Stress, Anxiety, and Insomnia

You can’t separate your mind and body. It looks like that computer has hardware and software. And it looks like that you are driving your car which is your body is car, and your mind is driver.

Fear and Fright

Stress is as like fear and fright situation. Fear and fright situation is as like that you see a lion at jungle when you are looking for a way to go home. At that situation, you have to run away immediately. You don’t have a time to eat, digest, toilet, dance, chat, smile, and sleep.

When you have a stress, your adrenal glands located at top of kidneys release cortisol which is stress hormone. With increasing cortisol level in your blood, your heart is pumping rapidly, and all blood is going to head, arms, and legs. So you can run away from a lion at jungle.

If you are under stress all the time, as above descriptions, your blood is going to head. Therefore, your stomach and other inside organs are not functioning any more by lack of blood supply to inside organs. For example, stomach is not enough blood supplied, leading to indigestion due to no blood no gastric juice. If you have indigestion, it is leading to abdominal bloating, reflux, discomfort, pain, and constipation. And furthermore, your heart is pumping blood fast, so you might be increasing blood pressure and headache.

From articles, there is a mention that “Cortisol release is increased in response to stress and low blood-glucose concentration. It functions to increase blood sugar through gluconeogenesis, to suppress the immune system, and to aid in the metabolism of fatprotein, and carbohydrates.[3] It also decreases bone formation.[4]https://en.wikipedia.org/wiki/Cortisol

. Anxiety

Anxiety is a common presentation in the daily practice.

Why do the patients present the anxiety?

Anxiety is a nervous situation by many reasons, which are coming from the stress. Stress is a kind of the certain amount of life-threatening event from our daily life.

Our life is not simple. We have always confronting the problem to overcome such as financial stress, relationship stress, work stress, etc in the daily life. Certain stress is good for our life to stimulate our life to live. However, if the stress is too much to overcome, it is affecting to our body and mind. First of all, our mind is confronting to the stress, which is meaning that our brain is busy to figure out what is threat, how can I do, etc. If that stress is not big and simple to solve it out, you’ll be fine. But if that stress is big enough and complex to solve it out with taking time, you’ll be starting anxious. Because you don’t know how you can handle these situations, how long it takes time, what is consequences from them, etc.

In those cases, your body responses with relieving the stress hormone such as corticosteroid from your adrenaline gland located at the top of kidneys. So, the high stress hormone may cause that you feel palpitation, tension of your body, irritability, anxious, nervous, agitation, easy to anger, frustration, etc.

Dr William Ju said that “ The autonomic nervous system is tied into emotional responses as well, and the fight-or-flight response probably sounds like a panic attack. In the modern world, these sorts of reactions are associated with anxiety as much as with response to a threat.”

Figure 1. Though the threats that modern humans face are not large predators, the autonomic nervous system is adapted to this type of stimulus. The modern world presents stimuli that trigger the same response. (credit: Vernon Swanepoel)http://neuroscience.openetext.utoronto.ca/chapter/anatomy-physiology-the-autonomic-nervous-system/

Fight-or-Flight response is to fight against threat to your body or to flight from threat. When you see a lion in jungle, what are you doing? Are you ready to fight or are you willing to flight from a lion? Most of you maybe choose run away from a lion. In that case, your adrenal glands release adrenaline to your blood stream. Your heart is running fast and pumping blood more than usual called as palpitation for suppling more blood to your body, bronchi of your lungs dilates to allow more air coming in to supply more oxygen to your body making more energy, your blood pressure is going up, and blood vessels in muscular-skeletal muscles are dilating to supply more blood to them. All bloods are going to head, four limbs, heart, lung, and muscular-skeletal muscles to fight or flight. There is no time to eat, digest, urinate, bowel motion, rest, sing, talk, love and sleep.

