Depression, Stress and Anxiety Treatment



Mental illness can be a vast scope to talk about, TCM/acupuncture has a long history of successfully treating the relevant disorder and conditions. We here only raise a small corner of it to tell you about some of the most common conditions in clinical practice: stress/anxiety and depression.

Western Introduction

What is Stress?

Stress is the feeling of being under too much mental or emotional pressure. It is the body's reaction to harmful situations. When you feel threatened, a chemical reaction occurs in your body that allows you to act in a way to prevent injury. These stress hormones are released to enable you to deal with pressures or threats – the so-called "fight or flight" response. Once the pressure or threat has passed, your stress hormone levels will usually return to normal. However, if you're constantly under stress, these hormones will remain in your body, leading to the symptoms of stress. People have different ways of reacting to stress, so a situation that feels stressful to one person may be motivating to someone else. Our bodies are designed to handle small doses of stress. But, we are not equipped to handle long-term, chronic stress without ill consequences.

What Are the Symptoms of Stress?

Stress can affect all aspects of your life, including your emotions, behaviours, thinking ability, and physical health. You may experience any of the following symptoms of stress.

Emotional symptoms:

  • Becoming easily frustrated, irritable and moody
  • Feeling anxious and losing your temper more easily
  • Having difficulty concentrating and relaxing
  • Feeling bad about yourself (low self-esteem), lonely and depressed

 

Physical symptoms:

  • Headaches, dizziness and sleeping problem
  • Loss of appetite or eating too much, nausea, upset stomach, diarrhoea or constipation
  • Muscle tension and pain
  • Loss of sexual desire and/or ability
  • Shaking, sweating, rapid heartbeat
  • Clenched jaw and grinding teeth

 

Other symptoms of stress include:

Constant worrying, Racing thoughts, Forgetfulness and disorganization, Inability to focus, Poor judgment, Avoiding responsibilities, Increased use of alcohol, drugs, or cigarettes, Exhibiting more nervous behaviours, such as nail biting, fidgeting, and pacing

A little stress is not an illness itself. However, ongoing and chronic stress can cause or exacerbate many serious health problems. It's important to recognise the symptoms of stress early. Recognising the signs and symptoms of stress will help you figure out ways of coping and save you from adopting unhealthy coping methods, such as drinking or smoking.

What is depression?

Depression is a common mental disorder that causes people to experience depressed mood. Depression is more than simply feeling down or fed up for a few days. Unhappiness is something which everyone feels at one time or another, usually due to a particular cause. But when you're depressed you feel persistently sad for weeks or months, rather than just a few days. A person suffering from depression will experience intense emotions of anxiety, hopelessness, negativity and helplessness, and the feelings stay with them instead of going away.

Depression affects people in different ways and can cause a wide variety of symptoms. Depressed mood is a feature of some psychiatric syndromes such as major depressive disorder, but it may also be a normal reaction to life events such as bereavement, a symptom of some bodily ailments or a side effect of some drugs and medical treatments.

What causes depression?

There is no single cause of depression. You can develop it for different reasons and it has many different triggers. Depression can happen suddenly as a result of physical illness, experiences dating back to childhood, unemployment, bereavement, divorce, illness, redundancy and job or money worries. Often, different causes combine to trigger depression. People often talk about a "downward spiral" of events that leads to depression. Some of chronic illnesses, include heart disease, back pain and cancer may cause depression too. Some studies have also suggested you're more likely to get depression as you get older, and that it's more common if you live in difficult social and economic circumstances.

Symptoms of Depression

The symptoms of depression can be complex and vary widely between people. But as a general rule, if you are depressed, you feel sad, hopeless and loss of interest or pleasure, feelings of guilt or low self-worth, disturbed sleep or appetite, low energy, and poor concentration. Depression can come on gradually, so it can be difficult to notice something is wrong. The symptoms persist for weeks or months and are bad enough to interfere with your work, social life and family life. If you experience four or more of these symptoms for most of the day - every day - for more than two weeks, you should seek help from your Doctor or therapists.

