MENTAL AND EMOTIONAL SYMPTOMS

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Chapter 79

MENTAL AND EMOTIONAL SYMPTOMS

Chapter contents

DEPRESSION

DEPRESSION AND MANIC BEHAVIOUR

DEPRESSION

Interrogation, Chapter 44

DEPRESSION AND MANIC BEHAVIOUR

Interrogation, Chapter 44

Depressive phase

Stagnation of Qi and Phlegm

Depression, apathy, dull thinking, incoherent speech, muttering to oneself, irritability, moodiness, not remembering to eat, hypochondrial or epigastric distension, a feeling of a lump in the throat, premenstrual tension, Swollen tongue with sticky coating, Wiry-Slippery pulse.

Heart- and Spleen-Blood deficiency

Depression, excessive dreaming, mental confusion, tendency to be easily startled, sadness, crying, shouting, shutting of windows, muttering to oneself, brooding, slightly obsessive thinking, anxiety, insomnia, dream-disturbed sleep, poor memory, tendency to be easily startled, palpitations, dizziness, dull-pale complexion, pale lips, tiredness, weak muscles, loose stools, poor appetite, scanty periods, Pale and Thin tongue, Choppy or Fine pulse.

Manic phase

Phlegm-Fire harassing the Mind

Manic behaviour, insomnia, dream-disturbed sleep, propensity to outbursts of anger, shouting, scolding or hitting people, overspending of money, exceptional physical strength, having several projects on the go simultaneously, staying up all night, forgetting to eat, singing, mental restlessness, a feeling of agitation, mental confusion, incoherent speech, rash behaviour, uncontrolled laughter, shouting, palpitations, thirst, red face, a feeling of oppression of the chest, expectoration of phlegm, sputum in the throat, bitter taste, Red tongue with redder-swollen tip and Heart crack with a sticky, dry yellow coating inside it, Slippery-Rapid or Slippery-Overflowing-Rapid pulse.

Stomach Phlegm-Fire affecting the Heart

Manic behaviour, desire to climb to high places, shouting, laughing, singing, taking off of one’s clothes, insomnia, mental restlessness, burning epigastric pain, thirst without a desire to drink, bleeding gums, dry stools, dry mouth, mouth ulcers, sour regurgitation, nausea, vomiting soon after eating, excessive hunger, foul breath, a feeling of heat, a feeling of oppression of the chest and epigastrium, tongue Red in the centre with a sticky yellow coating and a Stomach crack with a rough, sticky yellow coating inside it, Slippery-Rapid pulse.

Stomach and Pericardium Fire

Manic behaviour, mental restlessness, inability to lie down, hallucinations, incoherent speech, excessive dreaming, red face, hot hands, palpitations, burning epigastric pain, intense thirst with a desire to drink cold liquids, dry mouth, mouth ulcers, bleeding gums, dry stools, sour regurgitation, foul breath, nausea, vomiting soon after eating, a feeling of heat, tongue Red with a thick, dry dark-yellow coating, Deep-Full-Rapid pulse.

Fire injuring Yin

Chronic manic behaviour, excessive talking, tendency to be easily startled, mental restlessness, loss of weight, malar flush, a feeling of heat in the evening, Red tongue without coating, Fine-Rapid pulse.

Clinical note

• Remember: ‘manic’ behaviour does not occur only in its extreme form but also to a mild degree in many patients.

ANXIETY

Interrogation, Chapter 44

Heart-Blood deficiency

Mild anxiety, insomnia, dream-disturbed sleep, poor memory, anxiety, tendency to be easily startled, palpitations, dizziness, dull-pale complexion, pale lips, Pale and Thin tongue, Choppy or Fine pulse.

Heart-Yin deficiency

Vague anxiety that is worse in the evening, insomnia, poor memory, anxiety, mental restlessness, dream-disturbed sleep, tendency to be easily startled, uneasiness, ‘feeling hot and bothered’, palpitations, dry mouth and throat, night sweating, normal-coloured tongue without coating or with rootless coating, Floating-Empty pulse, especially on the left Front position.

