Anxiety Disorders - Liver Depression Transforming into Fire

TCM differentiation and treatment for anxiety disorders

Anxiety Disorders · Liver Depression Transforming into Fire Pattern

Updated: June 23, 2026

Reviewed by: Dr. Li Wei, DACM

Reading Time: 7 min

Body Area: Whole Body


Pattern Overview

Liver Depression Transforming into Fire is a common pattern in anxiety

disorders, characterized by **chronic stress-induced norepinephrine

overrelease, anxiety, irritability, headache, and agitation**. The core

pathogenesis is **prolonged stress causing Liver Qi stagnation

transforming into Fire**, leading to Shen (spirit) agitation,

irritability, and autonomic hyperactivity.


Key Symptoms and Differentiation Points

Differentiation Dimension Manifestations
Primary Symptoms Anxiety, irritability, headache, agitation
Associated Symptoms

constipation |

Tongue and Pulse

pulse |

Pathogenesis Liver Qi stagnation transforming into Fire
Etiology

|


Acupuncture Point Prescription

Point Location Function
Taichong (LR3)

metatarsals | Source point of Liver meridian; soothes Liver Qi and

clears Fire |

Xingjian (LR2)

metatarsals, proximal to the web margin | Spring point of Liver

meridian; drains Liver Fire |

Qimen (LR14)

the nipple | Front-Mu point of Liver meridian; regulates Liver Qi |

Yanglingquan (GB34) Depression below the head of the fibula

He-Sea point of Gallbladder meridian; regulates Qi and relieves pain |

Neiguan (PC6)
Relieves chest tightness and calms the spirit

Clinical Recommendation: Filiform needle, reducing method; Xingjian

may be pricked to bleed to enhance Liver Fire drainage.


Herbal Formula

Base Formula: Dan Zhi Xiao Yao San (丹栀逍遥散)

Composition:

Moutan (Dan Pi), Gardenia (Zhi Zi), Bupleurum (Chai Hu), Angelica (Dang

Gui), White Peony (Bai Shao), Atractylodes (Bai Zhu), Poria (Fu Ling),

Licorice (Gan Cao), Mint (Bo He)

Action: Soothes Liver Qi, clears Fire, and relieves depression.

Modifications

Associated Symptoms Additions/Subtractions
Severe anxiety Add Suan Zao Ren, Bai Zi Ren to calm the spirit
Insomnia Add Ye Jiao Teng, He Huan Pi to calm the spirit
Headache Add Ju Hua, Xia Ku Cao to clear Liver Fire

Western Mechanism Reference

Chronic stress-induced norepinephrine overrelease, 5-HT/NE imbalance,

and hypervigilance. Liver Depression Transforming into Fire corresponds

to anxiety with prominent irritability and autonomic symptoms, where

chronic stress and norepinephrine overrelease contribute to

hypervigilance and agitation.


References

1. Internal Medicine of TCM - Depression with Liver Depression

Transforming into Fire.

2. DB-TCMJB: Liver Fire.

3. DB-XJB: Chai Hu Shu Gan San, Hua Gan Jian.

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

Organization.


Explore More

Personalized herbal protocols and acupressure tools for anxiety relief.

research papers and clinical case studies on TCM mental health.


Last reviewed: June 2026 | Lead author: Dr. Li Wei, DACM | Content updated: Monthly

Disclaimer: This guide is for educational purposes only and does not constitute medical advice. Consult a licensed healthcare provider before starting any treatment.