Calm (ES)™

Extra-strength TCM herbal formula for severe stress, anxiety, restlessness, insomnia, hysteria, and addiction withdrawal — sedative, anxiolytic, and tranquilizing; spreads Liver qi; purges excess Liver fire; calms the shen (spirit) and tranquilizes the Heart

⚠️ Contraindicated during pregnancy and nursing. Patients with a weak digestive system may experience mild GI disturbances — reduce dosage or take with GI Care for nausea and Gentle Lax (Deficient) for constipation. Contains Dang Gui (Radix Angelicae Sinensis) which invigorates blood — use with caution or avoid with Coumadin (warfarin) or anticoagulant/antiplatelet therapy due to higher risk of bleeding and bruising. California Prop 65 warning: this product contains Da Huang (Radix et Rhizoma Rhei) — do not use if you have or develop diarrhea, loose stools, or abdominal pain as Da Huang may worsen these conditions. Consult your physician if you have frequent diarrhea or are pregnant, nursing, taking medication, or have a medical condition. In addition to using Calm (ES), efforts should be made to identify the underlying cause of illness — treat both symptoms and cause concurrently for optimal results.

CLINICAL APPLICATIONS

* Stress with poor appetite, headache, tension, insomnia, and similar stress responses

* Extreme or severe emotional and psychological disorders such as hysteria, neurosis, and schizophrenia

* Insomnia with disturbed sleep and night awakenings

* Withdrawal signs and symptoms associated with alcohol, drug, and smoking addiction

Background: Stress is a normal physical and psychological reaction to the demands of life. When confronted with stress, the body responds with a burst of hormones — the "fight-or-flight" response. Once the stress is gone, the body is supposed to return to a normal relaxed state. Unfortunately, the nonstop stress of modern life often keeps the body in a constantly stressed state. Over time, this leads to serious health problems affecting the brain (feelings and emotions), heart (hypertension, arrhythmia, atherosclerosis, coronary artery disease), muscles (stiffness and pain), stomach (acid reflux, peptic ulcer disease, IBS), and immune system (weakened immunity, frequent infection).

Key herb-level clinical data:

— Long Gu (Os Draconis) + Mu Li (Concha Ostreae): mineral medicinal substances — anchor the floating shen (spirit); tranquilizing and sedative effects; subdue hyperactivity of Liver fire; Mu Li also neutralizes gastric acid and treats gastric and duodenal ulcers

— Gou Teng (Ramulus Uncariae cum Uncis): treats headache associated with sudden rise of blood pressure; moderate and prolonged antihypertensive effect — decreases heart rate and reduces peripheral vascular resistance; cardioprotective — prevents and treats vascular proliferative disorders such as atherosclerosis and restenosis after angioplasty via corynoxeine (ERK1/2 phosphorylation inhibition)

— Huang Qin (Radix Scutellariae): clears heat; relieves irritability; anxiolytic — positive allosteric modulation of GABA(A) receptor complex via wogonin (benzodiazepine receptor ligand); significant anti-inflammatory activity via inhibition of nitric oxide, COX-2, prostaglandin E2, and proinflammatory cytokines

— Da Huang (Radix et Rhizoma Rhei): clears heat; relieves irritability; remarkable laxative and purgative effect — works directly on the large intestine to increase peristalsis and induce bowel movements

— Chai Hu (Radix Bupleuri): disperses stagnant Liver qi; calming effect on the brain — promotes relaxation and improves sleep; antihyperlipidemic — lowers total cholesterol, LDL, and triglycerides; analgesic and anti-inflammatory via saikosaponins; stimulates both humoral and cellular immunity

— Dang Gui (Radix Angelicae Sinensis): nourishes Liver blood; analgesic and anti-inflammatory with potency comparable to or greater than acetylsalicylic acid — treats low back and leg pain, vascular headache, and migraine; antiarrhythmic — especially against arrhythmia induced by epinephrine, cardiac glycosides, aconitine, and barium chloride; improves blood circulation by decreasing whole blood specific viscosity; reduces plasma cholesterol and triglycerides; decreases risk of atherosclerosis; increases phagocytic activity of macrophages

