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Mental Illness, Anxiety and Depression

Chinese medicine believes that the mind and body are intimately entwined and interactive

Over the past two decades Western psychiatry has evolved from the stereotype of a bespectacled, bearded middle-aged man in a cardigan sweater sitting behind the head of his reclining patient to face-to-face medically based assessment and diagnosis. With remarkable breakthroughs in understanding how brain chemistry functions, Western medicine is now armed with numerous medications that can effectively treat a range of psychiatric disorders.

The Open-Box Versus Sealed-Box Approach

Compared to the much more scientific orientation of other medical specialties, the field of psychiatry remains a blend of art and science. In Western medicine the body has become an open box. In fact, the Western approach began with gross anatomy by opening the box of the human body to find out what was inside—organs, blood, bones. As medical technologies evolved, those boxes were opened to find other boxes—cells, molecular structures and on down. This analytical approach has allowed scientists to discover the cures for many diseases. Western medicine takes the position that the whole cannot be understood until the components that make up the whole are analyzed and understood. In treating a health problem, Western medicine looks for the cause. In looking for the cause, many boxes must be opened.

Over the past twenty years there has been a tremendous improvement in the quality and effectiveness of the medications utilized to treat a variety of psychiatric disorders. However, given the ethical prohibitions against removing the top of people's skulls to do research on the brain, the inner workings of the brain have remained a sealed box—a mystery. Recently with the advent of MRIs and PET scans Western medicine has begun to acquire a rudimentary understanding of the inner workings of the brain. However, for the most part, the brain still remains a closed box. When a person is suffering from a mental illness, X rays, blood tests or even spinal taps will not show any meaningful, supportive information.

The Chinese medical approach is a sealed-box approach. Unlike Western medicine, Chinese medicine does not attempt to open the box (the human body). If a person is depressed, the Chinese doctor asks questions about the person's symptoms, then prescribes herbs and observes how these symptoms change. Say a person is suffering from a particular type of depression. Considering that this type of depression has afflicted people for a couple of thousands of years, a wealth of knowledge has accumulated over generations and generations and Chinese doctors have this wealth of knowledge to draw from. This accumulation of knowledge is referred to as empirical evidence—in other words, it is derived from observation and experimentation.

Psychiatry is much like Chinese medicine in that the psychiatric field relies on symptoms and outward appearances and manifestations to make the best scientific/experiential judgment regarding a diagnosis as well as the first best guess as to what medication and dosage to prescribe. The patient is then observed and monitored over several days, weeks and months—in a fashion very similar to Chinese medicine.

The Human as a Whole

The philosophy of wholeness is at the very heart of Chinese medicine. The whole is in constant motion and involves many factors simultaneously. No part can be accurately studied without its dynamic connection to the whole.

Everything that happens inside a body is reflected outwardly. For example, you can look into a person's eyes and see what is going on in their Liver. The Liver Energetic system is considered to be a regulator of Energy flow, circulation and emotions. That is what it means to be holistic. Your body is wired by Qi, so every part is related to some other part. You do not have to cut into the body to know what is going on internally.

Think about the way Western medicine diagnosed scurvy. Descriptions of scurvy are found in ancient writings and clear accounts are found in records of medieval crusades. For hundreds of years on ships where fruits and vegetables were not supplied, men suffered and died of scurvy. In the 1500s French explorer Jacques Cartier observed as Huran Indian healers cured his dying men with white pine tea. Nearly two centuries later, this account, along with the empirical evidence of hundreds of years, inspired Scottish naval surgeon James Lind to perform experiments that demonstrated the link between citrus and scurvy. British ships began taking limes on board—and the sailors subsequently earned the moniker limeys. Like this story of the discovery of the connection between scurvy and citrus fruit (vitamin C), Chinese medicine has several thousand years of empirical knowledge from which to cull information about herbs and their effects and benefits.

