25 May, 2020 Physician Tan Yuan Ming

Managing Stress the TCM Way

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Stress is an all too familiar part of life in Singapore. According to the 2019 Cigna 360 Well-Being Survey, a staggering 92 per cent of working Singaporeans reported feeling stressed at work, highlighting the prevalence of stress in today’s society.

I myself am feeling a little stressed out as I write this article, the irony being that having knowledge on stress does not necessarily make one immune to it. Stress in moderate amounts can be beneficial, but excessive or long-term exposure to stress is detrimental for both our physical and mental well-being and can lead to several health issues down the road. Listed below are 4 common stress related ailments and what TCM can do to address such issues.

1. Digestive Disorders

According to TCM principles, there are 5 major organs in the body namely the heart, liver, spleen, lungs and kidney. Apart from their physiological functions, from a TCM point of view these organs also have other important functions as well. The liver for example is in charge of regulating our emotions and the circulation of “Qi” throughout the body, while the spleen governs our digestive system. The liver and spleen are very closely linked, since the regular flow of “Qi” is essential for the smooth circulation of blood throughout our digestive system. Thus, emotional disturbances caused by stress that affect the liver directly will also inadvertently affect the spleen and digestive system.

The common body types of those susceptible to stress induced digestive disorders include:

  • Liver “Qi” Stagnation: Feeling gloomy or easily angered, pain or distension in the chest and/or ribs, frequent sighing, feeling restless, sensation of having something stuck in your throat.
  • Spleen deficiency: Poor appetite, stomach bloating, chronic fatigue, loose stools, flatulence.

Generally speaking, the liver is usually the first organ to be affected by stress. Thus, those with an underlying condition of spleen deficiency may see some symptoms of liver “Qi” stagnation appearing with the introduction of stress, whilst also seeing some of their symptoms of spleen deficiency being aggravated. Conversely, those with an underlying condition of liver “Qi” stagnation may see their symptoms worsen with the introduction of stress, or be accompanied by symptoms of spleen deficiency.

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Using your thumb or middle finger, press hard into the acupoint and gently massage in a circular motion for 1-2 mins.
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1. Place the ingredients required in a cup
2. Add boiling water and let steep for 5 minutes
3. Consume the beverage gradually throughout the day (add warm water as required)

*Contraindications: Pregnant Women

2. Insomnia

As mentioned previously, the liver governs our emotions and any stress that we experience has the biggest impact on our liver. Exposure to stress causes stagnation of liver energy, which over time gives rise to “liver heat” or 肝火(gan huo). Just like how hot air rises, “liver heat” tends to travel upwards towards the head, affecting our sleep and causing various symptoms in and around the upper regions of the body. Insomnia caused by “liver heat” is characterised by having trouble falling asleep, having too many thoughts in the mind and waking up between the times of 1 am to 3 am (The timing which corresponds to the liver meridian). 

Other symptoms of a “Heaty Liver” include: headaches, giddiness, bitterness and/or dryness in the mouth, redness and/or dryness in the eyes, uneasiness, heart palpitations and increased blood pressure.

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Using your thumb or middle finger, press hard into the acupoint and gently massage in a circular motion for 1-2 mins.
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1. Place the ingredients required in a cup
2. Add boiling water and let steep for 5 minutes
3. Consume the beverage gradually throughout the day (add warm water as required)

3. Musculoskeletal Disorders

Often overlooked is the impact that stress has on certain musculoskeletal disorders. For instance, desk-bound workers tend to have sore or tight muscles from having to maintain the same posture for long periods of time. Coupled with stress that puts our bodies in a “fight or flight” mode, this causes already tense muscles to tense up even more. Over time this can cause a worsening of pre-existing musculoskeletal conditions like neck, shoulder and lower back pain, or give rise to new conditions, if these issues are not addressed properly.

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Using your thumb or middle finger, press hard into the acupoint and gently massage in a circular motion for 1-2 mins.

