Depression may be expressed in any number of ways such as increased irritability and dissatisfaction, withdrawal from others, crying spells, moodiness, nervousness, anxiety, unwillingness to get out of bed in the morning, tiredness, insomnia, headaches, muscle aches and pains and/or palpitations. Depression may also be expressed through "sudden" anger and aggressive behavior.

Depression has become so widespread, particularly in the U.S., that Europeans call this country the "Prozac Nation". It is very common for those with symptoms of depression to turn to antidepressants. It is not unusual for women to experience mild depression before or during menses, after childbirth or through peri/menopausal years. 

In Traditional Chinese Medicine (TCM), there are actual physiological causes for depression that can be treated and improved. Thus, it is important to determine and correct the root cause of depression. While there are many patterns and causes for depression like hormone imbalance, deficient Kidney chi due to chronic stress, pregnancy and childbirth, in TCM, the most common is stagnant Liver Qi. Just as a tree spreads out freely in all directions, so does the Liver promote unrestrained and regular movement of Qi and Blood throughout the body. In its ideal state, Qi flows smoothly and disperses and circulates freely. When imbalanced, its flow is irregular and Qi doesn't flow smoothly, evenly or in the right directions. This can occur in anyone - male, female, young, or old - but because the Liver is so intimately involved with women's monthly cycles, menstruating women tend to experience it more often (this is probably why more women feel depressed). When Liver Qi stagnates, it has far-reaching effects, many of which co-exist with depression: pain and distension in the ribs, breasts and lower abdomen, moveable or fixed cysts, fibroids and other lumps in the abdomen and breasts with little to extreme stabbing pain; irregular menstruation, dysmenorrhea or amenchronic diarrhea, abdominal distension, loss of appetite, or jaundice.

Smooth Liver Qi harmonizes emotions with the Mind by keeping a happy state, sensitivity, ability to reason, an even disposition and a sense of ease. Thus, obstructed Liver Qi adversely affects emotions, causing emotional swings, irritability, frustration and depression. It also triggers pain in chest or under ribs, sighing, a feeling of a "lump" in the throat and PMS symptoms.
As well, the Liver is associated with the Ethereal Soul (Hun) in TCM, the part of us that dreams, plans, envisions, creates and imagines. If the Ethereal Soul is unsettled, Mind (Shen) is cut off from the Universal Mind, resulting in a lack of direction in life, feelings of aimlessness, and unrealized dreams and plans. Such "isolation" leads to moodiness, sudden outbursts of anger or aggression and depression.

GENERAL TREATMENT
At first signs of depression, physicaly move your body - this is the most efficient way to move stagnant Qi and change emotions. Do whatever is easiest and most satisfying - walk, run, dance, pound pillows, garden or do yoga, Qi Gong or something similar. A half an hour is ideal but you should feel noticeably better after five or ten minutes. Moving in nature is even better, as nature is powerfully healing.

In general, daily exercise is beneficial for preventing and treating depression, as it keeps Liver Qi healthy and stimulates production of endorphins, natural mood-elevating chemicals.

And if you are angry know that anger is energy so it must be expressed and released in healthy ways. Bottled up it can morph into anxiety and acute panic attacks that can be dibilitating. If you are feeling anxious, angry frustrated and resentful, move, cry, scream, clean up the kitchen, unload old drawers/closets, or run around the block -express and release anger energy in healthy ways.

Since stagnant Qi results from any long-term suppressed or repressed emotions, it is important to discover their underlying causes and outlets. Do not repress or stuff emotions, as this creates more depression and anxiety. Take time to explore your feelings with a spiritual counselor/therapist. Journal write, as this unloads repressed feelings, moving energy and inviting insights, solutions and ideas that may help sort through painful emotions and clarify decisions. Go on a retreat, take time off and explore what is not working in our life so you can come up with a plan for change. Identify stressful factors in your home and work environments and modify them. Put energy into creative outlets since creativity opens doors to your subconscious mind, allowing energy to flow again. It doesn't have to be a big project, simple activities as decorating or gardening or singing is beneficial. Any form of appropriate self-expression moves stagnant Qi.

To relieve depression, it is extremely important to refine your diet by eliminating depression-causing foods and including stagnation-moving ones. Foods that congest Qi are, unfortunately, very prevalent in the Western Diet. Eliminate: fried, greasy and fatty foods, nuts and nut butters, avocados, cheese and dairy, chips of all kinds, turkey and red meats, alcohol, caffeinated foods and drinks (coffee, black tea, mate, cocoa, colas and chocolate) and recreational drugs. Beneficial decongesting and Liver-aiding foods include vegetables, lemons, dark leafy greens such as kale, collards, dandelion, mustard, beet and other bitter foods.

