The Treatment of Depression with TCM

A couple of weeks ago, I was asked if I could go into detail about the treatment of mental illnesses with TCM.  While this is a very interesting topic to write about, it's also a very difficult one.  A great many people perceive TCM diagnosis as quackery based on its "alternative" view on how we look at the body.  When dealing with mental illness, people expect us to drill holes in the head to "release the demons!".  We do not drill holes in the head ... Well, actually we do with acupuncture, but they're actually very small holes and they don't go all the way through!  All jokes aside, there are similarities in what TCM describes as the root causes of mental illness as in general medicine.  Therefore, I'm going to discuss a single type of illness per article, just so it stays easier to follow.  Much of the explanations may seem odd, but I'll try to be as descriptive as I can to TCM's reasoning behind them.

In this article, I'm going to be covering depression considering how widespread it is in America.  At some point, everyone has become depressed or have felt depression symptoms.  It's impossible not to.  Children get upset when they don't get what they want and tend to mope.  Young kids can become depressed being singled out or shunned in school.  Older kids can become depressed from poor grades and increasing pressures from parents.  Young and old adults alike can become depressed from breakups, death of loved ones, and tremendous stress from work and home.  These are only a handful of situations that can start depression.  However, no matter how hard life is, these depression symptoms go away after a certain amount of time and we pick ourselves back up.  It is how we adjust and rebalance ourselves to what life throws at us (aka being Song).  The old saying "Time heals all wounds" isn't true, but time does help you get back on your feet again.  This is perfectly normal ...

What happens when there's too much pressure, pain, stress, death?  What happens when the symptoms don't go away and you can't regain control?  This is not normal and needs to be addressed right away, whether by speaking to your teacher, family, consular, or even a close friend and visiting a licensed psychologist.  A huge problem in our society is it's difficult to know whether or not a person has gotten this far.  Some may see a person showing constant depression symptoms as an "attention seeker" or "diva" and sadly, some are.  When they're not and when they're actually in dire need of treatment, they're usually ignored and bushed aside as just being overemotional.  This can lead to severe mental problems (and possibly suicide) later in life.

Thankfully, we have increasing amount of therapies and medication today that can help to nudge the body back in the right direction to balance.  Some of these therapies also include TCM, such as Tui Na, Qi Gong, meditation, and acupuncture.  Working in conjunction with doctors and psychologists, a TCM practitioner could help optimize those TCM therapies for the individual.

Going back hundreds of years ago in China, mental illnesses were diagnosed differently based on aspects of the person's life.  Without something akin to the DSM, TCM doctors had to use the knowledge they based on books like the Huang Di Nei Jing  and the Jin Gui Yao Lue.  From this information, they found chronic depression started from emotional, physical, and congenital factors.  

Emotional factors are based on the emotions of the 5 Elements (Anger, Joy, Worry, Grief, and Fear).  Too much of any of these emotions (or similar) will manifest Stress and cause the body harm.  Physical factors are based on injury and chronic illness to the body.  Too much pain, injury, or illness will disturb the mind.  Lastly, congenital factors are conditions you were born with and may be mental, physical, or both

Chronic emotional and physical factors show similar internal problems and can be treated with acupuncture, herbs, and exercise therapy.  This would help a patient recover enough to start the natural healing process once again.  Congenital factors, unfortunately, were much harder to treat, but there was some easement based on its severity.

When TCM doctors did their initial inspection of a patient, they would often find the following:

1 - Liver Qi Stagnation
Liver Qi stagnation is more commonly found in people with the beginning signs of emotional distress, but can show in all types listed here.  It means the Qi is constricted and not flowing as smoothly through the body as it should be.  Symptoms can include irritability, anxiety, tightness or squeezing in the chest, pain on the sides, possible belching, and what feels like a lump in the throat (Plum pit qi).

Normally, Xiao Yao Wan is used in early instances, but Chai Hu Shu Gan Wan is used for more severe case.  For plum pit qi, we use the formula Ban Xia Hou Po Tang.

2 - Qi and Blood Stagnation
Qi and blood stagnation is more commonly found in people with physical distress.  Pain is sign to let you know something is wrong with the body and a signal to rest.  Not getting enough rest can damage the body further and can knock you of your feet for several days.  For some people who can't afford to not be working, this is devastating to them.  When this happens, it can also lead to emotional issues that constricts the Qi even more.

