Treatment of emotional health disorders with Chinese herbal medicine
Insomnia
By Dr. Hong-Yen Hsu (developed by Pascal)
Chinese herbal medicine treats insomnia according to the specific cause of the insomnia, and in regard for the patient’s conformation of deficiency or excess – which usually fall within the following conformations.
1. Deficiency of heart and spleen: marked by insomnia or dreaminess, fitful sleep, amnesia, palpitation, fatigue, weakness, anorexia, poor facial complexion, pale tongue, and a thready and weak pulse. Commonly treated with Ginseng and Longan Combination to nourish the heart and invigorate the spleen. Recent studies have found this formula to regulate mental excitability, and to promote digestion. For frequent insomnia, schizandra, polygonum stem, biota can be added; and if there is also a poor appetite, add shen-chu.
English name: Restore the Spleen Decoction
Pattern: Spleen Qi deficiency with Heart Blood and Yin deficiency
Actions: Tonifies Blood and Qi – Nourishes the Heart and strengthens the Spleen.
Indications: Fatigue, poor memory, palpitations, insomnia, anxiety, phobias, poor sleep or dream disturbed sleep, poor appetite, sallow complexion, withdrawal, low-grade fever, and night sweating. Early periods with loss of excess pale blood, continuous spotting, blood in the stool, leukorrhea, metrostaxis, and metrorrhagia.
Possible Tongue Appearance: Pale tongue with a thin white coat, possibly swollen
Possible Pulse Patterns: Thin and weak pulse
Ingredients: Ginseng (Ren shen), Atractylodes Rhizome (Bai zhu), Hoelen (Fu ling), Astragalus Root (Huang qi), Angelica sinensis (Dang gui), Semen Zizyphi Spinosae (Suan zao ren), Longan Fruit (Long yan rou), Honey-fried Chinese Senega Root (Zhi yuan zhi), Licorice (Gan cao), Jujube (Da zao), Radix Aucklandiae Lappae (Mu xiang), Fresh Ginger (Sheng jiang)
Reviews: used for insomnia, for anemia, for osteopenia (bone density), to improves Cognitive Function in Alzheimer’s Disease Patients, for dementia… Read
Article: THE QI KEEPS THE BLOOD WITHIN THE VESSELS by Subhuti Dharmananda, Ph.D. Read
2.Hyperactive fire due to yin deficiency: marked by anxiety, insomnia, dizziness, tinnitus, feverish sensation in the palms and soles, dry mouth with little saliva, nocturnal emissions, spermatorrhea, premature ejaculation, palpitation, amnesia, soreness at the waist, red tongue, and thready and rapid pulse. Most commonly indicated is Ginseng and Zizyphus Formula. Ginseng and Zizyphus Formula is more effective in regulating mental disturbances which affect sleep, and it can tranquilize without causing restlessness.
English name: Emperor of Heaven’s Special Pill to Tonify the Heart
Pattern: Heart and Kidney Yin Deficiency
Actions: Nourishes the Blood and Yin, Tonifies the Heart and Kidneys, clears deficient heat, and calms the spirit
Indications: Anxiety, irritability, palpitations, fatigue, insomnia, easily wakened, restless sleep, inability to think clearly, trouble with concentration, poor memory, forgetfulness, nocturnal emissions, dry throat and mouth, and possible mouth and tongue sores. Neurasthenia. Insomnia. Hypertension, hyperthyroidism
Possible Tongue Appearance: Red tongue with little coat
Possible Pulse Patterns: Thin and rapid pulse
Ingredients: Dan Shen (Radix Salviae Miltiorrhizae); Dang Gui (Radix Angelicae Sinensis); Shi Cang Pu (Rhizoma Acori Tatarinowii); Dang Shen (Radix Codonopsis); Fu Ling (Poria cocos); Wu Wei Zi (Fructus Schisandrae Chinensis); Mai Dong (Radix Ophiopogonis); Tian Dong (Radix Asparagi); Di Huang (Radix Rehmanniae); Xuan Shen (Radix Scrophulariae); Yuan Zhi (Radix Polygalae); Suan Zao Ren (Semen Ziziphi Spinosae); Bai Zi Ren (Semen Platycladi); Jie Geng (Radix Platycodonis); Gan Cao (Radix Glycyrrhizae).
