Depression and depressive symptoms
What's depression?
Everyone feels gloomy, sad or less motivated. In depression, these feelings last longer and clearly affect daily functioning. In addition to gloom, there may be loss of pleasure and interest, fatigue, sleep problems, difficulty concentrating and a reduced self-esteem. Physical complaints may also be at the forefront.
Depressive symptoms may occur after a difficult period, loss, prolonged stress or overload, but sometimes there is no obvious cause. Often several factors play a role simultaneously.
Within Chinese medicine, therefore, not only the depressive mood itself is considered. Also sleep, energy, tension, digestion, physical complaints and other changes are taken into account to determine which underlying pattern is most prominent.
Common symptoms
Depression can express itself differently per person. Common symptoms are:
- persistent gloominess or feeling empty;
- less pleasure or interest in activities;
- low energy and faster fatigue;
- lack of motivation or initiative;
- difficulty in concentrating and making decisions;
- worry, guilt or feelings of worthlessness;
- irritability, anxiety or inner restlessness;
- sleep problems or a lot of sleep;
- changes in appetite and weight;
- decreased libido;
- physical symptoms such as pain or digestive problems.
Severe depression can also prevent thoughts of death or suicide. This requires professional medical and psychological guidance. Acupuncture or Chinese herbal medicine can never replace the necessary conventional care.
Possible causes
Depression does not usually have one cause. Genuine predisposition, prolonged stress, loss or profound events, physical illness and social or psychological factors can all play a role.
Sometimes depression occurs clearly after an event, such as death, breakup, prolonged overload or childbirth. In other cases the depression develops gradually and there is no obvious cause.
Physical and psychological complaints can also reinforce each other. Poor sleep, prolonged tiredness and low movement, for example, can help to maintain depressed symptoms.
How can acupuncture help with depression?
In acupuncture, the treatment is tailored to the way the depressive symptoms express themselves to you. Someone who is particularly tense, frustrated and irritable has a different pattern within Chinese medicine than someone who is exhausted, withdrawn and unmotivated.
The treatment may include:
- Improve Qi flow when voltage and stagnation are at the forefront;
- the Shen . . within TCM an understanding for, among other things, mental and emotional functioning . .
- Supporting Qi and Blood in case of fatigue and exhaustion;
- To reduce Phlegm when heavy or blurred sensations and concentration problems are present;
- Support Yin or Yang when there are clear signs of a deficit;
- treat sleep, digestion and other additional symptoms.
The selected acupuncture points therefore differ per person. In the TCM sources consulted, among other things, they describe points that are used to support the mood, calm the Shen and, in the absence of motivation and decisiveness, to support the Zhi .
How can Chinese herbal medicine help with depression?
Chinese herbs are also chosen based on the underlying pattern and not just on the diagnosis of depression. This allows two people with similar depressive symptoms to receive a very different herbal treatment.
For example, treatment may be directed at:
- move stagnated Qi in the event of tension, frustration and a steady feeling;
- Reduce heat when depressive symptoms are associated with strong irritability and restlessness;
- Transforming Dampness and Phlegm in heaviness, mental fog and listlessness;
- Qi and Blood nourish during fatigue, paleness and poor sleep;
- Feed Yin in the event of dryness, nocturnal disturbance and heat problems;
- Yang strengthen in case of pronounced cold, exhaustion and lack of initiative.
Herbs can be used daily and thus support the treatment between acupuncture sessions. The formula is adapted to the overall picture and can change during the treatment course.
How does Chinese medicine view depression?
Western medicine uses depression as a diagnosis. In traditional Chinese Medicine (TCM) it is also investigated which underlying imbalance causes or maintains the complaints.
An important traditional understanding of depressive complaints is Yu , which is associated with both depression and stagnation. Emotional stress can first disrupt the free movement of Qi. Long-term stagnation may then coincide with, among other things, Heat, Phlegm or Blood stasis. Otherwise deficits of Qi, Blood, Yin or Yang can also play an important role. In practice, combinations of stagnation and shortages are common.