Heart-Yin deficiency with Empty-Heat

Anxiety that is worse in the evening, mental restlessness, insomnia, dream-disturbed sleep, poor memory, uneasiness, ‘feeling hot and bothered’, palpitations, dry mouth and throat, a feeling of heat in the evening, malar flush, night sweating, five-palm heat, Red tongue with redder tip and without coating, Floating-Empty and Rapid pulse.

Heart-Fire

Severe anxiety, mental restlessness, a feeling of agitation, insomnia, dream-disturbed sleep, palpitations, thirst, mouth and tongue ulcers, a feeling of heat, red face, dark urine or blood in the urine, bitter taste, Red tongue with redder tip and yellow coating, Overflowing and Rapid pulse.

Heart-Blood stasis

Severe anxiety, agitation, palpitations, stabbing or pricking chest pain which may radiate to the inner aspect of the left arm or to the shoulder, a feeling of oppression or constriction of the chest, cyanosis of lips and nails, cold hands, tongue entirely Purple or Purple only on the sides in the chest areas, Choppy or Wiry pulse.

Phlegm-Fire harassing the Heart

Severe anxiety, agitation, mental restlessness, manic behaviour, phobias, insomnia, dream-disturbed sleep, mental confusion, depression, palpitations, thirst, red face, a feeling of oppression of the chest, dark urine, expectoration of phlegm, rattling sound in the throat, bitter taste, Red tongue with redder swol-len tip, and Heart crack with a sticky yellow coating inside it, Slippery-Rapid or Slippery-Overflowing-Rapid pulse.

Heart- and Kidney-Yin deficiency with Empty-Heat

Anxiety, mental restlessness, a feeling of agitation that is worse in the evening, insomnia, dream-disturbed sleep, poor memory, palpitations, dizzi-ness, tinnitus, hardness of hearing, lower backache, nocturnal emissions with dreams, a feeling of heat in the evening, night sweating, five-palm heat, scanty dark urine, dry stools, Red tongue with redder tip and a Heart crack, Floating-Empty and Rapid pulse.

Liver-Blood deficiency

Mild anxiety, mild depression, lack of direction, insomnia, excessive dreaming, dizziness, blurred vision, floaters, numbness/tingling of limbs, scanty menstruation, dull-pale complexion, Pale tongue, Choppy or Fine pulse.

Liver-Yin deficiency

Vague anxiety, depression, lack of direction, insomnia, excessive dreaming, dizziness, blurred vision, floaters, dry eyes, dry hair, dry nails, insomnia, numbness/tingling of the limbs, scanty menstruation, tongue without coating, Floating-Empty pulse.

Liver-Qi stagnation

Anxiety, depression, irritability, moodiness, hypochondrial or epigastric distension, a feeling of a lump in the throat, premenstrual tension, Wiry pulse.

Liver-Fire

Severe anxiety, irritability, propensity to outbursts of anger, headache, red face, dizziness, tinnitus, thirst, bitter taste, constipation, dark urine, Red tongue with redder sides and dry yellow coating, Wiry-Rapid pulse.

Liver-Yang rising

Anxiety, headache, dizziness, tinnitus, irritability, propensity to outbursts of anger, Wiry pulse.

Kidney-Yin deficiency

Vague anxiety that is worse in the evening, dizziness, tinnitus, hardness of hearing, poor memory, night sweating, dry mouth and throat at night, lower backache, constipation, scanty dark urine, tiredness, normal-coloured tongue without coating, Floating-Empty pulse.

Deficiency of Qi of the Heart and Gall-Bladder

Mild anxiety, insomnia, timidity, absentmindedness, indecisiveness, tendency to be easily startled, palpitations, slight breathlessness, tiredness, Pale tongue, Weak pulse.

Diaphragm-Heat

Anxiety, a feeling of heat and stuffiness in the region under the heart, thirst, dry mouth, irritability, insomnia, Red tongue, Rapid pulse.

This pattern is caused by residual Heat following an invasion of Wind-Heat.

