Bipolar+Affective+Disorder+(BAD)

One of the three major affective disorders (along with unipolar depression and schizoaffective disorder) This disorder is characterized by repeated (i.e.) at least two) episodes in which the patients mood and activity levels are significantly disturbed. On some occasions, this disturbance consists of an elevation of mood and increased energy and activity (mania or hypomania) and, on other occasions, of a lowering of mood and and decreased energy and activity (depression). Characteristically, recovery is complete between episodes. Manic episodes tend to begin abruptly and last from 2 weeks to 5 months. Depression tends to last longer (median duration 6 months). Episodes of both kinds often follow stressful life events or other mental trauma, but the presence of such stress is not essential for this diagnosis.

Relevant TCM Diseases: Withdrawal and mania (Dian Kuang), Manic condition (Kuang Zheng), Epilepsy (Xian)

Differential Diagnosis: Medical Disorders: A. Endocrinologic diseases including thyroid and adrenal dysfuction B. Cancer C. Infectious diseases including HIV, Hepatitis, and others D. Neurologic diseases including epilepsy and tumors Effects of Substances: A. Alcohol abuse or or illicit substances B. Medication side effects Psychiatric Disorders: A. Major Depressive episode B. Cyclothymic disorder C. Schizoaffective disorder D. Schizophrenia and other psychotic disorders E. Borderline personality disorder (and other personality disorders)

TCM Etiology and Pathogenesis: “In Chinese medicine, the disease evils assocated with this condition are mostly internal engenderment of (depressed) qi, fire, phlegm, and stasis. The site of this disease is located in the heart, liver spleen and kidneys. The disease can be divided into Yin and Yang, vacuity and repletion... Most cases of this condition are believed in Chinese medicine to be due to great fright, excessive stimulation by the seven affects, and the five minds transforming fire. This leads to fire exuberance and phlegm congestion with qi and blood counterflow harassing and causing chaos in to spirit brilliance. This then reults in mania. In terms of the depression pole of bipolar disorder, worrying and thinking may become depressed and bound and not able to extend themselves or frustrated anger may not be discharged. In either case the qi may become depressed and the blood static, and hence the heart spirit may become clouded and congealed.”1

TCM Pattern Differentiation: Liver Depression-Blood Heat Pattern 1 High spirits, tension, agitation, easy anger, difficulty thinking, rushing about, meddlesomeness, intrusiveness, bilateral rib-side distention and pain, insomnia, profuse dreams, bitter taste, dry mouth [Chai Hu (10g.), Zhi ZI (10g.), Mu Dan Pi 15g.), Su Geng 10g.), Bai Shao (10g.), Gou Teng (15g., added later)]
 * A. **** Manic State **
 * Tongue:** crimson tongue, scanty coat
 * Pulse:** bowstring, rapid
 * Treatment Principles:** Course the liver & drain heat, resolve depression, quiet the spirit
 * Acupuncture Treatment:** LR-2, LI-4, LI-11, SP-10, HT-7, GB-20, GV-20. draining technique.
 * Herbal Treatment:** //Chai Hu Qing Gan Yin//1

Liver Depression-Phlegm Fire Pattern 1 Emotional tension & agitation, ecited, impetuous behavior, bitter taste, raving, bilateral rib-side distention & pain, insomnia, profuse dreams, dizziness, headache, spitting yellow phlegm Qing Qi Hua Tan Tang: [Che Pi (10g.), Xing Ren (10g.), Zhi Shi (10g.), Huang Qin (15g.), Gua Lou (15g.), Fu Ling (15g.), Dan Nan Xing (15g.), Ban Xia (12g.) Gun Tan Wan: [Meng Shi, Da Huang, Huang Qin, Chen Xiang] Rash & impetuous & uncontrolled manic behavior: + Tie Luo, Ci Shi, Dai Zhe Shi Constipation w/ yellowish red urine: + Da Huang, Mang Xiao Headache & dizziness: +Ju Hua, Gou Teng, Bai Ji Li
 * Tongue:** red tongue, slimy yellow coat
 * Pulse:** bowstring, slippery, rapid
 * Treatment Principles:** Course the liver & resolve depression, transform phlegm, drain fire
 * Acupuncture Treatment:** LR-2, ST-40, CV-12, CV-17, HT-7, PC-8, GB-20, GV-20. draining technique, strong stim.
 * Herbal Treatment:** //Qing Qi Hua Tan Tang He Gun Tan Wan//1
 * Modifications:**

