I have been concerned about the number of patients and lovedones who are experiencing anxiety and depression during this quarantine. Muchsuffering is going around these days. Sickness and death, fear of illness,unemployment, loneliness, a massive disruption in our environment and life aswe know it are enough to make anyone to feel miserable. Humans are social creaturesand isolation is an unfamiliar, unnatural challenge. Moreover, the uncertaintyof these times and the revelation that our government is not prepared to handlethe pandemic situation is truly unsettling. How can one not feel apprehensiveor low?
Anxiety and depression are part of the human emotional landscape.Anxiety is a feeling of apprehension about an event yet to come. It may affectour ability to function due to an intense, persistent worry and can lead tosymptoms such as rapid heart rate and respiration, sweating and fatigue. It canescalate and cause a feeling of trepidation or episodic panic attacks. Likeanxiety, depression is a low mood that interferes with daily life, and itaffects a person’s interest in activities and in in their basic living. Aperson may feel completely disinterested in things that once brought joy andsatisfaction, and they may feel excessively tired or run down with a sense of despair.Both anxiety and depressive disorders can be a result of changes in brainfunction as a result of biological, psychological or social stressors. Rightnow, we are dealing with many assaults on our collective psyche and we need to protectourselves from this kind of ongoing suffering which can take a toll on so manyaspects of our lives- and our very lives themselves.
It is completely normal to experience both these emotionsduring this unprecedented time. Every single person has been affected by thesituation. The future is unpredictable in many ways and we all just want thingsto “get back to normal.” The news is discomforting, and often downrightalarming. Whether or not you fall ill from it, the coronavirus pandemic affectseveryone emotionally on some level. Ask yourself: are you feeling hopeless ordisinterested in things that once made you feel happy? Do you feel constantly worriedand does it keep you up at night? Are you lonely?
Even in pre-pandemic times, the majority of new patients whofilled out my health history form checked off the “I feel stressed” box and thebox for anxiety/nervousness and depression. This is significant. Many patientsexplain their difficulty with ruminating thoughts, inability to sleep,overwhelming concern about their jobs, relationships, health, but sometimesthere is no known identifiable source for their distress. When I addressanxiety and depression with my patients, we review many factors in order to properlydiagnose it. Is this a panic disorder? Was the depression caused by an eventthat occurred, like a divorce or the death of a loved one? Is it something constantor episodic and what makes symptoms worse or better? Is it manifesting as intrusivethoughts or perhaps the inability to make decisions or take action? Does it runin his/ her family? Is the patient seeking help from a mental healthprofessional? And so on.
In Chinese medicine, which is a truly holistic approach, mentalhealth is integral to overall health and well-being. In fact, it is integral toa healthy immune system. Anxiety and depression weaken the zheng qi, or the vitalupright energy that supports and protects one’s body from disease. There aremany facets to mental energy in this tradition, involving (in lay terms) thoughts,sensitivity, creativity, motivation, etc. The root of the mental disturbancemay be from a blockage between the process that governs thoughts into action,or perhaps a disturbance of the shen (spirit), or perhaps liver qi stagnationwhich means that the flow of blood and energy in the body is congested. These disharmoniescan be addressed energetically and require treating the aspects most prominentlyinvolved, which might include the spleen, the kidneys, the heart, liver/galbladder or lungs. Each of the organs is associated with an emotion- worry,fear/fright, joy, anger and sadness/grief, respectively. Any prolonged intense emotioncan lead to a disruption of energy in that organ. For example, prolonged grievingcan lead to a deficiency in the lung. The lung, as mentioned in the lastnewsletter, governs wei qi or defensive qi which protects the body from invadingpathogens and therefore, can lead to a vulnerable immune system. Likewise, intenseworry or anger over the current situation we are in can lead to disruption inthe spleen or liver. This can lead to deficiencies or excesses in how the bodytransforms and transports qi and how well it flows to the rest of the body. Manysyndromes have an emotional component. The emotional state of a person is helpfulfor diagnostic and treatment purposes.
At its most simple presentation, anxiety is often rooted inthe spleen, and depression in the liver. There may be a deficiency of energyand/or a flare-up of excess or a stagnation often accompanied by physicalsymptoms, such as digestive disturbances, insomnia, headaches, menstrualirregularities in women, fatigue and so forth. The tongue and pulsescorroborate what aspects of the body are at play in each individual case. Mostof the points to treat emotional disturbances are dictated by the specificdiagnosis, but generally supportive points on both back side and front side,lower legs, wrist, abdomen and head are used. Points that quell the shen (ormind) are applied along with ear points for more intense relaxation.