— Suan Zao Ren (Semen Ziziphi Spinosae): calms the Heart; nourishes the shen (spirit); anxiolytic; hypnotic — jujubosides promote sleep

— Xie Cao (Radix et Rhizoma Valerianae / Valerian): calms the Heart; nourishes the shen; anxiolytic and antidepressant — valerenic acid interacts with GABA(A)-ergic system, mechanism similar to benzodiazepine drugs; significant reduction in anxious behavior in neurobiological research

— Xi Yang Shen (Radix Panacis Quinquefolii / American Ginseng): strengthens and harmonizes middle jiao; anxiolytic — saponins relieve stress and anxiety

— Bai Zhu (Rhizoma Atractylodis Macrocephalae): adaptogenic — enhances duration and relieves restlessness under physical stress; anti-inflammatory via TNF-alpha and nitric oxide inhibition; dual effect on digestive tract — treats both constipation and diarrhea; increases macrophage activity, WBC, lymphocytes, and IgG

— Fu Ling (Poria): adaptogenic; strengthens and harmonizes middle jiao; prevents Liver from overacting on Spleen

— Da Zao (Fructus Jujubae): strengthens and harmonizes middle jiao; calming effect on the brain; promotes relaxation and sleep; positive cognitive effect — improves memory

— Gui Zhi (Ramulus Cinnamomi): promotes qi and blood circulation

— Chuan Xiong (Rhizoma Chuanxiong): promotes qi and blood circulation; anti-inflammatory via TNF-alpha and NF-kappaB inhibition; clinically effective for vascular headache, migraine, and various headache types

— Zhu Ru (Caulis Bambusae in Taenia): clears heat and phlegm; calms the shen

— Sheng Jiang (Rhizoma Zingiberis Recens): strengthens and harmonizes middle jiao

— Gan Cao (Radix et Rhizoma Glycyrrhizae): harmonizes formula; gastroprotective — prevents and treats peptic ulcers via gastric acid inhibition, binding and deactivation of gastric acid, and promotion of ulcer recovery; clinically: 100 patients with gastric or duodenal ulcers treated with 90% effectiveness; marked effectiveness for palpitations and arrhythmia; positive cognitive effect — ameliorates memory impairment

WESTERN THERAPEUTIC ACTIONS

* Sedative / tranquilizing — Long Gu + Mu Li (anchor shen, subdue Liver fire); Suan Zao Ren (jujubosides, hypnotic); Xie Cao (valerenic acid, GABA-A)

* Anxiolytic — Huang Qin (GABA-A, wogonin); Xie Cao (GABA-A, benzodiazepine-like); Suan Zao Ren (anxiolytic); Xi Yang Shen (saponins); Chai Hu (brain calming, relaxation, sleep)

* Antidepressant / adaptogenic — Xie Cao (antidepressant); Bai Zhu + Fu Ling (adaptogenic, physical stress endurance)

* Antispasmodic / analgesic / anti-inflammatory — Dang Gui (analgesic ≥ aspirin, anti-inflammatory); Chai Hu (saikosaponins); Bai Zhu (TNF-alpha↓, nitric oxide↓); Chuan Xiong (TNF-alpha↓, NF-kappaB↓); Huang Qin (COX-2↓, prostaglandin E2↓)

* Cardiovascular — Gou Teng (antihypertensive, cardioprotective); Dang Gui (antiarrhythmic, blood viscosity↓, cholesterol↓); Chai Hu (LDL↓, triglycerides↓); Gan Cao (arrhythmia↓, palpitations↓); Zhi Zi (antihypertensive, parasympathetic stimulation)

* Gastroprotective — Mu Li (gastric acid neutralization, ulcers); Gan Cao (peptic ulcer prevention and treatment); Bai Zhu (dual digestive regulation — constipation and diarrhea); Da Huang (laxative, peristalsis↑)

* Immune enhancement — Chai Hu (humoral + cellular immunity); Dang Gui (macrophage phagocytic activity↑); Bai Zhu (macrophages↑, WBC↑, lymphocytes↑, IgG↑)

