TCM for Anxiety and Depression

Sufferers Benefit from Three Pillars of Healing – Counselling, Chinese Medicine, and Diet

By Kate Kent

Anxiety is a very unpleasant type of mental disorder that affects literally millions of people. Anxiety can go hand in hand with depression and can range from mild unease to intense fear and panic. Medication, a panacea for many, can ease both the depression and anxiety but can also have side effects. Dr. Peter Breggin, a Harvard-trained psychiatrist, points out that drug therapy, while suppressing the symptoms of depression and other mental disorders, can make a person chemically toxic, which will actually deepen the problem.

This article is going to approach anxiety from three directions: counselling, acupuncture and Traditional Chinese Medicine (TCM), and diet. 

Counselling Approach

My clinical experience suggests that people in difficulties are very hard on themselves. “I should be over this by now,” they say, or “Why does it still bother me after all these years?” However, in order to deal with anxiety, we need to remember and reintegrate the experiences and feelings that gave rise to our anxiety in the first place. Patients often talk about what is bothering them, but few have actually dared to experience situations or emotions that trigger their anxiety in order to come to terms with them. With counselling I encourage patients to face and deal with whatever feelings surface. 

For example, a young woman came to see me suffering from panic attacks and manifestations of acute anxiety and fear. She was quite open about what was bothering her and could explain everything to me in minute detail. But, she could not face the deep emotions that had led to her present crisis. She could talk about them but she couldn’t experience them. This concept of experiencing was totally new to her because she had been coping for years by talking and by suppressing any feelings that came up.

Her presenting problem was anxiety, but she came to understand that the anxiety was not the issue. In fact the anxiety was only there because of all her suppressed emotions. Any supportive comments from me or her boyfriend increased her anxiety. She would get tunnel vision, start to shake all over, her mind would go blank and she felt, in her own words, “as though she was going crazy.” She had suffered in the past from drug addiction and bulimia that she had worked hard to overcome. With gentle probing on my part and a real determination to get to the bottom of the problem on hers, we uncovered the fact that she was terrified of closeness. The more loving and caring her boyfriend was the more anxiety she felt.

In our sessions we had to go step by step, monitoring her anxiety, looking at deep emotions that emerged, like anger, and learning how to deal with them. We had to look closely at what her real needs were and we had to deal with the emotions that her needs evoked. For example, she longed for closeness which evoked pain and anger at what she had never had. She felt, subconsciously, that anxiety was safer than anger. Now she learned that when she stood up to her boyfriend in an argument, her anxiety level decreased and when she shut her emotions down and did not stand up to him, her anxiety level increased. She had to learn how to experience anger in a healthy way which not only decreased her anxiety and increased her vitality but also allowed for a measure of closeness with her boyfriend.

The TCM Approach

Traditional Chinese Medicine approaches anxiety from a completely different but complementary direction. We link anxiety and depression to the Liver and Heart and we also treat any accompanying symptoms like insomnia, palpitations and fatigue. With new patients, we will take a careful assessment using the tongue and pulse as guides to the kind of treatment required, and then we insert tiny disposable needles that calm and nourish the Heart and relax the Liver. We use herbs in exactly the same way, to nourish, calm and move the Qi and Blood.

(Editor’s Note: Depression is sometimes attributed to suppressed anger. Since anger is the emotion associated with the liver, according to TCM theory, clearing the liver of stagnation and “toxic heat” can often have good results. I have personally witnessed more than one case where cleansing and toning of the liver meridian with acupuncture and Chinese herbs actually worked to clear the anger and anxiety, causing the patient to feel calmer, more relaxed, and happier.)

Dietary Therapy

In TCM we consider diet central to well-being, and problems with diet as causes for emotional problems. For example, we use terms like Hot, Cold, Damp or Sweet to describe the ways in which certain foods are good or bad for different conditions. In some cases, by eliminating sugar and refined carbohydrates, a patient will feel less sluggish and depressed. This is because the sugars can cause wild fluctuations in blood sugar and insulin levels, which can have a profound effect on mood and mental health, and which eventually leads to pancreatic exhaustion, hyperinsulinemia, and adult onset diabetes. Furthermore, refined sugars strip B vitamins from the body, a deficiency of which affects the nervous system and the mind.

