Saturday, 24 January 2026

TCM Approach to Bereavement-Related Depression with Heart-Liver-Spleen Disharmony

 

Kit Li


Two weeks ago, a male patient had been suffering from depression since the death of a family member last September. Since then, he had been severely depressed and emotionally suppressed, experiencing mixed feelings, particularly unexpressed anger, as he continues to move through the stages of bereavement (denial, anger, depression, bargaining and acceptance). (1) 

He came to me after being referred by his best friend, who had experienced approximately 80% recovery from an anxiety disorder after receiving scalp acupuncture combined with Chinese herbal medicine for over six weeks.

In this case, the patient had never received any acupuncture treatment before, including scalp acupuncture. I advised him to remain well hydrated prior to treatment in order to reduce stiffness of the connective tissues (2) in the scalp.

In general, from a TCM perspective, patients suffering from emotional disorders are primarily diagnosed with Qi stagnation. Emotional factors damage the Liver, resulting in Liver Qi constraint. Over time, this gradually affects the functions of the internal organs, particularly the Five Zang organs. (3)  Primarily affecting the Liver, Spleen and Heart, with manifestations of Qi and Blood imbalance.


TCM Diagnosis:

  • Liver-Qi stagnation (inexpressive anger mixed with depressed)
  • Heart-Blood deficiency (insomnia, forgetful and palpitations)
  • Spleen-Qi deficiency with dampness accumulated in the Lower Jiao (fatigue, no appetite)
Pulse:
  • Left - cun (weak) and guan (wiry)
  • Right - generally weak, guan (slippery)
Tongue:
  • pale, thin coating
  • teethmarks
  • red tip of the tongue
TCM treatment Plans:
  • Regulating Qi and Blood
  • Calm the Shen
  • Strengthening Spleen and immunity
Acupoints:

  • Scalp Acupuncture is always my primarily treatment as it's excellent for Emotional Disorders: Head Area, Spirit Emotion Area...etc.
  • Abdominal Acupuncture: Dao-qi technique was applied with the key points on Ren-mai which is good for regulating emotions, also supporting digestion.
  • Key body acupoints were selected to regulate Qi, tonify the Spleen and Stomach, nourish Blood, calm the Shen, and clear dampness.

Chinese Herbal Prescriptions:


Gui Pi Wan (4, 5): This formula is for tonify Qi and Blood. it also tonifies Spleen-Qi, nourishes Heart-Blood, as well as calms the Shen.  The core ingredients are:

1) Qi-tonifying and strengthen the Spleen:

  • RenShen (Ginseng Root)
  • Huang Qi (Astragalus Root)
  • BaiZhu (Atractylodes Rhizome)
  • FuLing (Poria)
2) Blood nourishing and Calms the Shen:
  • DangGui (Chinese Angelica Root)
  • SuanZaoRen (Sour Jujube Seed)
  • LongYanRou (Longan Fruit)
  • YuanZhi (Polugala Root)

After two weeks of taking the prescribed medication combined with acupuncture treatment once a week, he feels more settled. His sleep has improved significantly, and he reports increased energy levels as a result of better quality sleep.  Overall, his condition shows clear improvement, and the treatment appears to be effective at this stage.


References:

1) The Stages of Bereavement: https://www.nhs.uk/mental-health/feelings-symptoms-behaviours/feelings-and-symptoms/grief-bereavement-loss/

2) From a TCM and anatomical perspective, good hydration can help:  Improve tissue elasticity
    reduce tightness in the scalp’s connective tissues, make needle insertion more comfortable, 
    potentially enhance circulation during scalp acupuncture.

3) Five Zang Organs (Wu Zang):  In TCM, the Five Zang organs are core Yin organs that store vital          substances (Qi, Blood, Body Fluids, Essence) and support overall physiological and psychological       balance. They are not just anatomical organs but functional systems with emotional and elemental          associations. 

4) Prescription of chinese herbal medicine and selection of acupoints in pattern-based traditional                 chinese medicine treatment for insomnia: a systematic review:                                                                 https://pubmed.ncbi.nlm.nih.gov/23259001/

5) Effect of Kami Guibi-Tang (KGT) in elderly subjects with insomnia: a study protocol from a single        center, randomized, double-blind, placebo-controlled trial:                                         https://link.springer.com/article/10.1186/s12906-023-04199-y?utm_source

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