There is no terminology for “depression” in ancient China, but from the historical literature, we can see many descriptions similar to the clinical manifestations of this disease. In Traditional Chinese medicine(TCM), the basic pathogenesis of depression is attributed to stagnation of liver Qi, which can cause malfunction of the spleen, the kidney and the heart. Stagnation of Qi can also cause phlegm coagulation, blood stasis, etc.
Therefore, treatment should be focused on soothing liver and relieving depression.
Although the clinical manifestations of depression are complicated, it does not appear to be out of the scope of illness in both Xing( the body ) and Shen ( the mentality), with the functional activity exhibits inhibitory changes, of which, Yang-Qi stagnation is the core of the pathogenesis. When the Yang-Qi stagnation happens, the body’s normal activity is suppressed, which is manifested as inability to concentrate during the day and to fall asleep at night. Therefore, it is proposed that Yang Qi is the basic method to treat depression.
Treatment can be given according to the TCM syndrome differentiation.
1. Liver-qi stagnation syndrome: mental depression, with chest and hypochondriac pain, lack of appetite or sleep, nausea, belching, irregular stool, thin white or thin greasy coating, stringy pulse.
Commonly used herbs: Bupleurum, Peony, Citrus aurantium, Licorice，Poria, etc
Acupoint selection: Fengchi, Taiyang, Baihui, Liver-shu, Taichong, etc
2. Qi stagnation and fire syndrome: depression with irritability, insomnia, headache, chest and hypochondriac pain, bitter and dry mouth or red eyes and tinnitus, heartburn, acid indigestion, red tongue, yellow coating, string and rapid pulse.
Commonly used herbs: Bupleurum, peony, Citrus aurantium, licorice, gardenia, fermented soybean, etc.
Acupoint selection: Fengchi, Yintang,Sishengcong, Liver-shu, Taichong and Neiting, etc
3. Qi stagnation and blood stasis syndrome: Depression, with impatient temperament, insomnia, headache, forgetfulness or chest pain, or fever or tingling sensation in a certain part of the body, dark purple tongue or petechiae, ecchymosis, stringy or astringent pulse.
Commonly used herbs: Bupleurum, peony, Citrus aurantium, licorice, platycodon, fritillaria, cinnamon sticks, tuckahoe, tree peony bark, red peony, peach kernel.
Acupoint selection: Tianzhu, Yintang,Sishengcong, Liver-shu, Taichong, Taiyuan, Heart-shu, etc
4. Liver depression and spleen deficiency syndrome: Depression with chest tightness, irritability or silent( not speaking with others), difficulty falling asleep, fatigue, loose stools, greasy tongue coating, slow pulse string,
Commonly used herbs: Bupleurum, Peony, Citrus aurantium, Licorice, Magnolia officinalis, Ginger, Pinellia, Licorice, Ginseng.
Acupoint selection: Fengchi, Tianhu, Liver-shu, Spleen-Shu, Zusanli,Sanyinjiao, Neiguan, etc
5. Phlegm-qi stagnation syndrome: Major depression with feeling of congestion in the chest, fullness of the flank, or indifferent expression, suspicious, or muttering, or feeling of obstruction in the pharynx, inability to swallow and vomit, white and greasy moss, pulse The string is slippery.
Commonly used herbs: Ramulus Cinnamomi, Poria, ginseng, licorice, orange, bile star, pinellia, bamboo, citrus aurantium, calamus
Acupoint selection: Fengchi, Fengfu,Taiyang, Stomach-shu, Spleen-shu, Zu sanli, Hegu, Neiting, etc
6. Phlegm-heat accumulation syndrome: mental depression, restlessness, red face and bad breath, irritability and insomnia, red tongue, yellow and greasy coating, slippery or slippery pulse string.
Commonly used herbs: Coptis, Pinellia, Trichosanthes, Agarwood, Scutellaria, Rhubarb, etc.
Acupoint selection: Fengchi, Taiyang, Stomach-shu, Spleen-shu, Zu sanli, Fenglong, Taichong, Neiting, etc
7. Heart and kidney yang deficiency syndrome: lethargy, low mood, addiction to sleeplessness, upset and panic, insomnia and dreams, pale face, decadent body and spirit, impotence and nocturnal emission, pale tongue and fat white fur, heavy pulse. Commonly used herbs: Rehmannia glutinosa, Chinese yam, Cornus officinalis, Poria cocos, Moutan bark, Alisma orientalis, Guizhi, Aconite, Achyranthes, Plantago
Acupoint selection: Baihui,,Taiyang, Tianzhu, Heart-Shu, Kidney-Shu, Spleen-shu, Zu sanli, Neiguan, etc
8. Insufficiency of Qi and Blood: Depression after Chronic illness or postpartum, lack of energy, lazy talk, lack of appetizer and sleep, pale face, easy to forget and vivid dreams, pale tongue, thin white tongue coating, thin and weak pulse. Commonly used herbs: Ginseng, Atractylodes, Poria, Licorice, Tangerine Peel, Astragalus, Angelica, White Peony, Rehmannia, Schisandra, Guixin, Polygala,
Acupoint selection: Qihai, Guanyuan, zhongwan, yintang, Fengchi, Stomach-shu, Kidney-shu, Zu sanli, Xuehai, Hegu,, etc
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