CHINESE THERAPEUTIC ACTIONS

* Spreads Liver qi; purges excess Liver fire (Chai Hu, Huang Qin, Da Huang, Gou Teng)

* Calms the shen (spirit); tranquilizes the Heart (Long Gu, Mu Li, Suan Zao Ren, Xie Cao, Zhu Ru)

* Nourishes Liver blood (Dang Gui)

* Strengthens and harmonizes middle jiao; prevents Liver overacting on Spleen (Xi Yang Shen, Bai Zhu, Fu Ling, Sheng Jiang, Da Zao)

* Promotes qi and blood circulation (Gui Zhi, Chuan Xiong)

DOSAGE

Standard (stress and anxiety): 3–4 capsules three times daily.

Severe emotional/psychological disorders or addiction withdrawal: 6–8 capsules every 4–6 hours or as needed. Reduce to 3–4 capsules three times daily once symptoms are stabilized.

Supplementary formulas: Moderate stress, anxiety, or PMS — use Calm. Stress and anxiety with insomnia in deficiency patients — use Calm ZZZ. Insomnia from blood deficiency — add Schisandra ZZZ. Crying spells or depression — add Shine or Shine (DS). ADD/ADHD — add Calm (Jr). Stress-related IBS — add GI Harmony. Stress-related ulcerative colitis — add GI Care (UC). Chronic stubborn insomnia with blood stagnation — add Circulation (SJ). Menopausal signs — add Balance (Heat). Hypertension — add Gentiana Complex or Gastrodia Complex. Headache — add Corydalin (AC) or Corydalin (CR). Constipation — combine with Gentle Lax (Excess) or Gentle Lax (Deficient). Hyperthyroidism — add Thyrodex. Heartburn or gastric ulcers — add GI Care. Excess fire — add Gardenia Complex. Thirst and dryness — add Nourish (Fluids).

Nutrition: A diet high in calcium, magnesium, phosphorus, potassium, and vitamins B and E is recommended — these are easily depleted by stress. Recommended foods: apricots, asparagus, avocados, bananas, broccoli, brown rice, dried fruit, figs, salmon, garlic, green leafy vegetables, soy products, and yogurt. Avoid caffeine (coffee, tea, cola, chocolate), tobacco, alcohol, and sugar. Avoid warm and hot-natured foods that damage qi and yin: heat-producing fruits (mango, durian), stimulants (coffee, alcohol, energy drinks), and spicy/pungent/aromatic vegetables (pepper, garlic, onions, basil, rosemary, cumin, fennel, anise, leeks, chives, scallions, thyme, saffron, wormwood, mustard, chili, wasabi). Avoid artificial coloring. Minimize meat — no processed meats (lunch meats, hot dogs, sausages) as nitrites are linked to inflammation and chronic disease.

Tao of Nutrition (Dr. Maoshing Ni and Cathy McNease) — Restlessness and emotional instability: Make a tea of wheat bran, licorice root, and dates. Drink three times daily until symptoms are relieved.

Lifestyle: If insomnia is related to work or stress, do not work in the bedroom and remove anything that reminds you of the office. A warm bath or light snack before bedtime may help. Regular exercise, adequate rest, and normal sleep patterns are beneficial for stress reduction. Relax the mind and body through meditation, yoga, breathing exercises, imagery exercises, tai chi chuan, and qi gong. Get away from daily routines to do something enjoyable — laughter really is the best medicine. Noise greater than 65 decibels can cause psychological disturbance; greater than 90 decibels can cause emotional damage; greater than 120 decibels can cause nervous system and hearing damage. Sleep by 10 p.m. — in TCM, 11 p.m. to 1 a.m. is when yin shifts to yang; the body must be at rest during this time for optimal health.

CASE STUDIES

— 54-year-old female (C.K.): OCD, anxiety, overthinking; on Celexa and Effexor for years; shen disturbance. Calm (ES) 4 capsules 3x/day + vitamin B12. Result after 1 year: began handling and recognizing emotions, no longer uses drugs. At 5-year follow-up: 2 capsules 2x/day, doing spiritual work, breathing properly, much happier.

