Mental Health Awareness Month: Depression and Anxiety from a Traditional Chinese Medicine Perspective
In 2011-2013 “The top three most commonly reported causes of WD (work disability) were back/neck problems 30.3%, depression/anxiety/emotional problems 21.0%, and arthritis/rheumatism 18.6%.” according to the CDC with data taken from 20.1 million adults at the time.
If that was the case over 10 years ago, I can only imagine the number growing daily in 2025 with the traumas we’ve endured over the past 5 years.
May is Mental Health Awareness Month
It’s thought that ~50-60% of people with depression have anxiety and vice versa.
Now, before any MDs or other healthcare professionals get their panties in a bunch - this is not medical advice - but it is a guide to better understanding your body.
Traditional forms of medicine are more needed than ever to combat feelings of sadness, grief, pain, inadequacy, dread, apathy, worry, anger, frustration, the list goes on.
How does Traditional Chinese Medicine (TCM) view depression?
as stasis, constraint, or accumulation/retention.
What are some common TCM patterns associated with depression?
Qi Stagnation turning into Fire
Irritability, short temper, distention or burning pain in the hypochondriac and chest regions
Other Sx: headache, tinnitus, red face and eyes, dry mouth, bitter taste in the mouth, upset stomach, acid regurgitation, constipation
T: red tongue with thin yellow coating
P: wiry and rapid
Obstruction of Phlegm & Qi
Discomfort in the throat, a sense of a foreign body lodged in the throat that cannot be swallowed or expectorated
Other Sx: suffocating sensation in the chest, or distention and pain in the hypochondriac and chest regions
T: greasy coating
P: wiry and slippery
Heart Deficiency and Liver Constraint
Depression, frequent attacks of sadness or crying, frequent bouts of yawning
Other Sx: disorientation, restlessness, restless leg syndrome
T: red or pale red
P: thready and wiry, maybe sl. rapid
Heart and Spleen Deficiency
Overthinking, palpitation, timidity, insomnia, poor memory
Other Sx: pale complexion, dizziness, fatigue, poor appetite
T: pale tongue with thin white coat, maybe puffy
P: thready and weak
Lack of communication between the Heart and Kidneys
Irritability and easily angered, dizziness, tinnitus, palpitations, insomnia
Other Sx: soreness of the lower back and knees, nocturnal emission, irregular menstruation
T: red tongue with scanty coating
P: thready and rapid
How does Traditional Chinese Medicine (TCM) view anxiety?
as rebellious energy.
What are some common TCM patterns associated with anxiety?
Heart and Gallbladder Deficiency
Palpitations, anxiety, timidity, easily frightened, lack of self-confidence or worth, easily discouraged
Other Sx: having a hard time sitting or lying down, insomnia, waking up early in the morning
Tongue: pale
Pulse: weak
This person is timid, shy, and lacking in drive. They find it difficult to make decisions.
The anxiety is mild.
Seen in children, and many eventually grow out of it.
Heart Blood Deficiency
Palpitations, anxiety, dizziness, pale face
Other Sx: insomnia, poor memory, tiredness
Tongue: pale and thin
Pulse: choppy or fine
More common in women.
The anxiety may be worse in the evening or after a period.
Kidney and Heart Yin Deficiency with Empty Heat
Palpitations, anxiety that is worse in the evening, mental restlessness, insomnia, night-sweating
Other Sx: a feeling of heat in the evening (especially in hands, feet, and trunk), dizziness, tinnitus
Tongue: red without coating
Pulse: floating-empty and rapid
In women, this type of anxiety is markedly aggravated with the onset of menopause. There is a characteristic restlessness and fidgetiness.
The anxiety is experienced more in the evenings.
Heart Yang Deficiency
Palpitations, anxiety, pale face, feeling cold, cold hands
Other Sx: slight breathlessness, discomfort in the chest
Tongue: pale, wet
Pulse: deep-weak
This person is more likely to experience anxiety and depression.
Everything requires more effort, and they speak with difficulty.
Lung and Heart Qi Deficiency
Palpitations, anxiety, timidity, easily frightened, sadness, cries easily or often, weak voice
Other Sx: slight breathlessness, gets sick easily, pale complexion
Tongue: pale
Pulse: weak on both front positions
This person’s anxiety tends to be more centered around sadness and grief.
The anxiety is more physical and experienced in the chest.
Lung and Heart Qi Stagnation
Palpitations, anxiety, a feeling of distention or oppression of the chest or upper epigastric region, depression, slightly purple lips, pale complexion
Other sx: feeling of a lump in the throat, slight shortness of breath, sighing, sadness, weak voice
Tongue: slightly pale-purple on the sides
Pulse: empty but slightly overflowing on both front positions
This person may experience consistent worry.
The anxiety is more physical and experienced in the chest.
Lung and Heart Yin Deficiency
Cough which is dry or with scanty sticky sputum, weak and hoarse voice, dry mouth and throat, scratchy or itchy throat
Other sx: palpitations, insomnia, dream-disturbed sleep, poor memory, propensity to be startled, mental restlessness, uneasiness, tiredness, a dislike of speaking, thin body or thin chest, night sweating
Tongue: pink, dry without coating (or with rootless coating) in the front part
Pulse: floating-empty
Heart Blood Stasis
Palpitations, anxiety, insomnia, agitation, poor memory, chest pain.
Tongue: purple on the front sides (chest area)
Pulse: wiry, choppy or firm
This person is more likely to be middle-aged and up.
The anxiety is experienced more in the evening or the middle of the night, where the person wakes up in a panic.
Phlegm-Heat Harassing the Heart
Palpitations, anxiety, insomnia, frequent and intense dreaming
Other sx: a feeling of oppression in the chest, phlegm in the throat, confusing behavior
Tongue: red, swollen with sticky yellow coating
Pulse: slippery, rapid
This person’s behavior may feel erratic.
Anxiety is marked and to the point of agitation.
Some of these patterns may seem very similar. And they are! Those similar patterns are differentiated mostly by tongue and pulse diagnosis.
This list is not exhaustive, but it outlines some of the more common patterns seen in practice.
If you’re scratching your head on the term “pattern” read the first little bit of this post to better understand!