As a hyper-holistic tradition, Chinese medicine conceives of the mind, body, and spirit as inextricably linked, essentially teaching that every layer of our multifaceted beings is comprised of different manifestations of Qi (vital energy). Qi that is condensed is the material aspect of our beings while Qi that disperses is Spirit, with emotions also considered a form of Qi. Though mental-emotional issues are classified according to their effects on Qi, Blood, Yin, and the generation of pathogenic factors, it is brilliantly also understood that energy moves bidirectionally. That is to say, disharmony of Qi, Blood, or Yin, as well as the presence of pathogens, will also contribute to mental, emotional, and spiritual disharmonies. TCM offers highly valuable and time-tested insights into not only the patterns of mental-emotional disorders, but also into courses of treatment.
Bipolar disorder closely corresponds to the ancient TCM disease of Dian Kuang, which roughly translates to manic depression, but it does not necessarily always align neatly with a Western conception thereof. For the purposes of learning, we can note this connection while honoring the sometimes significant departures between Western and Eastern medicines, and therefore focus on the TCM conception of Dian Kuang. Dian connotes a state of depression, indifference, being withdrawn, worry, unresponsiveness, and incoherent speech. Kuang connotes agitation, aggression, irritability, offensive speech, inappropriate laughter, excessive physical strength, and abstaining from sleep and food. It is always characterized as an imbalance between Yin and Yang, with excess Yin expressing as Dian and excess Yang expressing as Kuang. Because tending to the harmony between Yin and Yang is fundamental to TCM philosophy, this could be understood as the generalized “core” of Dian Kuang, though the full patterns of pathology are more complex.
In TCM, patterns of pathology are identified through various methods, including pulse diagnosis, tongue examination, observation of symptoms, and interviewing the patient about lifestyle and emotional health. Beyond disharmony between Yin and Yang energetics, some of the main elements of pathology present in Dian Kuang are:
- Phlegm: This causes obstruction of the Mind and is a distinguishing factor between a more traditional expression of Depression and the depressive component of Dian Kuang. Phlegm can manifest as confusion, manic behavior, or severe emotional disturbances.
- Fire harassing upwards: Fire combines with phlegm and it harasses upwards to agitate the Mind. Deriving primarily from the Liver and Heart, it can contribute to anxiety, restlessness, insomnia, rage, and manic symptoms.
- Qi Stagnation and Blood Stasis: Emotional stress contributes to Qi stagnation, which over time leads to Blood stasis (a severe result of prolonged stagnation). In TCM, Blood is closely linked to the Mind and Shen (Spirit), so disturbances in flow can significantly affect mental and emotional well-being, expressing as depression, anxiety, and a deep sense of emotional pain or sadness that feels unresolvable.
- Disharmony of the Ethereal Soul (Hun): The organ system of the Liver is responsible for regulating Qi and Blood, governed by the Hun, which oversees intuition, inspiration, life visions, and ideas. It is also responsible for emotional regulation, especially as related to the balance between depression, anxiety, and anger.
- Kidney Yin Deficiency: Associated with symptoms like anxiety, insomnia, impaired memory, and emotional instability, this pattern reflects depletion. Shock and fear injure the Kidneys, compromising our stores of Jing (essence) and damaging Zhi (will-power).
These patterns of disharmony guide us toward treatment principles to help resolve symptoms and even cultivate a deeper state of healing. Interestingly, diet is extremely important here as it is a primary cause of phlegm. A more severe and concentrated form of Dampness, phlegm has a destructive effect on the flow of Qi, but can be mitigated by avoiding excess sugar, dairy, and fried or fatty foods, as well as being present and calm during mealtimes. Following a TCM pro-metabolic dietary framework would also help prevent Dampness and phlegm. A comprehensive treatment protocol would also entail moving Qi, nourishing the Heart and Spleen, draining excess Fire, nourishing Yin, invigorating the Blood, and calming the Mind. Of course, acupuncture, Chinese herbs, diet and lifestyle adjustments, and meditation and movement can all help the body return to balance—especially when guided by a doctor of TCM.
For more in-depth information, see our primary source for this overview: The Psyche in Chinese Medicine by Giovanni Maciocia.
