CLINICAL APPLICATIONS

* Depression/Stress

* Anxiety, stress, irritability

* Sadness, lack of interest

* Possible chest distension, abdominal bloating, generalized weakness and/or discomfort

* Note: This formula has no known interactions with antidepressant drugs.

 

WESTERN THERAPEUTIC ACTIONS

* Antidepressant effect to elevate mood and lift depression

* Anxiolytic effect to alleviate stress and anxiety

* Gastrointestinal effect to regulate and restore normal digestive system and improve energy

 

CHINESE THERAPEUTIC ACTIONS

* Spreads Liver qi

* Clears Heart fire

 

DOSAGE

Take 3 to 4 capsules three times daily on an empty stomach. The dosage may be increased up to 6 to 8 capsules every four to six hours as needed.

 

INGREDIENTS

Bai Shao (Radix Paeoniae Alba)

Bai Zhu (Rhizoma Atractylodis Macrocephalae)

Cang Zhu (Rhizoma Atractylodis)

Chai Hu (Radix Bupleuri)

Chuan Xiong (Rhizoma Chuanxiong)

Dang Gui (Radix Angelicae Sinensis)

Fu Ling (Poria)

He Huan Pi (Cortex Albiziae)

Mu Dan Pi (Cortex Moutan)

Shen Qu (Massa Fermentata)

Xiang Fu (Rhizoma Cyperi)

Yuan Zhi (Radix Polygalae)

Zhi Gan Cao (Radix et Rhizoma Glycyrrhizae Praeparata cum Melle)

Zhi Mu (Rhizoma Anemarrhenae)

Zhi Zi (Fructus Gardeniae)

 

BACKGROUND

Depression is a mood disorder that encompasses more than just sadness. Stress and anxiety are among the most common symptoms that also affect patients with depression, and more often than not, the symptoms from stress, anxiety, and depression are difficult to separate out.

        Controlling depression with pharmaceuticals is difficult, and may require months of trial and error with different medications. Often a combination of two or more drugs is needed to keep depression under control. The disadvantages of using pharmaceuticals for the treatment of mood disorders include long-term dependency, and of course, the myriad side effects that may come with the medication, or the combination of medications. Traditional Chinese medicine (TCM) has a long history of dealing with mood disorders in an all-natural way. At the root of the issue is an imbalance of the internal organs; by correcting the relative imbalances of these organs, the individual¡¦s mood disorder should naturally improve. However, with TCM alone, it is often more difficult and time-consuming to treat serious mood disorders. Sometimes it is most effective to utilize a combination of Western and Chinese herbal medicine to gradually bring the patient back into health.

 

FORMULA EXPLANATION

Shine (DS) treats depression characterized by Liver qi stagnation accompanied by interior heat and underlying blood and Spleen deficiencies. Often, this constraint leads to other complications, such as stagnation of blood, phlegm, heat, dampness, and food. If the qi is stagnant in the chest and abdomen, qi is not able to ascend or descend freely; chest distension and oppression as well as abdominal fullness and pain may occur.

        Chai Hu (Radix Bupleuri) and Xiang Fu (Rhizoma Cyperi) enter the Liver channel to activate qi circulation and relieve qi stagnation. Mu Dan Pi (Cortex Moutan), Zhi Mu (Rhizoma Anemarrhenae) and Zhi Zi (Fructus Gardeniae) sedate interior heat arising from Spleen and blood deficiencies, and from Liver qi stagnation. Chuan Xiong (Rhizoma Chuanxiong) activates blood circulation to dispel blood stagnation. Bai Shao (Radix Paeoniae Alba) and Dang Gui (Radix Angelicae Sinensis) tonify the yin and the blood to contain the fire in the body.

        Bai Zhu (Rhizoma Atractylodis Macrocephalae), Cang Zhu (Rhizoma Atractylodis), and Fu Ling (Poria) strengthen the Spleen and dry dampness to clear damp and phlegm stagnation. When the Spleen is strong, the patient is less likely to worry and overthink. He Huan Pi (Cortex Albiziae) and Yuan Zhi (Radix Polygalae) calm the shen (spirit). Shen Qu (Massa Fermentata) promotes digestion, clears food stagnation and relieves the digestive symptoms arising from Liver overacting on the Spleen. Finally, Zhi Gan Cao (Radix et Rhizoma Glycyrrhizae Praeparata cum Melle) harmonizes the entire formula.

        In conclusion, Shine (DS) treats depression and stress by regulating Liver qi and clearing interior heat.