Chinese Medicine Does Not Make Distinctions Between the Mind and the Body

Chinese medicine revolves around the philosophy that the mind and body are intimately entwined and interactive. In Chinese medicine Internal Causes— Anger, Joy, Sadness, Grief, Pensiveness (anxiety or obsessiveness), Fear and Fright—influence your body's Energetic systems. These emotions are neither good nor bad in themselves, but when they are excessive or out of control, they can lead to imbalances (illness). For example, anger is toxic to Liver Energy, causing stagnation and leading to depressive or anxious tendencies. Lack of Joy weakens Heart Energy, which drains joie de vivre—the vitality for life—and can lead to a feeling of isolation and alienation from humanity. Sadness and Grief weaken Lung Energy, which interferes with the reception of Qi, resulting in de pression. Pensiveness knots up Spleen Energy, resulting in loss of appetite and a propensity toward eating disorders and chronic anxiety. Fear and Fright damage Kidney Energy, resulting in anxiety, arrested development and insomnia, and can lead to addictions. When Internal Causes dominate we tend to make poor choices in life, either through neglecting aspects of our body, mind or life or through choosing toxic or injurious substances or activities to self-medicate or to temporarily escape. Therefore, the disorders typically considered to be psychiatric in nature can be treated by rebalancing and harmonizing the appro priate Energetic system(s).

Integrating Chinese and Western Medicines to Treat Mental Illness

Many of the prescription medications currently used in the treatment of mental disorders are far less likely to cause intolerable side effects compared to those used as recently as five or ten years ago. Even so, side effects are the primary reason mentally ill patients discontinue their medications or take less than the prescribed dose. In an attempt to help people deal with medication side effects, many physicians prescribe additional medication(s), which can leave patients with a whole new set of side effects.

The use of integrative medicine has been proven to hold great promise in providing the mentally ill with much more effective health care. Just as the integration of psychotherapy and psychopharmacology (treating mental disorders with prescription medications) has shown greater effectiveness than either intervention used alone, the use of specific prescription medications along with the use of specific Chinese herbs has also been found to provide improved effect. Moreover, it has been found that patients have greater compliance when these two approaches are integrated.

A second obstacle to accessing mental health care is the cost of ongoing treatment. The use of certain Chinese herbs can help counteract the side effects of many psychiatric medications. Oftentimes, the cost of these herbs can be significantly less than the prescription Western medications also designed to counteract side effects. By making the total cost of care less expensive, while still effectively treating side effects, overall compliance and efficacy are likely to improve.

Although cost and medication side effects are indeed two primary obstacles faced by the mentally ill, these problems can pale in comparison to the social stigma of mental illness. Fear of stigmatization often prevents people from accessing necessary care and treatment. This social stigma includes fear of being found out by your employer, family members and friends. Some occupations exclude those who have been or are being treated for mental illness, whether it be something as common as depression and anxiety or more severe conditions such as schizophrenia.

Panic Attacks

Panic attacks are becoming increasingly common in our stressful world. There is a big difference between an appropriate fight-or-flight response and panic attack. The fight-or-flight stress response is an appropriate physiological response to a perceived danger. A panic attack is the same response, but it occurs in the absence of any identifiable danger or threat. A panic attack is a sudden onset of intense apprehension, fearfulness or terror, often associated with feelings of impending doom. During a panic attack one may suffer shortness of breath, palpitations, chest pain or discomfort and choking or smothering sensations, accompanied by the fear of going crazy or losing control.

Think of a TV set that is constantly scanning the room waiting for a signal from the remote. We can describe the TV as being in standby mode. Unconsciously, we are constantly scanning our environment (being vigilant) for any potential threat. When you click the remote, the TV set turns on. Likewise, the adrenals are programmed to respond to danger signals by secreting the stress hormones necessary for the body to mobilize for fight or flight. We hear an explosion and turn sharply to see and assess the perceived danger. Most of the time, we will say, “Oh, a car backfired.” Some individuals, however, do not have the capacity to respond to an assessment of no true danger and readjust back to a standby mode. Their adrenal glands secrete large amounts of adrenaline inappropriately, resulting in a panic attack.

More recently people suffering from panic attacks have been prescribed medications such as Paxil, Prozac and Zoloft, which are selective serotonin reuptake inhibitors (SSRIs) that increase serotonin levels in the brain. Serotonin is the most widely found neurotransmitter—a chemical that carries messages between cells—within the central nervous system. Low levels of serotonin can create depression, panic attacks, obsessive-compulsive disorder, eating disorders and sleep disorders, to name a few problems. In treating panic attacks, increased serotonin levels calm the hot centers of the brain thereby returning the output signals to the adrenal glands back to normal. Other medications such as clonidine and guanfacine work by blocking signals between various centers within the brain so that the ultimate output signal to the adrenal glands returns to a normal range and stress hormones are not secreted inappropriately.

