Herbal Remedies for Depression, Anxiety, Insomnia, and Psychosis
In China, before the twentieth century, all mental illnesses were treated exclusively with herbal medicine. Since Chinese doctors have been keeping records for thousands of years, there is historical evidence suggesting that such treatments were sometimes successful. One example is the famous Fog Tea of Tianmu Mountain, a blend of herbs which helped free millions of people from opium and morphine addiction. Whereas the best Western approach to addictive opiates at that time was to substitute a newly invented and presumed less addictive drug, heroin. Live and learn; which is exactly what Chinese herbologists have been doing for several thousand years.
I contend that Chinese herbal drugs of the19th century were at least as effective as whatever European or American doctors were inventing and prescribing at that time.
This may still be true. Obviously Western psychiatric drugs, have advanced in a hundred years. We don't administer potassium bromide, chloral hydrate, and morphine to the mentally ill anymore. Today's tranquilizers are clearly safer and more effective. However, no mental health worker would say that these drugs could actually cure mental illness. I am suggesting that Chinese herbal drugs can offer more than relief to the mentally ill. Properly administered, in some cases, I believe these herbs can cure.
Whether or not they actually cure the patient, at the very least, herbs can complement any modern day prescription or therapy. I can assure you that the herbs recommended in this article are safe, and like a food, won't react negatively with any drug.
Visit any city in China, and despite the deluge of Western ideas and money, you'll find very few mental health facilities. Though It's estimated that China has over 100 million mentally ill people, China has only 17,000 certified psychologists, which on a per capita basis is only ten percent of what you'd find in most developed countries.
A history of poverty and an attitude that mental illness should be stoically endured are two reasons for this. Also, Asian cultures have traditionally downplayed individuality, so spending money on personal improvement has been frowned upon. But there's another important reason that psychology never took root in the East. It simply wasn't needed as much. Chinese doctors, with the benefit of several thousand years of trial and error, had access to a full pharmacy of effective herbal medicines. Perhaps this made lobotomies, electroshock, and psychiatry less necessary.
Chinese herbal medicines, despite their effectiveness, should not be considered a substitute for modern drugs or counseling, however they can be a valuable resource for today's medical professionals or mental health workers. You don't have to be Chinese or an herbalist to use them, however a little basic knowledge of Oriental medicine theory can help. This article will help you get started. I have used common names for herbs that are known in the West, botanical names for Herbs without common Western names, and Chinese pin yin names to distinguish herbs that may be of the same species but differ in other ways.
It's the qi, stupid.
'Qi' means the flow of our bodily energies. Practitioners of Chinese medicine believe that health is linked with these invisible flows, and that when our qi flows improperly we get sick.
Besides the flow of qi, health is also about harmony or balance, or the lack of it. The terms yin and yang help to describe this. When life is out of balance, we say that yin and yang become unbalanced in our body, causing physical or mental distress and disease.
The discipline of Ching-Zhi-Bing concerns disorders of the emotions and will, and is closely related to the treatment of mental diseases. To practitioners of most forms of TCM, any mental disease is, first of all, a sign of poor flow or bad balance or both. Phobia, paranoia, schizophrenia, depression, insomnia, etc. are symptoms of disharmony or congestion, not separate diseases in themselves. Healing these symptoms requires normalizing flow or restoring balance in the life and body of those afflicted. Herbal medicine can help immensely.
Chinese herbal medicine is easily the most highly evolved medical system in the world. Its scale of experience spans countless trillions of administrations over thousands of years. Its methods, to a great degree, are systematic and based on written observation, experiment and commentary. It's pharmacopoeia includes over 10,000 natural substances; vegetable, animal, and mineral.
Some of these substances may be strange to Western sensibilities, however this article will recommend only safe ordinary substances which can be easily obtained. Though sour dates, hare's ear root, and mimosa bark may not be as available as coffee, tea, or marijuana, you can easily find these potentially mind bending substances on the web or in Chinese communities throughout North America, Europe, and Asia.
Mind bending doesn't imply that these herbs are stimulants or psychedelics. Though there exist Chinese herbal stimulants such as ephedra (ma huang) and psychedelics such as morning glory seeds (qian niu zi). The herbs recommended in this article, when properly combined, effect the mind in different and perhaps less understood ways.
The term 'mind' is seen differently through the lens of TCM. We view mind and body as inseparable expressions of a single being, and must be assessed together for a useful diagnosis. In the West, the human being is divided into separate fields of study - spiritual, mental and somatic. Recently the Western point of view has begun to blur the distinction between mind and body. The 1996 Diagnostic and Statistical Manual of Mental Disorders (DSM-IV, 1996, Introduction, p.xxi) acknowledges:
“ A compelling literature documents that there is much ‘physical’ in ‘mental’ disorders and much ‘mental’ in ‘physical’ disorders.’
In this article the term mind means: consciousness, emotion, imagination, remembrance, thought, memory, and intelligence. We don't include spirit as an aspect of mind, because TCM reserves a special place for spirit, known as the Shen. The Shen means you, the actual being that is not your mind. The Shen resides in the heart, not in the brain. Mental disharmonies often indicate that the Shen is unsettled or troubled. We call this Disturbed Shen.
