Depressive State
Overview
A depressive state is centered on persistent low mood, loss of interest, reduced energy, changes in sleep and appetite, poor concentration, self-blame, and hopelessness lasting two or more weeks and impairing function. Chinese medicine groups it under constraint syndrome and related entities, mainly from emotional injury with loss of liver coursing, gradually affecting the heart and spleen; patterns include liver qi stagnation, heart–spleen deficiency, and stagnant qi transforming to fire. Moderate-to-severe depression or self-harm thoughts require standard psychiatric/psychological care; TCM and lifestyle are adjuncts, not substitutes.
Pattern differentiation (clinical patterns)
Liver Qi Stagnation
Low mood with chest/rib distension, frequent sighing, epigastric stuffiness, belching, premenstrual breast distension in women, thin white coating, wiry pulse.
Soothe the liver and resolve constraint; regulate qi and loosen the middle.
Heart–Spleen Deficiency
Excessive worry, palpitations, insomnia, forgetfulness, dull complexion, dizziness, fatigue, poor appetite, pale tongue white coating, fine weak pulse.
Strengthen the spleen and nourish the heart; tonify qi and blood.
Stagnant Qi Transforming to Fire
Irritability and anger, bitter/dry mouth, headache, insomnia with dreams, constipation, dark urine, red tongue yellow coating, wiry rapid pulse.
Soothe the liver and drain fire.
Connections
Daily care & prevention
Keep regular sleep, daylight exposure, and exercise (frequent weekly aerobic activity helps mood); stay connected with trusted people and avoid isolation; break tasks into small steps and track mood and sleep. Massage Taichong (LR3), Neiguan (PC6), Shenmen (HT7), Baihui (GV20), and Yintang (EX-HN3). Low mood lasting two or more weeks that impairs work or life warrants psychological/psychiatric care; antidepressants must not be stopped abruptly—work with the prescriber.
When to seek medical care
Any suicidal/self-harm thoughts, a specific plan or action, feeling there is no reason to live, or arranging affairs warrants immediate contact with a crisis line, emergency services, or a trusted person, with 24-hour company and removal of dangerous items; such thoughts after childbirth require urgent help.