Review: Tian Wang Bu Xin Dan for Insomnia: A Systematic Review of Efficacy and Safety, by Xi-qian Yang, Ling Liu, Shu-ping Ming, Jie Fang, and Dong-nan Wu. Read
Article: Tian Wang Bu Xin Dan, Famous Patent for Nourishing The Heart, by Subhuti Dharmananda, Ph.D. Read
3. Fright caused by deficiency of heart qi: marked by insomnia, anxiety, palpitation, dreaminess, fitful sleep, easily frightened, neurosis, and taut and thready pulse; Zizyphus Combination or Ginseng and Acorus Combination is commonly used. Research has shown Zizyphus Combination to be effective in inducing sleep and bringing down fever. Astragalus and Zizyphus Combination can also be used.
English name: Sour Jujube Decoction
Pattern: Liver Blood Deficiency with Heat from Deficiency
Actions: Nourishes Liver and Heart blood Nourishes Yin. Clears deficient heat and calms the spirit.
Indications: Anxiety, irritability, restlessness, inability to or difficulty in falling asleep, palpitations, night sweats, dizziness, vertigo, thirst, dry mouth and throat
Possible Tongue Appearance: Dry and red tongue with little coat
Possible Pulse Patterns: Wiry, then, and rapid pulse
Ingredients: Spiny Jujube Kernel Processed (Chao Suan Zao Ren), Anemarrhena Rhizome (Zhi Mu), Chuanxiong Rhizome (Chuan Xiong), Poria (Fu Ling), Licorice Root (Gan Cao)
4. Stagnation of liver-qi· marked by mental depression with a tendency to lose temper, anxiety, vertigo, blurred vision, fullness in the abdomen, eructation, anorexia, feeling of oppression in the chest, hypochondriac pain, irregular menstruation, taut pulse; Bupleurum and Cyperus Combination is commonly recommended. If there is also upflushing fire marked by bitter taste in the mouth, restlessness, headache, conjunctival congestion, yellowish tongue fur and taut rapid pulse, moutan, gardenia, chrysanthemum and gambir should be added.
English name: Bupleurum Powder to Spread the LiverActions: Spreads Liver Qi. Promotes Qi circulation. Harmonizes the Blood. Alleviates pain
Indications: Depression. Easily angered. Hypochondriac pain and distention. Alternating fever and chills. Chest fullness. Bitter taste in mouth. Fidgeting. Abdominal pain and cramps. Breast distention and pain. Irritability. Dysmenorrhea. Irregular menstruation. Amenorrhea
Possible Tongue Appearance: Pink. Thin and white coat
Possible Pulse Patterns: Wiry or Tight
Ingredients: Radix Bupleuri Chinensis (Chai hu), Pericarpium Citri Reticulatae (Chen pi), Radix Paeoniae Lactiflorae (Bai shao), Fructus Aurantii (Zhi ke), Rhizoma Ligustici Chuanxiong (Chuan xiong),
Rhizoma Cyperi Rotundi (Xiang fu), Radix Glycyrrhizae Uralensis (Gan cao).
Review: Treatment of depression with Chai Hu Shu Gan San: a systematic review and meta-analysis of 42 randomized controlled trials, by Yan Sun, Xia Xu, Jinping Zhang and Yuanyuan Chen. Read
5. Disorder of stomach-qi: marked by insomnia with symptoms of indigestion including stuffiness and fullness in the epigastrium, distention in the abdomen with periodic pain, regurgitation of stomach acid, eructation with fetid odor, loss of appetite, nausea or vomiting, greasy and yellowish tongue fur and slippery pulse; Citrus and Crataegus Formula is commonly used for resolving such a retention of food.
Chinese name: Bao He Wan
English name: Preserve Harmony Pill
Pattern: Acute and mild food stagnation
Actions: Promotes digestion and reduces food stagnation. Dries damp and clears heat.
Indications: Epigastric and abdominal distention (bloating) and fullness with intermittent pain. Acid regurgitation, belching, nausea and vomiting, and loss of appetite. Constipation or Diarrhea.