Depending on the cause of stagnation, certain formulas such as Xiang Sha Liu Jun Zi Tang, Suan Zao Ren Tang, and Zhen Zhu Mu Wan can be used.  Even external liniments like Die Da Jiu can help clear stagnation in a specific area and lessen pain.

3 - Dampness, Phlegm, and Food Retention
TCM believes water, phlegm, and food retention can also cause stagnation symptoms, much like the above.  Very common formulas such as Xiang Sha Liu Jun Zi Tang or Bao He Wan are used in this case.

4 - Heat disturbing the Shen
When a stagnation is not cleared after a long time, it can create heat.  That heat can disturb your body and make stagnation symptoms feel even more oppressive.  In addition to the earlier symptoms, it will also include palpitations, trouble sleeping, and stronger irritability and anger. 

Formulas used to help clear the heat include Jia Wei (Dan Zhi) Xaio Yao Wan, Long Dan Xie Gan Wan, and even An Gong Niu Huang Wan if the heat is severe.

5 - Heart and Spleen Deficiency
Another condition that may occur if stagnation is left too long without treatment is Heart and Spleen deficiency.  Out of all the conditions listed here, this is the one I find the most common next to Liver Qi Stagnation.  When the emotional imbalance continues long past when it should, you start to see fatigue in the body.  Symptoms include over thinking a lot, palpitations, becoming more shy and introverted, trouble sleeping, and poor memory.

The formula used to treat this case is Gui Pi Tang.  It helps to strengthen and calm the body.  Another formula used for this case when it has more Liver Qi stagnation is Gan Mai Da Zao Tang.

6 - Kidney and Heart Deficiency
In TCM, the Kidneys control the "life" of the body.  Kidney Yin pertains to the fluids that help moisten and nourish the organs and tissues.  When this is impaired, weakness in the body occurs.  Chronic illnesses will always lead to Kidney deficiency, congenital issues also show this condition, and it can appear briefly from long periods (as in several hours worth) of drinking, smoking, drug use, and/or sex.  

TCM believes that the Heart houses the Shen (or spirit).  When the Shen is disturbed, the person also becomes disturbed.  This is why TCM explains why there are mania symptoms with high fevers (which is an example of Heat disturbing the Shen). Since the Heart is no longer nourished by the Kidneys, heat signs begin to appear.  Symptoms included more irritability, easily angered, dizziness, tinnitus, palpitations, and trouble sleeping.

The formula used for this case is Tian Wang Bu Xin Dan, which nourishes the Kidney Yin, clears the heat, and calms the Shen.

7 - Phlegm misting the Heart
Phlegm misting the heart is a condition where the Shen is blocked off completely for a few seconds.  Now, control is completely lost and more serious problems can occur such has a heart attack, stroke, severe mania (yelling, screaming, and anger), epilepsy, and sudden sensory loss.

An example of a traditional formula used for this condition is Wen Dan Tang.  It is used to clear phlegm to prevent it from obstructing the heart again.  However, more specialized treatment and help is needed at this point, as the patient may not even be able to take it themselves.

Each diagnosis listed above has it's own treatment principle, acupuncture points, herbal formula, and exercise.  They are tailored to the person based on their physical and mental condition.  Specialized treatment of this type allowed the person to recover faster, but there's always a risk of a occurrence.  Keeping up with treatments could be difficult if you didn't have enough money to see the doctor regularly.  Also, some people didn't want to recover and did so for a  specific reason (such as getting out of work or joining the army).

I hope you enjoyed this article and that its given you some insight on how TCM looks at one aspect of mental health.  Please be aware that everything written here was generalized for easier reading and it is not recommended to be used for self-diagnosing.  It's always better to talk to a licensed professional before doing anything you read on the internet.

After all that, if your still wondering what acupuncture point we use on the head to help with depression, it's YinTang.  That's the point right in between the medial ends your eyebrows and more commonly known as the "Third eye".  Acupuncturists use that point to help calm the Shen, relax, and relieve stress and anxiety.  Thankfully, no special (power) tools are needed to benefit from using this point.  You (or someone else!) can massage it daily for a few minutes from some relief.  I've used this point, along with the Four Gates (Liver 3:TaiChong and Large Intestine 4:HeGu), to great effect to help Liver Qi flow more easily.

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The information written here is not intended to diagnosis or treat Depression or related conditions.  The formulas mentioned are not FDA approved and are not meant to cure, diagnosis, treat any specific condition.  Please speak a licensed health professional for any medical advice pertaining to mental illness.

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