Monday, May 5, 2014

Insight into Depression: Why it is Different for Everyone

Depression: a serious medical condition in which a person feels very sad, hopeless, and unimportant and often is unable to live in a normal way.
b (1) :  a state of feeling sad :  dejection (2) :  a psychoneurotic or psychotic disorder marked especially by sadness, inactivity, difficulty in thinking and concentration, a significant increase or decrease in appetite and time spent sleeping, feelings of dejection and hopelessness, and sometimes suicidal tendencies. --from Merriam Webster Dictionary.

TCM poses that there are many different types of depression with different sets of symptoms. While the definition above covers many bases, not every depressed person will present with all of those symptoms.

According to Chinese Medicine there are 5 elements: Wood, Fire, Earth, Metal and Water. Each of these elements has a different set of internal organs associated with them:
  • Wood-- Liver and Gallbladder
  • Fire-- Heart, Small Intestine, Pericardium, Triple Warmer (no Western equivalent)
  • Earth-- Spleen and Stomach
  • Metal-- Lung and Large Intestine
  • Water-- Kidney and Bladder
Each element and internal organ set expresses depression in a different way:

  • Wood: Anger, frustration, irritability and feeling stuck are all symptoms of Liver depression. Since the Liver is in charge of the smooth movement of Qi through the body, when it is stuck or stagnant, you can see signs of emotional stagnation, like feeling emotionally stuck. If the Qi is moving in fits and starts (not smoothly), you can have bursts of anger or feeling short tempered. You may also find yourself yawning or sighing a lot.

  • Fire: Depression with anxiety, feeling ungrounded, lack of joy and mania are all symptoms of Heart depression. All emotions are felt by the Heart so the Heart is usually involved with all types of depression. The Mind is also connected with the Heart in Chinese medicine, another reason why the Heart is often associated with depression.

  • Earth: Fatigue where you can't get out of bed, all of your muscles ache or are weak, and apathy toward food are symptoms of Spleen depression. There could also be OCD (obsessive compulsive disorder) with overthinking, worrying and obsessing in a way that is emotionally paralyzing.

  • Metal: Sadness and grief. This type of depression is common after the loss of a loved one, or multiple losses in a short period of time. When grief is prolonged, it is common for people to develop Lung illnesses, such as bronchitis, pneumonia or asthma. They can also be more susceptible to colds while grieving.

  • Water: Lack of motivation. The Kidney is the source of the Will (Zhi), or will power, so Kidney depression often presents as lacking the motivation to get things done. Sometimes it is small like not having the energy to do housework but having energy for things you enjoy; sometimes it is bigger, like not being able to make yourself do the big work project that has a deadline and people are counting on you. There is often an element of fear to it as well; putting things off for fear of not being good enough, fear of success, or other possibilities.
Traditional Chinese Medicine treats the person, rather than the disease. Although you may be seeking treatment for depression, your practitioner will treat all of you; by addressing the imbalance that is causing the depression, your symptoms will go away. Depression is a symptom (or set of symptoms), not a definition of who you are.

I find it interesting that some antidepressant medications work for some people and not others, and I believe it is because depression presents so differently for each person. I don't have research to back this up, but I feel like this would be a great place for Eastern and Western medicine to mix and support each other. It would be an interesting study to figure out if certain drugs would work better with certain types of depression as outlined by Traditional Chinese Medicine; this could then help doctors prescribe the right medications for the right people and minimize or possibly even eliminate side effects, or the jumping from one anti-depressant to the next, hoping to find the right one. Chinese herbal medicine typically has no side effects because each prescription is tailor made for each person. Wouldn't it be great if Western medications could be prescribed in the same way?

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