Psychological symptoms include:

  • Continuous low mood or sadness
  • Feeling hopeless and helpless
  • Loss of self-confidence and self-esteem.
  • Feeling tearful
  • Very strong feelings of guilt or worthlessness
  • Feeling irritable and intolerant of others
  • Having no motivation or interest in things
  • Finding it difficult to make decisions
  • Not getting any enjoyment out of life
  • Feeling anxious or worried all the time
  • Having suicidal thoughts or thoughts of harming yourself

 

Physical symptoms include:

  • Moving or speaking more slowly than usual
  • Difficulty concentrating
  • Change in appetite or weight, constipation
  • Physical aches and pains
  • Tiredness and loss of energy
  • Loss of sex drive and/or sexual problems
  • Changes to your menstrual cycle
  • Disturbed sleep

 

Other symptoms include:

Not doing well at work, avoiding other people, sometimes even your close friends, not being able to enjoy things that are usually pleasurable or interesting, having difficulties in your home and family life.

Types of Depression

Major depression

You may hear your doctor call this "major depressive disorder." Major depression interferes with an individual’s daily life - with eating, sleeping and other everyday activities. You might have this type if you feel depressed most of the time for most days of the week. Some people may experience only one episode but it is more common to experience several episodes in a lifetime. It can lead to hospital admission, if the person is so unwell they are at risk of harm to themselves.

  • Loss of interest or pleasure in your activities
  • Weight loss or gain
  • Trouble getting to sleep or feeling sleepy during the day
  • Feelings of being "sped up" or "slowed down"
  • Being tired and without energy
  • Feeling worthless or guilty
  • Trouble concentrating or making decisions
  • Thoughts of suicide



Your doctor might diagnose you with major depression if you have five or more of these symptoms on most days for 2 weeks or longer. At least one of the symptoms must be a depressed mood or loss of interest in activities.

Bi-polar disorder

The mood swings in bi-polar disorder can be extreme - from highs, where the individual feels extremely elated and indestructible, to lows, where they may experience complete despair, lethargy and suicidal feelings. Sometimes people have very severe symptoms where they cannot make sense of their world and do things that seem odd or illogical.

Post-natal depression

Many new mothers experience what are sometimes called 'baby blues' a few days after the birth. These feelings of anxiety and lack of confidence are very distressing but in most cases last only a couple of weeks. Post-natal depression is more intense and lasts longer. It can leave new mothers feeling completely overwhelmed, inadequate and unable to cope. They may have problems sleeping, panic attacks or an intense fear of dying. They may also experience negative feelings towards their child. It affects one in ten mothers and usually begins two to three weeks after the birth.

Seasonal Affective Disorder (SAD)

SAD is associated with the start of winter and can last until spring when longer days bring more daylight. When it is mild, it is sometimes called ‘winter blues’. SAD can make the sufferer feel anxious, stressed and depressed. It may interfere with their moods and with their sleeping and eating patterns.

2 Chinese introduction

Stress, Anxiety and Depression (SAnD) are three of the most common emotional disorders affecting lots of people in their lives.

According to the Traditional Chinese Medicine (TCM) theory, these emotional problems are three different stages of the same disease which is called YU ZHENG by the Traditional Chinese Medicine. At first, the natural body's reaction to situation under stress/tension is meant to protect us, but when we are under intense pressure or feel out of control of it, these reactions then become negative and destructive. As a result, anxiety thus occurs, in the end depression may show up if we have difficulty sorting them out for a long term. That is why many people may suffer from a combination of Stress, Anxiety and Depression.

Mind, Body and Spirit are inseparable in Chinese Medicine. In TCM, Stress, Anxiety and Depression are often the result of an imbalance or blockage in the body's liver and heart meridian, the pathway/channel where the energy of the organs travels within. From the view of TCM, The heart is believed to control the body’s blood circulation, and is also housing the mind and Spirit. When the heart meridian is obstructed by various toxins, mind and spirit will get disturbed and unsettled, so to make people feel restless and panic. If the heart is deficient, mind and spirit will not get enough nourishment, so to make people suffer from Fatigue, Poor concentration or become indecisive, Guilty, or even stuck in to abnormal thoughts of death and suicide etc. The Liver is in charge of Qi circulation and coordination between different organs. The smooth flow of Qi is the key of a stable emotional state. Liver is housing ethereal soul in our body, which is associated with brain’s unconscious activities and dreams. The liver meridian, paired with the gall bladder channel, runs over the stomach, chest and breast, pelvis, and shoulders, up the neck and on the sides of the head. That explains why most people with SAnD also very often experience digestive, hormonal disorders, palpitation and breath/chest complaints, as well as shoulder pain, neck pain and headaches.

