Treatment of Depression with Traditional Chinese Medicine

The depression in modern medicine falls into the categories of "Yu-syndrome" (depressed syndrome) and "Zang Zao" (restlessness of Zang-organs) in traditional Chinese medicine (TCM), which are understood to be caused by abnormal emotions leading to the stagnated flow of Qi. Clinically depression seems similar to the deficient syndromes of Yu-syndrome since there appear in patients the manifestations of physical leanness, sallow complexion, willingness of staying alone but being isolated from other people, unhappiness all day long, reluctance to speak, susceptibility to sadness and weeping, palpitation, and insomnia. Basically 3 syndromes could be differentiated in accordance to variation of the chief manifestations, i.e. depressed emotion leading to the disturbance of mind; coexistent deficiency of heart and spleen; and flaring of fire resulting from Yin-deficiency.

Depressed emotion leading to the disturbance of mind
Protracted or excessive emotional depression could consume the heart Qi and undermine the blood so that the heart fails to be nourished and is thus unable to house the mind, so the mind becomes out of order. Consequently there appear the manifestations of susceptibility to sadness and weeping, pale tongue with white coating, and wiry-thready pulse. The syndrome should be treated with the method of replenishing the heart and restoring the mind. The prescription used is the modified "Gan Mai Dazao Tang (Decoction of Licorice, Wheat and Date), including, (Zhi) Gancao (Radix Glycyrrhizae Praeparata)12g, Fuxiaomai (Fructus Tritici Levis)30g, Dazao(Fructus Zizophi Jujubae) 6g, Fushen (Poria cum Ligno Hopite) 15g, Hehuanhua (Flos Albiziae)12g, Baishao (Radix Paeoniae Alba) 20g, (Chao) Zaoren (Semen Ziziphi Spinosae) 20g, (Sheng) Muli (raw Concha Ostreae) 30g,(starts to be decocted in advance of the others) , and (Sheng)Longchi (raw Dens Draconis)30g.

When there is associated with irritability and hot-temper, tinnitus and dizziness and headache, (Sheng) Shijueming(raw Concha Haliotidis) and Daizheshi (Ochra Haematitum) are supplemented to balance the hyperactive liver-Yang. To make acupuncture treatment, such points as Shenmen (HT7), Tongli (HT5), Neiguan (PC6), Shenting (DU 24), and Sanyinjiao (SP 6) are selected for the needling.

Coexistent deficiency of heart and spleen
Excessive thinking and worrying could over-exert the heart and spleen, leading to the insufficiency of both Qi and blood, so the heart is malnourished and the mind is disturbed, resulting in the waning of heart Qi and the declining of courageousness. As the consequence, such manifestations may occur as palpitation, timidness, insomnia, amnesia, poor appetite, sallow complexion, listlessness and fatigue, pale tongue, and thready and weak pulse. The treatment concentrates on building up the spleen to reinforce its Qi and replenishing blood to nourish the heart. The modified "Gui Pi Tang" (Decoction for Invigorating Spleen and Nourishing Heart), with the following materials prescribed: Taizishen (Radix Pseudostellariae) 15g, Huangqi (Radix Astragli seu Hedysari) 15g, Fushen (Poria cum Ligno Hopite) 15g, Dangui (Radix Angelicae Sinensis) 10g, (Chao) Baizhu (Rhizoma Atractylodis Macrocephalae) 10g, Longyanrou (Arillus Longan)10g, (Zhi) Gancao (Radix Glycyrrhizae Preparatas) 6g, Yujin (Radix Curcumae) 10g, Dazao (Fructus Zizophi Jujubae) 6g. Meanwhile, Foshou (Fructus Citri Sarcodactylis) and Xiangfu (Rhizoma Cyperi) could be also added to disperse the stagnated liver-Qi and to pacify the stomach. To do acupuncture, Xinshu(BL15), Pishu (BL 20), Shenmen (HT7), Zusanli (ST36), and Sanyinjiao (SP 6) are prescribed in the treatment.

Flaring of fire resulting from Yin deficiency
Constitutional Yin deficiency or prolonged liver-Qi stagnation turns to fire, which takes from the Yin-fluid in the body, so the insufficient Yin leads to the flaring up of fire and the floating of the imbalanced Yang. Such manifestations would take place as the consequence: palpitation, insomnia, dizziness, tinnitus, irritability, hot temper, red tongue, and wiry-thready-rapid pulse. The treatment focus on nourishing Yin to clear away heat, and calm down the mind by means of heavy and suppressing medicinal materials. The prescription is the modified "Liu Wei Dihuang Wan"(Bolus of Six drugs Including Rehmannia), including (Sheng) Dihuang (Radix Rehmanniae) 12g, (Shu) Dihuang(Radix Rehmanniae Praeparata) 12g, Shanyurou (Fructus Corni) 10g, Shanyao (Rhizoma Dioscoreae) 12g, Mudanpi (Cortex Moutan Radicis) 10g, Baishao (Radix Paeoniae Alba) 10g, Hanliancao (Herba Ecliptae) 20g, Nuzhenzi (Fructus Ligustri Lucidi) 10g, Fushen (Poria cum Ligno Hopite) 15g, and Zhenzhumu (Concha Margaritifera Usta) 20g. Other heavy materials could also be put into the prescription to calm down the mind and reinforce the kidney for the astringency of essence, e.g. (Sheng) Muli (raw Concha Ostreae), Cishi (Magnetitum), Guiban (Plastrum Testudinis), and Qianshi(Semen Euryales). Acupuncture could also be done in such points as Sanyinjiao (SP6), Taixi (KI 3), Taichong (LR 3), Shenshu (BL 23), and Yinlingquan (SP9).