By Robert A. Victor, L.Ac.
The National Institute of Mental Health recently conducted a $20 million study in which more than 18,500 people, selected at random, underwent detailed diagnostic interviews. It found that mental illness is one of the leading causes of hospitalization in this country. One in three people in the U.S. will be affected by an acute mental illness at some time during their life. At any given time, major mental disorders afflict almost 15 per cent of the nation’s population.
Psychotherapy may be the primary mode of treatment for emotional disturbance if the person is ready, willing, and able to engage in the process. The Oriental medical concept of establishing harmony offers us a new approach and a helpful addition to our understanding of emotional illness. The use of Chinese herbal formulas has consistently proven of benefit in improving a patient’s health to a level that enables the patient to engage in life and the therapeutic process.
Mental disorder is defined by the American Psychiatric Association as “distress (painful symptom) or disability (impairment of one or more areas of functioning)”. The range of defined mental disorders is very broad. It includes everything from mild transient depression to severe, irreversible organic brain damage. Some of these disorders have simple, identifiable causes such as ‘situational stress’. Others are extremely complex, involving an interaction of factors, including genetics, biochemical imbalances and the effects of childhood trauma.
Traditional Chinese Medicine has always viewed the emotions as corollary to organ-energy systems of the body. Each organ and its energy system relate in well-defined and insightfully understood patterns with each other organ-energy system of the body. Thus, one’s body and one’s emotional states are intimately related. This understanding provides the rationale for inclusion of herbal therapies in the psychotherapeutic process.
The organ and meridian system that most relates to one’s emotional state is that of the Liver. The Liver stores the Blood and is responsible for regulating all other Zang-Fu organs. When the Qi of the Liver is smooth and flowing, all other organs are nourished. When the regulating function of the Liver is unimpeded, all other organs can interact in an orderly manner. The Liver is therefore central to emotional well-being.
Each organ has a special connection with a particular emotional state. The emotion that relates to the Liver is that of anger. Anger is an expression of stagnant Liver Qi. Practitioners of Chinese Medicine are well aware of the degree to which stagnation of Liver Qi is found in our culture. Our many life stressors represent a definite contributing factor to disruption of the smooth flow of Qi through out the body.
When the regulating function of the Liver is compromised, an astounding degree of disarray occurs in the body. An emotional component is ever present in these disorders. This can be illustrated in the TCM diagnosis and treatment of menstrual conditions. Since the Liver stores the Blood and thus regulates menstruation, many Chinese herbal formulas are known as women’s formulas. Formulas such as Women’s Balance and Heavenly Water from Health Concerns regulate the Liver to benefit the physical and soothe the emotional components of menstrual dysfunction.
Currently, our nation is undergoing a deep healing process which crosses all lines of gender, race, and culture. In virtually every community, Twelve Step groups such as A.A. (Alcoholics Anonymous), N.A. (Narcotics Anonymous) and A.C.A. (Adult Children of Alcoholics) can be found. The healing of emotional wounds, dysfunctional patterns and addictions becomes paramount in the lives of men and women who have seen the futility of these patterns. Formulas that treat Liver Qi stagnation can play an enormous role in the treatment of mental and emotional anguish in the United States.
Traditional Chinese Medicine views emotional extremes as pathogenic factors that become entrenched in the organ-meridian system of the body. Early life traumas or recent life stressors are examples of these factors. Even though the ‘stress’ occurred weeks or years prior, its effects may remain as a present factor in the body, hindering the free flow of Qi. Once the flow of Qi is constrained, both emotional and physical wellness are compromised. Initial signs of Qi stagnation are anxiety and depression. Inappropriate anger may indicate that the factor of Liver Fire has entered into the scenario.
The great classic of Traditional Chinese Herbal medicine, the Shang Han Lun, lends insight into herbal treatment for emotional disorders through a systematic description of formulas using the theory of the Six Stages of Disease. A great deal of attention in the text is given to the formula Minor Bupleurum Decoction (Xiao Chai Hu Tang). The formula is prescribed when a disease is neither completely external nor completely internal and is considered to be harmonizing in nature.
A logical extension of the formula comes when several herbs are added, creating a unique formula called Bupleurum and Dragon Bone Combination (Chai Hu Jia Long Gu Mu Li Tang). Although mentioned only briefly in the Shang Han Lun, the formula has been found to be rewardingly useful in the treatment of emotional disorders in China and the U.S. As one of the most widely prescribed formulas for emotional disturbance, it is available from Health Concerns as Ease Plus.
In the context of the theory of the six stages of disease, the formula is said to unblock the three Yang stages and sedate and calm the Spirit. Since the basis of the Schisandra formula is to clear the Liver/Call Bladder system, it is applicable to circulate the Liver Qi, and to clear heat and phlegm from the Shao Yang channels. With the addition of oyster shell (Mu Li) and dragon bone (Long Cu), the formula takes on the qualities of subduing floating Yang and calming Heart Spirit. This action has a strong effect upon anxiety.
Dr. Michael Smith, M.D.,L.Ac.,of Lincoln Hospital in New York has noted that anxiety is the basis by which addictive cycles perpetuate. Anxiety serves as a link in the addictive process for which the afflicted patient seeks relief. Currently, Ease Plus is being used for treatment of the anxiety associated with substance withdrawal in private and public clinics throughout the country, where it is a preferred addition to the psychotherapeutic process.
