Lost in the woods: Chinese medicine, depression, and the liver

chinese medicine depression portland

I’ve briefly discussed depression in past articles, specifically that depression that can arise from a closed heart wherein a person loses the ability to feel joy. Today I want to turn to a more common kind of depression: stagnation of liver qi.

In Chinese medicine, as in western medicine, the liver has an extraordinary number of functions.

Paramount among these is the smooth circulation qi and blood in the entire body, in a cyclical and rhythmic way. The liver also “stores” the blood, which is a function closely linked with hormonal cycles in both women and men, and with the circulation of blood in the lower abdomen.

Emotionally, when we are in balance our liver helps us to strategize and plan our way around obstacles.

The liver is deeply connected to the sympathetic or “fight or flight” nervous system, and it takes charge when we need a dose of healthy fear or anger to get ourselves out of dangerous situations. Our ability to manifest healthy anger, to set boundaries or reestablish them when they are violated, is a liver function.

As with anything tasked with so many jobs, the liver tends to be the bottleneck in our bodies where things get stuck.

Liver issues are the most common presentation in any Chinese medicine clinic. Because the liver is managing the flow of qi and blood in the entire body, any problem with either substances anywhere will cause extra stress on it. This is true for physical illness and injury, but more often applies to any kind of emotional stress.

If your life is putting you in positions where you feel frustrated, anxious or unsafe in a chronic way, this will eventually wear down the liver organ and channel’s ability to smooth things out. When the liver gets overwhelmed, quite a wide variety of symptoms can manifest.

The liver channel begins on the foot and runs up the inner leg, over the belly and then winds around the ribs before diving into the chest. When qi and blood stop moving smoothly, or stagnate, people will often experience a painful stuck sensation in the ribs. This is often diagnosed as costochondritis, or inflammation of the rib junctions. The rib junctions are indeed inflamed, because they are no longer receiving what they need from the channel that runs through them.

In general the liver supplies all of the tendons and sinews in the body with blood, so stiffness and pain around the joints often occurs with liver pathology. Cold hands and feet, even to the point of turning white or black, can be a symptoms of liver channel problems if the organ is unable to send the blood all the way out to the ends of the limbs. Cramping in the intestines is also common, because the rhythmic flow of the healthy liver keeps GI tract in time.

In terms of a person’s inner world, the liver’s function of healthy anger can turn inward to create frustration and even rage that is self-directed.

This kind of reversed anger congeals, over time, into a toxic and volatile kind of depression. People stuck in the wilderness of liver pathology often lose the ability to see their way out of the situation that are causing them pain, because the liver’s ability to persevere and plan an escape has been impaired. They are often morose and argumentative; the kind of depressed person who will argue with anyone who tries to cheer them up, almost as if they don’t want to stop feeling sad.

It must be said here that Chinese medical pathology in the liver does not always correlate with frank biomedical liver disease.

Chaihu 柴胡 Bupleurum chinensis plant – the main ingredient in Xiao chaihu tang

Liver qi stagnation is the beginning of a long process of possible decline, during which the biomedical liver might become subtly less efficient in its function. If left unchecked for years, this can manifest in the physical body as frank liver disease, but our aim is to treat it before things progress that far.

In Chinese medicine, most treatments are fairly straightforward in their logic. If something is blocked, unblock it. If it’s empty, fill it with something. For the liver, if it has become stagnant, we get it moving again and smooth it out. One easy way to accomplish this goal is to needle the liver channel, and channels connected to it. As the flow of qi is corrected, mostly people feel significant relief from their symptoms.

Another strategy for smoothing the liver qi is to prescribe herbal remedies that balance the liver with other organs, a technique we call “harmonizing” the liver. One common Chinese herbal formula that accomplishes this goal is Xiao chaihu tang 小柴胡湯, which unblocks the flow of qi in the Liver while simultaneously building the qi of the Earth organs, Spleen and Stomach.

Liver issues can range from mild and transient to chronic and longterm.