Furthermore, eliminating caffeine can create a noticeable lowering of anxiety and anger, once the patient has overcome the withdrawal symptoms of caffeine addiction. Caffeine creates “toxic heat” in the liver, which can aggravate it and cause anger and anxiety to accelerate Furthermore, it is an adrenal stimulant, which if relied upon long term can eventually cause adrenal exhaustion which in turn leads to depression.

By replacing refined sugar and caffeine with low glycemic foods and beverages which stabilize blood sugar levels and support the adrenals, patients experience a greater sense of well-being and a dramatic reduction in anxiety.

There is, of course, much more to Chinese dietary therapy than eliminating allergenic foods. For example, a TCM practitioner will, over a period of visits, be able to determine whether the patient’s fundamental constitution is “hot” or “cold” or a combination of the two. Appropriate foods are then recommended in order to balance the constitution to restore digestive strength and improve assimilation of nutrients.

Conclusion

All three of these approaches are beneficial. However, I consider counselling and diet to be most important at the start of treatment. They are essential for getting to the underlying cause of the anxiety. Acupuncture and herbs can then be used as an adjunct therapy to clear and strengthen the organs which in turn helps the patient to overcome the anger underlying their anxiety.

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Liver Yang Rising

Treating pain with Traditional Chinese Medicine

By Kate Kent

I found her hunched over holding her head in my waiting room. She had called for an emergency treatment – a young mother of four who suffered from debilitating headaches. I had to laugh because during the assessment, still holding her head, she weakly pointed to a funky new bag I had just bought and was rather pleased with and whispered “nice bag.” I knew she was going to be OK.

But pain is no laughing matter. Millions of people suffer pain at some point in their lives – some on a daily basis. Like my patient, it can take the form of debilitating headaches or menstrual pain, injury from trauma and, as the baby boomers slide into their late 50s and 60s, arthritic pain.

We can be grateful for the vast array of drugs that are available to ease the suffering, but prolonged use of these drugs can cause problems of their own and do not get to the underlying cause.

In Traditional Chinese Medicine, pain can be treated successfully with acupuncture and herbs. The premise of TCM is one of flow and balance – flow of Qi and Blood and balance of Yin and Yang –  so we see the pain as a blockage known as a Qi Syndrome. In TCM the kind of pain is a strong indicator of what type of treatment is appropriate. For example, if the pain is dull, we look for a deficiency in Blood or Qi;  severe pain leads us to ask about Cold in the body; a sharp, stabbing and fixed pain is most likely Blood Stasis and a throbbing pain with a feeling of irritability and insomnia could be Liver Yang rising (too much Heat in the head). If there is swelling and heaviness with the pain, it is probably Damp invasion and this may turn to Heat or be of a Cold nature. When Damp or Cold is involved, rainy weather will often bring on a heavy, dull type of pain.

In TCM looking at the tongue and taking the pulse is like opening a book of the body. It tells us a great deal about the general health of the patient and the cause of the pain. So with these tools, the practitioner, like a sleuth, makes a thorough assessment and comes up with a treatment plan. Once the assessment is accomplished, tiny disposable needles are inserted into acupuncture points (I think of them as little Esso stations of Qi) to move the blockage, strengthen the body’s defensive mechanism and balance the whole system.

A good way to describe this is to think of a traffic jam where tempers are beginning to fray. Along comes the ambulance (the needle) and moves what is blocking the flow, enabling the traffic to move freely again. Needling is sometimes painful and sometimes not, depending on the practitioner, depth of treatment, and how chronic the condition is. In my practice, patients commonly describe sensations like like burning, numbness, or tingling. Acupuncture ultimately causes deep relaxation and some of my patients even fall asleep.

I find herbs a useful adjunct to a treatment because they continue the work of the needles. They have no side effects and are gentler on the system than drugs. Depending on the severity and duration of the pain, three to 10 treatments is about average. However, if a patient has suffered years of pain, treatments may take longer.

Very rarely does pain, except that of trauma, occur on its own. Often there will be an underlying cause of disharmony in the body that needs to be addressed and diet plays a large part in recovery. In general, patients suffering from dampness and cold, should avoid greasy type foods, dairy products, tofu, salads, and cold drinks as these create more dampness and will make the problem worse. If the concern is a pounding headache that feels hot, then the patient should avoid hot spicy foods and alcohol.

A patient once described her pain to me as something that, “eats you up, takes up space in your head and takes over your life.” It is not necessary to live on pain killers or to suffer pain. TCM has been around for thousands of years and is an excellent and safe way to treat this problem.