— 65-year-old female: Husband recently died, left to run business; BP 160/92 mmHg, HR 78 bpm; stress, sleeping difficulties, waking anxious at night; Liver qi stagnation and phlegm fire. Calm (ES) 4 capsules 3x/day. Result: Western doctor stopped pushing drugs after seeing results; BP improved over time.

— 46-year-old female (P.I.): Spotting and uterine bleeding, irregular short cycles 15–27 days, heavy bleeding, night sweats, chronic anxiety worse before menses; perimenopausal syndrome; Liver and Kidney yin deficiencies with deficiency heat, blood stagnation, Liver qi stagnation, shen disturbance. Calm (ES) 2g 3x/day + Nourish + Notoginseng 9. Result: irregular bleeding and night sweats resolved over 6 months; periods returned to normal; anxiety much better.

— 35-year-old male (J.K.): Alcoholism with constant urge to drink; had just quit smoking cold turkey. Calm (ES) + Liver DTX + acupuncture. Result: no longer had urge to drink.

— 37-year-old female (J.H.): Anxiety, depression, addiction symptoms, history of ulcerative colitis; qi and blood stagnation, Liver qi stagnation, shen disturbance. Astringent Complex + Calm (ES) + Gui Pi Tang. Result after 2 months: stopped Western medication, quit smoking, felt stable and happy.

— 41-year-old female (M.D.): Manic depressive disorder, PMS, constipation, history of depression and addiction; Liver qi stagnation with heat disturbing shen. Calm (ES) + Zhi Zi + Da Huang. Result: patient stated she had never felt this good naturally before.

— 58-year-old female (A.D.): Nervousness, worrisome scattered thoughts, anorexia; BP 112/74 mmHg, HR 60 bpm; Spleen and Heart qi deficiencies with Liver qi stagnation agitating shen. Calm (ES) during times of stress. Result: responded very well, continues to use during stressful periods.

— 43-year-old female (L.H.): Anxiety, restless thoughts, insomnia, waking at 3 a.m. nightly; overwhelmed at work; Liver qi stagnation with fire harassing shen. Calm (ES) before and during business trip. Result: immediate relief from stress and insomnia; peaceful feeling with work situation.

— 42-year-old female (S.L.): Sensation of insanity, grief, sadness; wide-open eyes, shaking hands; shen disturbance. Calm (ES) as needed. Result after 4 days: calmer and less hysterical — noted needing to take several times daily for effectiveness.

— 35-year-old female (A.L.): PMS with stomach cramping, moodiness, breast tenderness; wiry pulse, red tongue tip and sides; Liver qi stagnation. Calm (ES) 2 capsules 2x/day. Result: 1 week before next cycle — more relaxed, no breast tenderness or cramping.

— 62-year-old male (W.Y.): Insomnia from stress and anxiety, waking 2–3 times nightly; red cheeks, purple lips; blood stagnation with Liver fire. Circulation + Calm (ES) 2 capsules 2x/day. Result within 1 week: sleep improved to waking only once nightly.

— 22-year-old female (A.B.): Anxiety, fear of failure, depression, insomnia, poor eating habits; Liver qi stagnation and Spleen qi deficiency. Calm (ES) daytime + Calm ZZZ nighttime → Schisandra ZZZ nighttime + Shine daytime + Bu Zhong Yi Qi Tang. Result after 1 month: insomnia resolved, depression lifted, major attitude and life changes. At 6 weeks: maintained with Calm; anxiety reduced to only stressful situations.

— 49-year-old female (S.B.): Mood swings, night sweats, tinnitus, borderline diabetic; Kidney and Liver yin deficiencies with Liver qi stagnation. Calm (ES) + Zhi Bai Di Huang Wan. Result by end of week 1: less volatile, decreased night sweating, sleeping more deeply.

— 56-year-old female (L.L.): Frustration, anger, sadness over losing home in hurricanes; hypertension, high cholesterol, PTSD; BP 138/78 mmHg, HR 82 bpm; temporal and vertex headaches, eye twitching, agitation, red eyes; damp-heat in Liver and Gallbladder, Kidney yin deficiency, excess fire and wind rising. Calm (ES) 1–3 capsules as needed + Cholisma 4 capsules 2x/day + Gentiana Complex 5 capsules 2x/day. Result: immediate emotional control; BP gradually reduced to 120/72 mmHg.

