The first officially documented management of the
mentally ill in China was in the Tang Dynasty (618-907 AD), when homeless
widows, orphans and the mentally ill were cared for in the Bei Tian Fang, a
type of charity facility administrated by monks.
In ancient China, depression and mental health disorders
were understood and treated within the context of traditional Chinese medicine
(TCM). The approach to treating depression in ancient China was holistic and
encompassed a combination of herbal remedies, acupuncture, lifestyle
adjustments, and philosophical practices.
Chinese Philosophy
Mental illness is often thought to be a matter of
individual disorder. Modern psychiatry looks to features of individual
experience, behavior and thoughts to diagnose mental illness, and focuses on
individual remedies to treat it. If you are depressed, this is understood
as your response to circumstances, based on features of your
genetics, disordered patterns of thinking, or personal problems and emotional
states. Western treatment of mental illness follows these same individualistic
lines. The individual is provided with medicine and therapy, which are
certainly helpful.
But such an emphasis on the individual can lead us to
neglect communal
approaches to treatment. Often overlooked are the ways in which social
norms, cultural beliefs and communal attitudes contribute to mental illness.
Ancient Chinese scholars understood this well.
These thinkers recognized a number of mental and behavioral
disorders as illnesses (bing), which were categorized and discussed in
the earliest-known medical text in China, the Huangdi Neijing Lingshu
Jing (the oldest parts of which date to the 4th century BCE). This
text describes a number of mental illnesses, most prominently dian,
marked by ‘unhappiness, headache, red eyes and a troubled mind’, and kuang,
marked by ‘manic forgetfulness, flying into rages’ and ‘wild activity’, among
other symptoms. Early Chinese medical scholars understood such mental illnesses
to have a number of contributing causes, including overabundance of emotion,
failure to control desires, the depletion of ‘vital energy’ from the organs –
and the community to which one belongs.
Mental illness is linked to emotion in a number of early
philosophical and medical texts. A passage from the Guanzi instructs
that harmonious and effective action is possible only in the absence of the
kinds of extreme joy, pleasure and anger that can disorder the mind, leading it
to ‘lose its (original) form’. The Zhongyong associates
harmony (he) with the proper restriction of the emotions. A passage in
the Huangdi Neijing reads: ‘When anger abounds and does not
end, then it will harm the mind.’ Just as in the case of tools or machines,
there are ways in which we can use our bodies that overtax or harm them, and
thus cause injury and illness (including mental illness), according to ancient
Chinese scholars. This is an astute insight into the nature of illness.
According to ancient Chinese scholars, we can avoid
illnesses caused by overabundant emotion (or treat them) by learning to
restrain the mind. ‘Let the mind have no anger,’ instructs a passage from
the Huangdi Neijing. However, achieving this requires more than
just individualized approaches aimed at restructuring the way that ill
individuals think about their experience.
Early Confucians recognized that the behaviors and
attitudes of individuals are not due solely to individual character and
decisions. This is the reason why Confucius taught that, if you wish to become
virtuous, you must be careful whom you are around. He advised that we should
take as friends only those who are at least as morally good as we are. Being part
of harmonious and virtuous communities is necessary for the development of
healthy behaviors, attitudes and emotions. If we are in bad, vicious or
unhealthy communities, our beliefs, emotions, expectations and attitudes (among
other things) will be disordered in critical ways.
This is relevant when it comes to mental illness, because
such illness is at least in part a matter of behavioral and emotional norms
governed by society. Confucians would likely have said of our own modern world
that the alienation created by the self-centeredness required for modern
economic and consumer culture plays a major role in driving mental illness. Tu
Weiming, a contemporary scholar of Confucianism, writes that, according to the
Confucian view, ‘self-centeredness easily leads to a closed world … to a state
of paralysis’. The kinds of community that promote self-centeredness and
self-concern – ranging from the seemingly innocuous concern with ‘defining
oneself’, via various individual and consumer choices, to the corrosive lack of
empathy or care for others in the community – are communities likely to
inculcate in individual members behavioral and attitudinal traits that
contribute to mental illness.
Herbal Medicine
Traditional Chinese medicine relied heavily on herbal
remedies. Specific herbs were used to balance the body's energy (Qi) and
restore harmony.
