This 40-year-old woman began experiencing these symptoms after a traumatic experience during an earthquake, when her building shook significantly. She was at home relaxing after dinner when she felt extreme fear as the building trembled. The symptoms persisted and eventually led her to seek treatment at the clinic.
She is a mother of two in her early 40s. According to her husband, she is usually positive and cheerful. Since the earthquake, she has suffered from severe anxiety, insomnia, and heart palpitations. These physical symptoms intensified, and she has been on sick leave from work. Despite resting at home, her symptoms have not improved, and she has been emotionally unstable. She has difficulty falling asleep, experiences nightmares, and frequently wakes up, leading to severe insomnia. She feels constant anxiety, is easily startled by small noises, and has become irritable, often snapping at her husband and children. She avoids old or high-rise buildings due to anxiety. When she must enter such buildings, she feels extremely uneasy and cannot stay long, which significantly disrupts her daily life.
Her heart rate was between 110–120 beats per minute. Other vital signs were within the normal range. Her tongue was red at the tip, with little coating. She reported a dry mouth, reduced appetite, but normal digestion. Her hands and feet were cold, though she felt heat in her chest. Her menstrual cycle was usually irregular.
Due to the severe trauma, she developed disrupted circulation of Qi and blood, along with issues affecting the heart. Her diagnosis included Qi Stagnation with Blood Stasis (기울혈어어) and Heart Yin Deficiency (심음휴허). Based on this diagnosis and PTSD from a previous mental health practitioner, her treatment plan included herbal medicine, acupuncture, moxibustion, and meditation as part of oriental psychotherapy. The herbal medicine Initially focused on clearing stagnant blood to improve Qi and blood circulation. Later, prescriptions were adjusted to nourish the heart Yin and blood. Acupuncture focused on points that aid in clearing blood stasis and reducing tension, using electroacupuncture, heat therapy, moxibustion, and aromatherapy. She came in 1–2 times per week for treatment.
- After two weeks, she reported reduced dryness in her mouth and chest tightness. She still experienced insomnia and heart palpitations, but physical symptoms were gradually improving.
- After week 4, she no longer felt chest tightness or heat, and heart palpitations had decreased by over half in both frequency and intensity. Her husband observed that her irritability and hypersensitivity were also lessening.
- After week 7, although her physical symptoms continued to improve, she still had difficulty entering old or tall buildings and felt discomfort at dusk.
- After week 9, physical symptoms only appeared when she thought about the earthquake, though they were less intense. She reported waking from nightmares about once every 2–3 days.
- After week 12, she rarely thought about the earthquake during the day, and physical symptoms were minimal. Though she still experienced flashbacks at dusk, they didn’t last as long.
- After week 16, she still occasionally had nightmares but was able to sleep through them. She began entering buildings she previously avoided and felt increasingly comfortable.
- After week 20, earthquake-related dreams almost disappeared. She still experienced slight anxiety at dusk, but it quickly faded as she distracted herself with other activities. She said she felt almost the same as she had before the earthquake.
In this case, the patient’s physical symptoms, combined with re-experiencing and avoidance behaviors, worsened her anxiety and overall symptoms. Initially, treatment focused on reducing blood stasis and stabilizing physical symptoms. Once her physical symptoms had improved and re-experiencing of the traumatic event subsided, she was gradually exposed to similar environments while practicing oriental psychotherapy and visualization techniques to control her anxiety and physical responses. After 6 months, she achieved near-complete recovery and continues to come in for monthly follow-up sessions.