When fight or flight situation is going away, now it is time to restore all body functions, especially, digestion, bowel motions, etc. Adrenal glands are slowing down and/or reduce the release of adrenaline, and then your heart is slowing down to normal rate and less pumping, your brochi of lung is narrow to normal size to reduce intake of air, and blood vessels in muscular-skeletal muscles are narrow to normal size, due to the fact that there are no needs to supply extra nutrients and oxygen for fight-or-flight situation.

. Stress & Burnout

You may have the physical stress and mental stress. Many patients are complaining regarding upon the mental stress which is mainly coming from relationship issues and/or financial issues, work stresses, etc.

But lots of patients are ignoring the physical stresses coming from the body pains such as muscular-skeletal pain, nerve pain, GI track pain, etc.

If you are suffering the physical pains for a while, it’ll be affecting your stress hormone coming up, leading to the similar situation as like mental stress.

Mental stress may increase your stress hormone and the physical stress may increase your stress hormone such as cortisol.

So, please do not ignore your physical stress as well as the mental stress. I asked my patients regarding upon waking up during the night for pain. If the patients woke up during the night for pain, it is severe problem you may be concerned.

PLATE 120. Atlas of Human Anatomy 2nd Edition 1997 by FRANK H. NETTER, M.D.

The Vagus nerve is the main nerve of the parasympathetic autonomic nervous system, which is responsible for “rest, digest, and recover” functions. The Vagus nerve is doing an important role in maintaining physiological homeostasis (Capilupi MJ, Kerath SM, Becker LB. Vagus Nerve Stimulation and the Cardiovascular System. Cold Spring Harb Perspect Med. 2020 Feb 3;10(2):a034173. doi: 10.1101/cshperspect.a034173. PMID: 31109966; PMCID: PMC6996447.)

The recent article ( Butt MF, Albusoda A, Farmer AD, Aziz Q. The anatomical basis for transcutaneous auricular vagus nerve stimulation. J Anat. 2020 Apr;236(4):588-611. doi: 10.1111/joa.13122. Epub 2019 Nov 19. PMID: 31742681; PMCID: PMC7083568.) mentioned that auricular vagus nerve stimulation is considered as “a management option in a number of clinical disorders, such as heart failure, migraine and inflammatory bowel disease.”

As it was mentioned at the previous sentences, when you have a stress, the stress may affect to your sympathetic nerve system via the stress hormone such as cortisol, leading to palpitation, tension of your whole bodies, constipation, indigestion, insomnia, etc.

So, if your parasympathetic nerve stimulation is leading to suppress the sympathetic nerve system, your whole body will be regulated, leading to the homeostasis which is regulating status, ideal body status.

Transcutaneous auricular vagus nerve stimulation(taVNS/ta-VNS)

Wang Y, Li SY, Wang D, Wu MZ, He JK, Zhang JL, Zhao B, Hou LW, Wang JY, Wang L, Wang YF, Zhang Y, Zhang ZX, Rong PJ. Transcutaneous Auricular Vagus Nerve Stimulation: From Concept to Application. Neurosci Bull. 2021 Jun;37(6):853-862. doi: 10.1007/s12264-020-00619-y. Epub 2020 Dec 23. PMID: 33355897; PMCID: PMC8192665.

ABVN is Auricular Branch of the Vagus Nerve.

GAN is Greater Auricular Nerve.

ATN is Auriculo-Temporal nerve.

Butt MF, Albusoda A, Farmer AD, Aziz Q. The anatomical basis for transcutaneous auricular vagus nerve stimulation. J Anat. 2020 Apr;236(4):588-611. doi: 10.1111/joa.13122. Epub 2019 Nov 19. PMID: 31742681; PMCID: PMC7083568.

