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Five types of Depression – from a Chinese medicine perspective

Depression is a debilitating condition that prohibits people from living and enjoying their lives.

As a Chinese medicine practitioner working with mental health, the term depression isn’t adequate. It is an umbrella term that groups together a number of different experiences.

The reason why it is worthwhile making and understanding these categories is to provide effective treatment for individual patients.

Group 1 - illness or stressful event

These individuals may have suffered from a severe illness or stressful event.

However, the depression progressed because the pressures of everyday life were too great to allow them a proper recovery. Pressures can include home life situation, diet, work/life balance, financial or emotional pressures.

Symptoms include:

  • Low mood that comes and goes

  • Feeling restricted by daily chores and obligations – everyday life is a challenge

  • Tightness in the chest, mid back, upper back and neck

  • Low appetite in the morning, improves later in the day

  • Mood improves with movement/ mild exercise

  • Strenuous exercise or over-sweating can cause insomnia

Group 2 - inertia that slows things down

This group experiences depression as a fogginess or inertia that slows things down, or numbs response. They report:

  • Constant or ongoing confusion and indecisiveness

  • Lack of desire or spark

  • Unable to build up momentum to make changes

  • When mild, this type of depression is often confused for a personality type. It still responds to treatment. When it is severe, it is debilitating and quite a departure from the ‘real person’. This type of depression can be due to:

  • Enduring fatigue

  • Shock or trauma

  • Medication, and/or recreational drug-use

Group 3 - sadness or dissatisfaction

This group might be described as anxiety, but also includes an element of sadness or dissatisfaction. Characteristics include:

  • Strong, overwhelming emotions that come and go, not constant

  • Fears and phobias

  • Palpitations, headaches, migraines, vertigo

  • Urinary or bowel issues

  • A tendency to want to shut down:

  • Wanting to stay home

  • Avoid social situations

  • Avoid work

Group 4 - grumpy or prickly

This type of depression is seen as grumpy or prickly. It can be hard for these people to relax, as many small things can be irritating.

Characteristics include:

  • First response being negative, irritable or disagreeable

  • Easily upset when things don’t go according to plan

  • Unhappy with the outside world (compared to low self-esteem)

  • Physical symptoms can include:

  • Heat intolerance

  • Digestive problems (constipation, indigestion, reflux, bile issues)

  • Skin problems

Group 5 - internal triggers or external events

This is the last group because all the previous pictures can progress to this group. This progression can be due to internal triggers or external events. This group can experience:

  • A severe and persistent discomfort inside one’s own head

  • Rage and violence

  • Suicidal thoughts or actions


Chinese medicine doctors interpreting depression

This way of diagnosing depression characteristics is useful to Chinese medicine doctors because it indicates what treatment the individual will respond to. It doesn’t say anything about the personality, it describes the disease.

Each person can suffer from a combination of these groups. For example, in Chinese medicine hospitals, people experiencing a bipolar episode will often receive treatment for groups 1, 3 and 5 simultaneously.

Looking at depression from Chinese medicine perspective does not seek to reduce the contemporary understanding of depression. There still can be:

  • Neurochemical imbalances

  • Severe, traumatic or overwhelming life events and circumstances

  • Unhelpful behaviours or perspectives

  • Bad diet, lifestyle and environments

A Chinese medicine perspective looks at the bigger picture behind the depression symptoms. Looking at how depression is expressed, and what physical symptoms are associated in each individual, gives us information as to how to get that person functioning and feeling well again.


Acupuncture and depression - current research

A recent 2018 Cochrane review of 64 studies (7104 participants) looking at acupuncture for depression found evidence that acupuncture could improve the severity of depression. The review looked at studies of:

  • acupuncture vs no treatment

  • acupuncture vs sham acupuncture

  • acupuncture vs medication

  • acupuncture plus medication vs medication alone

  • acupuncture vs psychological therapy

In all instances, except the last, results showed that acupuncture produced a small to moderate reduction in the severity of depression (compared to the control). In the last group, there was no evidence to show that acupuncture was more beneficial than psychological therapy.

The Cochrane review noted that further studies are required, as the quality of evidence was quite low. It also noted that across the 64 studies, variations appeared in:

  • Administration of acupuncture (ear acupuncture, traditional body acupuncture, electro-stimulated acupuncture, laser acupuncture)

  • Prescribed medications as control

  • Techniques and styles of psychotherapy as control

It is this author’s view that evidence-based research for treating depression with acupuncture or Chinese medicine is challenging because little research takes into consideration the Chinese medicine differential diagnosis, that is used in a clinical setting.


Smith CA, Armour M, Lee M, Wang L, Hay PJ. Acupuncture for depression. Cochrane Database of Systematic Reviews 2018, Issue 3. Art. No.: CD004046. DOI: 10.1002/14651858.CD004046.pub4

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