Possible Tongue Appearance: Greasy yellow or sticky yellow coat
Possible Pulse Patterns: Slippery pulse
Ingredients: Hawthorn Fruit (Shan zha), Massa Fermentata (Shen qu), Pinellia Tuber (Ban xia), Hoelen (Fu ling), Tangerine Peel (Chen pi), Forsythia fruit (Lian qiao), Semen Raphani Sativi (Lai Fu Zi)
6. Uprising phlegm-heat: marked by insomnia with symptoms of anxiety, vertigo, palpitation, oppressed sensation in the chest, vomiting, copious phlegm, gastric discomfort with acid regurgitation, bitter taste in the mouth, yellow greasy tongue fur, and slippery rapid pulse; c and Bamboo & Ginseng Combination are usually recommended. These formulas have effects in tranquilizing the mind, and coordinating the functions of the vegetative nerve.
English name: Warm the Gallbladder Decoction
Actions: Clears Gallbladder heat, regulates Qi, reduces phlegm, and regulates the stomach
Indications: Timidity. Over-thinking. Nausea and vomiting, bitter taste, sour regurgitation, dizziness, vertigo, anxiety, palpitations, insomnia, slight thirst, and gnawing hunger. Seizures with copious sputum and focal distension in the chest.
Possible Tongue Appearance: Red with a greasy yellow coat
Possible Pulse Patterns: Rapid and slippery pulse. Rapid wiry pulse
Ingredients: Pinellia Rhizome Processed With Ginger (Jiang Ban Xia), Unripe Bitter Orange Processed (Fu Chao Zhi Shi), Bamboo Shavings Processed (Jiang Zhu Ru), Tangerine Peel (Chen Pi), Licorice Root Processed (Mi Gan Cao), Poria (Fu Ling), Fresh Ginger Root Rhizome (Sheng Jiang), Jujube Fruit (Da Zao)
Depression
Nine traditional Chinese herbal formulas for the treatment of depression: an ethnopharmacology, phytochemistry, and pharmacology review (developed by Pascal)
Conventional antidepressants, such as selective reuptake inhibitors of serotonin (5-HT) or norepinephrine (NE), monoamine oxidase inhibitors, tricyclic antidepressants, or methyl-d-aspartate receptor (NMDAR) antagonists, fail to help at least 40% of depressed patients. Existing treatments for MDD usually take several weeks or months to achieve their therapeutic effects. During this lag period, patients continue to have depressive symptoms and risk self-harm. Despite this, there has been little notable progress in the development of drugs to treat depression over the last few decades. Scientists are seeking new, improved therapeutic approaches to deal with depression, and the drive to develop next-generation drugs with improved safety profiles has intensified.
Traditional Chinese medicine (TCM) is attracting increasing attention as a method for meeting the demands for higher remission rate, faster onset, persistent antidepressant action, and fewer adverse effects. TCM is one of the oldest medical systems in the world, and includes Chinese herbal medicine, acupuncture, and massage. Herbal medicine has been used for the treatment of depression in People’s Republic of China for centuries, and is becoming more frequently used in Western countries.
Some of the common formulas described in the review
Chinese name: Ban Xia Hou Po Tang
English name: Pinellia and Magnolia Bark Decoction
Pattern: Qi Stagnation with Phlegm, Plum-Pit Qi
Actions: Moves Qi and disperses nodules. Descends rebellious Qi. Resolves phlegm.
Indications: Plum-Pit Qi – A subjective feeling that something is stuck in the throat, usually due to emotional upset. A fullness, oppression, or stifling sensation in the chest and hypochondria. Cough with white sputum, nausea and vomiting. Globus Hystericus. Hysteria. Gastro-intestinal Neurosis. Esophagospasm. Chronic Laryngitis. Tracheitis.
Possible Tongue Appearance: Dusky or normal with a greasy or moist white tongue coat
Possible Pulse Patterns: Wiry and slippery pulse
Ingredients: Pinellia rhizome cured (Zhi Ban Xia), Magnolia bark (Hou Po), Poria sclerotium (Fu Ling), Ginger rhizome fresh (Sheng Jiang), Perilla leaves (Zi Su Ye).
