From the point of view of Chinese medicine, both kinds of depression usually involve impediments to natural flows in your body. Hence the secret of overcoming depression is to restore healthy flows.
Mild transient depression happens easily in a stressed society in which a fast pace of living and societal expectations tax our emotions. It is also common among the retired and aged who do not live active lives and may lose a sense of purpose and experience diminished self- worth. Sadness or frustration from the loss of friends and loved ones, or from relationships that hit a rough patch, can also be triggers for depression.
Exercise, qigong, yoga, relaxation, and a change of environment can be therapeutic, as is talking to friends, relatives and counsellors to release pent-up emotions and sort out personal problems. But the most important role is played by the person himself who must make the effort to snap out of the depressive state: allow emotions and thoughts to flow naturally and the body to return to a balanced healthy state.
Certain herbs with soothing and calming may be helpful. Chinese herbs which help to improve qi flow include chaihu柴胡, xiangfu香附, foshou佛手, hehuanpi 合欢皮and rose flower玫瑰花.
A simple recipe for a calming cup of herbal tea uses rose and jasmine flowers, which have the actions of soothing the liver, dispersing qi stagnation and hence, improving qi flow and alleviating symptoms such as chest tightness, tension and anxiety.
At what stage the episodes of mild depression evolve into clinical depression is not well defined. The Singapore Health Promotion Board uses the following criteria “persistent sadness, loss of interest in all or almost all activities, decrease or increase in appetite; unintentional weight loss or gain, difficulty in sleeping or sleeping excessively, restlessness or feeling agitated, fatigue, difficulty concentrating, frequent thoughts of death or suicide, feelings of worthlessness or excessive guilt.” But psychiatrists appear not to have a consensus on the definition of depression. What may happen in practice is that when doctors see a number of these symptoms, they make a judgment as to what anti-depressant drugs to prescribe. These drugs are powerful and patients can develop dependencies on them, hence they should be taken under strict medical advice.
Western medicine views genetics, chronic illnesses, hormonal imbalances and stress as possible underlying causes of depression. Traditional Chinese Medicine (TCM) takes a different approach. The TCM term yubing 郁病 refers to a group of conditions arising from blocked flows in the body, leading to sadness, anxiety, panic, mood swings, or autism, or a combination of these symptoms. Although yubing does not exactly correspond to the Western medical meaning of depression, they have many conditions in common. For convenience, the term depression used below refers to TCM yubing.
Yu 郁refers to stagnation of qi in the body and is the main underlying pathological mechanism of depression. A common cause of qi stagnation is the emotional factor. Excessive anger and emotional stress can lead to stagnation of liver qi, which may progress into liver fire if no treatment is given. Anxiety may result in the stagnation of spleen qi, which causes the production of phlegm and dampness that further impede the flow of qi. Another contributing factor is weakness or “deficiency” of blood and nourishment to the heart, resulting in symptoms such as insomnia, paranoia and anxiety. This is sometimes seen among menopausal or postpartum women who are also low in yin and qi.
TCM treatment for depression is holistic in the sense of identifying blockages and imbalances and resolving them with herbal medications to restore qi flow. Common prescriptions used in treating depression include chaihushugansan 柴胡疏肝散, xiaoyaosan 逍遥散for alleviating depression associated with blocked qi flows in the TCM gan (“liver”) whereas ganmaidazao tang 甘麦大枣汤is generally used in blood deficiency syndrome. Caution: consult a TCM physician to identify the underlying condition (syndrome) and the appropriate formulation to use rather than try to self-medicate.
Lifestyle changes are also an important part of the treatment regimen. Our body is like a water pipe along which water flows smoothly when things go well. If flow is blocked, pressure builds up and the pipe may burst. Without an outlet for our emotions, depression may result. Social interactions, group exercise sessions like qigong and yoga, and regular walks in peaceful environments all help with healthy emotions and improve the flow of qi.
For emotional health we must have work-life balance, and the pursuit of happiness should reign over an obsession with material achievement. Sounds like a tall order for driven Singaporeans, but we ignore it at our peril!
Authored by Hong Hai and Karen Wee