From a Chinese medicine perspective, panic attacks are caused by imbalance in certain aspects of Kidney and Liver Energies. Kidney Energy has a particularly strong association with the feeling of centeredness, emotional stability and self-confidence. When Kidney Energy is compromised, the individual will be susceptible to fear and panic. Liver Energy plays an important role in regulating emotions. Imbalances of Liver Energy can create over as well as under-regulation of emotions. Overregulated Liver Energy can result in aggression, anger and anxiety attacks, a hyperactivity of emotions. Underregulated Liver Energy can result in depression, withdrawal and isolation. The interactions between Liver and Kidney Energies are supportive of each other. Kidney Energy nourishes Liver Energy, and Liver Energy regulates Kidney Energy. When one system is out of balance, over time it will affect the other system as well. Sometimes due to this mutually supportive relationship between the systems, the imbalances can develop into a vicious cycle.

Severely mentally ill people are best put under close supervision to protect themselves and others. In these cases, Western medicine is equipped to provide specific drugs and a controlled institutional setting. Yet, controlling or stabilizing mentally ill people is quite a different matter from healing them, and that is why an integrative approach to mental illness would produce gentler results and fewer side effects than drugs. Chinese medicine has accumulated much experience in treating so-called mental illnesses, ranging from depression, anxiety disorder and cognitive dysfunction to even schizophrenia. The effect is often reliable yet gentler and well sustained, especially for mild and moderate cases. Its effectiveness is rooted in Chinese medicine's recognition that mental illness is not purely mental but involves a person's whole being.

Ways to Address Internal Causes to Treat Mental Illness, Anxiety and Depression

Catalogue your symptoms and be your own advocate

Almost all of us can relate to experiencing temporary periods of depression. And some of us would go so far as to admit that we had periods of our lives in which we experienced obsession, whether it be over a girlfriend or a boyfriend, a new car, overeating or undereating or something else. Emotional fluctuations are a normal part of a human's makeup. As the stress in our day-to-day lives increases, it is not unexpected to see emotional ups and downs increase.

Depression is usually accompanied by a certain degree of anxiety. Certain emotionally uplifting medications used to treat depression may raise anxiety levels. Conversely, medications that are intended to sedate and reduce anxiety often send the patient deeper into depression. Some medications cause people to lose touch with their emotions and feel a lack of motivation and inspiration. For these and other reasons, many people cannot tolerate pharmaceuticals usedto treat depression and anxiety.

Western medicine focuses on correcting underlying biochemical abnormalities. Consequently there is a risk of overcorrection. Because of their regulating

properties, however, herbs can reduce depression without aggravating anxiety and still keep a person emotionally centered. Depression and anxiety disorders can be well treated by Chinese medicine alone, especially for mild and moderate cases. The effect is often comparable to that of Western medicine. The basic approach is to harmonize and balance certain aspects of the major Energetic systems such as Liver, Kidney, Heart and Spleen, and sometimes certain minor Energetic systems such as Gall Bladder.

Many people do not understand how to recognize and catalogue their symptoms. Sometimes people have learned to live with a symptom, other times their symptoms may be dismissed as irrelevant or insignificant.

Our society uses words such as anxiety and depression to explain a wide gamut of emotional experiences. Depression to one may be a whole different experience than it is to another. People who are sad, who are severely disappointed, who have low energy, who worry, who obsess, who are anticipating a significant challenge like taking a test, will all describe themselves as anxious. A psychiatrist's job is to tease out of the patient as clearly as possible the true feeling being experienced.

As the majority of people with psychiatric challenges will likely go to their primary-care physician rather than to a psychiatrist, the more accurately you can describe your problems, issues and symptoms, the more able your primary-care doctor will be to treat you effectively. Before you go to your doctor, write down all of your questions, and do not let the doctor leave the room until they are answered. Write down or tape-record the doctor's answers so that after you leave you can review and absorb everything the doctor said.

Develop meaningful relationships

A very important aspect in healing from mental illness from both a Western and Chinese medicine perspective is to establish meaningful relationships. Such relationships breathe Vital Energy (Qi) into your life and remove stagnation, helping you to heal. The support provided by these relationships can be very important in providing the strong foundation for improving your condition. To prevent severe isolation from developing, contact with at least one other person every day is crucial, whether it be family or friends.

