Pearl (often referred to as "Zhen Zhu" in traditional Chinese medicine) has a long history of use in East Asian medicine to calm the spirit ("Shen"), reduce anxiety, and promote restful sleep. The traditional basis for its use is grounded in centuries-old texts where powdered pearl is described as having sedative and anxiolytic properties. It is thought to nourish the heart and calm the mind, and is included in several classic herbal formulas targeting symptoms such as palpitations, restlessness, and insomnia associated with anxiety disorders.

Scientifically, there is limited modern research exploring pearl's efficacy for anxiety. Some preclinical studies suggest that compounds found in pearl powder, such as calcium and certain proteins, may exert neuroprotective or calming effects, but robust clinical trials in humans are lacking. The majority of available evidence remains anecdotal or based on small, uncontrolled studies. As such, while pearl is traditionally used to treat anxiety and related symptoms, the evidence base from contemporary medical research is insufficient to confirm its effectiveness for anxiety disorders according to modern standards.