In depression, especially the Heart, the Liver, the Spleen, the Lungs and the Kidneys are relevant. These are TCM organ systems and have a broader meaning than the anatomical organs with the same name.
Within TCM, the Heart is closely associated with the Shen: consciousness and mental and emotional functioning. The Liver is involved in the free movement of Qi and the Hun, which is traditionally linked to inspiration, planning, creativity and a sense of direction. The Spleen plays a role in energy and thinking and worrying. The Lungs are connected with grief and mourning. The Kidneys are linked to the Zhi: willpower, strength and perseverance.
A recognizable combination of such disturbances and symptoms is called a TCM pattern.
A TCM organ system includes, in addition to the body organ, a set of functions associated with one another within Chinese medicine. Therefore, it is not the same as the organ as described in Western medicine.
A TCM pattern is a recognizable combination of signs and symptoms that indicates which functions according to Chinese medicine are out of balance. Only the most common patterns are discussed below. Other patterns are possible, multiple patterns can be present at the same time and not everyone with the same pattern has all the mentioned symptoms. The pattern is determined based on the overall grievance picture.
Most common TCM patterns
Liver-Qi-stagnation
Brief explanation
With Liver-Qi stagnation, the natural movement of Qi is less free. This pattern is especially apparent when depressed feelings are associated with tension, frustration and feeling emotionally or physically stuck.
Common symptoms
- gloomyness and varying moods;
- frustration and irritability;
- feeling tense or hunted;
- sighs;
- tension in neck and shoulders;
- bloating or varying bowel movements;
- in women sometimes PMS or irregular menstruation.
Examples of Western disorders
Depressive symptoms associated with prolonged stress or burn-out and depressive symptoms associated with hormonal changes, for example PMS or PMDD.
Liver-Qi-stagnation with Heat
Brief explanation
If stagnation is present for a longer time, according to TCM Heat can occur. In addition to gloom more restlessness and irritability are present.
Common symptoms
- depressive mood with irritation or anger;
- inner restlessness and tension;
- be irritated quickly;
- headache;
- dry mouth or bitter taste;
- red face or eyes;
- constipation;
- sometimes reflux or acidic rebuffing.
Examples of Western disorders
Depressive complaints involving gloomyness associated with obvious irritability, anger and inner restlessness, for example in stress-related depressive complaints or hormonal mood symptoms.
Heart- and Lung-Qi-stagnation
Brief explanation
This pattern is especially seen when grief, mourning, loss or prolonged care play an important role. The tension is often literally felt in the chest.
Common symptoms
- sadness and a tendency to cry;
- gloomy mood;
- chest pressure or tightness;
- sighs;
- superficial breathing or slight shortness of breath;
- feeling of a lump in the throat;
- palpitations;
- decreased appetite.
Examples of Western disorders
Depressive symptoms after loss or mourning and complaints involving gloomyness associated with grief, withdrawal and chest tightness.
Qi-stagnation with Phlegm
Brief explanation
During prolonged stagnation, the processing of moisture according to TCM can be disturbed, resulting in Phlegm. This does not necessarily mean visible mucus. It can also express itself as a feeling of mental heaviness or blockage.
Common symptoms
- gloomyness and restlessness;
- feeling blurred or confused in the head;
- difficulty in thinking clearly;
- chest pressure;
- sighs;
- Smell in the throat;
- difficulty swallowing sometimes;
- feeling heavy in the body.
Examples of Western disorders
Depressive symptoms in which listlessness, mental inertia and a heavy or clouded feeling are at the forefront, possibly combined with physical or digestive problems.
Blood stasis
Brief explanation
Blood stasis means that blood circulation is not sufficiently free within TCM. In depressive complaints this is more often a long-term pattern and may be associated with obvious physical pain or symptoms that are stronger at night.