Shoulder Drop Exercise

  1. Sit upright in a chair, with your hands on your laps and feet shoulder-width apart.
  2. Raise both shoulders high towards the ears and drop the shoulders at the same time as low as possible, creating a “jerking” effect. Repeat 5 times.
  3. Rotate the shoulders in a circular motion forward 5 times and backward 5 times.
  4. Repeat 2-3 times a day.

Chair Twist Exercise

  1. Sit upright in a chair.
  2. Turn from your hip towards the right to face the back of the chair.
  3. Hold the backrest of the chair with the right hand and place the left hand on the outside of the right knee.
  4. Hold for 10 seconds, repeat for the left side.
  5. Repeat 2-3 times a day.

4. Women’s Health

Apart from regulating our emotions and circulating “Qi” around the body, the liver also has a role in storing blood. With regards to women’s health, a healthy menstrual cycle is closely related to these functions of the liver.  Stress can affect the menstrual cycle in two ways. Firstly, stress can generate “liver heat” that affects the liver’s ability to store blood causing blood flow to increase. Secondly, stress can also cause liver “Qi” stagnation that affects the liver’s ability to move the energies of the body around smoothly, leading to stagnation within other areas of the body.

Symptoms include:

  • “Heaty liver”: Excessive blood flow, blood that has a crimson red colour with a thick texture, menses that come early or lasts longer than normal.
  • Liver “Qi” stagnation: Swelling sensation/pain in the breast before or during menses, menstrual cramps, blood clots, reduced blood flow, menses that come late.
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Using your thumb or middle finger, press hard into the acupoint and gently massage in a circular motion for 1-2 mins.
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1. Place the ingredients required in a cup
2. Add boiling water and let steep for 5 minutes
3. Consume the beverage gradually throughout the day (add warm water as required)

Contraindications: Pregnant Women

Treatment

TCM treatment for stress related ailments usually involves one or a combination of: herbal medication, acupuncture, tuina, cupping and moxibustion. Treatments would mostly be focused on regulating liver function, whilst also paying attention to any other areas of imbalance according to each individual’s unique body constitution.

Bonus: “Rub The Ribs” Exercise

The Liver Meridian mainly runs through the lateral side (outer side) of the body and can be stimulated through massage as well. Apart from the treatments mentioned above, this exercise is suitable for anyone who is experiencing stress and can be done on a regular basis.

  1. Sit or stand upright with your feet shoulder width apart.
  2. Place the palm of the left hand on the left ribcage area and the palm of the right hand on the right ribcage area.
  3. Move both hands back and forth in a rubbing motion for 10 seconds, rest, and repeat for another 10 seconds.
  4. Perform this exercise 2-3 times a day.

Stress is an inescapable part of the fast-paced world we live in today, and thus how we cope with this stress will have a direct impact on our health and well-being. The ailments listed above are not exhaustive and many other health issues are also known to be linked to stress. Apart from using TCM to manage stress, one should also eat well, rest well, participate in regular physical activity as well as have a good work-life balance to better manage and overcome any stressors that we may face. 

Note: Information provided is not a substitute for a physician or any form of medical care. Individual symptoms differ due to different body constitutions and diagnosis. One should consult a licensed TCM practitioner for accurate diagnosis and treatment.

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About the Author

Physician Tan Yuan Ming

Physician Tan Yuan Ming

Management Trainee

Double Degree (Honours with Distinction): Bachelor of Science in Biomedical Sciences & Bachelor of Medicine (Chinese Medicine), Nanyang Technological University and Beijing University of Chinese Medicine.

As an avid sportsperson who has sustained many injuries over the years, Yuan Ming has developed a strong interest in the area of TCM pain and injury management. He regularly follows and learns from renowned physicians in Singapore and is constantly looking for new ways to better help his patients.

By breaking down difficult concepts and providing simple tips for his patients, Yuan Ming hopes that more people can learn about TCM and be inspired to take charge of their own body and health.

Physician Tan’s expertise:General Wellness, Sports Injury, Pain Management, Internal Medicine.