A traffic jam will cause mild to moderate liver qi stagnation in everyone. An emotionally abusive boss can cause severe liver qi stagnation that can lead to pelvic pain, menstrual irregularity and chronic depression. Whatever the presentation, the good news is that healing is always possible.

This article is not intended to help you diagnose yourself or your friends, but simply to shed light on how Chinese medicine understands and treats emotional distress. Your particular depression or rib pain may or may not fit this Chinese medical pattern, which is why finding a qualified practitioner who can diagnose and treat your condition is important. If you’ve enjoyed my articles, why not get on my schedule to get yourself on a path to healthier Liver qi!

Massage for Stress Relief – It’s a Real Thing

Earlier this year, I realized that I needed a change in my life.

Portland, Oregon Waterfront

Portland has been getting busier and busier, and I was starting to realize that this busy-ness, the daily stress, was starting to have a cumulative effect on my body. In essence, I was shorting out. My nervous system couldn’t calm down and I’d developed an eye twitch. In my daily practices of yoga and meditation, I couldn’t let go all of the way. I knew that something had to change.

You may think that the life of a massage therapist has to be stress free, right? We spend long hours in dark rooms with relaxing music facilitating an environment that promotes stress relief, pain reduction and a possibility of letting go. But my life, like any Portlander’s life, is filled with complications, challenges, stress and the realities of living in a burgeoning city. I realized that I needed a change in my life. I realized that stress was starting to creep into my life, and into my body, in a way that was unexpected and that felt potentially harmful in the long term. What I needed was some serious stress management.

The more I learn about the negative effects of stress on the body, the more solid I get in why I chose massage therapy as a profession.

I talk to my clients all of the time about the effects of stress on their bodies, and I was starting to feel those effects in my own body in a real, and serious way. Heart disease, asthma, obesity, diabetes, headaches, depression, anxiety, gut problems – stress is a major contributor to all of these common health problems. Common health problems that we can, hopefully, prevent by managing our stress!

Massage for relaxation and stress reduction is often less valued than deep tissue or therapeutic massage. I often have clients who tell me that they don’t feel like they’ve had a massage if they don’t feel like you’ve “worked it out”. Sure, I’m all for getting into those points of pain and tension that we all feel, but I’m going to do it in a relaxing context. I’m going to facilitate and promote a sense of letting the body sink in and let go.

How does massage relieve stress?

Massage induces a relaxation state that slows your heart rate and breathing rate, your blood pressure goes down and your muscles relax. Massage also releases oxytocin into the body. Oxytocin is a hormone that is produced by the hypothalamus and is, interestingly, a stress hormone that is pumped into your body as part of the stress response. It motivates you to seek support in times of stress. Oxytocin is a natural anti-inflammatory and helps blood vessels stay relaxed during stress. It is enhanced by social contact and is known as the “cuddle hormone”. When you choose to connect with others when under stress, you become more resilient to stress. Oxytocin release lowers anxiety, facilitates healing, enhances digestion and increases trust.

Massage is one of the best ways to get oxytocin release into the body.

High Resolution -103Seeking out massage for stress reduction is a safe way to connect with another person. Massage therapy is one of the few ways that we are allowed safe, non-agenda touch from another human. Even light touch has been shown to be helpful in releasing oxytocin.

Massage (even relaxation massage!) is not a luxury but rather a natural and enjoyable way to get some much needed stress relief in this world that seems to be moving very fast.

The massage therapists at Watershed Wellness are committed to providing therapeutic massages in a relaxing context. We love to work out the aches and pains, but we also realize that we provide a much needed reprieve and repair from the stressful things in life. We love what we do, and it comes through in our work. In fact, we get a similar oxytocin release by giving massages!

If you want to know more about how we can help, please reach out to us at info@nullwatershedwellnesspdx.com and we’re happy to answer any questions you may have. If you are ready to schedule, you may do so online here.

P.S. There’s a great TED talk that changes perspective on stress that we found to be helpful for this article.