The following is adapted from one lesson in my new course. I love this example of unity between ancient and modern ways of knowing, so I wanted to share it.
Herbal Remedies
From the topic “Cultural Differences” in the chapter “Depression”
In traditional Chinese medicine (TCM) practitioners believe depression is caused by a lack of vital energy (qi) which is the result of an imbalance in the five elements. TCM aims to treat depression, therefore, by restoring these imbalances. One way it does this is through herbal remedies. This is when herbs and plants are crushed into a powder, brewed like a tea, or made into a pill. While these are mostly made from herbs and plants, they’re sometimes animal products. For example, the velvet from a deer’s antler is a remedy that is mostly taken as a pill. Some are controversial, like tiger bones or bear bile, which can be made into powder, tonic or pills.
The five element theory is the cornerstone of traditional Chinese medicine.
For treating depression a common herbal remedy in TCM is Kaixinsan (aka Kai-Xin-San, or KXS). This is made by combining different herbs (one is ginseng) and herbs are dried and crushed into a powder, boiled in water to make a hot drink or made into a pill. KXS is based on the five elements theory as it treats problems with the heart (fire) and spleen (earth).
But does it work? Traditional ways of knowing is based on trusting ancient wisdom passed down through generations. We can, therefore, know that it works by trusting this wisdom. However, TCM has been criticised for being pseudoscientific because it’s not based on scientific evidence. Therefore, modern Chinese psychologists (and others) have started to run randomised clinical trials on KXS to see if it works or if it’s just a placebo. The results from these experiments show that it’s not just a placebo – KXS significantly reduces depression. Meta-analyses of these experiments show the results are consistent and that KXS is an effective drug for treating depression.
But is it better than an SSRI? There’s only one way to find out….a randomised, double-blind, placebo-controlled experiment.
The aim of this experiment was to compare KXS with an SSRIs to see which is better for treating depression. The participants had mild to moderate depression. Half were given KXS and an SSRI placebo. The other half were given the SSRI (fluoxetine) and a KSX placebo. In other words, both groups believed they were taking both medications but only one of them was the actual medicine. The results showed that KXS reduced depression after 8 weeks of treatment. There was also no significant difference between the KXS and SSRI group. The results show that KXS is just as effective for treating people with mild to moderate depression. (Hu et al.)
Traditional knowledge and modern science have combined to show that the traditional herbal remedy KXS is effective in treating depression. Now we know that it does work, we can use modern science to go deeper into understanding why it works.
Kaixinsan is made from ginseng root and other herbs.
KXS’s effect on depression might be explained by its effect on neurotransmitters. Animal and human studies have shown that it affects levels of the monoamine neurotransmitters – dopamine, noradrenaline and serotonin. Other studies have shown that it increases tryptophan in the blood. Remember that tryptophan is the building blocks of serotonin. Without tryptophan, the body can’t produce serotonin. We know that tryptophan comes from our food, so it’s logical that herbs like ginseng might affect tryptophan and neurotransmitter levels.
It seems like traditional Chinese medicine practitioners were addressing the monoamine hypothesis of depression thousands of years before Western doctors even knew about it. The study of traditional Chinese medicine through empirical studies is, in my mind, a wonderful example of the combination of traditional knowledge and modern science. In some countries, especially post-colonial countries like my own New Zealand, there is conflict and distrust between ancient and modern ways of knowing. Instead of division, I love the see the unity shown in the research above. Why not take ancient knowledge and put it through the scientific method? Unite both ways of knowing to develop a deeper understanding of mental health and psychology.
I love when cultural ideas unite. Perhaps that’s my own bias as my East and West interracial marriage is such an important of my life.
References
- Li C, Huang J, Cheng YC, Zhang YW. Traditional Chinese Medicine in Depression Treatment: From Molecules to Systems. Front Pharmacol. 2020 May 7;11:586. doi: 10.3389/fphar.2020.00586. PMID: 32457610; PMCID: PMC7221138.
- Yang Y, Chen YK, Xie MZ. Exploring the transformative impact of traditional Chinese medicine on depression: Insights from animal models. World J Psychiatry. 2024 May 19;14(5):607-623. doi: 10.5498/wjp.v14.i5.607. PMID: 38808079; PMCID: PMC11129158
- Kwon CY, Kim H, Kim SH. The Modernization of Oriental Music Therapy: Five-Element Music Therapy Combined with Artificial Intelligence. Healthcare (Basel). 2024 Feb 5;12(3):411. doi: 10.3390/healthcare12030411. PMID: 38338296; PMCID: PMC10855257.
- Yan, L., Wei, M., Gong, A. G., Song, P., Lou, J., Bi, C. W., Xu, S. L., Xiong, A., Dong, T. T., & Tsim, K. W. (2017). A Modified Chinese Herbal Decoction (Kai-Xin-San) Promotes NGF-Induced Neuronal Differentiation in PC12 Cells via Up-Regulating Trk A Signaling. Frontiers in cell and developmental biology, 5, 118. https://doi.org/10.3389/fcell.2017.00118
- Li, J. L., Lin, L., Wu, M. M., Zhang, J. Y., Zhang, Y. X., Cao, M. R., & Wang, L. (2024). A meta-analysis of the efficacy and safety of the traditional Chinese medicine formula Kaixinsan decoction for depression. Medicine, 103(1), e36719. https://doi.org/10.1097/MD.0000000000036719
- Hu, Y., Chen, C., Wang, Y., Yang, W., Wang, Y., Zhu, W., Yan, C., & Liu, P. (2021). The effects of KaiXinSan on depression and its association with lipid profiles: A randomized, double-blinded, placebo-controlled trial. Phytomedicine : international journal of phytotherapy and phytopharmacology, 83, 153467. https://doi.org/10.1016/j.phymed.2021.15346
- Hu, Y., Wang, Y., Chen, C., Yang, W., Zhu, W., Wang, Y., & Liu, P. (2021). A randomized, placebo-controlled, double-blind study on the effects of SZL on patients with mild to moderate depressive disorder with comparison to fluoxetine. Journal of ethnopharmacology, 281, 114549. https://doi.org/10.1016/j.jep.2021.114549
Travis Dixon is an IB Psychology teacher, author, workshop leader, examiner and IA moderator.