— 49-year-old female social worker: Stress, anxiety, dizziness, irregular menses, irritability, hot flashes, night sweats, dysmenorrhea, dry eyes, muscle cramps; Kidney and Liver yin deficiencies with Liver qi stagnation. Balance (Heat) + Calm (ES). Result: reduced hot flashes, less irritability, stress, anxiety, and dizziness; better sleep; less painful menses.

— 44-year-old female police officer: Chronic occipital/temporal headaches aggravated by stress; qi and blood stagnation in Gallbladder, Urinary Bladder, and Small Intestine channels; myofascial syndrome. Corydalin (AC) + Neck & Shoulder (AC) + Calm (ES). Result: replaced Imitrex (sumatriptan) — stress management was a critical aspect of treatment success.

— 18-year-old female: Vivid visual hallucinations at night; paranoia with visual hallucination; Liver qi stagnation with shen disturbance. Calm (ES) 3 capsules 3x/day for 2 weeks + positive visual imagery and mental clarification. Result: hallucinations and fears resolved.

— 40-year-old male: Severe insomnia, restlessness, hyperactivity; red tongue, rapid wiry pulse; schizophrenia; Heart fire and Liver fire. Calm (ES). Result within 1 week: sleep increased from 2–3 hours to 7–8 hours nightly; restlessness and hyperactivity subsided.

— 53-year-old female (M.C.): Severe anxiety and fear of flying; Liver fire. Calm (ES) 4–6 capsules before flight. Result: 4 capsules 1 hour before flight — anxiety under control; able to fly regularly when taking Calm (ES).

— 53-year-old male miner: Insomnia, depression, stress, anxiety, fatigue; difficulty falling asleep with relentless worrying; palpitations, occasional dizziness; choppy pulse, pale tongue; Heart and Spleen blood deficiency. Schisandra ZZZ + Calm (ES). Result: sleep improved from 2–3 hours to 5–6 hours nightly; no longer fatigued, much calmer. Could not take Western medication due to drowsiness side effect — herbal combination managed condition with no known side effects.

— 78-year-old female (stroke history): Memory loss, insomnia, nightmares, easily frightened, waking nightly from dreams; dementia; qi and blood stagnation, Liver and Kidney yin deficiency, Heart fire. Calm (ES) + Neuro Plus. Result after ~1 month: recalled practitioner's name for the first time; sleep, mood, complexion, and energy greatly improved; much calmer and less irritable.

— 51-year-old female (B.B.): Daily moderate headaches, breast tenderness and headache worsening before period, insomnia, irritability from quitting smoking; purplish red tongue, rapid wiry pulse; Liver fire and Liver qi stagnation. Jia Wei Xiao Yao San + Calm (ES) 2g each daily. Result: breast soreness resolved; headache diminished especially after nicotine detox; irritability greatly reduced. Continued 1 year — continues at 1g/day each.

Related Reading

Also see: Calm – for moderate stress, anxiety, or PMS | Calm ZZZ – for stress and anxiety with insomnia in deficiency patients | Schisandra ZZZ – for insomnia from blood deficiency | Shine – for crying spells or depression | Shine (DS) – for crying spells or depression | Calm (Jr) – for ADD/ADHD | GI Harmony – for stress-related IBS | GI Care (UC) – for stress-related ulcerative colitis | Circulation (SJ) – for chronic insomnia with blood stagnation | Balance (Heat) – for menopausal signs | Gentiana Complex – for hypertension | Gastrodia Complex – for hypertension | Corydalin (AC) – for headache | Corydalin (CR) – for headache | Gentle Lax (Excess) – for constipation | Gentle Lax (Deficient) – for constipation | Thyrodex – for hyperthyroidism | GI Care – for heartburn or gastric ulcers | Gardenia Complex – for excess fire | Nourish (Fluids) – for thirst and dryness | Stress & Sleep Collection.