 

CAUTIONS & CONTRAINDICATIONS

* This formula is contraindicated during pregnancy and nursing.

* Allergy warning: Shen Qu (Massa Fermentata) used in this product contains wheat. Persons with allergy to wheat should not take this product.

* This herbal formula contains herbs that invigorate blood circulation, such as Dang Gui (Radix Angelicae Sinensis). Therefore, patients who are on anticoagulant or antiplatelet therapies, such as Coumadin (warfarin), should use this formula with caution, or not at all, as there may be a higher risk of bleeding and bruising.[1]^,[2]^,[3]

 

CLINICAL NOTES

* Depression may be treated effectively with Shine or Shine (DS).

¡± Shine is more effective for depression characterized by stagnation (food, qi, blood and phlegm). Shine should not be used concurrently with antidepressant drugs, as this formula contains Guan Ye Jin Si Tao (Herba Hyperici Perforati), commonly known as St John¡¦s Wort.

¡± Shine (DS) is more effective for depression and stress characterized by Liver qi stagnation and Heart fire. Shine (DS) may be used concurrently with antidepressant drugs, as there are no known interactions.

* Discontinuation of antidepressant drugs, particularly abruptly, may cause certain withdrawal symptoms such as "electric shock" sensations (also known as "brain shivers" or "brain zaps"), dizziness, acute depression and irritability. Therefore, it is best to taper off the drugs slowly, and offer herbal treatment simultaneously. Shine (DS) may be used concurrently with antidepressant drugs or during the tapering process. Shine should not be used until the antidepressant drugs have been discontinued for two weeks.

 

Pulse Diagnosis by Dr. Jimmy Wei-Yen Chang:

* Inward-directed mood disorders: concave and deep pulse on the left guan

* Outward-directed mood disorders: convex and forceful on the left guan

 

SUPPLEMENTARY FORMULAS

* With stress, anxiety, restlessness, and bipolar disorders (manic-depressives), add Calm (ES).

* For purplish tongue, blood stasis or chronic depression, add Circulation (SJ) in the first month of treatment.

* With Liver blood deficiency and insomnia, add Calm ZZZ.

* With overthinking or over worrying due to Spleen qi deficiency, add Schisandra ZZZ.

* With indigestion and bloating, add GI Harmony.

* For more phlegm, add Pinellia Complex.

* For constipation, add Gentle Lax (Excess) or Gentle Lax (Deficient).

* For a quick boost of energy and vitality, combine with Vibrant.

* For constant fatigue and lack of energy due to deficiency, combine with Imperial Tonic.

* For loss of sexual desire, combine with Vitality.

* For over-weight or obesity, combine with Herbalite.

* For heat sensations, irritability or nightmares due to excess fire, add Gardenia Complex.

* For chronic depressive patients who do not respond to any of the above treatment or show little result, add Circulation (SJ) for two months and re-evaluate.

 

ACUPUNCTURE POINTS

Traditional Points:

* Taichong (LR 3), Yanglingquan (GB 34), Hegu (LI 4), Yintang, Taixi (KI 3), Qimen (LR 14), Zusanli (ST 36), Shenmen (HT 7), Neiguan (PC 6)

 

Classic Master Tung's Points:

* Depression: Tongguan (T 88.01), Tongshen (T 88.09), Neiguan (PC 6), Tianhuangfu [Shenguan] (T 77.18), Huoying (T 66.03), Huoxi (T 11.16). Bleed the HT and LU areas of the back with cupping. Bleed before needling for best result.

* Stress: Zhenjing (T 1010.08), Tianhuangfu [Shenguan] (T 77.18), Huoying (T 66.03), Dizong (T 44.09), Dan (T 11.13)

 

Master Tung¡¦s Points by Dr. Chuan-Min Wang:

* Depression: Zhenjing (T 1010.08), Huoying (T 66.03)

 

Balance Method by Dr. Richard Tan:

* Left side: Zulinqi (GB 41), Yanglingquan (GB 34), Shenmen (HT 7), Tongli (HT 5), Shaohai (HT 3), Quze (PC 3), Daling (PC 7)

* Right side: Taichong (LR 3), Ligou (LR 5), Ququan (LR 8), Zhongzhu (TH 3), Waiguan (TH 5), Tianjing (TH 10)

* Bilateral ear Shenmen, Anmian

* Alternate sides with each treatment.

