Depression is a disease of Qi, actually a disease of Qi disturbance, originating from the stagnation of Qi.
Why is Qi stagnant?
Only two reasons: one is the suppression of emotions, the other is the constraint of behaviors.
For those with suppressed emotions, they desire but cannot obtain; for those with constrained behaviors, they desire to act but are unable.
When actions are hindered, the body suffers, and Qi stagnates.
In the initial stage of Qi depression, the liver is primarily affected, leading to the stagnation of liver Qi.
When liver Qi accumulates and stagnates for a prolonged period, it results in impaired movement and eventually manifests as the solidification of liver Yin, which is the sign of depression.
For mild depression, two commonly used approaches are the Xiaoyao San and Chaihu Shugan San.
Chaihu Shugan San benefits the gallbladder and liver, resolving depression within the digestive system;
Xiaoyao San promotes liver Qi circulation and resolves depression within the blood circulation system.
Despite their differences, both target the root cause of Qi stagnation.
If depression is not resolved, it will further develop. Prolonged liver stagnation can lead to other conditions, such as heat pathogens, stagnant blood, and turbid phlegm.
Heat pathogen indicates the transformation of Qi stagnation into fire.
When liver fire is vigorous, emotions become erratic and signs of heat manifest on the face and head.
Mentioned previously for mild depression were the use of Chaihu Shugan San and Xiaoyao San.
Now, with the emergence of heat, what should be done?
Treatment should focus on clearing the heat, such as adding ingredients like Danpi and Zhizi to Xiaoyao Pill for heat clearing; in severe cases, Longdan Xiegan Pill can be used to clear liver and gallbladder and disperse damp heat.
Stagnant blood indicates the result of Qi stagnation leading to blood stasis.
There is a saying, “where Qi goes, blood flows.” Now that Qi is stagnant, blood will coagulate.
Symptoms of blood stasis often include palpitations, chest pain, and rib pain.
The treatment should focus on promoting blood circulation and removing stasis, as with the Xuefu Zhuyu Tang, combining the essence of Sini Powder and Taohong Siwu Tang, specifically designed for liver blood stasis.
Turbid phlegm indicates the generation of phlegm due to Qi stagnation.
Phlegm is produced by the spleen, with spleen dysfunction caused by liver constraint affecting the spleen.
The turbid phlegm affects the mind and spirit, leading to a lack of vitality and delayed responses.
To determine the presence of phlegm, key signs to observe are sticky tongue coating and slippery pulses.
The treatment methods for phlegm include Erchen Tang and Wendan Tang.
Erchen Tang eliminates phlegm and dampness, while Wendan Tang strengthens the power to descend Qi and transform phlegm.
In conclusion, treating depression should focus on regulating Qi smoothly, adapting treatment according to symptoms to achieve efficacy.