Chinese herb, acupuncture and massage can help strengthen and unblock liver and heart meridian. A lot of researches show that Chinese herb, acupuncture and massage can alleviate symptoms by releasing endorphins, the body's own natural painkillers, and improving the circulation of blood and lymphatic fluids, which brings fresh oxygen to body tissues. This increased oxygen flow eliminates waste products from inside the body and enhances recovery from diseases.

3 The comments on TCM acupuncture from NHS and WHO

Acupuncture treating psychiatric conditions has been widely acknowledged. There have been many reports and articles on the effectiveness of acupuncture and TCM treatment for stress, anxiety and depression.

Here is a brief summary on acupuncture and psychiatric conditions of WHO’s report: “ACUPUNCTURE: REVIEW AND ANALYSIS OF REPORTS ON CONTROLLED CLINICAL TRIALS”.

“Acupuncture is said to be comparable with amitriptyline in the treatment of depression but has fewer side-effects….In addition, acupuncture has been found to be more effective in depressive patients with decreased excretion of 3-methyl-4hydroxy-phenylglycol...It was found that some of the patients whose postoperative pain was relieved by acupuncture were hiding a dependence on opium. In 1979, a study carried out jointly in Hong Kong and London showed that endorphin concentrations were raised by acupuncture in heroin-dependent persons, resulting in successful suppression of withdrawal symptoms. Since then, acupuncture has been used to treat dependence on a variety of substances. Acupuncture treatment has also been used in patients who wish to give up smoking….”

On NHS website, it states that the National Institute for Health and Care Excellence (NICE) only recommends considering acupuncture as a treatment option for chronic lower back pain, chronic tension-type headaches and migrain. It is often used to treat pain conditions such as headache, lower back pain and osteoarthritis, but is also sometimes used in an attempt to help people with conditions ranging from infertility to anxiety and asthma.

Although, conclusions from past studies and researches haven’t been consistent, it has proven a huge potential of acupuncture treating the mental and psychiatric conditions, especially like stress, depression and anxiety. And it has in fact turned out that seeking acupuncture for treating conditions related to mind-body imbalance like stress, anxiety and depression are nowadays becoming an increasing interest of the NHS doctors’ advice.

4 What actually TCM and acupuncture are doing to help with depression, stress and anxiety? Compared to western medicine, what TCM and acupuncure is better at?

Traditional Chinese Medicine (TCM) is a holistic medicine- it has an integrated view over our mind, body and spirit, and so can comprehensively treat conditions with both physical and mental symptoms.

TCM practitioners believe that physical health issues are connected to a person’s emotional state. Practitioners of TCM view emotions as an integrated aspect of organ functions, and sometimes the root cause of disease. TCM classifies emotions into seven categories, with each emotion corresponding to a particular organ. For example, the lungs are commonly linked to grief and the ability to let go. The seven emotions are anger, joy, fear, worry, grief, fright, and sadness.

Depression can be described as stagnant energy within the body. This stagnation can create imbalances that lead to symptoms of depression, such as an inability to focus, melancholy, anger, fatigue, and a lack of inspiration. Acupuncture and herbs address the issue by enabling the energy to move more efficiently, balancing the organ systems and creating homeostasis. The ideas are that creating balanced energy better equips a person to manage stress and steady emotions, and enables a more peaceful feeling.

TCM theory on anxiety is that a person can have excessive energy, also referred as heat or energy (Qi), in the head. Symptoms of anxiety include insomnia, racing thoughts, and excessive worry. In such a case, the treatment would consist of acupuncture, inserting needles into various points on the body, such as the fingers, hands, wrists, ankles, and feet, in an effort to redistribute the patient’s energy, in order to improve sleep and reduce worry.

For western medicine side, some physical/biomedical causes of depression are: chronic pain, chronic fatigue, normal grief, vitamin B12 deficiency, anemia, chronic viral infections/ M.E, connective tissue/collagen disorders (arthritis), and organic brain disorder, drug side-effects, cancer, and endocrine abnormalities.

Controlling depression with pharmaceuticals usually requires weeks or months of experimentation with various drugs at different dosages. During this experimentation, the patient experiences physical and mental side-effects which can range from the annoying to the unbearable.