 

Ear Acupuncture:

* Shenmen, Endocrine, Subcortex, Sympathetic, Heart, Spleen, Kidney

 

Auricular Medicine by Dr. Li-Chun Huang:

* Shenmen, Liver, Heart, Occiput, Nervous Subcortex, Anxious Point, Be Happy Point. Bleed Ear Apex.

 

NUTRITION

* Depression may be due in part to nutritional deficiency. Foods such as white bread, flour, saturated animal fats, hydrogenated vegetable oils, sweets, soft drinks, and canned goods deprive the body of B vitamins and increase the probability of depression.

* Avoid a diet too low in complex carbohydrates as it may cause serotonin depletion and depression.

 

General Guidelines for a Healthy Diet

* Eat a variety of fresh, organic fruits and vegetables of all colors. 

* Incorporate more high-fiber whole grains and nuts into diet.

* Drink warm or hot liquids with meals. Putting cold and ice on any part of the body will immediately constrict the flow of blood to that region. Similarly, drinking cold or iced drinks with meals will hinder the natural peristaltic movements of the digestive system.

* Foods with antioxidant effects, such as vitamin A, C and E are beneficial as they neutralize the free radicals and minimize damage to cells. Beneficial foods include citrus fruits, carrots, green leaf vegetables, and green tea.

* Chew food completely and thoroughly. The digestive tract can process and absorb smaller pieces of food much better than food that is incompletely chewed. Larger pieces of food can lead to incomplete digestion and digestive discomfort.

* Always eat breakfast. According to the TCM clock, the most optimal time for the digestive system is in the morning from 8 to 10 a.m.

* Give the body two to three hours between the last meal of the day and bedtime. During sleep, the digestive system slows down as well. Make sure the body has adequate time to digest the food before going into sleep mode.

* If the patient is allergic to any food or feel uncomfortable after eating certain foods, then avoid eating it.

* Avoid fast food, processed foods, junk food, artificial sugars, and carbonated drinks. Stay away from meat, greasy food, alcohol, caffeine, dairy products (except for unsweetened low-fat yogurt), tap water, iron supplements and vegetables and fruits with pesticides.

* Spleen is responsible for generating post-natal qi and good Spleen function also contributes to a healthy immune system. Foods that damage the Spleen should be avoided:

¡± Avoid any and all foods that contain sugar, such as cake, dessert, candy, chocolate, canned juice, soft drinks, caffeinated drinks, stevia, sugar substitutes, agave, xylitol, and corn syrup.

¡± Avoid raw or uncooked meats, such as sashimi, sushi, steak tartar, seared meat. Minimize consumption of foods that are cooling in nature, including tofu, tomato, celery, asparagus, bamboo, seaweed, kelp, bitter melon, cucumber, gourd, luffa, eggplant, winter melon, watermelon, honeydew, citrus, oranges, guava, grapefruit, pineapple, plums, pear, banana, papaya, white radish, mustard leaf, potherb mustard, Chinese kale, napa, bamboo sprout. Do not eat foods straight from the refrigerator. Long-term use of cold fruits and vegetables like the ones listed above may be damaging to the Spleen. To make the property more neutral, one can add about 20 pieces of Gou Qi Zi (Fructus Lycii) when cooking them.

* Warm and hot natured foods that damage qi and yin should be avoided, such as:

¡± certain fruits like mango and durian that produce heat.

¡± stimulants like coffee, alcohol, and energy drinks.

¡± spicy/pungent/aromatic vegetables such as pepper, garlic, onions, basil, rosemary, cumin, funnel, anise, leeks, chives, scallions, thyme, saffron, wormwood, mustard, chili pepper, and wasabi.

* Avoid food and drinks with artificial coloring.

*  Consume as few meat products as possible. Do not eat processed meats, such as lunch meats, hot dogs and sausages, as they contain nitrites that are associated with inflammation and chronic disease.

 

LIFESTYLE INSTRUCTIONS

* Regular use of steam rooms or saunas can help to eliminate toxins through sweating.

* Take a 30-minute walk after meals to help stimulate the circulatory and digestive systems.

* Incorporate some form of cardiovascular exercise.

* Do not postpone bowel movements, respond to the urge immediately.

* Sleep by 10:00 p.m. In traditional Chinese medicine (TCM), 11:00 p.m. to 1:00 a.m. is when the yin shifts to yang. It is crucial for the body to be at rest during this time for optimal health.

* Eliminate things that are unhealthy (e.g., alcohol, coffee, cigarettes, refined sugars, or saturated fats) or potentially toxic (e.g. chemical-based household cleaners and personal hygiene products).

