Holistic and Herbal Approaches to Sleep, Depression, and Anxiety

Transcription

1 Holistic and Herbal Approaches to Sleep, Depression, and Anxiety When the Stomach and Intestines are coordinated the five Yin organs are peaceful, Blood is harmonized and mental activity is stable. The Mind derives from the refined essence of water and food. Ling Shu (Spiritual Axis) of the Nei Ching, compiled 100 BC Mood disorders are the fourth leading cause of illness in world. Depression and anxiety interplay / interact with each other and are not always distinct from each other. Lack of adequate sleep, and/or poor sleep quality can cause or exacerbate anxiety and depression, and in turn be exacerbated or caused by them. The terms antidepressant or nervine are not very helpful unless and until we consider the overall pattern, including energetic and/or physiological patterns. Some basic parameters or factors to consider (differential diagnosis): Is it (the insomnia, depression, anxiety) situational or not? Heightened sensitivity leading to maladaptation is common especially in people suffering from anxiety and insomnia. Circadian rhythm can be a major factor not only in sleep disorders but also in depression and anxiety o Cortisol reaches peak mid-morning o Serotonin naturally higher in day time with sunlight o Melatonin production increases in the evening Look to possibility of other endocrine dysfunction: o Overall autonomic equilibrium (H-P-A) o Thyroid (H-P-T) o Reproductive: LH/FSH imbalance, endometriosis, PCOS, etc. (H-P-G) o Metabolic / blood sugar / pancreatic (H-P-P) Disorders of synaptic transmission; abnormal release or reception of neurotransmitters (our alkaloids) o Dopamine (when low can lead to Wind / motor dysfunction; when high to mania) o Serotonin (when low can lead to depression) o GABA (when low can lead to anxiety, when high to depression) Past or current trauma or abuse Genetics and epigenetics vs. learned behavior and the contagious nature of depression 1

2 2 Food allergies and/or nutritional deficiencies, especially: o Omega 3s esp. EPA o Vitamin B6, B12, folates o Vitamin D (SAD) Liver health and hepatic function: o Too low cholesterol leads to depression o Liver qi stagnation leading to frustration, anger, liver depression Inflammation: inflammatory cytokines can induce depression as a defense mechanism Gut health o What is happening in our gut is often also happening in our Mind o Limited biodiversity in our macro- and microbiome can challenge our mental and emotional well-being o The Microbiome We share our microbial cloud with those around us Our microbiome shapes our mood and personality including precursors of neurotransmitters Possible direct microbiome link from gut to CNS via the vagus nerve Infectious agents can profoundly alter mental health The Spleen-Mind (Gut-Mind) as our grounding and centering, following one s path o Focus, concentration, and finding our path reside in the Gut the Enteric Brain; the Spleen houses the Intellect o Are we processing? Are we digesting, assimilating, and eliminating mentally as well as physically? Chewing our thoughts, digesting our thoughts, listening to what our gut tells us o Brooding and pensiveness from Spleen Qi depletion o Damp accumulation from stagnation The Lung-Mind as our Sense of Self, Empathy, and Right and Wrong o Lungs and Spleen (respiratory and digestive health) closely linked o The Breath as Spirit o What we hold on to and what we let go; heightened sensitivity o Our moral and ethical code, our sense of Right and Wrong o Holding onto grief and sadness; mourning and loss The Kidney-Mind as our Confidence, Will, and Self-Esteem o Houses our Essence, our deep vitality o Low self-esteem, fear and phobias can reflect a Kidney deficiency, or cause one o Lack of nurturing, pre- and post-birth The Liver-Mind as our Motivation and Assertiveness o Regulator of the smooth flow of Qi and Blood o Courage to take the step and then to see things through; lack of drive is a Liver Blood deficiency o Liver depression from Constrained Qi o Emotional volatility, mood swings, alternating anxiety and depression Wind