IRRITABILITY

Interrogation, Chapter 44

Irritability is a common emotional complaint. It includes feeling irritable frequently, flying off the handle easily, feeling frustrated and similar emotional states. Of the traditional seven emotions, irritability is akin to ‘anger’ but it encompasses a broader range of emotional states than ‘anger’ and is generally not so intense. A propensity to anger is generally due to Liver patterns, whereas irritability may be caused by many different patterns affecting most organs.

Liver-Qi stagnation

Irritability, moodiness, premenstrual irritability, hypochondrial or epigastric distension, irritability, moodiness, a feeling of a lump in the throat, premenstrual tension, Wiry pulse, ‘I feel extremely irritable before my periods and take it out on my family.’

Lung-Qi stagnation

Mild irritability, bouts of crying, sighing, sadness, depression, a feeling of a lump in the throat, difficulty in swallowing, a feeling of oppression or distension of the chest, slight breathlessness, tongue slightly Red on the sides in the chest areas, pulse very slightly Tight on the right Front position, ‘I feel this lump in the throat, I am on edge and feel like bursting into tears.’

Liver-Blood stasis

Severe irritability, agitation at night, hypochondrial/abdominal pain, painful periods, dark and clotted menstrual blood, masses in the abdomen, purple nails and lips, purple or dark complexion, Purple tongue, Wiry or Firm pulse, ‘I seethe with resentment.’

Heart-Blood stasis

Irritability, obsessive thinking, palpitations, stabbing or pricking chest pain which may radiate to the inner aspect of the left arm or to the shoulder, a feeling of oppression or constriction of the chest, cyanosis of lips and nails, cold hands, tongue entirely Purple or Purple only on the sides in the chest areas, Choppy or Wiry pulse, ‘My mind is constantly judging and I feel resentful.’

Liver-Yang rising

Severe irritability, propensity to outbursts of anger, headache, dizziness, tinnitus, Wiry pulse, ‘I fly off the handle easily.’

Liver-Fire

Severe irritability, propensity to outbursts of anger, headache, red face, dizziness, tinnitus, thirst, bitter taste, constipation, dark urine, Red tongue with redder sides and dry yellow coating, Wiry-Rapid pulse, ‘I explode into a rage.’

Heart-Fire

Severe irritability, rage, agitation, insomnia, dream-disturbed sleep, palpitations, thirst, mouth and tongue ulcers, mental restlessness, a feeling of heat, red face, bitter taste, Red tongue with redder tip and yellow coating, Overflowing-Rapid pulse, ‘I feel irritable, impatient and angry.’

Lung-Heat

Irritability, bouts of crying, restlessness, cough, slight breathlessness, a feeling of heat, chest ache, flaring of nostrils, thirst, red face, Red tongue with yellow coating, Overflowing-Rapid pulse, ‘I feel frustrated, weepy and irritable.’

Stomach-Heat

Irritability, insomnia, dream-disturbed sleep, restlessness, burning epigastric pain, thirst, sour regurgitation, nausea, excessive hunger, foul breath, a feeling of heat, Red tongue with a yellow coating, Overflowing-Rapid pulse, ‘I feel often angry and obsessive.’

Liver-Blood deficiency

Mild irritability, mild impatience, vague anxiety, dizziness, blurred vision, floaters, numbness/tingling of limbs, scanty menstruation, dull-pale complexion, Pale tongue, Choppy or Fine pulse, ‘I feel lost, overwhelmed and on edge.’

Kidney-Yin deficiency

Mild irritability, vague anxiety and fear which is worse in the evening, lack of will-power, tendency to be easily annoyed, dizziness, tinnitus, hardness of hearing, poor memory, night sweating, dry mouth and throat at night, lower backache, constipation, scanty dark urine, tiredness, normal-coloured tongue without coating, Floating-Empty pulse, ‘I feel helpless, unmotivated and on edge in the evening.’