Reviews: used for anxiety, for reducing Pneumonia Risk in Older Adults With Dementia, on the Swallowing Reflex in Parkinson’s Disease… Read
English name: Emperor of Heaven’s Special Pill to Tonify the Heart
Pattern: Heart and Kidney Yin Deficiency
Actions: Nourishes the Blood and Yin, Tonifies the Heart and Kidneys, clears deficient heat, and calms the spirit
Indications: Anxiety, irritability, palpitations, fatigue, insomnia, easily wakened, restless sleep, inability to think clearly, trouble with concentration, poor memory, forgetfulness, nocturnal emissions, dry throat and mouth, and possible mouth and tongue sores. Neurasthenia. Insomnia. Hypertension, hyperthyroidism
Possible Tongue Appearance: Red tongue with little coat
Possible Pulse Patterns: Thin and rapid pulse
Ingredients: Dan Shen (Radix Salviae Miltiorrhizae); Dang Gui (Radix Angelicae Sinensis); Shi Cang Pu (Rhizoma Acori Tatarinowii); Dang Shen (Radix Codonopsis); Fu Ling (Poria cocos); Wu Wei Zi (Fructus Schisandrae Chinensis); Mai Dong (Radix Ophiopogonis); Tian Dong (Radix Asparagi); Di Huang (Radix Rehmanniae); Xuan Shen (Radix Scrophulariae); Yuan Zhi (Radix Polygalae); Suan Zao Ren (Semen Ziziphi Spinosae); Bai Zi Ren (Semen Platycladi); Jie Geng (Radix Platycodonis); Gan Cao (Radix Glycyrrhizae).
Review: Tian Wang Bu Xin Dan for Insomnia: A Systematic Review of Efficacy and Safety, by Xi-qian Yang, Ling Liu, Shu-ping Ming, Jie Fang, and Dong-nan Wu. Read
Article: Tian Wang Bu Xin Dan, Famous Patent for Nourishing The Heart, by Subhuti Dharmananda, Ph.D. Read
Chinese name: Gan Mai Da Zao Tang
English name: Licorice, Wheat, and Jujube Decoction
Pattern: Restless Organ Syndrome (Zang Zao)
Actions: Nourishes the Heart and calms the Spirit. Harmonizes the Middle Jiao.
Indications: Depression, moodiness, frequent melancholy and crying, sadness, frequent yawning, restless sleep with possible sweating, in severe cases there can be abnormal speech and behavior. Hysteria. Mania. Convulsions
Possible Tongue Appearance: Red tongue with thin coat
Possible Pulse Patterns: Thin rapid pulse
Ingredients: Xiao Mai (Fructus Tritici) ~ Da Zao (Fructus Jujubae) ~ mix-fried Gan Cao (Radix Glycyrrhizae)
Review: Antidepressant-like effects of Gan-Mai-Dazao-Tang via monoamine regulatory pathways on forced swimming test in rats. Read
Chinese name: Si Ni San
English name: Frigid Extremities Powder
Pattern: Liver (Qi Stagnation) attacking the Spleen and Stomach
Actions: Spreads Liver Qi and regulates the Spleen. Eliminates internal heat and reduces stagnation.
Indications: Cool or cold extremities (fingers and toes). Possible irritability with distension and fullness in the epigastria and chest. Bitter taste in the mouth and dry throat. Possible abdominal pain with diarrhea. Dysmenorrhea and distending breast pain.
Possible Tongue Appearance: Red or dusky tongue with a yellow coat
Possible Pulse Patterns: Wiry pulse, possibly rapid
Ingredients: Bai Shao (Radix Alba Paeoniae) ~ Chai Hu (Radix Bupleuri) ~ Zhi Shi (Fructus Immaturus Aurantii) ~ mix-fried Gan Cao (Radeix Glycyrrhizae)
Review: Screening of the antidepressant-like effect of the traditional Chinese medicinal formula Si-Ni-San and their possible mechanism of action in mice. Read
Chinese name: Xiao Yao San
English name: Rambling Powder, Free and Easy Wanderer
Pattern: Liver Qi Stagnation with Blood Deficiency
Actions: Spreads Liver Qi and relieves stagnation. Tonifies the Spleen and nourishes the blood.
Indications: Irritability, depression, and moodiness. Fatigue, headache, and dizziness. Hypochondriac fullness or pain. Breast distention, irregular menstruation, and dysmenorrhea. Bitter taste in the mouth, dry mouth and throat, and poor appetite.
