🌿 Folk Prescriptions

Depression is a syndrome encompassing various symptoms and signs involving both physical and psychological aspects. Its diagnostic hallmark includes depressed mood or sadness, loss of interest or pleasure, accompanied by sleep disorders, appetite changes, fatigue, poor concentration, noticeable memory decline, frequent anxiety and tension, and in severe cases, suicidal thoughts or behaviors.According to statistics, around 300 million people worldwide suffer from depression, making it a common and widespread condition. Since the 1990s, awareness of depression among Chinese healthcare professionals has improved. Because many depression patients, especially those with mild to moderate cases, seek care in various departments of general hospitals—including TCM clinics—healthcare providers must have the ability to recognize, manage, and refer patients appropriately to ensure timely treatment and save substantial medical resources.Depression is not a fleeting mood swing that can be easily overcome; it is a disease caused by neurotransmitter imbalance. Recovery requires both medication and psychological therapy.In TCM, depression falls under the category of “Yu Zheng” (Stagnation Syndrome). The classic text Huangdi Neijing mentioned this condition over two thousand years ago. Later schools of thought also discussed it. For example, Wang Andao of the Yuan Dynasty stated: “Most illnesses arise from stagnation—meaning obstruction and lack of flow.” Zhu Danxi, in his Danxi Xinfab, proposed: “When qi and blood are harmonious, all diseases do not arise. Once stagnation occurs, various diseases emerge. Therefore, most bodily ailments originate from stagnation.” Numerous classical texts contain records and experiences in diagnosing and treating this condition, accumulating rich therapeutic wisdom.In treating depression, TCM employs the traditional method of syndrome differentiation and treatment. For patients with mental confusion, dizziness, palpitations, forgetfulness, easy awakening during sleep, pale tongue with thin coating, and fine pulse, use Gui Pi Tang to tonify heart and spleen qi. For those with fatigue, eye discomfort, bitter taste, flank distension, back pain, irritability, poor bowel movements, red tongue with thin coating, and wiry pulse, use modifications of Chai Hu Shu Gan Yin or Xiao Yao Wan. Some patients, besides irritability and insomnia, visit due to a sensation of a lump in the throat—these may be treated with Ban Xia Hou Pu Tang. Others who prefer solitude, avoid social interaction, cannot sleep at night, and frequently feel sad and want to cry may be treated with modifications of Bai He Di Huang Tang. Clinically, many patients present with chest tightness and shortness of breath, often seeking emergency care. Despite normal results from ECG and other tests, they feel generalized weakness, dizziness, heaviness, occasional palpitations, and restless sleep. Their tongue may be dark or purple, with white greasy coating, and wiry, slippery pulse. These patients may benefit from modifications of Di Tan Tang (to resolve phlegm) combined with Xue Fu Zhu Yu Tang (to invigorate blood and remove stasis).TCM theory holds that yin-yang balance is the foundation of physical and mental health. Imbalance leads to various diseases. From a TCM perspective, depression arises from yin-yang disharmony and disharmony between body and spirit. Formulae that regulate yin-yang, such as Gui Zhi Tang, can achieve good results. In Western medicine, selective serotonin reuptake inhibitors (SSRIs) like Prozac are commonly used, with reliable and safe efficacy. Combining Chinese and Western medicines enhances treatment efficacy and patient compliance.While the treatment models of TCM and Western medicine differ, they can complement each other. When using Western antidepressants, gastrointestinal discomfort is a common side effect. Taking TCM aromatic and digestive herbs such as Agastache, Patchouli, Guang Mu Xiang, Cardamom, Tangerine Peel, Poria, and Malt can alleviate gastrointestinal discomfort. Moreover, since Western antidepressants typically take one week or longer to take effect, patients may lose patience and discontinue treatment. At this point, giving TCM herbs that resolve phlegm and relieve stagnation—such as Calamus, Curcuma, Lily, Mimosa Flower, Schisandra, Prepared Star of Bile, and Green Plum Blossom—can improve symptoms, boost patient confidence, and enhance adherence.Additionally, sleep disturbances are a major suffering for depression patients, often waking up at night and unable to fall back asleep, feeling anxious and restless during the day. At such times, use formulas that calm the mind and relieve agitation, such as Polygala, Dragon Tooth, Magnetite, Green Plum Blossom, Stir-fried Sour Jujube Seed, Dragon Bone, and Oyster Shell. Or use patent medicines like Anshen Buxin Capsules or Qiyehen’an Tablets, which also show certain effectiveness.In conclusion, proper use of integrated Chinese and Western medicines will enable more depression patients to overcome their depressive shadows sooner.