Q Anticipatory anxiety—the fear that it might happen again—is harder to deal with than the panic attacks themselves. What should I do?
A Anticipatory anxiety is a core symptom of panic disorder and can be effectively alleviated by combining exposure therapy, cognitive restructuring, and autonomic nervous system stabilization therapy.
Detailed Answer
Anticipatory anxiety is maintaining a constant state of tension due to the fear that a panic attack will occur again, and it has a greater impact on quality of life than the frequency of panic attacks. In cognitive behavioral therapy, anticipatory anxiety is reduced by realistically modifying catastrophic thoughts about attacks and gradually exposing the individual to fearful situations. Heart rate variability (HRV) biofeedback and diaphragmatic breathing training are also helpful as they stabilize the autonomic nervous system.
Perspective of a Korean Medicine Clinic
In Korean medicine, anticipatory anxiety is viewed as a state where the decisiveness of the Gallbladder (Dam) is diminished and the Heart Qi (Simgi) is weak, leading to an excessive reaction to even minor stimuli. At Dongjedang, we strengthen phlegm energy with herbal medicines that dissolve phlegm and calm the mind, and during acupuncture treatment, we stimulate both the Gallbladder and Heart meridians to stabilize the neural circuits associated with anticipatory anxiety. When combined with breathing exercises, the effects appear rapidly.
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