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Mental health: when anxiety, stress or low mood is held deeper in the body

If you are in crisis or need immediate support, the helplines and services are here. If you are still deciding which kind of professional you need first, this guide explains the difference between a GP, psychiatrist, psychologist, psychotherapist and counsellor.

This page is different. It explains the part of my work that may matter when someone has already understood a lot about their anxiety, low mood, stress or trauma-linked patterns, but something deeper still feels held in the body.

When you understand the problem, but still do not feel free

Many of the people I see are not confused about the obvious options.

They know a psychiatrist can assess risk, diagnose, prescribe and manage more severe mental health conditions. They know therapy can be genuinely life-changing. They know crisis services matter. Those routes should be used when they are the right first step.

But some people reach a different kind of problem.

They have spoken about the past. They understand the story. They know why they are anxious, low, reactive or shut down. They may have read, researched, tried therapy, tried medication, tried supplements, tried meditation, tried lifestyle changes, and still something in the body does not feel free.

The mind may understand, but the body still reacts.

The chest still tightens. The sleep still breaks. The gut still changes. The jaw, shoulders or abdomen still hold tension. The person may look functional from the outside, but internally they feel like they are still living in protection, heaviness, fear, numbness or survival.

That is the layer I am most interested in.

Signs the pattern may be held deeper in the body

This may be the layer you are reaching if:

  • You understand your triggers, yet your body still reacts as if the threat is current.
  • You feel emotionally flat, heavy or reactive despite doing the right things.
  • You function well on the outside but privately feel you are still in protection or survival mode.
  • Your sleep is not restorative, and your energy feels suboptimal.

If several of these are familiar, the deeper layer may be what has not yet been reached.

The deeper layer

This is the part of mental health care that is most often left unreached, and it is the heart of what I do.

Psychiatry and psychology can be essential. However, for some people, talking, coping, understanding and medication do not fully reach the layer where the body is still holding the pattern.

Sometimes the work is not primarily about talking more.

Some patients have already talked about the problem many times. They may understand it intellectually, but their body is still responding as if the threat, grief, fear, anger, shame or shock is still present.

In those cases, the work often begins with regulation. When the body becomes safer and more settled, deeper material can come forward. A person may become aware of emotions, memories, inner conflicts, protective patterns or truths they already knew at a deeper level but had not yet been able to access and release clearly.

This is where the subconscious layer matters.

In Ayurveda and Traditional Chinese Medicine, body, mind and spirit were never treated as separate departments. The emotional pattern, the physical pattern, the person’s life, and their deeper sense of meaning are all part of the clinical picture.

For thousands of years, these systems have placed importance on deeper interventions that work with unresolved emotional patterns, the mind-body connection, and the way imbalance is held in the whole person. This helps explain why some people do not fully change until the deeper layer is addressed.1–4

Many people with long-running mental or emotional suffering are not only trying to reduce symptoms. They are trying to feel whole again. They want peace, purpose, meaning, self-trust, connection, and a sense of being themselves again.

For some people, that may mean less anxiety, less heaviness, better sleep, more emotional freedom, more inner safety, or the sense that they are no longer being run by an old pattern. For others, it may mean returning to therapy with more capacity, using medication more intelligently with their doctor, or making clearer choices in their life.

When the fit is right, this is the layer that can make the work feel different from simply talking, coping or managing symptoms.

To see how this has looked for real people, read the patient stories. For the more detailed anxiety and nervous-system explanation, read when anxiety is more than anxiety.

Who this work is suitable for

This work is most relevant when someone is suffering but stable enough to explore a deeper pattern. They may be anxious, low, stressed, burnt out, emotionally heavy, reactive or stuck in old patterns. They may also feel that their mental health is connected to the body: sleep, energy, digestion, pain, tension, hormones, inflammation or nervous-system overload.

For some people, a different first step is safer. Some need psychiatry first, some psychotherapy, some medication, some crisis care, and some blood tests or a medical workup before anything else. This approach does not replace emergency psychiatric care, and it does not manage suicidal crisis, psychosis, mania, severe depression or immediate risk of harm on its own. Where one of those is the right first step, that is what I will say.

How I hold this safely

I work as a doctor with training in conventional medicine, Ayurveda and Traditional Chinese Medicine.

That combination matters because this work needs both depth and boundaries.

Conventional medicine keeps the work safe. It helps identify red flags, medication issues, physical contributors, psychiatric risk, and situations where referral or standard care must come first.

Ayurveda and Chinese medicine help me understand the person as a whole: constitution, rhythm, digestion, sleep, depletion, emotional patterns, body-held tension, stagnation, overactivity, collapse, meaning, and the way someone has moved away from their natural state.

The aim is to understand the person properly and decide what should happen first.

For the full clinical framework behind this, see integrative medicine. How I work sets out the method in full.

How the work begins

This kind of pattern cannot be properly understood in fragments or in short appointments.

The first step is a three-hour, in-person deep assessment across conventional medicine, Ayurveda and Chinese medicine. This is where the medical picture, the emotional pattern, the person’s story, pulse diagnosis, physical examination where appropriate, and the depth of human encounter all happen in the same room. The purpose of the assessment is to understand what is most likely to matter and what needs to happen first.