We looked to Bernard Unterman, L.Ac., OMD, and coordinator of Phoenix House of Santa Barbara, to see how Health Concerns’ formulas assist in the treatment of emotional distress. Phoenix House is home to a population of people who have been institutionalized because of mental illness. It is the first stop for a patient who is just beginning to he able to cope with the outside world. The Phoenix House staff offers acupuncture and herbal treatment to patients diagnosed as schizophrenics. Although the stated purpose of the acupuncture program is to subdue the side effects of the many medications given to these patients, very positive results are seen in important areas of life function.
Dr. Unterman reports marked results from the view of the patient’s own perception of his or her illness and from the staff of therapists who interact with the patients on a daily basis. Both the emotional and physical problems associated with PMS are greatly improved with the use of Women’s Balance. Sleep patterns return to regularity and daytime agitation is subdued with Schisandra Dreams. Ease Plus has helped many of the patients with anxiety and irritability.
Other formulas treat emotional disturbances quite successfully. Aspiration is proving very useful for depression and menstrual problems, again, a situation in which Liver Qi stagnation plays a big role. Shen-Gem is used to treat insomnia in which there is Heart Blood deficiency. As storehouse of our consciousness, the Heart is a central organ in emotional disturbance and deserves much attention in our remedies.
All herbs, formulas, and acupuncture points in Chinese medicine treat a combination of physical and emotional distress. Chinese understanding and diagnosis of disease does not separate the two categories, but weaves them into useful and treatable patterns. However, certain of these patterns are endemic to our highly stressed culture, particularly those involving Liver Qi stagnation and Heart imbalances. Health Concerns has devised appropriate formulas to assist in solving the seemingly intractable dilemma of emotional disturbance in our culture.
Robert Victor, L.Ac., is an herbalist in residence with Health Concerns and holds a Masters in Traditional Chinese Medicine. He has worked within the psychiatric community of the San Francisco Bay area for 5 years. His clinical practice is in Berkeley, California.
FORMULAS FOR EMOTIONAL DISTURBANCE
ASPIRATION addresses all the major aspects and complications of depression – stagnant Qi, stagnant Blood, Heat, Dampness, and Food and Phlegm Entanglement. The formula treats the physical conditions which are the felt symptoms of depression, including chest oppression and constriction, irritability, anger, frustration, flank pain and various digestive complaints. The Chinese name of the chief herb, Polygala (Yuan Zhi), or Far- reaching Aspiration, attests to the formula’s ability to renew a zest for life. Each of the herbs in the formula has a traditional anti-depressant effect. However, Aspiration also includes two Western herbs, Vervain and Damiana, which have potent ability to lift depression.
EASE PLUS is described in the previous article this formula has broad-spectrum applicability for the treatment of emotional disorders, insomnia, anxiety and substance detoxification. The traditional formula Chai Hu Jia Long Gu Mu Li Tang (Bupleurum and Dragon Bone Combination) has been modified by the addition of Mu Xiang (Sausurrea) in the place of Da Zao (Jujube) to better assist with digestive functions. The formula harmonizes by dredging the Liver and strengthening the Spleen preventing the Liver from disrupting digestive functions. EASE PLUS clears Liver Heat to prevent disturbances of Heart Shen by rising Liver Yang. It consolidates scattered Qi to further calm the Spirit.
SCHISANDRA DREAMS contains both Chinese and western herbs that calm the Spirit and nourish the Heart. The combination is useful for insomnia and acts as a mild, calming sedative for agitation, anxiety attacks or substance withdrawal. This formula incorporates a new herb, Kava kava, into the Chinese pharmacopeia. Kava kava is a warm, spicy herb for nourishing the Heart and calming the Spirit, helping to provide deep, restful sleep. The formula helps to treat insomnia in patients who waken frequently at night with difficulty breathing. This is the formula of choice with strongly medicated patients.
WOMAN’S BALANCE is based on the formula Free & Easy Wanderer (Xiao Yao Wan) and Bupleurum and Peony Formula (Jia Wei Xiao Yao Wan) for the treatment of PMS and regulation of menstruation accompanied by depression, emotional instability and irritability. Cyperus (Xiang Fu) and Citrus (Chen Pi) are included in the formula to disperse stagnant Qi and moisture associated with abdominal bloating and breast swelling. Salvia (Dan Shen) is included to promote the circulation of Blood and relieve menstrual pain and inflammation. The formula is especially useful when the Liver Qi stagnation is based on Blood Deficiency and when there are heat symptoms present. This formula is also applicable for men when Liver Qi stagnation and Spleen Qi deficiency are present, manifesting in depression, digestive upset, and emotional distress.
ANNOUNCEMENTS
Dosage tips: Remember dosage on the label is for 100-200lb individuals. Dosage must be taken into account when treating children or large patients. When treating sensitive or food allergic patients for chronic conditions, start dosage slowly and work up to nine capsules per day over a 1-2 week period.
Recently, Bob Flaws, L.Ac., DOM, told us that 25% of the women he sees are treated for candidiasis. He has used the Phellostatin formula with success. At a recent lecture, Dr. Shu-rong Zhu, a gynecological specialist from China mentioned two formulas for menopause. These formulas are included in Two Immortals, designed for Health Concerns by Bob Flaws.
Remember to differentiate during cold and flu season. lsatis Gold may be used for either Wind Heat or Wind Cold. Nasal Caps 2 are used for yellow/green phlegm and Yin Chao Jin is used for Wind Heat.
Enhance, designed by Misha Cohen, L.Ac., OMD, is now being used in Immune HIV protocols all over the country. Clinicians report from Quan Yin Clinic which treats HIV and AIDS that patients receiving acupuncture and the Enhance formula are responding very favorably with less fatigue. Digestive tolerance to the formula is also very good.