As a TCM practitioner, I value the connections between everyday life, emotions and wellbeing. I would like to share a few reflections on these connections, including how emotions are understood within TCM.
A mental disorder affects a person’s thinking, emotions or behaviour and can cause distress or difficulties in daily life. In 2023, around 1.2 billion people worldwide, nearly one in seven, were living with a mental disorder. Anxiety and depression were the most common. Although effective prevention and treatment options are available, most people do not receive effective care. Many also face stigma, discrimination and violations of their human rights. (1)
Mental health is influenced by personal, family and social factors. poverty, violence, disability and inequality can increase the risk of mental health problems, whereas emotional skills and supportive relationships can help protect mental health.
Mental health services do not have enough resources to meet people’s needs. Only 40% of people with psychosis and around one third of those with depression receive formal mental healthcare. Alongside treatment, people may need support to maintain relationships, access education, work and housing, and take part in meaningful activities.
Countries should promote mental wellbeing and provide care for people with mental health conditions. Community-based care is more accessible, supports recovery and helps protect people’s rights. It should connect mental health support across hospitals, GP services, community centres, schools and other settings. To help more people with depression and anxiety, countries can also expand psychological support provided by trained non-specialists and offer digital self-help tools. (2)
One finding in WHO’s 2025 report that sparked my interest was the difference in mental disorders between males and females. ADHD, autism spectrum disorder (ASD), intellectual developmental disorder (IDD) with no known cause, and some other mental disorders are estimated to be more common in males. In contrast, anxiety, depression and eating disorders are estimated to be more common in females. Anxiety disorders tend to appear earlier in life than depressive disorders, which are uncommon before the age of ten. After the age of 40, depressive disorders become more common than anxiety disorders, with the highest prevalence among people aged 50-69. (3)
These findings made me think about TCM theory. In TCM, emotions and organ systems influence each other, so assessment considers each person’s constitution, symptoms and overall health.
The Kidney stores Essence and is linked with growth, development, reproduction and nourishment of the brain. The Liver stores Blood and supports the smooth flow of Qi, which relates to emotional balance and menstrual health. The saying '女子以肝为先天' in Lin Zheng Zhi Nan Yi An 《临证指南医案》highlights the Liver’s importance in women’s health. (4) In this traditional framework, Liver Qi stagnation may involve frustration, irritability or low mood, while Liver Blood deficiency may involve anxiety, poor sleep and difficulty concentrating.
However, each person has a different constitution, and the symptoms associated with TCM patterns can vary. People with the same diagnosis may have different patterns involving several TCM functional systems. Therefore, individual assessment remains important, and the reported differences between males and females do not directly establish a particular TCM pattern.
Let’s look at how TCM understands emotions:
TCM describes the relationship between mental activities and the five organ systems through the saying: The Heart houses Shen (神), the Liver houses Hun (魂), the Spleen houses Yi (意), the Lung houses Po (魄), and the Kidney houses Zhi (志). These traditional concepts relate to the mind, spirit, thought and will. They should not be treated as direct equivalents of modern brain functions.
Liver: Anger and Emotional Balance
The Liver stores Blood and supports the smooth flow of Qi. Ongoing anger, frustration or suppressed emotions may be associated with Liver-Qi stagnation. Possible symptoms include irritability, low mood, frequent sighing and tightness in the chest or around the ribs. Liver-stagnation may also affect the Spleen and Stomach, so emotional difficulties may occur alongside appetite changes and bloating. The traditional concept of the Liver housing Hun also relates to sleep and mental activity.
Heart: Joy and the Mind (Shen)
The Heart as governing Blood and blood vessels and housing Shen, which relates to awareness, thinking and emotions. Normal joy supports wellbeing, but excessive excitement or strong emotional experiences may disturb Shen. Assessment may consider palpitations, insomnia, frequent dreams and restlessness. Sadness can also affect Shen; the Heart is not connected only with joy.
Spleen: Thinking and Digestion
The Spleen helps process food and distribute nourishment. It also houses Yi, which relates to thought. Excessive thinking or repeated worry may affect these functions, with symptoms such as poor appetite, bloating, loose stools and tiredness. The Spleen also helps produce Qi and Blood to nourish other organ systems. Therefore, Spleen-related patterns may occur alongside patterns involving insufficient nourishment of Shen.
Lung: Grief, Worry and Qi
The Lung as governing Qi and breathing and housing Po. Prolonged grief or worry is traditionally thought to weaken Lung-Qi, possibly involving shortness of breath, tiredness and a weak voice. However, this traditional connection alone cannot explain the cause of a chronic cough or lung disease.