While the concept of depression in ancient China may not
directly correlate with modern clinical definitions, TCM had methods to address
symptoms that align with what we now understand as depression. Here are some
herbs that were commonly used in traditional Chinese medicine to address
emotional imbalances and mood issues:
1. St.
John's Wort (Hypericum perforatum): This herb was used in TCM to treat
conditions related to emotional disturbances, including symptoms that resemble
depression. St. John's Wort was believed to have calming and mood-stabilizing
effects.
2. Chinese
Skullcap (Scutellaria baicalensis): This herb has been used to address
anxiety, stress, and restlessness in TCM. It was believed to have sedative and
calming properties.
3. Polygala
Root (Polygala tenuifolia): Also known as Yuan Zhi, this herb was used to
address mental and emotional imbalances. It was believed to help clear the
mind, soothe irritability, and calm the spirit.
4. Rehmannia
Root (Rehmannia glutinosa): This herb was used to nourish and tonify the
Yin energy in TCM. It was believed that imbalances in Yin could lead to
emotional issues, and Rehmannia root was used to restore this balance.
5. Atractylodes
Root (Atractylodes macrocephala): This herb was used to strengthen the
Spleen and Stomach energies, which are important in TCM for overall well-being.
An imbalanced Spleen energy was thought to contribute to symptoms like fatigue
and low mood.
6. Ginseng
(Panax ginseng): Ginseng is a well-known herb in TCM with adaptogenic
properties. It was believed to help the body adapt to stress and improve
overall vitality, which could indirectly impact mood.
7. Licorice
Root (Glycyrrhiza glabra): This herb was used to harmonize and balance
other herbs in herbal formulas. It was believed to support the function of
other herbs and assist in overall treatment.
8. Astragalus
Root (Astragalus membranaceus): Astragalus was used to tonify Qi energy,
which is important for vitality and resilience. Addressing Qi imbalances was
seen as a way to support emotional well-being.
Acupuncture and Acupressure
Acupuncture was one of the therapeutic techniques used in
ancient China to address various health issues, including emotional and mental
imbalances. While the concept of depression in the modern clinical sense may
not have existed in ancient times, traditional Chinese medicine (TCM) had a
framework for understanding and treating emotional disturbances that align with
what we now recognize as mood disorders. Acupuncture was employed as part of a
holistic approach to restore balance and harmony within the body's energy (Qi)
and organ systems. Here's how acupuncture was used for emotional well-being in
ancient China:
1. Qi
Flow and Balance: In TCM, the body's vital energy, known as Qi, flows
through pathways called meridians. It was believed that disruptions or imbalances
in the flow of Qi could contribute to emotional and mental symptoms.
Acupuncture involves the insertion of thin needles into specific points along
these meridians to regulate the flow of Qi and restore balance.
2. Regulation
of Energy: Acupuncture points were selected based on an individual's
pattern of disharmony. For emotional issues, points related to the Heart,
Liver, Spleen, and Kidney meridians might be targeted. These points were
believed to have a direct influence on emotions and mental states.
3. Harmonizing
Organ Systems: In TCM, emotions were connected to specific organ systems.
For example, the Heart was associated with joy and sadness, while the Liver was
linked to anger and frustration. Acupuncture could be used to balance and
harmonize these organ systems to address emotional symptoms.
4. Stress
Reduction: Acupuncture was believed to have a calming and relaxing effect
on the nervous system. By stimulating specific points, practitioners aimed to
reduce stress, anxiety, and restlessness, which could contribute to emotional
imbalances.
5. Release
of Endorphins: Acupuncture was thought to stimulate the release of
endorphins, the body's natural pain and stress-relieving compounds. This could
contribute to an improved mood and a sense of well-being.
6. Restoring
Yin and Yang: TCM views health as a balance between the opposing forces of
Yin and Yang. Emotional imbalances were often seen as a disruption of this
balance. Acupuncture was used to restore harmony between Yin and Yang energies.
7. Individualized
Treatment: Acupuncture treatments were personalized based on an
individual's constitution, symptoms, and patterns of disharmony. This approach
aimed to address the underlying causes of emotional issues rather than just
treating the symptoms.
8. Holistic
Approach: Acupuncture was often combined with other TCM therapies, such as
herbal medicine, dietary adjustments, and lifestyle recommendations, to create
a comprehensive treatment plan for emotional well-being.