Qi Stagnation & Blood Stasis Pattern 1 Emotional lability, changes in diseases nature, somtimes agitated & impulsive, sometimes torpid & wooden, manic speech, a predilection to unstable anger, chest region fullness and oppression, headache w/ piercing, lancinating, red bloodshot eyes [Tao Ren (24g.), Chai Hu (10g.), Chi Shao (20g.), Mu Tong (10g.), Da Fu Pi (10g.), Che Pi (10g.), Sang Bai Pi (10g.), Xiang Fu (6g.), Ban Xia (6g.), Qing Pi (6g.), Zi Su Zi (12g.), Gan Cao 15g.)] Excitation & restlessness: +Mu Dan Pi, Sheng Di Huang, Di Long Insomnia & disquieted sleep: + Ku Shen, Ye Jiao Teng Raving speech, hasty breathing, red complexion, bad breath, constipation: + Da Huang, Huang Lian Rash, impetuous behavior & inability to control oneself: + Meng Shi, Chen Xiang Severe psycho-emotional excitation: + Tie Luo, Meng Shi, Zhi Mu
 * Tongue:** dark purplish tongue, possible static macules or engorged sublingual veins
 * Pulse:** bowstring, choppy
 * Treatment Principles:** Quicken the blood & transform stasis, rectify the qi, resolve depression
 * Acupuncture Treatment:** LR-3, LI-4, SP-10, BL-15, BL-17, BL-18, GB-20, GV-20. draining technique.
 * Herbal Treatment:** //Dian Kuang Meng Xing Tang//1
 * Modifications:**

Fire Exuberance Damaging Yin Pattern 1 Enduring mania and withdrawal, essence spirit listlessness, sometimes stillness, sometimes agitation, illogical speech, heart vexation, insomnia, excessive speaking, susceptibility to fright, 5-palm heat, dry throat w/ scanty fluids [Sheng Di Huang (30g.), Mai Men Dong (15g.), Xuan Shen (15g.), Huang Lian (10g.), Mu Tong (10g.), Zhu Ye (10g.), Deng Xin Cao (5g.), Fu Shen (15g.), Suan Zao Ren (15g.), Gan Cao (6g.)] Palpitations, restlessness, excessive speaking, susceptibility to fright, worry & anxiety: + Excitation & restlessness: +//Qian Jin Ding Zhi Wan// //[Ren Shen, Fu Ling, Shi Chang Pu, Yuan Zhi]// Heart vexation, chest oppression, sometimes aggrivation, sometimes depression: +Chai Hu, Bai Shao, Xuan Fu Hua Heart vexation, insomnia, excessive fear, long standing susceptibility to fright w/out ceasing: +Dan Shen, Hu Po
 * Tongue:** red tongue, scanty coat
 * Pulse:** fine, rapid
 * Treatment Principles:** Supplement the kidneys & enrich Yin, clear fire, quiet the spirit
 * Acupuncture Treatment:** SP-6, KI-3, LR-3 -> KI-1, HT-7, PC-6, GB-20, GV-20. even technique, light stim., if too high strung acupuncture may be counterproductive.
 * Herbal Treatment:** //Er Yin Jian//1
 * Modifications:**

Liver Qi Depression & Binding Pattern 1 Low spirits, many worries, susceptibility to anxiety, sorrow, hopelessness, decreased movement, slowed reactions, rib-side distention & pain, abdominal distention, scanty eating, loose stools which are not crisp [Chai Hu (10g.), Xiang Fu (10g.), Zhi Ke (10g.), Chen Pi (7g.), Chuan Xiong (5g.), Bai Shao (10g.), Gan Cao (6g.)] Qi depression is severe: + Yu Jin, Qing Pi Five depressions complicating food, dampness, phlegm, blood, fire): + //Yue Ju Wan// Sorrow, desire to commit suicide, muddled confused ntelligence: + //Su He Xiang Wan// Spleen & blood vacuity more pronounced: Use //Xiao Yao San// Spleen vacuity and.or stomach disharmony are pronounced w/ depressive lung heat & stomach phlegm damp: Use //Xiao Chai Hu Tang//
 * B. **** Depressive State **
 * Tongue:** pale tongue
 * Pulse:** bowstring, slightly slow
 * Treatment Principles:** Course the liver & resolve depression, rectify the qi, harmonize the center
 * Acupuncture Treatment:** LR-3, LI-4, ST-36, CV-17, CV-12, CV-6. mostly draining technique.
 * Herbal Treatment:** //Chai Hu Shu Gan Tang//1
 * Modifications:**

