Mental illness is common in the U.S., nearly 20 percent of adults live with a mental illness which vary in degree of severity—ranging from mild to moderate, to severe. It is not exaggerated to say that mental illness is an epidemic. Approximately 1 in 5 adults in the U.S., 43.8 million (18.5 percent), experience mental illness in a given year. This is a truly frightening statistic. In addition, approximately 1 in 25 adults in the U.S., 9.8 million (4 percent), experience a serious mental illness in a given year that substantially interferes with, or limits one or more of life's major activities.

Youths are not exempt from these startlingly statistically, with approximately 21.4 percent of those aged 13–18 experiencing a severe mental disorder at some point during their life. For children aged 8–15, the estimate is 13 percent. And this trend is only getting worse. The rates of youth with severe depression increased from 5.9 percent in 2012 to 8.2 percent in 2015; even with severe depression, 76 percent of youth are left with no or insufficient treatment.¹

Consequences With the Lack of Treatment

In the West, cost is always a factor, and the consequences of not treating mental illnesses are alarming. Serious mental illnesses cost the U.S. $193.2 billion in lost earnings per year. Mood disorders—including major depression, dysthymic disorder, and bipolar disorder—are the third most common cause of hospitalization in the U.S. for both youth and adults aged 18-44.

Unfortunately, individuals living with serious mental illness face an increased risk of having chronic medical conditions. Adults in the U.S. living with serious mental illness die on average 25 years earlier than others, largely due to treatable medical conditions. Over one-third (37 percent) of students with a mental health condition between the ages 14-21 drop out of school—the highest dropout rate of any disability group.

The sad reality is that people who suffer from mental illness disproportionately take their own life. Suicide is the tenth leading cause of death in the U.S., the third leading cause of death for people aged 10-14, and the second leading cause of death for people aged 15–24. More than 90 percent of children who die by suicide have a mental health condition; each day an estimated 18-22 veterans die by suicide. With things getting worse, something needs to be done. TCM might offer a realistic solution to helping to stem the tide of damage being caused by mental illness.¹

The Role of TCM in Mental Illness Treatment

By now, I hope you are wondering what a solution might be, and where TCM fits in. In classical TCM theory, assessing and treating spiritual disharmonies is fundamental for dealing with emotional disorders. In TCM, psychiatric disorders frequently relate to energetic disharmonies involving the so-called Five Spirits.

• The Hun (the non-corporeal spirit) is associated with the liver qi. This spirit is responsible for benevolence (loving kindness), awareness of suffering, empathy, compassion, and tolerance; and serves as a reservoir for ideas that bring meaning into life. Disharmonies that affect the Hun may lead to anger, frustration, resentment, unkindness, and feeling "cut-off" from the meaning of life.
• The Po (the corporeal spirit) is associated with the lung qi and is responsible for sensation and for emotional and physical responses to circumstances; it promotes justice and fairness. Disharmonies of the Po may lead to complicated grief, sadness, a blunted affect, a tendency to overreact, or unjust/immoral behavior.
• The Zhi (the will) is the spiritual aspect that resides in the kidneys. The Yang (or active) Zhi provides the motivation for self-determination and the Yin (or passive) Zhi leads one down the path to an unknowable fate. Disharmony may cause illogical fears or reckless behaviors.
• The Yi (the intellect) enables creative visions and proper courses of action. The Yi is associated with the spleen. Disharmonies may lead to worry and overthinking.
• The Shen (the mind and the connecting spirit) is responsible for the establishment of meaningful relationships and is associated with the heart qi. Disharmonies of the Shen may lead to edginess, shyness, social awkwardness or, in extreme cases, agitation and delusions.²

For any given psychiatric diagnosis, there is a range of possible TCM patterns. Thus, it is possible to formulate an overlay of TCM patterns on a specific diagnosis in Diagnostic and Statistical Manual of Mental Disorders (DSM-5).³ For example, The DSM-5 diagnostic criteria (below) for Generalized Anxiety Disorder include:⁴

Chinese herbal therapy is one method of healing mental conditions. For instance, the Chinese herbal formula Jia Wei Xiao Yao Wan has been in use for six hundred years in China to deal with depression. Other common herbal remedies for depression include a spleen tonic herbal formula (known as Bu Zhong Yi Qi Wan) and a kidney nourishing herbal formula (known as Jin Gui Shen Qi Wan). Many other curatives are widely used with different patterns of depression by treating the organs that correspond to the emotion.

In the research review by Lee Butler and Karen Pilkington, the five systematic reviews addressed the Chinese literature, adjunctive use of Chinese herbs, and the formula Chai Hu Shu Gan San and Xiao Yao San. Positive results were reported: no significant differences from medication, greater effect than medication or placebo, and reduced adverse event rates when combined or compared with antidepressants. However, limitations in methodology and reporting were revealed.⁵

Many clinical studies have been performed to test acupuncture's effect on mental health. According to recent studies, acupuncture is a valuable adjunct therapy for those suffering from mental health disorders. A study conducted at the University of Arizona examined the responses of 34 women who suffered with depression to acupuncture, generalized acupuncture that didn't use specific points, and no treatment at all.

Of the women who received acupuncture (specifically for depression), 43 percent experienced a reduction in their symptoms, compared with 22 percent who received general acupuncture and 14 percent who received no treatment. After eight weeks, over half of the women who received specific acupuncture were no longer depressed. Statistically, this means that acupuncture is just as effective as antidepressants.⁶

Traditional Chinese medicine can be used as an adjunct to the psychotherapy and medication. TCM can offer an entirely new method of healing for patients suffering from mental health issues. Depression is most commonly discussed, but ailments like anxiety, mania, various phobias, stress, and even schizophrenia can be alleviated by traditional Chinese medical methods like acupuncture and herbal treatment.

The TakeAway

Mental illnesses are more common than we would like to think. Prevalence rates and affected populations point to greater increases going forward unless real steps are taken to curb its growth. Whether it is depression, anxiety, or any mental illness, every possible methodology should be investigated in order to lower the shockingly high statistics surrounding those who suffer with it.

While TCM is gaining traction in the U.S., there is still stigmatization from lack of familiarity with its methods and track record in China, as well as around the globe. Acupuncture and herbal therapy, in conjunction with an understanding of qi and organs, can provide a less intrusive alternative to drug therapies. Studies that have investigated its efficacy point to a similarly successful result when compared to existing treatment.

From a clinical and practical standpoint, more inroads need to be made in terms of exposure to TCM for those suffering from mental illness. Literature, case studies, and clinical trials need to focus on healing those mot burdened by mental illness through TCM.

References

1. National Alliance on Mental Illness (NAMI). "Mental Health By The Numbers." NAMi.org, 2018.
2. Aung S, Fay H, et al. "Traditional Chinese Medicine as a Basis for Treating Psychiatric Disorders: A Review of Theory with Illustrative Cases." Med Acupunct, 2013 Dec 1; 25(6): 398–406.
3. American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-5. Arlington: Psychiatry Online, 2013.
4. Locke A, Kirst N, et al. "Diagnosis and Management of Generalized Anxiety Disorder and Panic Disorder in Adults." Am Fam Physician, 2015 May 1;91(9):617-624.
5. Butler L, et al. "Chinese Herbal Medicine and Depression: The Research Evidence." Evidence-Based Complementary and Alternative Medicine, 2013; Article ID 739716.
6. Allen JJ, Schnyer RN, et al. "The Efficacy of Acupuncture in the Treatment of Major Depression in Women." Dept. of Psychology, Univ of Ariz., 1998.

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Click here for more information about Nadiya Melnyk, DAOM, LAc.

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