Dietary Changes: Diet played a crucial role in
traditional Chinese medicine. Specific foods were recommended to support
emotional balance. For instance, foods that were considered to have a calming
effect on the mind, such as herbal teas and certain fruits, were incorporated
into the diet. Here are some dietary considerations that were believed to
promote emotional balance in ancient China:
1. Balancing
Yin and Yang: TCM emphasizes the balance between Yin (cooling and
nourishing) and Yang (warming and energizing) energies. A balanced diet
included foods from both Yin and Yang categories to maintain harmony.
2. Moderation:
Moderation in food consumption was a key principle in ancient Chinese dietary
practices. Overindulgence or extreme dietary habits were believed to disrupt
the body's balance.
3. Warm
and Cooked Foods: Cooked and warm foods were preferred over raw and cold
foods. Cooked foods were considered easier to digest and gentler on the
digestive system.
4. Herbs
and Spices: Certain herbs and spices were incorporated into the diet for
their potential to support emotional balance. For example, ginger, garlic, and
scallions were believed to have warming properties that could invigorate the
body's energies.
5. Seasonal
Eating: TCM emphasizes eating foods that are in season and locally
available. Seasonal foods were believed to be more aligned with the body's
needs.
6. Bitter
and Astringent Flavors: Bitter and astringent flavors were thought to have
a calming effect on the mind. Foods with these flavors, such as bitter greens
and certain grains, were included in the diet.
7. Avoiding
Excess Sugar and Stimulants: Excessive consumption of sweets and stimulants
(such as caffeine) was discouraged, as these substances were believed to lead
to imbalances and disrupt emotional harmony.
8. Qi-Building
Foods: Foods that were believed to strengthen the body's vital energy (Qi)
were considered beneficial. These might include foods rich in complex
carbohydrates, such as whole grains.
9. Bone
Broths: Nutrient-rich bone broths made from simmering bones and vegetables
were often recommended for their nourishing properties.
10. Mindful
Eating: TCM emphasizes mindful eating, paying attention to the flavors,
textures, and aromas of food. This practice was thought to promote a deeper
connection between the body and mind.
Physical Activity
In ancient China, physical exercises were considered an
important aspect of maintaining overall health and well-being, including
emotional balance. These exercises were often rooted in the principles of
traditional Chinese medicine (TCM) and were designed to promote the flow of
vital energy (Qi) and harmonize the body's energies. Here are some examples of
physical exercises that were believed to have benefits for emotional balance in
ancient China:
1. Tai
Chi (Taijiquan): Tai Chi is a traditional Chinese martial art that is now
widely practiced for its health benefits. It involves slow, flowing movements
that are performed in a meditative and mindful manner. Tai Chi is believed to promote
the smooth flow of Qi and balance Yin and Yang energies. The practice's
emphasis on relaxation and mindfulness can contribute to a sense of calm and
emotional well-being.
2. Qigong
(Chi Kung): Qigong is a system of exercises that involves breath control,
gentle movements, and meditation. Like Tai Chi, Qigong aims to cultivate and
balance Qi within the body. There are various forms of Qigong, some of which
specifically target emotional imbalances and promote inner peace.
3. Daoist
Yoga and Stretching: Ancient China had its own forms of stretching and
yoga-like practices that were associated with Daoist philosophy. These
practices were aimed at maintaining flexibility, enhancing circulation, and
promoting a harmonious flow of Qi.
4. Five
Animal Frolics (Wu Qin Xi): This is a set of exercises that imitate the
movements and behaviors of five animals: the tiger, deer, bear, monkey, and
bird. Each animal's movements were thought to correspond to specific meridians
and organs in the body. The Five Animal Frolics were believed to have physical
and mental health benefits.
5. Walking
Meditation: Walking meditation involves combining mindfulness with walking.
It's a practice that encourages focusing on each step and the sensations of
walking, which can help quiet the mind and reduce stress.
6. Breathing
Exercises: Controlled and mindful breathing exercises were often used in
conjunction with other physical practices. These exercises aimed to regulate
the breath, promote relaxation, and balance the body's energies.
7. Calm
Abiding Meditation: This form of meditation involves focusing the mind on a
single point, often the breath or an image. It aims to bring about a state of
mental clarity, calmness, and inner peace.
8. Dance
and Movement: Traditional dances and ceremonial movements were sometimes
used to promote emotional release, expression, and connection with the body's
energies.
Mind-Body Practices
Ancient Chinese philosophy, including Daoism and
Confucianism, emphasized the importance of finding harmony and balance in one's
life. Meditation, mindfulness, and contemplative practices were used to
cultivate inner peace and emotional resilience.
