Compared to synthetic drugs, natural mood stabilizers have their own unparalleled advantages. Most herbal remedies, Chinese herbs in particular, have been used for decades of years, if not hundreds. Over such a long period of clinical practice and experiments, it is generally recognized as safe and reliable on curative effect. Actually now many conditions have found the preferable matching herbal treatments accordingly, so does mood disorders like bipolar, depressive or manic episode.
It refers to a group of unknown psychiatric disorders, characterized by intense and prolonged mood shifts and often accompanied with mental and behavioral changes. Most sufferers are prone to recurrent mood disorders and get back to normal intermittently, generally without mental defects and personality changes after cured. It ranges from mild psychotic behavior to psychosis, but in a narrow sense referring typically to bipolar disorder or manic depression.
The incidence of mood swings is much lower than that of schizoaffective disorder, 3.6-25% reported in Europe and America and 0.6% in China. Patients initially developing this disease are mostly between 16 to 30 years old, rarely seen before 15 and after 50 years old. Manic episode is generally earlier than depressive phases, so does female than male with a prevalence rate of 1:2 to 1:3.2.
What is a mood stabilizer?
It is almost equal to anticonvulsants because most mood-stabilizing drugs are purely antimanic agents, which are mainly for treating mania. From this perspective, it is quite different from antidepressants, which is also called mood enhancers, elevators, or boosters in treating depression. By the way, it is different from antipsychotics too.
It has to achieve the following jobs:
- Treat effectively or prevent manic symptoms;
- Won’t aggravate the depressive symptoms, sometimes improving or preventing depressive symptoms;
- Stabilize moodswings, suppressing manic phases but not inducing depression and curing depressive episode while not causing mania;
- During treatment result in no tricky and complicated state, like mixed episodes of mania and depression, mixed multiple mental diseases, and rapid mood cycling and shifting;
- Won’t increase or reduce suicide risk.
Clinically common mood stabilizers list is as follows:
Lithium, Lamotrigine (Lamictal), Carbamazepine (Tegretol), Oxcarbazepine (Trileptal), Valproic acid (Depakene), Riluzole, Gabapentin (Neurontin), and Topiramate (Topamax), etc.
Herbal treatments with natural mood stabilizers
When it comes to herbal mood stabilizers, first comes to mind might be 5-HTP, St. John’s wort, and clarocet. But they are not our focus here as we would like to look into Chinese herbs instead.
TCM History about mood disorders
The cognition is a long journey for Traditional Chinese Medicine (TCM) too. It went through a few phases before what it looks now.
- Huangdi Neijing, also known as The Inner Canon of Huangdi or Yellow Emperor’s Inner Canon, clearly pointed out that emotional factors could contribute to the onset of depression;
- The Huangdi Bashiyi Nanjing, The Huang Emperor’s Canon of Eighty-One Difficult Issues, came up with the pathogenic mechanism and key differences between mania and depression. It argued that a manic episode was characterized by abnormally high moods, noise, and disturbance while a depressive episode by down moods and apathetic facial expressions;
- Zhu Danxi, the famous TCM doctor in the Jin and Yuan Dynasties, put forth a well-known theory of heart spirit confused by phlegm, which provided the direct theoretical ground to treat depressive episode by clearing phlegm;
- The Yi Lin Gai Cuo (Correcting the Errors in the Forest of Medicine), written by Wang Qing-ren in Qing dynasty, made a breakthrough by showing clearly the close connection between depressive phase and brain.
Difference among mania, depression, and bipolar
As stated, depression are manifested by symptoms of depressed mood, indifference, anxiety, pessimism, silence, retardation, and incoherency, etc. while mania by symptoms of hyperactive spirit, anger, agitation, restlessness, raving, hitting people and destructing things, hyperactivity, and irritability, etc. Among the patients, young adults are most susceptible to both while children and the eldly appear to be rare. In addition, these two phases are not entirely separated and could transform to each other easily, thus so called bipolar disorder in the case of violent mood swings.
There are two major basic patterns in TCM theory – access syndrome and deficiency syndrome. In the early stage most of them are excess types while thus mixed with access and deficiency in prolonged illness.
- In depressive phase, access manifests as Qi depression, phlegm blocking, and blood stasis while deficiency as depletion of spleen Qi and heart blood in chronic case;
- In manic phase, access presents as fire stagnation, phlegm obstructing, and heat accumulation while deficiency as impaired yin in heart and kidney combined with hyperactivity of fire due to yin deficiency by failing intercourse between fire and water.
Principles of natural remedies
Since most are caused by excess pathogen in early stage, the treatments should give priority to regulate Qi flowing, relieve Qi stagnation, smooth spiritual mechanism, lower fire, eliminate phlegm, and remove blood stasis for resuscitation;
since most are induced by deficient vital Qi in late period, the preferred remedies should be benefiting heart and spleen, nourishing yin to tonifying blood, and coordinating yin and yang.
Common herbs for bipolar disorder
According to the dominating phase in bipolar disorder, the lists of natural mood stabilizers (Chinese herbs) for depressive and manic episodes are as follows:
(1). Depressive phase (intermingled phlegm and Qi)
Ban Xia (Pinellia Rhizome), Chen Pi (Tangerine Peel), Tian Nan Xing (Arisaema), Bai Fu Zi (Typhonium Rhizome), Bai Jie Zi (White Mustard Seed), Zao Jia (Gleditsiae Fructus), Fu Ling (Poria), Hou Po (Magnolia Bark), Yuan Zhi (Senega Root), Shi Chang Pu (Sweetflag Rhizome), Yu Jin (Tumeric Tuber), Mu Xiang (Costus Root), Xiang Fu (Nut Grass Rhizome), Tan Xiang (Sandalwood), Chen Xiang (Aloeswood), Su He Xiang (Resin of Rose Maloes, Styrax), She Xiang (Navel Gland Secretions of Musk Deer), and An Xi Xiang (Benzoin).
(2). Manic phase (phlegm-fire disturbing mind)
Niu Huang (Cattle Gallstone), Zhu Li (Bamboo Juice), Tian Zhu Huang (Siliceous Secretions of Bamboo), Zhe Bei Mu (Fritillaria Bulb), Dan Nan Xing (Jack in the Pulpit Rhizome and Bile), Yu Jin (Tumeric Tuber), Bai Fan (Alum), Fu Shen (Poria Root), Shi Chang Pu (Sweetflag Rhizome), Zhu Ru (Bamboo Shavings), Meng Shi (Lapis Stone), Dan Shen (Salvia Root), Zhu Sha (Cinnabar), Huang Qin (Baical Skullcap Root, Scutellaria), Huang Lian (Coptis Rhizome), Bing Pian (Borneol), She Xiang (Navel Gland Secretions of Musk Deer), Zhen Zhu (Pearl), and Sheng Tie Luo (Iron Filings).