Depression
Definition
Western
Depression is a disorder in which an individual suffers from depressed mood with diminished interest or pleasure. It can be translated into a sense of guilt or low self-esteem, lack of energy and concentration, disturbed sleep or poor appetite. Serious cases of depression can result in suicides [1] .
Traditional Chinese Medicine (TCM)
A condition in which faecal matter resides in the intestines for over an extended duration, resulting in prolonged intervals between successive defaecations, or experiencing difficult and/or painful defaecation with dry stools or feelings of incomplete emptying of bowels [2-3].
Symptoms
Include irritated mood, diminished interest or pleasure in surrounding activities, uncontrolled weight loss or weight gain, decrease or increase in appetite, fatigue, reduced concentration or lowered self-esteem[1, 5].
Classifications
Emotional Issues
When one is under prolonged emotional stress without suitable emotional outlets or when these stressors are too overwhelming and exceed one’s ability to cope, individuals may experience tinnitus, constipation or loss of appetite [3].
Low Tolerance Threshold
Individuals usually have low threshold for stress tolerance and may have other underlying diseases. They typically suffer from night sweats, heart palpitations or insomnia [3].
Causes
Environmental factors
Depression may be triggered by major setbacks in life or the sudden loss of a family member or loved ones. Working in a stressful or suppressive environment for prolonged period may also cause depression [3, 6].
Illnesses
Often lead to disability or chronic pain, both of which can cause distress and stir emotions of the sufferers [3, 6].
Predisposition
Individuals who are withdrawn and pessimistic in nature are generally more prone to depression [3].
Risk Factors
· Women are at a higher risk of developing depression. Numerous explanations, such as differences in gender roles and hormonal fluctuations, have been proposed to account for this increase in risk [5-6].
· Depression is more prevalent in the elderly. Causes include normal ageing process, chronic medical or pathological conditions or undergoing drug therapy programmes [7].
Treatments
Herbal prescriptions: Herbs commonly used include:
1. Hou Po -厚朴
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English/ Common name
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Magnolia bark[8]
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Latin species
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Magnoliae officinalis Rehd. Et Wils [3]
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Park of plant used
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Bark [8]
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Action/s
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Aids in relieving emotions [9] and has antidepressant-like effects[8, 10-12] . Also used in the treatment of some gastrointestinal disorders and coughs[13].
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Precaution/s
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Women who are pregnant should use this herb with caution [9].
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2. Chai Hu -柴胡
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English/ Common name
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Thorowax root [14]
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Latin species
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Bupleurum scorzonerifolium Willd [14]
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Park of plant used
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Roots [14-15]
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Action/s
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Helps to calm nerves [16] and contains anti-inflammatory and anti-viral functions [17]. It is also used in the treatment of influenza, fever, malaria, menstrual disorders [18] and certain liver diseases [19].
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Precaution/s
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Individuals who suffer from headaches and dizziness should avoid consuming this herb [9].
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3. Sheng Jiang -生姜
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English/ Common name
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Ginger rhizome[8]
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Latin species
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Zingiber officinale Roscoe [3]
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Park of plant used
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Rhizomes[8]
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Action/s
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Found to exhibit anti-depressant activities[8, 10-11]. Also serves as a digestive aid [20] and can be used for nausea and vomiting associated with motion sickness, surgery or pregnancy [21]
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Precaution/s
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Individuals who have constipation or are prone to mouth ulcers are advised against consuming this herb [9].
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4. Long Gu -龙骨
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English/ Common name
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Fossil bone [15]
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Latin species
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Fossilia Mastodi Ossis [15]
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Park of plant used
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Leaves
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Action/s
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Found to have tranquilising[15], sedative and anti-convulsive effects [22] .
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Precaution/s
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Special attention must be paid to its boiling duration[9] .
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Acupuncture
Stimulation of specific acupuncture points aids in de-stressing the patient [23] .
Tests & Diagnosis
Actigraphy
A device is worn around the patient’s wrist, waist or ankle for 24 hours. Activity level, including frequency and intensity of movement are monitored [24] .
Automatic Thoughts Questionnaire
Serves to assess the frequency of negative and positive self-statements. Also requires patient to rate oneself on different aspects of his/her physical and mental state [24] .
Lifestyle
· Patients should participate in moderate physical exercises and try to confront this disease in a positive light.
· A strong social support network plays an essential role too [23].
References
1. World Health Organization International Statistical Classification of Diseases and Related Health Problems 10th Revision 2007; Available from: http://apps.who.int/classifications/apps/icd/icd10online/.
2. Zhanwen Liu, L.L., Depression, in Essentials of Chinese Medicine. 2009.
3. Ying, Z.Z., 中医内科学. 20 ed. 2008, 北京: 中国中医药出版社. 519.
4. Yanfu, Z., 中医诊断学. 2002: 上海中医药大学出版社.
5. Keith S. Dobson, M.C.S., Lauren C. Haubert, Practitioner’s Guide to Evidence-Based Psychotherapy. 2006.
6. Christine K. Cassel, R.M.L., Harvey Jay Cohen et al, Depression, Anxiety, and Other Mood Disorders in Geriatric Medicine. 2003.
7. Gottfries, C.-G., Late life depression. European Archives of Psychiatry and Clinical Neuroscience, 2009.
8. Li-Tao Yi, Q.X., Yu-Cheng Li, Lei Yang and Ling-Dong Kong, Antidepressant-like synergism of extracts from magnolia bark and ginger rhizome alone and in combination in mice Progress in Neuro-Psychopharmacology and Biological Psychiatry, 2009. 33(4): p. 612-624.
9. Fu, Z.Y., 中药学. 2003: 上海中医药大学出版社.
10. Li-Tao Yi, L.Z., An-Wei Ding, Qun Xu et al, Orthogonal array design for antidepressant compatibility of polysaccharides from Banxia-Houpu decoction, a traditional Chinese herb prescription in the mouse models of depression Archives of Pharmacal Research, 2009. 32(10): p. 1417-1423.
11. Li-Qin Qiang, C.-P.W., Fu-Meng Wang et al, Combined administration of the mixture of honokiol and magnolol and ginger oil evokes antidepressant-like synergism in rats Archives of Pharmacal Research, 2009.
12. Uwe Koetter, M.B., Svenja Lacher, Aliaa Abdelrahman and Deanne Dolnick, Interactions of Magnolia and Ziziphus extracts with selected central nervous system receptors Journal of Ethnopharmacology, 2009. 124(3): p. 421-425.
13. Hu-Quan Yin, Y.-T.J., Young-Chul Kim et al, Magnolia officinalis Reverses Alcoholic Fatty Liver by Inhibiting the Maturation of Sterol Regulatory Element–Binding Protein-1c. Journal of Pharmacological Sciences, 2009. 109(4): p. 486-495.
14. Run-tao Tian, P.-s.X.a.H.-p.L., Evaluation of traditional Chinese herbal medicine: Chaihu (Bupleuri Radix) by both high-performance liquid chromatographic and high-performance thin-layer chromatographic fingerprint and chemometric analysis Journal of Chromatography A, 2009. 1216(11): p. 2150-2155.
15. Liu, Z., Commonly Used Herbs in Essentials of Chinese Medicine. 2009.