Here are some examples of meditation practices that were
used for promoting emotional well-being in ancient China:
1. Daoist
Meditation: Daoism is a philosophical and spiritual tradition in China that
emphasizes living in harmony with the Dao, often translated as the
"Way" or the natural order of the universe. Daoist meditation
practices involved cultivating stillness, mindfulness, and aligning with the
flow of Qi (vital energy) in the body. These practices aimed to bring about a
sense of tranquility, clarity, and connection with the natural world.
2. Chan
Buddhism (Zen Buddhism): Although originating in India, Chan Buddhism was
adopted and adapted in China as a form of meditation practice. Chan meditation
focused on direct experience and insight into one's true nature. Practitioners
engaged in seated meditation (zazen) to calm the mind and cultivate awareness,
which could lead to a sense of inner peace and freedom from attachments.
3. Confucian
Self-Cultivation: Confucianism, a philosophy emphasizing ethics, social
harmony, and self-cultivation, included meditative practices as a means to
cultivate virtue and inner balance. These practices often involved
contemplation on moral principles, reflecting on one's actions, and cultivating
a sense of equanimity.
4. Visualization
and Imagery: Meditation techniques involving visualization of serene
landscapes, symbols, or deities were used to create a sense of tranquility and
mental clarity. These practices were believed to promote positive emotions and
a peaceful state of mind.
5. Body
Scan Meditation: Body scan meditation involved directing focused attention
to different parts of the body, promoting relaxation, and heightening body
awareness. This practice aimed to release tension and create a sense of
physical and mental ease.
6. Mantra
Meditation: Repeating sacred sounds or mantras was used as a way to focus
the mind and create a sense of inner peace. The rhythmic repetition of sounds
was believed to have a calming effect on the mind.
Literature and Art
Depictions of depression and related emotional states in
ancient Chinese literature and art are often embedded within broader cultural,
philosophical, and artistic contexts. While the concept of depression as
understood in modern clinical terms might not have existed, ancient Chinese
literature and art do contain portrayals of emotional struggles, inner turmoil,
and existential contemplations. Here are a few examples:
1. Poetry:
Chinese poetry, with its emphasis on emotions, nature, and the human
experience, often contains expressions of inner turmoil and melancholy. Some
poets, like those from the Tang Dynasty (618-907 AD), used nature metaphors to
convey emotional states. For instance, Li Bai's poem "Drinking Alone with
the Moon" reflects a sense of isolation and introspection.
2. Literary
Classics: Classic Chinese texts, such as the "Dao De Jing"
attributed to Laozi and Confucian texts, address themes of balance, virtue, and
the search for meaning. These texts often touch on the nature of human emotions
and the challenges of maintaining emotional equilibrium.
3. Philosophical
Discourses: The works of Confucian scholars, Daoist philosophers, and other
thinkers offer insights into the exploration of emotions, desires, and the
pursuit of contentment. Philosophical discourses often examined the
complexities of the human psyche and the search for a fulfilling life.
4. Paintings
and Calligraphy: Chinese painting and calligraphy reflect the inner world
of the artists. Depictions of landscapes, solitary figures, and scenes of contemplation
convey a sense of introspection and emotional depth. Some artists, like those
from the literati tradition, conveyed emotions through their brushstrokes and
compositions.
5. Fictional
Narratives: Ancient Chinese fictional works, such as "Dream of the Red
Chamber" (also known as "The Story of the Stone"), often delve
into themes of love, desire, suffering, and the impermanence of life. While not
explicit depictions of clinical depression, these narratives explore the
emotional and psychological experiences of characters.
6. Opera
and Drama: Traditional Chinese opera and drama, such as Peking opera,
sometimes portrayed characters experiencing emotional turmoil and inner
conflicts. These performances incorporated stylized movements, costumes, and
music to convey emotions and character psychology.
7. Spiritual
Texts: Buddhist and Daoist texts, which were influential in ancient China,
addressed the nature of suffering, attachment, and the quest for spiritual
enlightenment. These texts explored the human experience from a spiritual and
existential perspective.
8. Inscriptions
and Epitaphs: Inscriptions on tombs, monuments, and epitaphs sometimes
conveyed emotional expressions and reflections on life and death. These
writings offer glimpses into personal thoughts and feelings of individuals from
ancient times.