Possible Tongue Appearance: Pale red tongue
Possible Pulse Patterns: Wiry and deficient pulse
Ingredients: Bupleurum root (Chai Hu), Angelica sinensis (Dang Gui), Chinese peony root (Bai Shao), atractylodes rhizome (Bai Zhu), Poria sclerotium (Fu Ling), Chinese mint aerial part (Bo He), Ginger rhizome fresh (Sheng Jiang), Chinese licorice root (Gan Cao).
Review: Chinese Herbal Formula Xiao Yao San for Treatment of Depression: A Systematic Review of Randomized Controlled Trials. Read
Chinese name: Yue Ju Wan
English name: Escape Restraint Pill
Actions: Activates Qi, releases constraint, and reduces stagnation of Qi, Blood, Damp, Phlegm, Heat, and Food
Indications: Focal Distension, fullness in the abdomen and chest, hypochondriac distension and pain, belching, vomiting, indigestion, acid regurgitation, nausea, reduced appetite, distending breast or lower abdomen pain, dysmenorrhea, and possible cough with copious sputum
Possible Tongue Appearance: Purple, red, or dusky tongue body with a greasy white or yellow coat
Possible Pulse Patterns: Slippery and wiry pulse, possibly rapid (although the general attitude is subdued)
Western Uses: Gastrointestinal Neurosis. Gastric or Duodenal Ulcer. Chronic Gastritis. Infectious Hepatitis. Cholecystitis. Cholecystolithiasis. Intercostal Neuralgia
Some other formulas that may be used for depression
Chinese name: Bu Zhong Yi Qi Tang
English name: Tonify the Middle and Augment the Qi Decoction
Pattern: Middle Jiao (Spleen and Stomach) Qi Deficiency
Actions: Tonifies Spleen Qi and the Middle Jiao. Raises sunken Yang and counters prolapse.
Indications: Weariness, fatigue, weak limbs, and headache. Watery, soft, or loose stools. Spontaneous sweating, shortness of breath, pale complexion, tendency to curl up, and laconic speech. Dislike of cold and a desire for warm drinks. Absence of taste. Fever that is worse upon exertion.
Possible Tongue Appearance: Pale swollen tongue with teeth marks and white coat
Possible Pulse Patterns: Empty, weak, and flooding pulse
Chinese name: Jin Gui Shen Qi Wan
English name: Kidney Qi Pill from the Golden Cabinet
Actions: Tonifies and warms Kidney Yang. Drains damp and water accumulation and promotes urination.
Indications: Weakness and soreness in the lower back and knees, tenderness or tense feeling in the lower abdomen, a cold feeling in the lower half of the body, impotence, spermatorrhea, palpitations, clear and profuse urination possibly with incontinence, water retention, irritability with a difficulty or inability to lay down. Thirst and copious and frequent urination. Leg Qi with sore, weak, numb, and swollen lower limbs and difficulty walking.
Possible Tongue Appearance: Swollen and pale tongue, possibly with teeth marks
Possible Pulse Patterns: Weak and deep pulse, possibly thin or empty
The formulas listed in the section for insomnia may also be used for depression.
Anxiety
Herbal Medicine for Anxiety, Depression and Insomnia, by Lei Liu, Changhong Liu, Yicun Wang, Pu Wang, Yuxin Li, and Bingjin Li. Read (developed by Pascal)
It has been observed that people who suffer from anxiety often accompanied with sleep disorder. The most common sleep disorder is a subjective complaint that it has an inability to initiate or maintain sleep, or the sleep is non-restorative with poor quality and quantity. Insomnia is a prevalent health concern in the general population, which could induce significant physical disorders. It is estimated that about 9～15% of the people in the world suffer from insomnia which causes severe after effects in the day time. Thus, depression, anxiety, and insomnia are common comorbid psychiatric conditions in the complexity of mental health disorders.
The link between major depression, insomnia and anxiety disorders impairs the function of immune and cardiovascular systems. These psychiatric disorders not only affect individuals’ work and daily life, but also decrease their quality of life, and perceived well-being. To our knowledge about the present situation, the number of people with mental illness is rapidly increasing across the world. Therefore, searching for more effective treatments should be an important consideration.
Evidence-based options for treatment of psychiatric disorders are limited. Pharmacological therapy is currently the most commonly used treatment for mood disorders. Although many drugs appear to have an important role in cases of most severe mental illness, many complaints that the drugs are not effective for all patients and incur diverse adverse events, as well as tolerance (if used for a long time). Therefore, it is desirable to seek fast acting, better-tolerated, more effective and fewer side effects antidepressants. Numerous studies have demonstrated that the use of complementary and alternative medicine (CAM) among psychiatric disorders, especially depression and anxiety is a common phenomenon.