3 o Going with the flow versus easily set off course; remaining stable whether you are treated well or not o Fitful, interrupted sleep o Liver fire anger will damage the Heart The Heart-Mind as our Inner Peace and Clarity o The seat of the Mind and Joy o Cardiovascular health and mental health are interwoven; the Heart is the organ most permanently damaged by mental and emotional imbalance o Are we fulfilled and joyful? Are we loved and loving? o Deep-seated heart depression or anxiety from Heart Blood or Heart Qi deficiency o Anxiety / insomnia / agitated dreams from excess Heat in the Hart o Trouble falling asleep o Deconstruction of Mind-Body-Soul; the Ego and Isolation Does our lifestyle nourish our Essence and Shen, or deplete them? o Sleep allows our central nervous system to cleanse itself of metabolic waste o Physical activity (exercise) can be more effective than SSRIs in treating depression; many (most?) of us cannot be truly happy and at peace without being physically active o Healthy Food and Clean Air are the source of our Qi o Mindfulness (meditation, prayer) Clearing the Mind of negative and distracting thoughts being present nourishes the Mind (Heart) and replenishes our Essence (Kidneys) o Remembering our place in the world as a species of mammal on Earth; co-evolved as an integral part of life on this planet (forest bathing) What do we do? o Nourish the Heart Blood and Liver blood o Calm the Mind o Nourish the Essence o Move the Blood and Qi; break up stagnant energy o Tonify Qi, Blood, Yin, Yang To bring your anger to a halt, there is nothing better than poetry; To cast off worry there is nothing better than music The Nei-yeh (Inward Training) Anonymous - Mid 4th Century BCE, trans. Harold Roth 3 1. Remember that herbs support, potentiate, and synergize they work best within a holistic framework. 2. Is the imbalance secondary in nature, i.e. the direct result of another condition, disease, or health challenge? In which case, address that as a primary focus,

4 4 3. Adaptogens: which one is energetically and specifically indicated? o Stimulating versus grounding o Moistening versus drying o Warming versus cooling 4. Nervines: which one is energetically and specifically indicated? o Nervine stimulants o Nervine tonics - trophorestoratives o Nervine sedatives o Moistening versus drying o Warming versus cooling Energetic and Pattern Assessment Excess: irritability, restlessness, anxiety, insomnia, headache, red eyes, Bitter taste in mouth, yellow tongue coating, slippery rapid pulse Liver fire, phlegm accumulation Deficiency: dizziness, light-headedness, palpitations, fearfulness, night sweats, forgetfulness Pale tongue, thready pulse Major deficiencies: blood, qi, yin, yang Phlegm obstructing the Mind: Often cold, moist, stagnant Look to the Gut Swollen tongue, sticky coating, slippery pulse Confusion, poor memory, dizziness, dull thoughts, fatigue, depression, quiet and subdued Some possible herbs: Poria, Rosmarinus, Acorus, Polygala, Artemisia, Ocimum For the gut, add: orange peel, elecampane Phlegm Fire Tongue: swollen red with sticky yellow coating and midline crack. Pulse: slippery and rapid Tense, volatile, bipolar, agitated, anxious but alternating with depression Agitated restless anxious Clear heat from the Heart: Eschscholzia, Matricaria, Scutellaria, Rosa, Leonurus, Ganoderma, Verbena, Theobroma Deficient Liver Yin Deficient Cold, dry Dry, cracked tongue; may be pale or red (empty heat) Pulse thready, weak, deep Nourish yin: Glycyrrhiza, Avena, Selenicereus, Paeonia

5 Empty-Heat Floating empty or fine and rapid pulse Red tongue without coating, possibly with red tip and midline crack More severe anxiety, insomnia, mental restlessness Empty heat rising from deficient Yin; excessive Joy (too much play!), craving, obsessive love or love for one who abuses them Spontaneous sweating: Ziziphus, Astragalus, Codonopsis, Schisandra Night sweating: Cornus, Schisandra, Ziziphus Clear heat but also nourish Yin: Selenicereus, Crataegus, Avena Diagnostics: Pulse: o Weaker on left side: deficient Blood o Weaker on right side: Deficient Qi o Anger: wiry especially Liver, on left side o Sadness: Lung pulse weak, choppy o Excess Heat in the Heart: hollow / empty, esp Heart pulse o Fear: rapid, tight, fine Tongue: o Dry, cracking: yin depletion o Red, thin, dry tongue with cracking: kidney yin depletion o Bloated, pale: yang depletion o Swollen, tooth marks, central crack: Qi (Spleen) depletion o Pale / bluish: Blood deficiency o Quivering or asymmetric: Wind; Liver stagnation; adrenal exhaustion o Red tip: Heat in Heart, disturbed Shen, but may be from different causes o Red sides: anger, Liver Fire or yang Rising o Red sides and tip: severe frustration and anger o Combined St and H crack with sticky yellow coating: Phlegm-Fire, bipolar o Crack to tip, indented tip, swollen along central crack: Heart Qi deficiency 5

