Chinese Medicine Treatment for Depression and Anxiety: A Holistic Approach to Emotional Health
by Antonia Balfour, L.Ac.
Although depressive disorders and anxiety are commonly seen together, there are distinct differences between a diagnosis of depression and one of anxiety.
Common symptoms of depressive disorders include emotions such as hopelessness, despair and anger. Energy levels are usually very low, and depressed people often feel overwhelmed by day-to-day tasks and personal relationships. There is a decreased interest in most activities, possible insomnia, fatigue, and feelings of emptiness and worthlessness. When depression is at its worst, hopelessness sets in and, in some people suffering from severe depressive disorders, thoughts of suicide ensue.
Symptoms of generalized anxiety disorder may include excessive, ongoing worry and tension; an unrealistic view of problems; restlessness or a feeling of being “edgy”; irritability; muscle tension; headaches; difficulty concentrating; trouble falling or staying asleep; and being easily startled.
In addition, people with generalized anxiety often have other anxiety disorders such as panic disorder, obsessive-compulsive disorder, and phobias.
According to the National Institute of Mental Health, 18.8 million American adults suffer from clinical depression and 19.1 million Americans suffer from anxiety disorders.
Research on Acupuncture’s Effectiveness
The National Institutes for Health (NIH) have established the National Center for Complementary and Alternative Medicine which funds research studies in various holistic treatments. In one study of women suffering from depression, 70% of participants experienced at least a 50% reduction of symptoms. This research marked the first U.S. randomized, controlled, double-blind study of acupuncture’s effectiveness in treating depression. The NIH funded study concludes, “Acupuncture may alter brain chemistry by changing the release of neurotransmitters and neurohormones in a good way.”
Stanford researchers, using a small sample of 61 pregnant women, found that those who were given acupuncture treatments had significantly fewer depressive symptoms. The researchers conclude that “acupuncture holds promise for treatment of depression during pregnancy,” and may help with the long term management of depression. In an Australian study, 65% of patients diagnosed with anxiety and pain reported that acupuncture “greatly helped” relieve their symptoms. Another 24% said that it “helped.”
Further studies show that Traditional Chinese Medicine used in combination with western pharmaceutical treatment of depression and anxiety is more effective than either modality when used on its own.
The Chinese Medicine Perspective
With such promising statistics from Chinese Medicine research studies, it’s important to look at how Chinese medicine views depression and anxiety.
Traditional Chinese Medicine (TCM) has addressed the link between the body, spirit and mind for more than 2000 years. In TCM, the belief is that illness affects both the mind and body; there is no separation between the two. Therefore, emotional disturbances have associated physical symptoms and, in reverse, physical disorders evoke emotional responses.
The first objective of a TCM practitioner is to discern a relationship between all symptoms a patient presents with in order to establish what is called a “pattern of disharmony”. Treatment is aimed at restoring harmony and bringing the body into balance, and the whole person is always taken into account. The theories used to establish the TCM “patterns of disharmony” include Yin and Yang, Internal Organs; Qi, Blood and Body Fluids, and Five Phases. (Click here for more detailed information). The whole person is always taken into account.
Patterns of Disharmony in Depression and Anxiety
In looking at Patterns of Disharmony, the most important thing to remember is that organs in Chinese medicine are not the same as their western anatomical counterparts. If you have a Pattern of Disharmony affecting your “Liver Qi” or your “Heart Yin”, it is highly unlikely that anything is wrong with your western liver or heart. We capitalize the first letter of the Chinese medicine organs to make the distinction.
Patterns seen in depression and anxiety include:
* Heart and spleen Qi deficiency – Physical symptoms may include palpitations, insomnia, poor memory, lack of appetite, fatigue, poor digestion, and a pale tongue. Emotional symptoms include excessive worry and feeling timid.
* Heart Yin deficiency – Physical symptoms may include absentmindedness, dizziness, insomnia, low back soreness, dryness, sensations of heat, tinnitus, and a red tongue with little coating. Emotional symptoms include sensitivity and irritability. Yin deficiency is commonly seen during menopause.
* Phlegm – Physical symptoms may include obesity, feeling weighted down, congestion, dizziness, fatigue and a swollen tongue. Emotional symptoms include depression and feeling cloudy or experiencing dullness of thought.
* Liver Qi stagnation – Physical symptoms may include nausea, bloating, premenstrual symptoms, rib-side pain, belching and possibly insomnia. Emotional stress affects the liver and includes irritability, frustration, and anger.
* Liver and/or Heart fire – Fire is often caused by prolonged Liver qi stagnation. Therefore, the symptoms are the same as above and also include a bitter taste in the mouth, headaches, ringing in the ears, dizziness, sores in the mouth, red eyes, red face and a quick temper.
Patterns of disharmony usually do not exist on their own. Typically, patients manifest with anywhere between 3 and 8 patterns at any given time. This exemplifies the need for customized treatment – each patient should be diagnosed according to his or her own unique constitution and patterns of disharmony.
For example, an older frail man who has been diagnosed with depression comes in with a pale tongue, low energy, and sadness. He is deficient and given herbs and treated with acupuncture points to boost and strengthen his “Qi”. In contrast, if an overweight woman with a red face, headaches, bad temper and a heavily coated tongue comes in (also with a diagnosis of depression), she is more excess in nature and is given herbs and treated with acupuncture to clear her phlegm and heat. Had the man been treated identically to the woman (both with western diagnoses of depression), his symptoms may have worsened.
Generally, results with acupuncture and herbs are cumulative, improving week by week. Treatment begins with one or two sessions per week and tapers off as the condition improves.
Acupuncture and herbs are not only safe, but also effectively used together with anti-anxiety and anti-depressant medications. Many patients find these medications to be inadequate at completely resolving their symptoms. Others, together with their doctors, would like to wean themselves to lower dosages in order to decrease the occurrence of side effects. Patients turn to acupuncture and herbs for a variety of reasons – mostly because of their clinical success.
Antonia Balfour is an acupuncturist and herbalist practicing in Pacific Palisades, California. She is the co-owner and Clinical Director of Oasis Palisades, a Health & Wellness Center located in Pacific Palisades (on the Westside of Los Angeles, between Santa Monica and Malibu). She is a California-licensed, NCAAOM-certified acupuncturist. Antonia served as the 2008/2009 president of the Pacific Palisades Chamber of Commerce.