I have been concerned about the number of patients and loved ones who are experiencing anxiety and depression during this quarantine. Much suffering is going around these days. Sickness and death, fear of illness,unemployment, loneliness, a massive disruption in our environment and life as we know it are enough to make anyone to feel miserable. Humans are social creatures and isolation is an unfamiliar, unnatural challenge. Moreover, the uncertainty of these times and the revelation that our government is not prepared to handle the pandemic situation is truly unsettling. How can one not feel apprehensive or 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 affect our ability to function due to an intense, persistent worry and can lead to symptoms such as rapid heart rate and respiration, sweating and fatigue. It can escalate and cause a feeling of trepidation or episodic panic attacks. Like anxiety, depression is a low mood that interferes with daily life, and it affects a person’s interest in activities and in in their basic living. A person may feel completely disinterested in things that once brought joy and satisfaction, 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 brain function as a result of biological, psychological or social stressors. Right now, we are dealing with many assaults on our collective psyche and we need to protect ourselves from this kind of ongoing suffering which can take a toll on so many aspects of our lives- and our very lives themselves.

It is completely normal to experience both these emotions during this unprecedented time. Every single person has been affected by the situation. The future is unpredictable in many ways and we all just want things to “get back to normal.” The news is discomforting, and often downright alarming. Whether or not you fall ill from it, the coronavirus pandemic affects everyone emotionally on some level. Ask yourself: are you feeling hopeless or disinterested in things that once made you feel happy? Do you feel constantly worried and does it keep you up at night? Are you lonely?

Even in pre-pandemic times, the majority of new patients who filled out my health history form checked off the “I feel stressed” box and the box for anxiety/nervousness and depression. This is significant. Many patients explain their difficulty with ruminating thoughts, inability to sleep,overwhelming concern about their jobs, relationships, health, but sometimes there is no known identifiable source for their distress. When I address anxiety and depression with my patients, we review many factors in order to properly diagnose it. Is this a panic disorder? Was the depression caused by an event that occurred, like a divorce or the death of a loved one? Is it something constant or episodic and what makes symptoms worse or better? Is it manifesting as intrusive thoughts or perhaps the inability to make decisions or take action? Does it run in his/ her family? Is the patient seeking help from a mental health professional? And so on.

In Chinese medicine, which is a truly holistic approach, mental health is integral to overall health and well-being. In fact, it is integral to a healthy immune system. Anxiety and depression weaken the zheng qi, or the vital upright energy that supports and protects one’s body from disease. There are many facets to mental energy in this tradition, involving (in lay terms) thoughts,sensitivity, creativity, motivation, etc. The root of the mental disturbance may be from a blockage between the process that governs thoughts into action,or perhaps a disturbance of the shen (spirit), or perhaps liver qi stagnation which means that the flow of blood and energy in the body is congested. These disharmonies can be addressed energetically and require treating the aspects most prominently involved, 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 emotion can lead to a disruption of energy in that organ. For example, prolonged grieving can lead to a deficiency in the lung. The lung, as mentioned in the last newsletter, governs wei qi or defensive qi which protects the body from invading pathogens and therefore, can lead to a vulnerable immune system. Likewise, intense worry or anger over the current situation we are in can lead to disruption in the spleen or liver. This can lead to deficiencies or excesses in how the body transforms and transports qi and how well it flows to the rest of the body. Many syndromes have an emotional component. The emotional state of a person is helpful for diagnostic and treatment purposes.

At its most simple presentation, anxiety is often rooted in the spleen, and depression in the liver. There may be a deficiency of energy and/or a flare-up of excess or a stagnation often accompanied by physical symptoms, such as digestive disturbances, insomnia, headaches, menstrual irregularities in women, fatigue and so forth. The tongue and pulses corroborate what aspects of the body are at play in each individual case. Most of the points to treat emotional disturbances are dictated by the specific diagnosis, but generally supportive points on both back side and front side,lower legs, wrist, abdomen and head are used. Points that quell the shen (or mind) are applied along with ear points for more intense relaxation.

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