond traditional depressive
symptoms, leaving the patient with little to no emotional expression
or feeling. Like Emilie, presenting a combination of the psychological
symptoms and physical symptoms as mentioned above are quite common in
other neuropsychiatric patients suffering from insomnia and panic
disorders. In severe cases, the patient feels the need to pound his or
her chest to relieve the stuffiness whereas some mild cases will only
show as frequent sighing as signs of chest tightness. This symptom is
a common manifestation when there is stagnation of the vascular and
lymphatic circulation in the chest. The presence or absence of this
symptom is used as an index to distinguish neuropsychiatric diseases.
In many cases, the symptoms that Emilie complains about are treated
with herbs called Zhi Zi (Gardenia, Cape Jasmine Fruit, Fructus
Gardeniae Jasminoidis) and Zhi Shi (Immature Fruit of the Bitter
Orange, Fructus Immaturus Citri Aurantii.) Gardenia is a medicinal
herb that is used as a natural dye due to its beautiful and vibrant
color. It clears the congestion of the blood vessels and promotes
smooth bile secretion. The young fruit of bitter orange contracts the
myocardium and promotes cardiac output to boost circulation in the
chest. It stimulates the peristalsis of the intestines and helps
digestion. In particular, synephrine – similar to ephedrine, but less
potent – the bitter orange is found to act as an antidepressant
currently being developed as a new antidepressant. Young bitter orange
is the most effective medicine that can be used to reduce chest
tightness and indigestion.
Emilie was treated with acupuncture treatments and herbal medicine
consisting of Zhi Zi (Gardenia) and Zhi Shi (Young Bitter Orange) for
three months, after which all her symptoms improved and the treatment
was terminated. Emilie’s main symptoms of depression such as, chest
tightness, and indigestion also significantly improved, as well as all
the other symptoms described above.