Kidney: Fear, Essence and Will
In TCM, the Kidney stores Essence and houses Zhi, which relates to will. It is associated with growth, development, reproduction and nourishment of the brain and Marrow. Persistent fear or sudden fright is traditionally thought to affect Qi and the Kidney system. Assessment must also consider other symptoms, such as weakness in the lower back and knees or tinnitus. Fear alone does not establish Kidney deficiency.
The chapter 'Ju Tong Lun in the Huangdi Neijing Suwen' (5) describes how emotions may affect Qi: anger makes Qi rise, grief weakens Qi, fear makes Qi descend, fright disturbs Qi, and excessive thinking causes Qi to become constrained. These connections are a starting point for understanding emotions in TCM; one emotion can affect more than one organ system.
From a TCM perspective, these conditions may involve different patterns, depending on the person’s symptoms and overall health. Below are some examples of TCM patterns described in the literature and their possible associated symptoms. These are traditional pattern descriptions, rather than diagnostic criteria or established biological explanations. The examples come from different studies and may vary between practitioners.
1) ADHD: Heart-Spleen deficiency (心脾两虚), phlegm-fire disturbing the Heart (痰火扰心), Liver-Qi stagnation turning into fire (肝郁化火), and Kidney-deficiency with Liver hyperactivity (肾虚肝亢). (6)
Possible Symptoms: Poor concentration or memory, tiredness, poor appetite, sleep problems and palpitations. Other symptoms may include restlessness, irritability, anger, headaches, a bitter taste, thirst, dizziness and lower-back weakness.
2) Autism spectrum disorder (ASD): Exuberant fire of Heart and Liver (心肝火旺证), Heart spirit confused by phlegm (痰蒙心窍证), deficiency of Heart and Spleen syndrome (心脾两虚证), and deficient Kidney-essence syndrome (肾精不足证). (7)
Possible Symptoms: Tiredness, poor appetite, irritability, restlessness and disturbed sleep.
3) Intellectual developmental disorder (IDD): Insufficient congenital Essence (先天精气不足) and inadequate nourishment from acquired Essence (后天失养). These interpretations involve the Kidney, Heart, Spleen and Stomach. (8)
Possible Symptoms: Tiredness, poor appetite, and ongoing difficulties with learning or memory.
4) Anxiety disorders: Heart-Kidney disharmony (心肾不交), Heart-Spleen deficiency (心脾两虚), phlegm-heat disturbing the Heart (痰热扰心), Liver stagnation with Spleen-deficiency (肝郁脾虚), and Liver-stagnation turning into fire (肝郁化火). (9)
Possible Symptoms: Restlessness, poor concentration, insomnia, night sweats, palpitations, irritability, headaches and digestive discomfort.
5) Depressive disorders: Liver-Qi stagnation (肝气郁结), Liver-stagnation with Spleen-deficiency (肝郁脾虚), Heart-Spleen deficiency (心脾两虚), and other deficiency or excess patterns. (10)
Possible Symptoms: Low mood, frustration, frequent sighing, tiredness, poor appetite, bloating, loose stools and sleep problems, poor concentration or memory.
6) Eating disorders: Liver-Qi stagnation (肝气郁结) and Liver-stagnation with Spleen-deficiency (肝郁脾虚). However, anorexia nervosa, bulimia and binge-eating disorder are different conditions and should not be explained by one digestive pattern. (11)
Possible Symptoms: Emotional tension, digestive discomfort, changes in appetite, bloating and loose stools, tiredness.
Please bear in mind that a person may have more than one co-occurring condition. In TCM, a person may also present with several overlapping patterns.
I hope that, over time, TCM may have a greater role in supporting mental wellbeing alongside modern mental health care. I look forward to continuing to learn and making a modest contribution where I can.
References:
1) Mental Disorders (published 11 September 2026)
2) Mental Health (published 11 September 2026)
3) World Mental Health Today: latest data (published 2 September 2025)
4) 《临证指南医案》卷九·调经 - Lin Zheng Zhi Nan Yi An, Volume 9, Regulating Menstruation: Clinical cases of Ye Tianshi (叶天士), compiled by Hua Xiuyun and others (华岫云等). The phrase '女子以肝为先天' appears in Qin Tianyi’s (秦天一) commentary summarising Ye’s cases.
5) 《黄帝内经·灵枢·本神》第八 - Huangdi Neijing Lingshu, Chapter 8, 'Ben Shen': This passage describes the relationship between the five organ systems and Shen, Hun, Yi, Po and Zhi.
6) Treat ADHD with herbal medication and acupuncture
7) Research status and prospects of acupuncture for autism spectrum disorders
8) The treatment of intellectual disability with acupuncture
9) Analysis of syndrome discipline of generalized anxiety disorder using data mining techniques
11) Development of a Chinese Medicine Pattern Severity Index for Understanding Eating Disorders
© 2026 Kit Li. All rights reserved. Please obtain permission before reproducing this article. Referenced materials remain the property of their respective rights holders.
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