Liver Blood Stasis & Stagnation Pattern 1 Emotional depression, suicidal thoughts/behavior, vexation & agitation, difficulty thinking, slowness making connections in the mind, slow movement, a dark, dusky facial complexion, bilateral rib-side pain, blocked menstruation [Tao Ren (12g.), Hong Hua (10g.), Dang Gui (10g.), Sheng Di Huang (10g.), Chuan Xiong (6g.), Chi Shao (6g.), Jie Geng (5g.), Chuan Niu Xi (10g.), Chai Hu (3g.), Zhi Ke (6g.), Gan Cao (3g.)] Heavy qi depression w/ suicidal thoughts & behavior: +Tao Hua, Yu, Yu Jin, Shi Chang Pu Severe blood stasis: + Jiang Xiang, Chuan Shan Jia, Su Mu
 * Tongue:** dark-purplish tongue, possible static spots
 * Pulse:** bowstring, choppy
 * Treatment Principles:** Quicken the blood & transform stasis, rectify the qi, resolve depression
 * Acupuncture Treatment:** LR-3, LI-4, SP-10, SP-6, HT-7, PC-6, CV-17, CV-6. mostly draining technique.
 * Herbal Treatment:** //Xue Fu Zhu Yu Tang//1
 * Modifications:**

Heart-Spleen Dual Vacuity Pattern 1 Emotional depression, lack of interest, self-blame, self-reproach, decreased activity, excessive thinking/worry, timidity & fearfulness, insomnia, impaired memory, fatigue, exhaustion, pale white or sallow yellow complexion, scanty eating, loose stools Severe depression w/ poor sleep: + Yu Jin, ZHi Ke, He Huan Hua Scanty eating w/ disinclination to speak: + Sha Ren, Chen Pi
 * Tongue:** pale enlarged tongue, white coat
 * Pulse:** fine, weak
 * Treatment Principles:** Fortify the spleen & nourish the heart, boost qi, supplement blood
 * Acupuncture Treatment:** HT-7, SP-3, ST-36, BL-15, BL-17, BL-20. tonifying technique.
 * Herbal Treatment:** //Gui Pi Tang//1
 * Modifications:**

Spleen-Kidney Yang Vacuity Pattern 1 Essence spirit listlessness, low spirits, addiction to lying down, scanty movement, diminished willpower, sorrow, ennui, decreased sexual desire, impotence & seminal emission, clear/watery vaginal discharge and/or early menstruation, somber white complexion, cold limbs [Dang Shen (15g.), Shu Di Huang (15g.), Xian Ling Pi (5g.), Rou Cong Rong (15g.), Gui Ban (15g.), Fu Zi (10g.), Huang Qi (10g.), Gan Cao (10g.), Rou Gui (6g.), Gan Jiang (6g.)] Devitalized essence spirit (scanty movement, short of breath, disinclination to speak, scanty eating): + Bai Zhu, Sheng Ma, Chen Pi, Mai Ya Depression not resolved & decreased willpower: + Chai Hu, Yuan Zhi, Yu Jin, Zhi Ke Slow & difficult thinking, slow relaxed behavior, terminal urinary dribbling: + Tu Su Zi, Yi Zhi Ren, Wu Yao, Shi Chang Pu
 * Tongue:** pale puffy tongue, white coat, teeth marks
 * Pulse:** deep, fine
 * Treatment Principles:** Fortify the spleen, boost qi, warm yang, supplement kidneys
 * Acupuncture Treatment:** ST-36, CV-4, CV-6, BL-23, GV-4, BL-20, GV-20. moxa.
 * Herbal Treatment:** //Wen Yang Xing Fen Tang//1
 * Modifications:**

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 * IBIS:**

Definition:
A bipolar condition with cyclic states of mania and depression (see these terms for more information). In 85% of cases, depression dominates the personality cycle

Etiology:
There are many possible causes, ranging from circumstantial events to neurotransmitter imbalances to toxicity. Manic phase may be associated with adrenal compensation following liver hypoglycemia in which liver glycogen stores are chronically inadequate; while the depressive phase may be associated with the hypoglycemic drop following adrenal exhaustion, relief of stressors or attempts to relax.

