As a primer to this second article on depression and Chinese Medicine, please read the first article here: Acupuncture for Depression I.
According to Traditional Chinese Medicine, the body/mind complex of a person is basically looked at in terms of patterns of energy. In a nutshell, vigorous mental, emotional and physical health is related to the unobstructed flow of psycho/physical energy throughout the energy system or energy channels of the body. Many types of diseases that affect people are due to stagnation of this psycho/ physical energy; termed “Chi” in Chinese Medicine. The type of particular disease pattern that energy stagnation might cause in a person is related to a person’s constitutional weaknesses as well as the location of the energy stagnation; which energetic channels and which organ systems are affected etc. In general, energy stagnation of any sort will affect the liver channel and organ system as the liver is primarily in charge of circulation of energy throughout the entire psycho/ physical system.
Depression, according to TCM, is always related to stagnation of energy affecting the channel and organ system of the liver to some degree. The relationship between liver energy stagnation and depression is dynamic and double directional, meaning that liver energy stagnation may cause depression and that in “reactive depression” one’s circumstances and emotional reaction to them may conversely cause liver energy stagnation. This is a common aspect of TCM diagnosis, that pathologies are often times not linear, but rather multidimensional and occurring mutually and simultaneously. In other words, one may already have mild liver energy stagnation caused by poor diet or lack of exercise that combines with some devastating life circumstance to create a depressive disorder, or vice versa: some negative life circumstance might cause one to become lethargic and to begin eating poorly, thus exacerbating the liver energy stagnation already induced by emotions. It is an interesting clinical note that liver chi stagnation almost always attacks its neighbors the spleen and stomach, causing digestive upset, lack of appetite and/or other gastrointestinal distress. Irrespective of the etiology of the liver energy stagnation and concurrent depression, the treatment plan for such initial stage depression would be to unblock and circulate the energy of the liver utilizing acupuncture, herbs, diet and exercise. Untreated, liver energy stagnation may give rise to excess heat in the body. The pattern is then considered more serious and is termed “liver heat” or “liver fire”. Liver heat or liver fire can in turn damage the body’s fluids and give rise to “liver blood” or “liver yin” deficiency. It is another interesting clinical note that anti depressant medications, while often helpful in the short term, will over time exacerbate liver energy stagnation and eventually lead to liver blood and liver yin deficiency making them a poor long term solution. Acupuncture on the other hand, has also been shown to stimulate serotonin production in the brain which makes it an ideal alternative to SSRI (selective serotonin re-uptake inhibitor) anti depressants. See an article about serotonin production and acupuncture here.
As we can see from this brief synopsis of depression in TCM, although depression can often times be classified simply as “liver energy stagnation” in its initial stages, the pattern can become quite a bit more complicated in later stages. In addition to the possible patterns of liver heat, liver fire, liver blood deficiency and liver yin deficiency, other organ systems may be affected as a consequence of the imbalance of liver energy. Liver fire may over time give rise to “heart fire”, “heart blood deficiency”, “heart yin deficiency” or “kidney yin deficiency” as the heat spreads and the pattern becomes more complex. It is therefore important that in the treatment of depression within the context of Chinese Medicine, that all components of the imbalance be adequately diagnosed and taken into account in order to render the most complete treatment possible. I will delve more deeply into the various patterns of depression according to Chinese Medicine in the third article in this series. In the next article we will also look more closely at the mental, emotional and psychological aspects of the liver, heart and kidney energetic systems.
Terry M. Chen, Licensed Acupuncturist
Open Sky Acupuncture, Eugene Oregon