Anxiety Disorders - Yin Deficiency with Fire Pattern

Dr. Li Wei, DACM

Anxiety Disorders · Yin Deficiency with Fire Pattern

Updated: June 23, 2026

Reviewed by: Dr. Li Wei, DACM

Reading Time: 7 min

Body Area: Whole Body

Pattern Overview

Yin Deficiency with Fire is a common pattern in anxiety disorders, characterized by sympathetic-adrenal medullary system hyperactivity, anxiety, palpitations, insomnia, and night sweats. The core pathogenesis is insufficient Yin failing to control Yang, leading to ascendant deficiency fire, Shen (spirit) restlessness, and autonomic hyperactivity.

Key Symptoms and Differentiation Points

| Differentiation Dimension | Manifestations |

| :— | :— |

| Primary Symptoms | Anxiety, palpitations, insomnia, night sweats |

| Associated Symptoms | Heat in palms and soles, dry mouth, irritability, restlessness |

| Tongue and Pulse | Red tongue with little coating, thready and rapid pulse |

| Pathogenesis | Yin deficiency with deficiency fire, failing to calm the spirit |

| Etiology | Chronic stress, prolonged illness, excessive sexual activity, aging |

Acupuncture Point Prescription

| Point | Location | Function |

| :— | :— | :— |

| Taixi (KI3) | Depression between medial malleolus and Achilles tendon | Source point of Kidney meridian; nourishes Kidney Yin |

| Shenmen (HT7) | On the wrist crease, ulnar side | Source point of Heart meridian; calms the spirit |

| Sanyinjiao (SP6) | 3 cun above the medial malleolus | Nourishes Blood and Yin; regulates the Spleen and Kidney |

| Zhaohai (KI6) | 1 cun below the medial malleolus | Nourishes Yin and clears deficiency heat |

| Daling (PC7) | Center of the wrist crease | Source point of Pericardium meridian; calms the spirit |

Clinical Recommendation: Filiform needle, reinforcing method; Taixi and Zhaohai may be needled with reinforcing method to enhance Yin nourishment.

Herbal Formula

Base Formula: Tian Wang Bu Xin Dan (天王补心丹)

Composition:

Rehmannia (Sheng Di), Scrophularia (Xuan Shen), Asparagus (Tian Dong), Ophiopogon (Mai Dong), Angelica (Dang Gui), Sour Jujube Seed (Suan Zao Ren), White Peony (Bai Shao), Licorice (Gan Cao)

Action: Nourishes Yin, clears deficiency fire, and calms the spirit.

Modifications

| Associated Symptoms | Additions/Subtractions |

| :— | :— |

| Severe insomnia | Add Suan Zao Ren, Bai Zi Ren to calm the spirit |

| Night sweats | Add Mu Li, Fu Xiao Mai to stabilize the exterior |

| Irritability | Add Zhi Zi, Dan Pi to clear deficiency heat |

Western Mechanism Reference

Sympathetic-adrenal medullary system hyperactivity with HPA axis negative feedback dysregulation and elevated cortisol. Yin Deficiency with Fire corresponds to anxiety with prominent autonomic symptoms, where HPA axis dysregulation and elevated cortisol contribute to hyperarousal and anxiety.

References

  1. Internal Medicine of TCM - Depression with Yin Deficiency and Fire.

  2. DB-XJB: Tian Wang Bu Xin Dan.

  3. WHO. (2023). Mental health and anxiety disorders. World Health Organization.

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