Somatic Therapies:
• qigong • tai qi chuan

Nutrition:
therapeutic foods: • increase foods that calm the Shen (Spirit), tonify the Heart, harmonize the Stomach and Spleen • increase foods rich in Vitamin B-complex and Vitamin C • longan, oyster, rice, rosemary, wheat, wheat germ, mushroom

specific foods: » Stagnant Liver Qi or Stagnancy in the Liver channel: • foods that invigorate the Qi, Liver foods, sour foods, Dispersing foods, foods that open channels • citrus peel, figs, honey • liver-cleansing foods: beets, carrots, artichokes, lemons, parsnips, dandelion greens, watercress, burdock root • Vitamin C foods

fresh juices: • carrot (Walker) • carrot and spinach (Walker) • carrot, beet, and cucumber (Walker) • lemon juice in warm water

specific remedies: • 2 oz. fresh walnuts, 2 oz black sesame seeds, crush together and eat three times daily (Butt and Bloomfield, p. 149) • for nervous tension: 3 oz. fresh oysters, 3 oz. peanuts, 2 oz. celery. Boil in 2 pt. water until reduced to half. Divide into 2 halves and eat and drink twice daily for 7-14 days (Butt and Bloomfield, p. 149)

avoid: • meat, alcohol, hot sauces, spicy foods, fried foods, fatty foods, rich foods, salty foods, coffee, caffeine, sweet foods and sugar

Botanicals
• Hypericum perforatum (Anderson Geller) • Scutellaria lateriflora (NCNM Botanicals) • Valeriana spp. (Anderson Geller)

Chinese Formulae
• Gun Tan Wan; She Dan Chen Pi Mo (patent): Heart Agitated by Phlegm Fire (Gun Tan: Bensky and Barolet, p. 424; She Dan Chen: Zhu, p. 80) • Dao Tan Tang: Wind Phlegm: dizziness or vertigo, headache, dyspnea (Yeung, p. 82; Bensky and Barolet, p. 448) • Qing Shu Yi Qi Tang I: Summer-Heat: desire to curl up, apathy, thirst (Yeung, p. 174; Bensky and Barolet, p. 106) • Fu-shen 16 (patent) plus Zizyphus 18 (patent): Heart Fire Blazing with Shen Disturbance (Dharmananda, 1990; Fu-shen, p. 68: Zizyphus, p. 29) • Cerebral Tonic Pills (patent): Heart Xue Xu (Blood Deficiency) with Heart Agitated by Phlegm Fire (Fratkin, p. 227) • Ardisia 16 (patent): Liver Wind Arising From Liver Yang Rising (Dharmananda, 1990, p. 36)

Acupuncture
after assessing the person and palpating, consider these patterns: Shen Disturbance; Heart Xue Xu (Blood Deficiency); Heart Misted by Cold Phlegm; dysfunction of the Du Mai (Governing Vessel); Depression is Yang Ming Xu (Deficiency) and Tai Yin Shi (Excess); Mania is vice versa.

» therapeutic note: see also "depression" and "Attention-Deficit Hyperactivity Disorder/ADD" as the polarities will often demand very different approaches in terms of point selection, combinations and technique

