LU JI HONG—Senior Physician
I’ve recently seen a young woman who gets extremely paranoid and anxious whenever she leaves the house. Her living circle is basically limited to her house. She was diagnosed with depression.
Depression from a TCM perspective
Although depression wasn’t a diagnosis in the TCM literature, there were many documented clinical presentations that are similar to depression. Many illnesses and syndromes depicted in Treatise on Cold Injury and Essential Prescriptions from the Golden Cabinet are comparable to depression. In addition, there were many case studies as well. In Ancient and Contemporary Case Studies, the author documented a patient who was paranoid of death. He had visited countless fortunetellers and famous doctors. Although they all helped temporarily, none of the methods provided lasting relief for him. In fact, this is also a case of depression.
TCM believes that the fundamental issue with depression is deregulation and blockage of Qi in the liver, leading to inhibition of the spleen system, and injury of the kidney system. When Qi is not moving correctly, it also causes fluid retention and circulation problems. Treatments should focus on soothing the liver to reduce depression. Common used prescriptions for depression are ChaiHu ShuGan San, XiaoYao San, WenDan Tang, YangXin Tang, TianWang BuXin Tang, SiNi San, Xiao ChaiHu Tang, and GanMai DaZao Tang.
In addition, many patients are also fatigue, passive, forgetful, and indecisive. These are all characteristics of Qi deficiency or Yang deficiency. Deficiency of heart and spleen presents as palpitation and forgetfulness. Deficiency of heart and gallbladder presents as fear and lack of confidence. Spleen deficiency due to liver blockage presents as loss of appetite and diarrhea. Deficiency of liver and kidney presents as dizziness and insomnia.
TCM Treatment for Depression
The key to treatment is replenishing Qi and unblocking Yang to uplift one from depression. Yang energy mobilizes Qi in the visceral organs and excites the central nervous system to stabilize one’s mood. The heart system is considered the most Yang in the human body. It controls the cardiovascular system, and also has its own consciousness that modulates our mental and psychological activities. Hence, unblocking Yang is therapeutic for the heart system, and, in turns, is beneficial for mental health. Commonly used prescriptions are TianWang BuXin Dan and YangXin Tang.
Chronic depression is detrimental to one’s mental health. It leads to brain fog, difficulty with concentration, excessive skepticism, overactive startle response, sadness, inactivity, frequent yawning and increased irritability. Treatments should focus on nourishing the heart system, and tranquilizing the mind. Commonly used prescriptions are GanMai DaZao Tang and LongGu MuLi Tang with cinnamon twigs.
In addition, phlegm and Qi retention are also extremely common among depressed patients. They often are depressed, quiet and spacey, skeptical and untrusting. They may experience chest fullness, abdominal bloating, and hypomimia. They sometimes talk to themselves. They may feel like there’s a foreign object in the throat. They may have thick white coating on the tongue, and taut pulses. Treatments should focus on regulating Qi to mobilize body fluid, uplift the mood, and tranquilize the mind. It is appropriate to use GuiZhi BanXia Tang and modified DiTan Tang.
Obviously, medications should not be the only mean of therapy. Counseling for mental health is also extremely important. One should be pro-active and embraces the journey to resolve the root cause of depression.
Source: Life Care magazine © Ma Kuang Chinese Medicine & Research Centre Pte Ltd. Reproduced with permission.
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