A nationally representative investigation performed in America demonstrated that people with self–reported depression were about 53.6% and non-institutionalized adults with insomnia were 4.5% according to certain forms of CAM to treat their psychiatric disorders in the past year. Many literatures indicated the importance of CAM for the treatment of mental illnesses. Meanwhile, herbal medicine is the most commonly used form of complementary and alternative medicine therapies. It was observed that more than 18.6 percent of the adult population in America (that is about 38 million) used herbs for the benefit of their health in 2002 as compared to the15% in 1997. Recently, it also has been found that the use of herbs was particularly prevalent in those with psychiatric problems. Comprehensive descriptions on herbs used to treat depression, anxiety or insomnia have been documented in the recent years.
The three formulas emphasised in this study are
Chinese name: Xiao Yao San
English name: Rambling Powder, Free and Easy Wanderer
Pattern: Liver Qi Stagnation with Blood Deficiency
Actions: Spreads Liver Qi and relieves stagnation. Tonifies the Spleen and nourishes the blood.
Indications: Irritability, depression, and moodiness. Fatigue, headache, and dizziness. Hypochondriac fullness or pain. Breast distention, irregular menstruation, and dysmenorrhea. Bitter taste in the mouth, dry mouth and throat, and poor appetite.
Possible Tongue Appearance: Pale red tongue
Possible Pulse Patterns: Wiry and deficient pulse
Ingredients: Bupleurum root (Chai Hu), Angelica sinensis (Dang Gui), Chinese peony root (Bai Shao), atractylodes rhizome (Bai Zhu), Poria sclerotium (Fu Ling), Chinese mint aerial part (Bo He), Ginger rhizome fresh (Sheng Jiang), Chinese licorice root (Gan Cao).
Review: Chinese Herbal Formula Xiao Yao San for Treatment of Depression: A Systematic Review of Randomized Controlled Trials. Read
Chinese name: Ban Xia Hou Po Tang
English name: Pinellia and Magnolia Bark Decoction
Pattern: Qi Stagnation with Phlegm, Plum-Pit Qi
Actions: Moves Qi and disperses nodules. Descends rebellious Qi. Resolves phlegm.
Indications: Plum-Pit Qi – A subjective feeling that something is stuck in the throat, usually due to emotional upset. A fullness, oppression, or stifling sensation in the chest and hypochondria. Cough with white sputum, nausea and vomiting. Globus Hystericus. Hysteria. Gastro-intestinal Neurosis. Esophagospasm. Chronic Laryngitis. Tracheitis.
Possible Tongue Appearance: Dusky or normal with a greasy or moist white tongue coat
Possible Pulse Patterns: Wiry and slippery pulse
Ingredients: Pinellia rhizome cured (Zhi Ban Xia), Magnolia bark (Hou Po), Poria sclerotium (Fu Ling), Ginger rhizome fresh (Sheng Jiang), Perilla leaves (Zi Su Ye).
Reviews: used for anxiety, for reducing Pneumonia Risk in Older Adults With Dementia, on the Swallowing Reflex in Parkinson’s Disease… Read
English name: Restore the Spleen Decoction
Pattern: Spleen Qi deficiency with Heart Blood and Yin deficiency
Actions: Tonifies Blood and Qi – Nourishes the Heart and strengthens the Spleen.
Indications: Fatigue, poor memory, palpitations, insomnia, anxiety, phobias, poor sleep or dream disturbed sleep, poor appetite, sallow complexion, withdrawal, low-grade fever, and night sweating. Early periods with loss of excess pale blood, continuous spotting, blood in the stool, leukorrhea, metrostaxis, and metrorrhagia.
Possible Tongue Appearance: Pale tongue with a thin white coat, possibly swollen
Possible Pulse Patterns: Thin and weak pulse
Ingredients:
Reviews: used for insomnia, for anemia, for osteopenia (bone density), to improves Cognitive Function in Alzheimer’s Disease Patients, for dementia… Read
Article: THE QI KEEPS THE BLOOD WITHIN THE VESSELS by Subhuti Dharmananda, Ph.D. Read