» illustrative combinations: • GV-20, ding shen, si shen cong, yao qi, PC-5, SI-3 St-40 and Kd-1: treat manic depressive patterns (Flaws, p. 98) • PC-7, LI-1, Sp-6 and Kd-4: treat manic depressive mood swings (Finkelstein, p. 53) • GV-26, Lu-11, Sp-1, PC-7, UB-62, GV-16, St-6, CV-24, PC-8, GV-23, CV-1 and LI-11 for mania and melancholia (Lee and Chuang, p. 325) • UB-58, St-23 and St-24 for melancholia and mania with protrusion of the tongue (Lee and Cheung, p. 325) • consider treatment for "Internal Dragons" or "External Dragons"; External Dragons: GV-20, UB-11, UB-23, UB-61; Internal Dragons: Master point 1/4" below CV-15, St-25, St-32, St-41; In both treatments, sedate first. If the person and the pulses change, fine. If no change with sedation, then tonify. (Worsley) • GV-15, GV-20, CV-11, PC-6, Ht-5 and Sp-6 (also consider Kd-4, GB-34, Lv-5 and Ht-7) for melancholia (Lee and Cheung, p. 324) • Kd-4 (listed as "Kd-5") and UB-15; PC-7 and GV-20; St-8, GB-37 and SI-3: when patient weeps without adequate cause (Mann, p. 141) • CV-11 and PC-6: "sweep away bitterness in the chest" (Ellis, et al, 1988, p. 356) • CV-4, CV-12, CV-22 and GV-9 are the Reunion Points of the Yin and Yang, they are needled when there is conflict between Yin and Yang, according to Su Wen (Finkelstein, p. 78) • GV-15, PC-8, Sp-6, Kd-1, Kd-3, CV-12, GB-30, St-36 and LI-4 are the Nine Needles for Returning the Yang (Li, p. 627-628; Ellis, et al, 1988, p. 66) • Kd-3, UB-23 and UB-15: adjust disharmony of Heart and Kidney (Finkelstein, p. 53) • CV-12 and PC-5: broaden the chest and treat Qi Depression (Finkelstein, p. 89) • CV-12 and Lv-2: broaden the Middle Warmer and treat Qi Depression (Finkelstein, p. 89) • SI-3 and UB-62: open the Du Mai (Governing Vessel) for which Shen disorders are a symptom of Shi (Excess)

Homeopathy
• Agaricus muscarius: from overexertion and prolonged study; history of late learning to talk and walk; > evening; averse to conversation; mental labor; delirious • Aurum metallicum: melancholy; desire to die; strong desire to weep; sees obstacles everywhere • Folliculinum: history of birth control pills and/or estrogen replacement therapy, esp. bad reaction, i.e., estrogen poisoning; tendency to put others' needs before her own, and then become resentful later; woman has lost touch with her own inner rhythms and her reference has become external rather than internal; often best used in a single dose, or repeated every two weeks, possibly at new and full moons • Hyoscyamus: acute mania with great paranoia, suspiciousness and jealousy; relatively passive state rather than outward violence and aggression; talks to people not there, the dead or to himself; mind revels in strange and ridiculous things; may degenerate to shameless genital exposure and lewd behavior; increased cerebral activity (non inflammatory); had no wants and makes no complains; low muttering delirium; intense sleepiness • Lachesis: following grief; feels empowered by higher force to bless or curse; < sleep; loquacious; impulsive insanity • Lithium carbonicum: hard to remember names; cries with self pity; anxiety at night • Mercurius solubilis: hastiness; slow to understand; time passes slowly; muttering delirium • Psorinum: trembling from moral emotion ; hypochondriasis; depression during menopause; self willed; • Staphysagria: acute; dullness from concern about future; dissatisfied about everything • Stramonium: loquacity; praying; beseeching; entreating; < from solitude and darkness; destructive forms of mania where patient smashes things across the room, shrieks, curses, strikes others, bites himself or others and the repressed unconscious violently erupts; sudden severe fright, emotional shock, head injury or fever can lead to mass killing • Syphilinum: loss of memory; sensation of going insane; dread of night • Veratrum album: want to help a lot of people; delusions; liars; argumentative; with sadness lot of crying; violent and destructive; nymphomania and satyriasis; religious mania; sensation of ice on vertex; combined manias of bell., hyos. and stram.

