How Seeing Depression as a Symptom Changes Everything

An Acupuncturist Perspective

An article I wrote about my experiences with depression in my youth and early adulthood was recently publishes in the Elephant Journal:

Etched into my mind with painful clarity is the window of my college dorm room, seven stories high, with a stark view of the street below. That street could have been my escape. Isolation and claustrophobia had pulled me into a conversation with death during a rough depressive episode and I wanted to escape the pain so desperately that I considered everything, including ending my life….. Continue reading

Depression is a heavy topic that is often considered taboo. As someone in a healing vocation, I feel it’s important to share my experiences in the article above, because sharing our experiences of pain offers solace to others and normalizes hidden aspects of being human.

I work a lot with people struggling with depression (and anxiety). Having direct personal experience with these emotions helps me understand more about what the people I see are going through and allows me to support them in ways I wouldn’t otherwise be able to.

Understanding Depression through the Lens of an Acupuncturist

I find acupuncture and Chinese herbal medicine to be unique in treating depression for a number of reasons. First and foremost, acupuncture brings a holistic approach, treating the mind, body, and spirit all at once. Certain acupuncture points have functions like “calm the spirit,” “soothe the mind,” or “brighten the eyes,” which illustrates how the medicine has always held space for mental and emotional health.

And it goes further than that. Acupuncture works by identifying “patterns of disharmony” that lead to constellations of symptoms. Depression is seen as a symptom of an underlying dynamic which generally involves physiological, along with psychological, social, and lifestyle elements. What does this mean and how does it work practically? Let’s look at two different cases.

Case 1 - Stifling Depression:

Here’s a person who is depressed and feels stifled by life circumstances. They may notice tightness in the chest and ribs and have difficulty taking deep breaths or find themselves sighing all the time. They tend to suffer from neck and shoulder tension and occasional headaches. Their eyes sometimes feel blurry, and they have trouble seeing at night, especially when driving. Occasionally (or not so occasionally), they’ll burst out in anger and frustration, and then feel terrible about it. These are all symptoms that fit into pattern of disharmony called “Liver Qi Stagnation.”

In Chinese medicine the liver is responsible for processing stress and promoting our ability to flow - both physiologically, as in blood flow and loose muscles, and psychologically, as in flowing through life. Feeling stifled leads to constraint, the antithesis of flow, and physical and emotional symptoms arise as a result. The specific symptoms are related to liver functions (governing the eyes, keeping muscles and tendons loose and supple, and relaxing the diaphragm). Whenever there’s constraint caused by either emotional factors (we respond to stress and anxiety by tensing up and impeding flow), or physiological factors (we’re not getting enough exercise movement, or we’re eating heavy foods that are congesting the ability for flow, or we’re undernourished so there’s not enough energy to for things to flow), things get stuck and we get Liver Qi Stagnation.

Case 2 - Heavy Depression:

This person is depressed and listless. They can hardly get out of bed and feel bloated, heavy, and foggy-headed. They generally have no appetite, and when they do want to eat they crave sweets. Their body aches, especially when it’s cold out, and their face and lips are pale white. They got to this point by overworking themselves. They used to feel energetic and alive and were engaged with life and their social circles. Over time, long days at work started eroding their joy until they felt truly numb and depressed. These symptoms suggest a case of “Spleen Qi Deficiency with Heart Blood Deficiency,”  a specific pattern of disharmony with a specific treatment protocol different from the Liver Qi Stagnation case.

The Spleen, and its partner the stomach, are responsible for quite a bit in Chinese Medicine. In this case, digestion is a key issue. When digestion isn’t working well, “dampness” is produced (think of that heavy, tired feeling one experiences on a cold, wet grey, day in the Pacific Northwest). This dampness can produce body aches and also temper our emotions. On top of that, when digestion isn’t operating well, we don’t produce enough blood* for the heart which manages our ability to feel joy and our capacity to experience emotions overall.

* The Chinese Medical concept of “Blood” is similar to, but not exactly the same as, the Biomedical definition for blood. So one could be experiencing “blood deficiency” without necessarily being anemic, for instance.

Through these cases I’m not trying to teach a comprehensive understanding of Chinese medicine. Rather, I hope to illustrate that both of these people may be depressed, but need very different types of support. Acupuncture has a useful lens for differentiating signs and symptoms to support people’s unique situations.

The Biomedical Perspectives on Depression

From a Biomedical perspective, acupuncture works to increase blood flow, reduce inflammation, and regulate the nervous and hormonal systems. These are all fundamental aspects of mental health and addressing these physiological aspects of our health is essential to working with depression. For instance, there is increasing evidence that inflammation is correlated with depression. And, biomedically speaking, a depressed nervous system is inherently dysregulated.

In other words, our biological systems are always seeking a “dynamic homeostasis” - dynamic, meaning changing; and homeostasis, meaning balance. So, for instance, we can get excited about something, and then calm down, and we can fall asleep at night, but then wake up in the morning with energy. There’s an overall balance in addition to our ability to change and adjust from situation to situation. This is reflected in levels of hormones circulating in our blood (like cortisol) and in levels of neurotransmitters (like serotonin and dopamine). Under stressors, we can get pushed too far out of balance to ever fully come back to center. A stressor could be a nutritional deficiency, or a boss or family member that’s always yelling at us. It could be one large intense event like a car accident or the loss of a loved one, or it could be a low intensity, but long-term situation, like living on a very tight budget years, or caring for someone you genuinely care about and love without reprieve. Regardless of the details, when we get pushed outside of the range of health, we sometimes need support getting back.

Holistic Solutions

Trying something new and different can be scary. You may not be confident that it will work for you and you may even be worried about what other people will think. The good news about acupuncture is that while modern science is continuing to validate its efficacy with research, it’s actually a practice that has thousands of years of validity behind it.

What matters most for people who are suffering is that they find relief, care, and support - regardless of whether it’s considered an Eastern or Western medicine approach.

One of the most useful things we can all do as a first step towards more vibrant living is to cultivate emotional resilience. If you’re interested in a free guide with Practices for Emotional Resilience, you can receive it by entering your information below.

If you’re interested in learning about how acupuncture may help you, please schedule an initial consultation here:

If you have any questions or need support please get in touch.