Chinese herbal medicine, properly practiced, can enhance the health of anyone with any of these conditions, causes much less side-effects and so may ultimately be preferable to psychiatric medications.

So more and more M.Ds are now working to minimize the amount of pharmaceuticals taken by each patient, and some are even working with TCMs to utilize acupuncture and Chinese herbs to slowly take the patient off of drugs and cure the root problem.

5 advices on account of the health care and prevention on depression, stress and anxiety from TCM view

Below are some good tips on keeping a healthier state of mind and preventing depression, stress and anxiety:

a. Those who develop depression should not feel resigned to living with the illness. This seems more realistic when we begin to recognize that depression is curable. Some of the steps we can take towards recovery, relate to changing how we think, such as; having a calm attitude towards illness, cultivating your mind and strengthening your character, challenging the irrational aspects of thought and personality, and don’t always be in the pursuit of perfection. Let your mind calm down.

b. Consider starting a hobby or pursuing something that you are interested in, this will help create a sense of contentment. When you feel low in mood, you may also use distraction techniques, such as cleaning the house, going for a car ride, creative activities such as writing and painting, listening to music, or even relaxing while watching a comedy movie.

c. Depression can be reduced by increased physical exercise. Try going outside to exercise and getting into the sun light, or even just the benefit of natural light. Exercise can take many forms; such as running, walking, boxing, all kinds of ball games and team sports. Exercise helps to speed up our metabolism and releases endorphins, which help make us feel cheerful, and improves mood.

d. Healthy living and getting enough rest is important. Good sleep can improve the body's ability to repair itself. Pay closer attention to strengthening nutrition, eat a balanced diet, with the appropriate level of calories. There are functions of the brain relating to mood which can be enhanced by food; certain meats, eggs, beans, bananas, citrus fruit, chocolate, and green tea are good "mood supplements"

e. Regularly keep contacts with friends and loved ones, especially when you are not well. “A friend is a good doctor” talking and opening up to a friend or loved one, can reduce the burden in our mind, and allow us to relax. Get into the habit of maintaining regular contact with friends and developing these friendships. Avoid shutting yourself away, to rid your life of loneliness, this will help alleviate the symptoms of depression.

6 Case study

Case 1

A thirty seven year old lady had been sufferring from stress and anxiety on and off since her husband died 9 years ago. The symptoms also include bad sleep, tiredness, palpitation, depression and low back pain, sore rib that were becoming worse and worse during the last 6 months. In addition, she found her periods was getting irregular and she developed hot flashs, mood swing and night sweat. She tried to get help from her GP with some western medication but that did not make much difference.
Chinese medicine views stress and anxiety as a problem caused by liver Qi stagnation and deficient heat due to over-burning resulted from long stagnant Qi and failed nourishment of declining Liver and kidney Yin. Normally the treatment with Chinese herbal remedy and acupuncture would help to move the Qi and balance the liver, kidney’s function. This lady felt the difference even only after a couple of sessions and she carried on weekly acupuncture and herbal treatment for over 3 months, and gradually achieved a good level of calm and did not suffer any of her old symptom which she was devastated about. Even sometimes the stress and a great deal pressure were still inevitable from her work and life, but they didn’t affect her health any more.

Case 2

A slim young lady, aged 31, suffered very bad anxiety for over 6 years, along with the symptoms like panic attack, sickness, poor appetite, very dry month, light-headedness, low energy, bad sleep and even vomiting in occasions. The situation was so bad that she had to give up her job because of the bad symptoms greatly interfering with her normal daily life. During the last few years, although through various blood tests, ECG, gastroscopy examination, nothing abnormal has been found. The only suggestion from the GP was to take antidepressants, but the medication has not really help. Eventually she decided to look into Chinese medicine and acupuncture. The change in her even after the first visit was amazing. She had acupuncture treatment twice in the first week and followed by once a week along with some Chinese herbal remedy. Four weeks after, she gained more confidence and her body was said to have returned “normal” according to herself. Chinese medicine, in her case, regards anxiety as a result of suppressed liver’s energy and weakness of the spleen and stomach, as well as the imbalance of YIN and YANG in the heart. Once the liver’s Qi energy regains smoother flow, the spleen and stomach strengthened and the heart balanced, by help of Chinese herbs and acupuncture, the symptoms were quickly cleared and the body returned to a healthy balance.