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Centers for Disease Control and Prevention (CDC) surveys indicate that about 10% of the United States resident who is 18 years older has a depressive disorder (Gonzales, 2008 and 2008). The pathophysiology of depression is not fully understood. Some scientists suspect the biochemical impact of depression may be stored in the neurons through changes in the activity of gene transcription factors and neuronal growth factors. The final pathway is the biochemical imbalance of biogenic amines or neurotransmitter (e.g., serotonin, norepinephrine, GABA and dopamine) and their relationships with their respective receptors in the brain neuron.

In Chinese Medicine, depression is called “Yu Zhen” (meaning Depressed Disease) and depression is an good example that a disease can start from emotional and develop into physical injury. In Chinese Medicine, the liver is the organ that like to “extend” and “discharge”. When a person’s emotion feeling is not smooth or being impeded, overtime, this emotional condition can cause Qi and blood imbalance with other internal organs. When the Liver Qi is pent-up, it can take advantage of the Spleen and resulting the deficiency of the Spleen. The stagnation of the Liver Qi can also transform into heat, and it can cause damp heat in the Liver and Gallbladder. Liver Qi stagnation can also cause injury to the Heart and Kidney as the Heart and the Kidney is the “son” and “mother” of the Liver, respectively.

As the Liver Qi stagnation progress, it can be differentiated into the following six categories based on their symptoms:

1. Liver Qi stagnation - This is the initial stage of this emotional induced disease. Patient’s symptoms may include, unsettled and irritated, gastric bloating, short temper and gets angry easily, dry mouth with bitter taste, may have red eyes, headache and tinnitus or acid re-flux, constipation with pebble shape stool. The pulse is wiry and the tongue is red with yellow tongue coat.

2. Liver and Gallbladder Damp Heat – Liver Qi stagnation can cause damp heat in the Liver and Gallbladder. Patient can have symptoms such as feeling depressed or impatient, easy irritated, insomnia and/or dream disturbed sleep, oppressive feeling in the coastal region, bitter taste in the mouth and loss appetite, feeling nausea and bloating, constipation and dark color urine. The pulse can be wiry or slippery and tongue coat can be thick and in light yellow color.

3. Blood circulate stasis - If Liver Qi stagnation is not treated, it can develop into blood circulation stasis or commonly known as blood stasis. At this stage, patient may have symptoms such as depressed vitality and mental state, impatient, headaches, insomnia, forgetfulness, chest and gastric pain. The patient may have purple tongue with dark color bruise dots and wiry or choppy pulse.

4. Liver Qi stagnation w/ Spleen Qi deficiency – As the Liver Qi stagnate, it become more excess and it can further cause the imbalance between the Liver and the Spleen (the digestion system). This imbalance can have symptoms such as gloomy spirit, chest congestion, bloating in epigastric region, excessive envisage, distrustful and anxiety, sigh frequently, poor appetite, loss weigh, tiredness, lump in the abdomen, belch and burp, alternating between constipation and diarrhea (i.e., a symptom similar to Irritable Bowel Syndrome), feeling a lump in the throat (i.e., Plum Pit Qi in Chinese medicine terminology). The pulse may be fine or wiry and tongue coat may be thin and white.

5. Melancholia and Shen Disturbance – When the Liver Qi stagnation caused imbalance with the Heart, it produces psychology related symptoms. Patient may be in a trance, confused, restlessness, distrustful and anxiety, mood swing, frequent sadness and sorrow, weep, wail and screaming (i.e., similar to schizophrenia symptoms), spasm on face or limbs. This type of patient may have pulse that is fine and wiry, the tongue is pale with thin white coat.

6. Liver Qi stagnation w/ Kidney Qi Deficiency - When the Liver Qi stagnation caused imbalance with the Kidney, it produce symptoms related to vital energy. The patients may have symptoms such as feeling of pessimistic and despondent, insipid interest of anything, will power go down, react slowly, sluggish behavior, belch and burp, no desire to eat or drink, achy back and weak knee, pale face. This is the most dangerous type of depression because when a patient's vital energy fade away and he/she lost the will to live, they may commit suicide.

It is interesting to note that while some Western scientists looking into the biochemical changes inside the brain neuron to find the ways to treat depression, the Chinese medicine’s approach is to fix the imbalanced between the organs due to the Liver Qi stagnation. There are treatments in Chinese Medicine for each Liver Qi Stagnation patterns as described above. The main treatment of Liver Qi stagnation should be focused to course the Liver and rectify Qi. For acupuncture, the treatment should be centered on the Liver and Gallbladder meridians and the meridian that is being injured due to the imbalance. Both acupuncture and herbal drinks can be used simultaneously for the best results.

Many human and animal studies have demonstrated that the stimulation of certain acupuncture point can alter neurotransmitter level (Han, 1986). The United Nation World Health Organization (WHO) recognized the acupuncture is effective in treating mild to moderate depression. This finding is supported by several uncontrolled and controlled studies.

I believe acupuncture is a good supplement treatment for depression and hence I present some of my study notes here to share with whoever has interest in this subject. If you have any further questions or would like to discuss this subject, please contact me at


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