Subtle Support
• Mi (Gardner, p. 72, 78) • Fa# (Gardner, p. 82, 87)

mental/emotional: • rhythmic folk songs • County Derry • songs of Steven Foster • Spanish tangos • Brahms' Hungarian dances • Sousa's marches • Strauss' waltzes • Gilbert and Sullivan • Indian Love Call • My Wild Irish Rose • Wishing • Estrellita (Heline, p.18)

Mind/Body
• An important characteristic of altered states is that many of them cannot be dealt with sufficiently without entering into them. At one end is consciousness and awareness, while at the other there is literally no control. Everyone's psychotic corner can be accessed by touching upon a central, mythical, painful issue. (Mindell, 1988, p. 164) • Cognitive processes of manic-depressive patients manifest typical state-dependent memory and learning characteristics: able to recall verbal information learned during their manic state better during their next period of mania; likewise, with depression and recall; known as 'affect state dependency' which is encoded by endocrine system hormones. (Rossi, 1986, p. 141) • Antinuclear factor (ANF) was present in serum of 30% of 53 patients admitted to a psychiatric hospital for mental depression. Clinically, ANF positive depression closely resembles manic-depressive psychosis but tends to be more resistant to treatment. (Locke, 1983, p. 164) • The presence of antinuclear antibody (ANA) was investigated in a group of patients suffering from recurrent affective disorders. There was no increase in ANA in patients treated with lithium, as compared with patients not on lithium, or controls. (The prevalence of ANA in the normal population is 9%). (Locke, 1983, p. 167) • Lithium carbonate may have a tendency to produce antinuclear antibodies. (Locke, 1983, p. 71) • 50 patients with manic-depressive psychosis, 120 neurotics, and 100 healthy controls underwent the toxoplasmin intradermal test. The highest percentage of reactors was with manic depressive psychosis (67%), and this group showed a higher intensity of reaction. Patients with depressive neurosis accounted for the highest number amongst the neurotics (56%). It is concluded that the percentage of reactors is higher among patients with depressive mental disorders, and also that this percentage increases with mental deterioration in patients. It is further concluded that the greater the severity of the psychiatric disease, the poorer the hygienic habits and the higher the contact with parasites. (Locke, 1983, p. 164) • The production of the human leukocyte antigens (HLA) is controlled by a gene complex on chromosome six. These HLA provide the best possible histocompatibility conditions. Various diseases with a noticeable autoimmune component and frequent occurrence within the family showed a statistically significant correlation with specific HLA. Nevertheless, results obtained are contradictory. In 8 studies of HLA in manic-depressive patients, 17 antigens were being recognized, which occurred with a different frequency when compared with controls. (Locke, 1983, p. 183) • For example, one study showed significantly more manic-depressive patients than controls were found to have HLA-A3, HLA-B7, HLA-Bw16, while significantly fewer had HLA-B8. (Locke, 1983, p. 185) • Beta-adrenergic receptors were studied in vitro in lymphocytes obtained from patients with major affective disorders and controls. Results indicated decreased lymphocyte beta receptor functioning in depression and mania. This decrease may be an index of changes in brain beta receptors in mania and depression, or may simply reflect homeostatic regulation of peripheral beta receptors in response to stress induced increase in circulating catecholamines. (Locke, 1983, p. 166)

• Liver ~ Gan is the home of the Hun (Ethereal Soul); it relates to decisiveness, control, and the principle of emergence; stores and cleanses the Xue (Blood); maintains smooth flow of Qi and Xue (Blood); opens into the eyes; expresses itself in the nervous system; and reflects emotional harmony and movement. » Healthy expressions are kindness, spontaneity, and ease of movement. » Liver Xu (Deficiency) signs include impotence; frigidity; pain in thighs, pelvic region, and throat; ready tendency to "the blahs" (Seem, p. 28); timidity; depression; irritability; vertigo; pruritus; dry eyes, skin, and/or tendons; asthma; aching at the waist; hernia; and difficulty raising head up and down. Liver Yin Xu (Deficiency) predisposes to the Shi (Excess) conditions of Liver Wind, Liver Yang Rising, and Liver Fire Blazing. » Liver Qi Stagnation reflects and accentuates emotional constraint as the Liver's function of facilitating smooth flow in the body is constricted. Stagnation is associated with frustration, irritability, tension, and feeling stuck. With time this pattern tends to produce a gloomy emotional state of constant resentment, repressed anger or depression, along with tightness in the chest, frequent sighing, abdominal tension or distension, and/or a feeling of a lump in the throat with difficulty in swallowing. (Maciocia, p. 216) » Liver Shi (Excess) signs include discontent; anger; priapism; pain in lumbar region and genitals (Seem, p. 28); muscular tension; excessive sex drive; insomnia; moodiness; excitability; genital diseases; red, tearing eyes; compulsive energy; and bitter taste in the mouth. » Liver Wind derives from Liver Yin Xu (Deficiency) and/or Liver Xue Xu (Blood Deficiency) and their subsequent inability to embrace the Yang, and can manifest as joint stiffness, dizziness, tremor, paralysis, convulsions, rashes, itching, and neurological problems.
 * Chinese psychophysiology:**