Recent research mentioned that “Anatomical research shows that the only branch of the VN that reaches the body surface is the auricular branch of the VN (ABVN). The ABVN is mainly distributed in the concha (cymba conchae and cavum conchae), and the cymba conchae is supplied exclusively by the ABVN.”(Wang Y, Li SY, Wang D, Wu MZ, He JK, Zhang JL, Zhao B, Hou LW, Wang JY, Wang L, Wang YF, Zhang Y, Zhang ZX, Rong PJ. Transcutaneous Auricular Vagus Nerve Stimulation: From Concept to Application. Neurosci Bull. 2021 Jun;37(6):853-862. doi: 10.1007/s12264-020-00619-y. Epub 2020 Dec 23. PMID: 33355897; PMCID: PMC8192665.)

In 2024, the article mentioned that “the Shenmen point is located at the lower edge of the crus of the helix, near the lateral edge of the triangular fossa. This region is closely associated with a rich distribution of nerves. The Shenmen point is primarily innervated by the auriculotemporal nerve and the auricular branch of the vagus nerve. The auriculotemporal nerve, a branch of the trigeminal nerve, is responsible for transmitting sensory information from the auricle and surrounding areas. The auricular branch of the vagus nerve originates from the main trunk of the vagus nerve within the cranium and passes through the jugular foramen, extending along the ear canal to the anterior part of the auricle and the external auditory canal. The innervation of the Shenmen point is complex and is closely related to the functions of the autonomic nervous system, particularly in regulating heart rate, blood pressure, and digestive functions. Stimulation of the Shenmen point can influence the central nervous system through the vagus nerve, thereby exerting calming effects, modulating mood, and alleviating pain. These neural pathways interact to make the Shenmen point a key acupoint in clinical practice for treating anxiety, insomnia, pain, and various other conditions.” 

Military Ear acupuncture called as BFA(Battlefield Acupuncture) is which is first developed by Richard C. Niemtzow, MD, PhD, MPH, in 2001. BFA is a unique, 5-point auricular acupuncture procedure that can be taught easily and is currently used in many military and VA HCS facilities. BFA has been described as a simple, safe, fast-acting, and cost-effective alternative to opioid medications for managing chronic pain. (Montgomery AD, Ottenbacher R. Battlefield Acupuncture for Chronic Pain Management in Patients on Long-Term Opioid Therapy. Med Acupunct. 2020 Feb 1;32(1):38-44. doi: 10.1089/acu.2019.1382. Epub 2020 Feb 3. PMID: 32110262; PMCID: PMC7044765.)

. Gut-brain Connection Issues

. Depression & Low Mood

. Panic Attack

. Post-Traumatic Stress Disorder (PTSD)

PTSD is quite common disorders after police officers, fire fighters, military soldiers, even if normal persons had been in situations of terrible stressful events. After the events were gone, they are still remembering and recalling that events which was causing their present life.

USA television program was showing at screen and their website.

. Addiction recovery Support

Addiction is a way to find out from anxiety, stress, PTSD, etc. Addiction is it can be drinking alcohol, smoking cigarettes. If you are feeling good by taking alcohol or smoking cigarettes, you’ll be addicted to go back to do the actions. And then it may be the habits to do continuously.

If you can control your habits, you are not addicted. However, many patients are doing them without the control for years and years.

Acupuncture is using the bare needles to stimulate the vagus nerves to stimulate the parasympathetic nerves to make you calmer and regulate your body functions such as heart rates, etc.

Military doctors are using the acupuncture for soldiers to help them to be calmer and do their duties.

. Insomnia & Sleep Disturbances

Insomnia is quite common complaint in the daily practice. But it is very difficult to treat insomnia, because the reasons the patients have insomnia are not simple, sometimes multiple conditions, and/or chronic conditions.

So, it need to be addressed properly with proper number of sessions, however, the patients are not patient and they want to get the result quickly. That meaning is that the sessions the patients took may help them to address those conditions they presented, but they are not longer lasting due to the facts that the problems of patients are big, and take time(with sessions) to solve it out.

It looks like that when you are eating foods, the first bite is not enough to fill your stomach to relieve your hunger. You need to finish your food to fil your stomach.

  • Major problem is Sleep ap