6 Materia medica: Acute anxiety/panic, fear, phobia: Piper methysticum, Pulsatilla, Selenicereus Eli Jones Formula for Hysteria (via Winston): Asafoetida, Valeriana, Lobelia, Cypripedium (replace with Eschscholzia) Anxiety with dyspnea /difficulty breathing, wheezing: Lactuca, Lobelia, Schisandra, Ganoderma; nourish Kidneys Hypothyroid depression Withania, Panax, Bacopa, Schisandra Winter depression/ Seasonal Affective Disorder Melissa, Hypericum, Coffea Depression and anxiety during withdrawal from substance abuse and recovery: Erythroxylum coca, Avena, Scutellaria, Acorus, Lobelia, Glycyrrhiza, Withania, Panax, Monotropa; Eschscholzia and/or Passiflora if there are signs of heat. Cardiovascular depression or anxiety Crataegus, Selenicereus, Leonurus, Ganoderma, Tilia, Rhodiola if not too stimulating Anxiety with tachycardia, palpitations, heaviness or tightness in the chest Selenicereus, Albizia, Leonurus, Ganoderma, Poria, Crataegus, Melissa, Lycopus Anxiety with insomnia / trouble falling asleep Eschscholzia, Lactuca, Matricaria, Humulus, Passiflora; look at blood sugar Anxiety with insomnia (restless sleep or waking up repeatedly) Valeriana, Ganoderma, Scutellaria Disturbed dreams Disturbed Shen Ganoderma, Scutellaria, Poria (fu shen), Albizia, Ziziphus Anxiety with monkey brain / scattered thoughts Ocimum, Acorus, Schisandra, Ganoderma, Boswellia Mental fixation / circular thinking, stagnant fixation on single traumatic event, Scutellaria, Passiflora, Ocimum, Albizia, Piper methysticum, Rosmarinus For PTSD consider monotropa and other herbs to change the mind Anxiety or depression with mental fog and lethargy Centella, Lavandula, Ocimum, Bacopa, Rosmarinus, Poria, Acorus 6

7 Depression with vascular insufficiency and old age Ginkgo, Rosa, Selenicereus, Rosmarinus Depression with cognitive dysfunction Ginkgo, Bacopa, Rosmarinus, Ocimum, Poria, Acorus, Panax, Melissa Depression or melancholy with dull thinking, constipation, sluggishness: Lavandula, Coffea, Erythroxylum coca Anxiety along with emotional fragility, easily startled Avena, Pulsatilla, Scutellaria, Lavandula Strengthen Po (Lungs): Ganoderma, Cordyceps, Schisandra Anxiety with dyspepsia Melissa, Nepeta, Lavandula, Valeriana, Humulus, Acorus, Matricaria With poor appetite: Acorus, Ziziphus, Inula, Zanthoxylum Depression with dyspepsia Hypericum, Artemisia absinthium, Valeriana, Poria With poor appetite: Acorus, Ziziphus, Inula, Zanthoxylum Female reproductive hormone-related depression Actaea, Pulsatilla, Paeonia, Glycyrrhiza, hepatics Depression with liver stagnant dysmenorrhea Actaea, Verbena, Bupleurum, Paeonia, Scutellaria With stagnation and heat, irritability, anxiety: Matricaria, Leonurus, Verbena To nourish the Blood: Paeonia, Salvia miltiorrhiza, Urtica, Angelica sinensis For stagnant liver Qi with sour / negative attitude: Hypericum PMS anxiety, menopausal anxiety Avena, Verbena, Leonurus, Humulus With irritability: Albizia, Chrysanthemum, Valeriana, hepatics To nourish the Blood: Paeonia, Salvia miltiorrhiza, Urtica, Angelica sinensis For stagnant liver Qi with sour / negative attitude: Hypericum PMS or menopausal depression / puberty-related depression Actaea, Pulsatilla, Serenoa, Angelica archangelica, Paeonia, Glycyrrhiza, Selenicereus, Cnicus and other hepatics Anxiety during pregnancy Avena, Viburnum prunifolium, Valeriana 7

8 Liver stagnation /alternating depression and anxiety Hypericum, Valeriana, Albizia, Withania To calm Liver and Extinguish Wind: Valeriana,Verbena, Actaea, Scutellaria Anger, frustration, irritability (Liver Wind) Verbena, Scutellaria, Chrysanthemum, Eschscholzia, Albizia, Bupleurum Anxiety with physical agitation Scutellaria, Valeriana, Matricaria Anxiety / hysteria with tics, spasms, tremors (Wind) Scutellaria, Lobelia, Verbena, Lactuca, Passiflora, Valeriana Anxiety or depression with muscular tension, aching and pain (emotional and physical tension): Actaea, Piper methysticum, Withania, Verbena, Lobelia, Lactuca Also consider Morus twig, Cinnamomum twig, Pueraria 8