You can find meaningful relationships by following your interests. Joining a Qigong, yoga, Tai Chi, spiritual/religious or meditation group is one way of being around other people in a positive environment.

Focus on your spiritual outlet

From an Eastern perspective, our thoughts, desires and actions reflect the degree of whatever it is we are stuck on. Meditation is a way of reflecting on the motivations behind our actions. Usually our motivations are based on some perception of a need that we feel will relieve whatever it is we are suffering from. In meditation emotional wounds from the past that unconsciously shape and motivate our thoughts, desires and actions can be experienced directly and the unconscious grip loosened. Meditating in a group is particularly comforting and can provide the security and safety you feel lacking in your life. See chapter for more on meditation and healing Energy.

Emphasize movement in your life

Movement and breathing therapies such as yoga, Tai Chi and Qigong consciously combine mind and body to induce a relaxation state that can purify the emotional residue of painful feelings.

Deep breathing exercises break up stagnation. It can be as simple as just taking deep breaths throughout the day, or as involved as participating in a Qigong class with others. The Chinese practice of Qigong combines graceful physical movements with mental concentration. This practice balances your body's Energy along the Meridians. Health is restored when your body's Qi is flowing and rebalanced. See chapter 16 for more on Qigong and healing Energy.

Take on life's challenges

Another important aspect in getting your Vital Energy moving is to take on life challenges, no matter how big or small, in such a way as to try not to be overwhelmed. This may mean taking challenges one day, one part of a day, one hour or maybe even just one minute at a time. Allow yourself to grow into challenges; rather than “eating the elephant all at once and choking on it, eat one small piece at a time,” as an old Chinese saying goes.

See a health care professional to be tested for food allergies or dysbiosis

A health care professional can test you for food allergies or dysbiosis, which is an imbalance of the healthy and unhealthy bacteria and yeast in the gut that may be inhibiting the absorption of nutrients or otherwise stressing your body, which would inhibit the optimum production of neurotransmitters.

Blood tests can determine amino acid levels. Amino acids build proteins, which build brain chemicals (neurotransmitters) that are important for mental health. If you are lacking in amino acids, you can take free-form amino acid complex, which provides readily absorbable amino acids (see page 132). See page 431 for a laboratory that can refer you to a health care provider in your area who does these types of tests. If you test positive for any of these factors, your health care professional can treat you on an individual basis.

Modify your diet

Eating sugar causes blood sugar imbalances that ultimately imbalance your brain chemicals. Eating a balanced diet of real, whole foods, including protein with every meal and snack, will keep your blood sugar levels balanced and will help stabilize your brain neurotransmitters.

Eat foods that have beneficial effects on depression and anxiety or panic. See pages 151–155 for guidelines on raising serotonin levels. Pages 338–339 provide a medicinal recipe to alleviate the anxiety associated with mental and emotional illness.

Chinese herbs and Western supplements

The Western treatment of the vast majority of mood and anxiety disorders consists of medications that increase neurotransmitters such as serotonin, dopamine and gamma-aminobutyric acid (GABA). When these medications are used appropriately, most people experience significant improvement in their symptoms of depression or anxiety. Severe cases of depression, anxiety and panic disorders require the evaluation of a psychiatrist and an appropriate prescription medication. However, mild cases of mood problems and anxiety can be treated with naturally occurring herbs, amino acids and other nutritional supplements. These do not require a doctor's prescription and can produce a similar increase in neurotransmitter levels in the brain, thereby improving your condition. 5H-GABA and GABA are amino acids that bind to the same receptors as the minor tranquilizer Valium—but they are nonaddictive and can effectively alleviate panic attacks. 5H-GABA is a more usable form than GABA.

Routinely, at bedtime, on an empty stomach take 100 milligrams 5-H GABA. If you do not feel the calming effects after one night, increase to 200 milligrams. Or take 500 milligrams GABA. If you do not feel the calming effects after one night, increase to 750 milligrams.

Routinely, thirty to forty-five minutes before breakfast and dinner take 1,000 milligrams free-form amino acid complex.

To ensure your body is absorbing all the nutrients in the food you eat, routinely, before each meal take the digestive formulas on page 102.

You can take Chinese herbal formulas and Western supplements specifically formulated to treat depression and anxiety. To order formulas log on to ancient herbsmodernmedicine.com.