Common symptoms
- prolonged or deeper depressive symptoms;
- inner restlessness and irritability;
- restless sleep and many dreams;
- complaints getting worse at night;
- local, persistent pain;
- sometimes a dark or purple discoloration of the tongue.
Examples of Western disorders
Long-term or persistent depressive symptoms, especially when associated with chronic pain or post-traumatic symptoms.
Heart-Blood- and Spleen-Qi-deficiency
Brief explanation
This is not a stagnation but a shortage. According to TCM, the Spleen has insufficient energy to support Qi and Blood properly, which also reduces the feeding of Heart and Shen. Somberness often goes together with fatigue and worry.
Common symptoms
- gloomyness with fatigue;
- a lot of thinking, worrying or grinding;
- difficulty sleeping;
- palpitations;
- poor concentration or forgetfulness;
- dizziness;
- low appetite;
- pale.
Examples of Western disorders
Depressive symptoms following prolonged overload, illness or exhaustion and depressive complaints in which fatigue, worrying, difficulty concentrating and poor sleep are clearly at the forefront.
Heart- and Kidney-Yin-deficiency
Brief explanation
Yin has a nourishing, cooling and soothing function within TCM. In the event of a shortage, gloom may go hand in hand with anxiety, inner restlessness and warmth. This pattern is seen more often around and after menopause.
Common symptoms
- depressive mood with anxiety or restlessness;
- symptoms stronger in the evening;
- difficulty sleeping or waking up at night;
- night sweats;
- heat sensation or hot flushes;
- dry mouth or other signs of dryness;
- palpitations;
- dizziness;
- low back pain;
- sometimes tinnitus.
Examples of Western disorders
Depressive symptoms around the transition or after prolonged stress and overload, especially when gloomyness is associated with anxiety, insomnia, night sweats and heat complaints.
Spleen- and Kidney-Yang-deficiency
Brief explanation
This pattern weakens the warming and activating energy of both the Spleen and the Kidneys. According to TCM, there is insufficient energy to activate body and mind. Depressive symptoms often have a heavy and exhausted character: someone feels fitless, withdrawn and has little motivation or initiative. The weakened Spleen can also lead to indigestion complaints and reduced moisture processing.
Common symptoms
- deep fatigue and physical exhaustion;
- lack of motivation, initiative or action;
- apathy and retreat;
- much need for rest or sleep;
- being cold quickly and cold hands and feet;
- low appetite;
- feeling bloated after eating;
- soft or thin stools, sometimes diarrhoea in the early morning;
- weak or painful lower back and knees;
- frequent and clear urination or need to urinate overnight;
- Sometimes stick to fluid.
Examples of Western disorders
Long-term depressive symptoms in which severe physical exhaustion, crookedness and little initiative are at the forefront, especially when digestive complaints are present.
Outlook
The course of depressive symptoms varies greatly per person. In relatively recent cases with obvious causes, change can sometimes occur faster than with prolonged or recurrent depression. In addition, if there is strong exhaustion, prolonged sleep problems or multiple underlying TCM patterns, a longer treatment course is usually required.
In the initial phase acupuncture is often applied approximately once a week. Depending on the severity of the complaints, treatment can be temporarily more frequent. If improvement occurs, the frequency can usually be reduced. Chinese herbs can provide daily support during the course.
In depression I see acupuncture and Chinese herbal medicine mainly as additional treatment. In moderate or severe depression, suicidal thoughts or major limitations in daily functioning is assessment and guidance by GP, psychologist or psychiatrist important.
Contact
Do you suffer from depressed or prolonged gloomy complaints and want to know if acupuncture and/or Chinese herbal medicine can mean anything to you? During the intake we discuss your complaints, health and personal situation. On this basis, we will examine which TCM pattern is most prominent and what treatment fits in with it.
You can make an appointment directly online or contact us for more information.