Lastly, reflect on your lifestyle habits and balance them as appropriate. Excessive activity, sex, or exercise deplete Qi, as do keeping late bedtimes (after 11 PM), working at jobs one doesn't like, overworking physically and mentally, and insufficient activity. To rebalance the Liver, go to bed before 11pm at the latest, get plenty of physical exercise, find enjoyable and fulfilling work and jobs and alternate work with rest and play. Regularity of habits regulates Liver Qi.

Examples of herbs that regulate Liver Qi, moving stagnation and easing depression include vitex, citrus (tangerine peel, both the ripe and unripe fruit of the bitter orange), cyperus (sedge root), sandalwood, Chinese chive, rose petals, mint, lemon balm and cumin, as well as the Chines herbs bupleurum and saussurea. 

To release postpartum depression and acute anxiety I first had my hormones and blood tested and found out I needed progesterone cream and iron. I then turned to an integrated therapist at www.breakingfreemedical.com for 90 minute therapy/bodywork to release the pain on a cellular level and move out of an abusive relationship. I eliminated bad food and ate whole foods and greens and drank plenty of clean ionized high alkaline water fromwww.beyondo2.com. To help provide the necessary precursers for healthy neurohormonal chemistry I drank aminio acid protein shakes and took Coenzyme Bcomplex supplements during the day, Calcium magnesium at night to help me sleep and deer placenta, Women's Jing and Bupleurum and Peony fromwww.dragonherbs.com to balance liver and hormones.

How do you handle Depression and anxiety?

I know what you're thinking...HELP! I'm so exhausted I can't see straight! I can't take much more of this! I'm counting the minutes till my partner comes home so I can collapse but he/she only holds the baby for 45 minutes and then I'm on call again. What do I do?  

What you do is start taking your sleep seriously. Sounds tough I know because it's all you think about but really, are you making it a priority?  Because, provided you're not sleep deprived due to a serious hormone imbalance, all you have to do is stay in bed.  Yup.  You heard me sister. There's no pretending you have the time and energy to be suzy homemaker anymore so let the dishes go, put down the thank you cards.  Call friends and family to drop off nutritious whole food meals and pure high alkaline water and throw in a few loads of laundry while you go back to bed like the Divine Dalais-Mama you are! As a postpartum doula and baby nurse I coach new mothers to do this and it works!  But before we go into the "How To's of Staying In Bed" you should know a few facts about sleep and postpartum balance:

Sleep Deprivation Facts:

1. A new mom loses about 350 hours of sleep during baby's first year.
2. Sleep deprivation is defined as a sufficient lack of restorative sleep over a cumulative period so as to cause physical or psychiatric symptoms and affect routine performances of tasks. (WebMed)
3. Sleep is essential to life and Postpartum Balance.  During sleep our bodies work throughout the night, performing a variety of biological processes to help restore organs and tissues and optimize bodily and cognitive functions. Our body needs adequate sleep to produce important hormones and neurotransmitters that make us feel happy, energetic and balanced. After childbirth, women experience a big drop in estrogen and progesterone hormone levels and possibly thyroid making it crucial to get enough sleep for neurohormonal balance,
4. According to Uzzi Reiss, M.D., OB/GYN, sleep deprivation can be a contributing factor in many serious health concerns associated with new motherhood including postpartum depression. If a new mom's fatigue is overwhelming and she experiences the "baby blues" for longer than two weeks after delivery, she must see her physician. (Things to look for: low energy level, low mental focus and confusion, irritability, depression, anxiety, diminished coordination, little interest in maintaining outward appearance or losing pregnancy weight, little or no sex drive.

Sleep Deprivation Solution:
The paragraphs below were adapted and edited from a handout by childbirth educator Penny Simkin.  It's entitled: How to Get Enough Sleep in the First Weeks After Birth".  Trust me, it works if you work it and you're gonna work it cause your worth it!  Sweet Dreams....

The following approach will help you get as much (or almost as much) sleep as you need. (It does not work as well if you have other children, unless you have help with them.)

• Calculate how many hours of sleep you used to need regularly before pregnancy in order to function well. Six hours? Eight hours? That is the amount of sleep you now owe yourself everyday
• Since you cannot get this amount of sleep in one stretch because of interruptions for feedings and baby care, you will require more hours in bed to get your allotted amount of sleep.
• Plan to stay in bed or keep going back to bed until you have slept your allotted number of hours. This means that with the exception of meals and trips to the bathroom, you do not get up. You do not brush your teeth, shower of dress in the early morning. Make a mental note of approximately how many hours you have slept since you went to bed (but try not to obsess about it). You may have to stay in bed from 10PM until noon the next day to get eight hours of sleep! If that’s what it takes, do it. Then brush your teeth, take a shower, dress, and greet the day.
• Many parents find it easier to follow this regime if their baby sleeps with them or nearby.
• As your baby grows and begins to sleep for longer stretches, it will take you less time to get enough sleep.
• Hiring a postpartum doula is also a great way to ensure you get enough sleep while baby is taken care of and the house isn’t falling apart while you’re snoozing.