The treatment that follows is built around what the assessment finds. Over time, the work may involve reviewing previous blood tests, checking for physical contributors, building a personalised nutrition and lifestyle plan, and using acupuncture, electroacupuncture, body-based treatment, breath, meditation, mindfulness, guided imagery, and deeper meditative states where appropriate.

More about how I work →

For patients whose pattern fits a structured first phase of care, Integrative Reset is where that work usually begins →

Common questions

Can anxiety and stress be treated without medication?

Yes, and in many cases it should be the first thing you try. The basics matter more than people expect: real downtime, rest, time with people you trust, a nutrient-dense diet, sunlight, movement, a walk, a massage, whatever genuinely settles you. Most of us already have our own ways of doing this, and that should be the baseline before anything else. When that is not enough, the right next step depends on what you are looking for. If you want medication started or adjusted, that is a psychiatrist. If you want to talk things through regularly, that is a psychologist. If you prefer a natural, whole-person approach that works with the body and helps release what it has been holding, that is where the work I do as an integrative doctor fits, often at the subconscious level, targeting what is actually needed and in the right order, which varies from person to person.

What does anxiety actually feel like, and what does it do to the body?

We have all felt it at some point, so most people recognise it. Anxiety is not only worry or racing thoughts in the mind. It shows up across the body too: palpitations, headaches, sweating, a tight chest, a restless gut, and more. In short bursts that is normal. When it is left for a long time, it starts to wear on sleep, energy and quality of life, and that is usually the point at which people come to me.

When does normal stress become chronic stress, and will it go away?

Normal stress is short-lived and tied to a specific event, and everyone has it. Chronic stress is when it persists for far longer, and left unresolved it can feed real health problems, from high blood pressure and insomnia through to more serious illness if it is not dealt with early. Whether it goes away depends on whether it is resolved at the root. In my experience that is less about the stressor itself and more about your capacity to meet it, so that the same situation no longer provokes the same reaction in your mind and body. When that capacity is rebuilt, the body responds to the old stress in a calmer, more adaptive way.

When does burnout become something more, and when should you see a doctor?

Burnout becomes something more when the same symptoms persist despite resting, taking time off and doing what you believe are the right things. If the exhaustion, low mood, hopelessness, or loss of interest in things you normally enjoy carry on, and especially if you have any thoughts of harming yourself, that is when to see a doctor. From there we can look at the bigger picture, check whether any tests are needed, and work out what is actually going on. Different doctors approach this differently: conventional, integrative, Chinese medicine and Ayurvedic practitioners each bring their own lens. Mine is the integrative approach described on this page.

Who should you see for anxiety?

It depends on several things. A psychiatrist is useful in more acute situations, or where you need or would prefer medication to be started or adjusted, and they can diagnose and prescribe. A psychologist can usually see you regularly, often weekly, and help you build ways to cope with anxiety. The work I do as an integrative doctor sits alongside both, taking a more natural, whole-person approach that is not only talking, but also releasing emotions held in the body using a combination of tools. For how these roles differ, see the difference between a psychiatrist, psychologist and counsellor.

Is this just another form of therapy?

No. I do not consider myself a therapist. I may ask many of the same questions, and I am glad to work alongside therapists and psychiatrists, but the approach is different. I have no intention of speaking with patients every week about their day-to-day anxiety. My interest is in reaching the root and treating it, to get meaningful results as quickly and as safely as possible.

Do I need to stop my medication or therapy?

No. Many people actually come to me because they would like to come off their medication over time. Where that is appropriate, I taper it gradually and in partnership with the psychiatrist who prescribed it, so it is done safely. As people genuinely feel less anxious, there is often a sensible case to reduce psychiatric medication. I would never change it unilaterally, and that collaboration is what keeps it safe.

How do I know if I am ready?

The most important thing is that you want to get better. Beyond that, it helps if you are prepared for a process that is not always comfortable, and willing to work with me as a team. When those things are in place, we can genuinely make headway on the anxiety together.

Is this covered by insurance?

It varies between providers and policies, so it is worth checking directly with your insurer. Acupuncture and medical consultations can sometimes be covered. Many patients pay privately for the deep assessment.

If you would like to talk

If this page described your situation, you can request a Suitability Review.

The first step is not to assume this is right for you. It is to check fit and safety first.

Request a Suitability Review

Medical disclaimer: This page is for educational and informational purposes. It is not a substitute for individual medical assessment, diagnosis, or treatment. Do not alter or stop medication, or begin new treatment, based on this page alone. If there is an immediate threat to life, call 112 or go to Mater Dei A&E. If you are in mental health crisis or someone you know is at immediate risk, contact 1579, 9933 9966, 179, or go to Mater Dei A&E. For the full directory of crisis lines and support services in Malta, see mental health support services in Malta. Consult a qualified clinician who can evaluate your specific situation.

Dr Shehan Wijesingha, MD, M.TCM, DipAP, BMedSci, CPT, practises at Serenity Holistic Medical Clinic, Malta. He is Vice President of the Association of Ayurvedic Professionals UK.

References and sources
  1. Russell EW. Consciousness and the Unconscious: Eastern Meditative and Western Psychotherapeutic Approaches.
  2. Joshanloo M. Eastern Conceptualizations of Happiness: Fundamental Differences with Western Views.
  3. Miller LJ, ed. The Oxford Handbook of Psychology and Spirituality.
  4. Watts A. Psychotherapy East & West.