Heart-Blood deficiency

Mild irritability, sadness, vague anxiety, insomnia, dream-disturbed sleep, poor memory, tendency to be easily startled, palpitations, dizziness, dull-pale complexion, pale lips, Pale and Thin tongue, Choppy or Fine pulse, ‘I feel sad and on edge.’

Kidney-Yin deficiency with Empty-Heat

Vague irritability, mental restlessness that is worse in the evening, a feeling of being on edge, ‘feeling hot and bothered’, depression, anxiety, insomnia, dizziness, tinnitus, vertigo, poor memory, hardness of hearing, night sweating, dry mouth at night, five-palm heat, a feeling of heat in the evening, thirst with a desire to sip fluids, lower backache, constipation, scanty dark urine, tiredness, Red tongue without coating, Floating-Empty and Rapid pulse, ‘I feel hot and bothered.’

Heart-Yin deficiency with Empty-Heat

Irritability, mental restlessness that is worse in the evening, a feeling of being on edge, sadness, anxiety, insomnia, dream-disturbed sleep, anxiety, tendency to be easily startled, uneasiness, ‘feeling hot and bothered’, palpitations, poor memory, dry mouth and throat, thirst with a desire to sip fluids, a feeling of heat in the evening, malar flush, night sweating, five-palm heat, Red tongue, redder on the tip with no coating, Floating-Empty and Rapid pulse, ‘I feel sad and hot and bothered.’

Damp-Heat

Irritability, mental restlessness, slightly obsessive thinking, a feeling of heaviness and fullness of the epigastrium, sticky taste, feeling of heat, sticky yellow tongue coating, Slippery-Rapid pulse, ‘I feel heavy, yucky and irritable.’

Other manifestations depend on the organ involved.

SCHIZOPHRENIA

Heart- and Spleen-Blood deficiency

Absentmindedness, insomnia, excessive dreaming, inability to concentrate, forgetfulness, anxiety, sadness, hearing of voices, depression, mental confusion, tendency to be easily startled, sadness, crying, shouting, muttering to oneself, brooding, obsessive thinking, palpitations, dizziness, dull-pale complexion, pale lips, tiredness, weak muscles, loose stools, poor appetite, scanty periods, Pale and Thin tongue, Choppy or Fine pulse.

Stagnation of Qi and Phlegm

Melancholy, apathy, mental dullness, incoherent speech, mumbling to onself, hearing of voices, moodiness, irritability, inappropriate laughing and crying, hypochondrial or epigastric distension, a feeling of a lump in the throat, premenstrual tension, sputum in the throat, a feeling of oppression of the chest, Wiry-Slippery pulse.

Phlegm-Fire harassing the Heart

Acute onset, hallucinations, hearing voices, violent behaviour, abusiveness, insomnia, dream-disturbed sleep, destructive behaviour, a feeling of agitation, mental confusion, incoherent speech, rash behaviour, tendency to hit or scold people, uncontrolled laughter or crying, shouting, muttering to oneself, palpitations, thirst, red face, a feeling of oppression of the chest, dark urine, expectoration of phlegm, rattling sound in the throat, bitter taste, Red tongue with redder swollen tip and Heart crack with a sticky yellow coating inside it, Slippery-Rapid or Slippery-Overflowing-Rapid pulse.

Phlegm-Fire and Yin deficiency with Empty-Heat

Hallucinations, hearing voices, abusiveness, insomnia, dream-disturbed sleep, destructive behaviour, agitation, mental confusion, incoherent speech, rash behaviour, tendency to hit or scold people, uncontrolled laughter or crying, shouting, muttering to oneself, palpitations, thirst, red face, a feeling of oppression of the chest, dark urine, expectoration of phlegm, rattling sound in the throat, a feeling of heat in the evening, malar flush, thirst with a desire to drink in small sips, dry throat at night, night sweating, five-palm heat, Red and Swollen tongue with redder tip and without coating and Heart crack with rough, dry yellow coating inside it, Slippery-Floating-Empty-Rapid pulse.

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MENTAL AND EMOTIONAL SYMPTOMS

MENTAL AND EMOTIONAL SYMPTOMS

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