 

MODERN RESEARCH

Shine (DS) is designed to treat depression by using herbs with demonstrated effectiveness to elevate mood, alleviate stress, and reduce anxiety.

        Zhi Mu (Rhizoma Anemarrhenae), Yuan Zhi (Radix Polygalae), and He Huan Pi (Cortex Albiziae) are three herbs in this formula that have also shown marked effects to treat depression. Zhi Mu (Rhizoma Anemarrhenae) contains sarsasapogenin which have shown significant antidepressant activity on two experimental models of depression.[4] Zhi Mu (Rhizoma Anemarrhenae) exerts its antidepressant influences in both the hypothalamus and the hippocampus.[5] Furthermore, use of Yuan Zhi (Radix Polygalae) is associated with a marked antidepressant effect to reverse the harmful effects of chronic mild stress on mood and behavior. The mechanism of this action is attributed in part to its neuroendocrine and neuroprotective activities, as well as involvement of the hypothalamo-pituitary-adrenal system.[6] Lastly, He Huan Pi (Cortex Albiziae) exhibits comparable antidepressant effect to Tofranil (imipramine), a tricyclic antidepressant drug.[7] Clinically, one study reported an 81.8% rate of effectiveness in treating depression in 33 patient (12 with recovery, 15 with improvement, and 6 with no effect) using an herbal formula that contained He Huan Pi (Cortex Albiziae), Shi Chang Pu (Rhizoma Acori Tatarinowii), and others.[8]

        Beyond using herbs to directly treat depression, Shine (DS) incorporates other herbs to support the patient and treat other aspects of depression. Since stress is a main contributor of depression, many herbs are used in this formula to calm the patient and alleviate depression, such as Chai Hu (Radix Bupleuri),[9] Chuan Xiong (Rhizoma Chuanxiong),[10] and Xiang Fu (Rhizoma Cyperi).[11] To improve sleep pattern and treat insomnia, Yuan Zhi (Radix Polygalae) is added for its sedative effect.[12] To improve and increase energy, Shen Qu (Massa Fermentata) is used to improve digestion and absorption of nutrients,[13] Bai Zhu (Rhizoma Atractylodis Macrocephalae) and Cang Zhu (Rhizoma Atractylodis) are incorporated to regulate and restore the digestive system,[14]^,[15] and Zhi Gan Cao (Radix et Rhizoma Glycyrrhizae Praeparata cum Melle) is utilized to protect and repair the intestines.[16] Lastly, Bai Zhu (Rhizoma Atractylodis Macrocephalae) has an adaptogenic effect to facilitate adjustment to various mental and physical stress.[17]

        In summary, Shine (DS) is a great formula to treat depression and its associated symptoms.

 

COMPARATIVE ANALYSIS

Depression is an emotional disorder that affects millions of people worldwide. In Western medicine, the biomedical understanding of depression is relatively new, as antidepressant drugs were mostly developed only in the last two decades. Though there are several categories of drugs for depression, the most commonly used are the serotonin specific reuptake inhibitors (SSRI), such as Prozac (fluoxetine), Zoloft (sertraline), and Paxil (paroxetine). As the name implies, these drugs have specific effects to increase serotonin activities in the brain to lift depression. However, despite their specific mechanism, they often require six to eight weeks before they exert their effect to lift depression. Furthermore, they are associated with a great number of side effects, including but not limited to nausea, vomiting, weight loss, sexual dysfunction, and increased risk of suicide. Therefore, these drugs must be prescribed and monitored carefully to avoid such adverse reactions.

        In TCM, depression is characterized by stagnation of qi, blood, food, and phlegm. If untreated or poorly treated, these stagnations can create heat, causing Heart fire and shen (spirit) disturbance. Therefore, optimal treatment requires use of herbs to relieve stagnation and clear Heart fire. These same herbs have also been found to have an excellent effect to increase energy levels and lift depression. Generally speaking, most patients begin to benefit within approximately two weeks. Most importantly, these herbs are safe and natural, and are associated with few or no side effects.

        Depression is an emotional disorder that should be addressed cautiously. Though use of drugs is effective, one must carefully evaluate the potential benefits against the potential risks. Once the decision is made to start drug therapy, the patient must be monitored carefully to ensure that the drugs do not cause serious side effects. In comparison, herbs are also effective, and definitely much safer. It provides an additional option that should be explored. Furthermore, in addition to drug or herbal therapies, counseling and behavior therapy should be initiated as they are extremely helpful toward long-term improvement. Lastly, exercise is also helpful as it increases one¡¦s inherent ability to deal with stress and depression.