• Heart ~ Xin houses the Shen (Spirit) and reveals itself through the brightness in the eyes; governs Fire and Heat; rules the Xue (Blood) and its vessels and directs the circulation; opens into the tongue and controls speech; and relates to the integration of the organs and the personality. » Healthy expressions are warmth, vitality, excitement, inner peace, love, and joy. » Heart Xu (Deficiency) signs include sadness; absence of laughter; depression; fear; anxiety; shortness of breath (Seem, p. 28); cold feeling in the chest and limbs; palpitations; cold sweat; inability to speak; memory failure; nocturnal emissions; and restless sleep. Yin Xu (Deficiency) predisposes to Empty Fire, acute and chronic. » Heart Shi (Excess) signs include false or facile laughter; sobbing; agitated spirit; insomnia (Seem, p. 28); frightful dreams; anxiety; tongue feels numb and heavy; heavy chest; hot sweat; and orange-colored urine. » The Heart is the Emperor of the bodily realm so that when the Heart is disturbed all the other organs will be disrupted. » Mental signs of Heart channel disorders include insomnia, anxiety, and all Shen disturbances. (Seem, p. 28)

• Pericardium ~ Xin Bao is the Minister who protects the Heart, the Emperor, and maintains the order of the Heart energy; and as such may be adversely affected by emotional stresses internally or invasion of Heat externally. The Pericardium is said to be the origin of joy and sadness. » Healthy expressions are joy, happiness, and healthy relationships. » Weakness, dysfunction, and illness are associated with confusion, delirium, nervousness, and psychosis. » Mental signs of Pericardium channel disorders include depression, sexual perversion, aversions, and phobias. (Seem, p. 28)

» Mental signs of Triple Warmer channel disorders include emotional upsets caused by breaking of friendships or family relations; depression; suspicion; anxiety; and poor elimination of harmful thoughts. (Seem, p. 28)

» Mental signs of Spleen channel disorders include mental sluggishness; vertigo; melancholia; obsessions turned toward the past; fixed and rigid ideas; sleepwalking; agitated sleep; and nightmares. (Seem, p. 27)

» Mental signs of Stomach channel disorders include depression; death wishes; instability; suicidal tendencies; mentally overwrought; doubt; suspicions; tendency to mania; and slowness at assimilating ideas. (Seem, p. 27)

• Kidney ~ Shen stores Jing (Essence) and governs birth, growth, reproduction, development, and aging; houses the Zhi (Will); expresses ambition and focus; produces the Marrow which generates the spinal cord and "fills up" the brain; nourishes the brain to sustain concentration, clear thinking, and memory; carries the constitutional endowment from the parents; and displays the effects of sexual dissipation, overwork, chronic degenerative processes, and extreme stress; likewise any severe disturbance in the complementary relationship between the Kidney and Heart expresses itself in emotional dys-stress. » Healthy expressions are gentleness, groundedness, and endurance. » Kidney Xu (Deficiency) signs include indecisiveness; confused speech; dreams of trees submerged under water; cold feet and legs; abundant sweating (Seem, p. 28); fearfulness; apathy; chronic fatigue; discouragement; scatteredness; lack of will; negativity; impatience; difficult inhalation; low sex drive; lumbago; sciatica; and musculoskeletal irritation and inflammation, especially when worse from touch. As always, Yin Xu (Deficiency) predisposes to Empty Fire. » Intense or prolonged fear depletes the Kidney. Often chronic anxiety may induce Xu (Deficiency) and then Fire within the Kidney. (Maciocia, p. 250) Overwork, parenting, simple aging, and a sedentary or excessively indulgent lifestyle all contribute significantly to Kidney Xu (Deficiency). » Mental signs of Kidney channel disorders include anxiety, fear in the pit of the stomach; sadness; mental and physical fatigue; antisocial tendencies; and laziness. (Seem, p. 28)