Anxiety, insomnia, and psychosis all originate with Disturbed Shen.. We consider them diseases of the chest rather than the brain, because the Shen resides in the heart, not in the head. Though sufferers may exhibit deviant brain chemistry, these are not brain diseases
The Troubled Spirit
For most people, Disturbed Shen won't lead to 'heart disease' or any physical problem. Nevertheless, it is considered a physical condition and will respond to therapies other than counseling. Exercise, massage, acupuncture, and herbal medicines are examples of highly physical modalities that can relieve this condition. A cure requires a deeper understanding of the root causes.
Shen can be disturbed by events in our life or in our memory, by stagnation, heat, drugs, diet, loss of sleep, or loss of blood. Often, the Shen is unsettled by constraint of emotion, or by excess emotions. Chinese medicine believes that strong emotions can also effect our organs. Excessive or lack of joy can stress the heart, worry eats at the gut, grief endangers the lungs, fear taxes the kidneys, and anger assaults the liver.
Shen is disturbed by tension in the chest. Thinking about loss, not being able to express oneself, and feeling guilty or under stress, cause the chest qi to tighten. In this protective state we feel fewer feelings and show less emotion. Modern clinicians call this condition 'depression'. We call it stagnation of the chest qi, or Liver Qi Stagnation (LQS), and we consider it to be the origin of many mental health problems. To us, clinical depression is not so much a definable disease, but a sign that the qi of the chest is stuck, constrained, or oppressed. In time, this chest constraint can effect the underlying organs, generating anger by inflaming the liver, or anxiety by heating up the heart.
Treatment With Herbs
The resulting symptoms of LQS are usually diagnosed as depression, anxiety, insomnia, tachycardia, or panic disorder. Even some heart arrhythmias, and forms of psychosis originate with liver qi stagnation.
Herbs can also be used to promote the circulation of qi in the chest and to clear heat from the heart. Taken alone, these herbs may have only a mild effect. However in certain combinations, the results can be quite powerful.
Hare's ear root (bupleurum chai hu), perhaps the best known of these herbs, is a good example. This bitter root is known to move the qi of the chest, however its ability to do this is greatly enhanced by combining it with a small amount of ordinary mint (bo he).
Other herbs that move the liver qi include immature tangerine peel qing pi , cyprus xiang fu, chinese rose mei gui hua, white peony root bai shao, caltrop fruit bai ji li, and bitter orange zhi shi.
Besides relieving constraint, the herbologist can effect the mind by administering herbs that Nourish the Heart. These substances have a markedly calming effect and help to create a comfortable environment for the Shen. You'll find herbs that nourish the heart in many formulas used to combat insomnia. Some of these substances are sour date seed (suan zao ren ), longan fruit (long yan rou), arbor vitae seeds (bai zi ren), and wheat berries (fu xiao mai)
Mimosa tree bark (he huan pi) is one of the most useful of this group. Though classified as a heart nourishing herb, when combined with salvia miltorrhiza (dan shen), it also strongly moves the qi of the chest. Thus it can relieve stress in the chest and nourish the heart simultaneously.
Herbs that Settle the Spirit
are used when emotions run high. Many of these substances are rich in calcium and other heavy minerals. There's a long history of using these stabilizing herbs in formulas to treat psychosis. There's nothing in the old texts about schizophrenia, but there are many references to delusional behavior, including muttering to oneself, and hearing voices. To practitioners of TCM, delusional behavior indicates that the spirit, under extreme duress, has indeed taken flight. Anchoring herbs are then required to settle the agitated spirit.
Oyster shell mu li, pearl zhen zhu, fossil bone long gu, amber hu po, and loadstone ci shi are some of the heavy stabilizing agents that settle the rising spirit They are given for short periods of time, as they are hard to digest, and long term use could damage the qi.
Fire and Phlegm
When used to treat psychosis, anchoring herbs are often combined with herbs that Dissolve Phlegm, because in many of these cases, phlegm has become an additional disease factor.
Now phlegm is a concept that is a little hard to grasp, but worth the effort, because it is phlegm that can turn a mild depression into a full blown psychotic episode. Actually, it's pretty simple. We already understand phlegm as a synonym for mucous, a thick viscous bodily fluid. According to TCM, heat causes normally free flowing fluids and vapors to thicken and become phegm. Phlegm impedes flow.
Psychosis happens when heat thickened vapor (hot phlegm) has obstructed the portals of consciousness, clouding and obscuring the Shen, and causing the mind to lose contact with its spiritual connection. Phlegm-Fire in the Heart, as this psychotic condition is known, requires herbs to Extinguish Fire and Dissolve Phlegm.
Sweetflag rhizome (chang pu) is the chief herb used to dissolve phlegm blocking the portals of consciousness. You'll find it in formulas for psychotic conditions as well as for ADD, mania, compulsive disorders, and other conditions hinting of clouded consciousness.
