How Depression Develops

Depression develops when the liver is unbalanced through stress and poor lifestyle
In this follow up article on the topic of depression and Chinese medicine, I will investigate how an unbalance in the liver's function will gradually lead to an unstable emotional pattern, and a depressive state.

In Traditional Chinese Medicine, the liver is responsible for regulating the energy (qi) throughout the body, and the storage of blood. Its mental attribute rests in its ability to control planning, and making decisions wisely.

When the liver's energy is in harmony, our emotional state will be happy, we will be able to deal with life's frustrations in a rational way and express our feelings freely.

If our liver's qi stagnates over a long period, due to poor lifestyle, inadequate diet, stress, or overwork, it will manifest in several ways. On the physical level there will be feelings of tightness in the chest, tension in the stomach, or an uncomfortable sensation of having something stuck in the throat with difficulties in swallowing. Our mental state will be affected by increasing levels of anger, frustration, resentment and irritation.

In my previous article, I drew an image of the liver represented by the bamboo tree, whose strength lies in its ability to bend and resist violent winds without breaking. To pursue this analogy, we can picture life as an emotional journey through inclement weather. Along the way we will encounter sunny periods where our confidence is high, and everything runs smoothly. Unfortunately, this emotional weather pattern will often change without warning, when unexpected and threatening clouds appear on the horizon. They could have a myriad of familiar names: relationship issues, difficult work colleagues, family conflicts, financial difficulties and so on. This is when the liver's ability to make decisions, to adapt, will become challenged.

If a person's liver's qi is constricted, that emotional flexibility, that capacity for tolerance and ability to adjust to sudden changes will have been lost. It will have been replaced by a rigid and dogmatic way of thinking. When confronted with challenging circumstances, it will result in rash decisions being made with little consideration for others, and harsh words being said. There will be needless antagonism between opposing parties and, before long, the battlelines will have been drawn.

Our individual's constricted liver's ego will not consider making apologies to others, or even accept reasonable compromises, because it would mean contemplating defeat and humiliation. As a result, our potential victim will soon find himself, or herself, alone and friendless, wondering what went wrong or why everybody seems against them.

In another pattern called Liver Yin deficiency, a weakness in the liver and gallbladder is reflected in an inability to make decisions. Like the proverbial stunned rabbit caught in the floodlights, we become overwhelmed with agonising choices, each with its own potential hazards, and find ourselves unable to decide on a course of action. So we do nothing.

This leads to a repeat cycle of disappointment and unhappiness in life, illustrated by a lack of direction, and a deep inability to make changes. According to Dr Leon Hammer, author of Dragon Rises, Red Bird Flies, Psychology & Chinese Medicine, "The onset of depression will often be seen as a welcome retreat from the incessant struggle, being experienced as an outside force, a chemical unbalance from which the ego is completely detached."

Sometimes, in the case of postpartum depression, the loss of blood during childbirth will have exacerbated an existing pattern of what Chinese medicine calls blood deficiency in the mother. She may have had a weak constitution prior to her pregnancy, been prone to dizziness, low blood pressure, or anaemia. The liver is responsible for the storage of blood, and it supplies the uterus with that substance. It has an important role in regulating a woman's menstruation cycle and the onset of pregnancy. If the liver blood is deficient, a woman will be suffering from lack of periods (amenorrhea), while a pattern of blood stagnation will result in painful menses (dysmenorrhea).

Also, blood is regarded as the material foundation for the mind. In oriental medicine, the heart houses the spirit (shen), or consciousness of the individual. It is also responsible for the circulation of blood, so any disturbance of blood circulation will leave the mind unsettled, leading to dysfunctions, such as palpitations, insomnia, anxiety and depression.

This explains why in both patterns of liver and also heart depression, blood supplementing herbs will be prescribed to the patient. The classic formula, Xue Fu Zhu Yu Tang, is often recommended for this type of emotional disturbance. In this formula, the leading herb is from the blood moving category acting on the upper part of the body, while the two assistant herbs have a similar action in the lower region. They are supported by another one or two herbs that cool, nourish the blood and moisten dryness. The remaining two herbs have an effect on promoting the movement of qi in the chest.

Chinese herbal medicine allows the practitioner to adjust his prescription according to the distinctive symptom pattern of each individual patient. Two thousand years after its conception, it remains a unique advantage which Western medicine has so far been unable to match.

Olivier Lejus MHSc (TCM), BHSc (Acup.) is an accredited acupuncturist practising in Sydney