Common herbs that put out fires in the heart and liver include gardenia seed (zhi zi), rush pith (deng xin cao), tree peony root bark (mu dan pi), and lotus plumule (lian xin). Not so common is rhinoceros horn (xi jiao), endangered and banned and never the legendary sex tonic of folklore, but really just an herb used to treat heat induced convulsions, mania, and delirium. Water buffalo horn (shui niu jiao) is usually substituted in larger amounts. Raw foxglove root (sheng di huang) is a good substitute for vegetarians.
Herbs Don't Work, Formulas Work.
Before going any further, you must understand the limited value of these single herbs. Used alone, none of these herbs has very much therapeutic value, and used alone any of them could present problems. That's why TCM is all about using herbs together. Call them formulas or recipes or mixtures or combinations; by combining herbs, synergies have been discovered that vastly increase the medicinal effects. Blending herbs in this way also allows us to neutralize unwanted side-effects. Herbs such as licorice, poria, codonopsis, and ginger are often added to increase digestibility and absorption. Since stagnation and deficiencies underly many of these conditions, formulas will also contain herbs that increase the quantity and stimulate the flow of qi and blood. The famous 'women's herb' herb Dang Gui is often used because it both builds and invigorates the blood simultaneously. This effect is magnified when combined with red or white peony root.
Formulas usually consist of principal herbs, assisting herbs, directional herbs, and herbs that reduce the side effects or aid the digestion of a particular herb. Herbs can be ingested as boiled teas called decoctions (tang), milled or granulated powders (san), pills (pian), tablets (wan), or tinctured extracts (gin).
The following table shows mental diseases, likely TCM diagnoses, a possible formula used to treat the condition, and the herbs contained in each formula. Most are available in prepared form.
Disease/ Condition: Depression, PMS
TCM Diagnosis: Liver Qi Stagnation
Formula Name:Free and Easy aka Hsiao Yao San
Ingredients: White peony root, Poria, Atractylodes, Bupleurum, Mint, Dang Gui, Ginger, Licorice,
Depression with Irritability, PMS
Liver Qi Stagnation with Heart Fire
Augmented Free Free & Easy
White peony, Poria, Atractylodes, Bupleurum, Mint, Dang Gui, Ginger, Licorice, Tree peony root bark, Gardenia,
Depression with Mania, Delirious speech, Heart Palpitations,
Liver Qi Stagnation with Liver Yang Rising
Bupleurum, Dragon Bone, and Oyster Shell
Bupleurum, Pinellia, Poria, Cinnamon Branch, Scullcap, Sour Date, Codonopsis, Fossilized Bone, Oyster Shell, Ginger, Rhubarb
Anxiety, Irritability, Restlessness, or Insomnia
Disturbed Shen caused by Heart Fire
Good Sleep and Worry Free
Sour Date Seed, Zhi Mu, Salvia, Polygala, Biota, Atractylodes, Licorice, Ginseng, Ophiopogon, Schisandra, Mulberries, Poria
Anxiety, Weepiness, PMS
Disturbed Shen from Deficient Yin or Blood
Polygonum, Weatberries, Sour Date, Poria, Lily, Mimosa bark, Licorice
Insomnia, Poor Concentration, Vivid Dreaming
Disturbed Shen caused by deficient heart qi
Stabilize the Heart
Biota, Ophiopogon, Dang Gui, Poria, Polygala, Sour Date Seed, Scullcap, Codonopsis, Amber
Insomnia, Poor Memory or Concentration, Nocturnal Emission
Disturbed Shen and Heart Fire cause by deficient Kidney Yin
Heavenly Emperor Tonify Heart
Raw Foxglove, Dang Gui, Schisandra,, Sour Date Seed, Biota, Asparagus, Ophiopogon, Scrophularia, Salvia, Codonopsis, Poria, Platycodon, Polygala
Psychosis, chest or rib pain, hiccup,. Mood swings
Blood stasis in the chest with Liver Qi Stagnation
Drive out Stasis in the Mansion of Blood
Safflowers, Dang Gui, Sechuan Lovage, Red Peony root, Niu Xi, Bupleurum, Platycodi, Bitter Orange, Raw Rehmannia, Licorice
Psychosis, Compulsive disorders, ADD, ADHD
Heart Blood Deficiency, Clouded Consciousness
Sweetflag, Sour Date Seed, Go ji berry, Salvia, Schisandra, Sechuan Lovage, Fleece Flower Branch, Polygala, Reishi Mushroom
© copyright Joel Harvey Schreck 2008
Joel Harvey Schreck, L.Ac.
Dr. Shen, to the thousand-plus daily visitors to DrShen.com. Dr Shen has been dispensing advice about herbs on the web since 1998. An acupuncturist and herbologist since 1987, Joel is also co-founder of the Shen Clinic and the Dr. Shen brand of natural medicines. He is also adjunct faculty member and lecturer at AIMC, Berkeley's Acupuncture and Integrative Medicine College. His book, A Patient's Guide to Chinese Medicine, is published by Baytree Publications,.