Maniaaccording to TCM

What is mania?

Mania is a severe psychological state characterized by abnormally elevated mood, energy, and arousal. It is most commonly associated with bipolar disorder, where it alternates with periods of depression. During a manic episode, individuals may experience euphoria, increased self-esteem, decreased need for sleep, racing thoughts, and engage in risky or impulsive behaviors. They often display heightened productivity or creativity, but this can quickly become disorganized and unfocused.

Manic episodes can last from several days to several months and may require hospitalization to ensure the person's safety. The intensity of symptoms can vary, with some experiencing hypomania, a milder form of mania. Left untreated, mania can lead to severe personal and professional consequences, including damaged relationships, financial troubles, and in some cases, psychotic symptoms such as delusions or hallucinations.

How does TCM view mania?

Traditional Chinese Medicine (TCM) approaches mania from a holistic perspective, viewing it as a manifestation of imbalance within the body's energy systems. Unlike Western medicine's focus on brain chemistry and neurotransmitters, TCM considers mania a result of disrupted Qi flow and disharmony among various organs, particularly the Heart, Liver, and Gallbladder. In TCM, mania can stem from multiple patterns of disharmony, each requiring a unique treatment approach. This individualized perspective emphasizes the importance of identifying the specific underlying pattern before initiating treatment, as addressing the root cause is crucial for restoring balance and alleviating symptoms.

Root Causes of Mania in TCM

In Traditional Chinese Medicine, mania is often attributed to imbalances involving Heat and Blood. One primary pattern associated with mania is Heat victorious agitating Blood. In TCM theory, excessive Heat in the body can cause Blood to move recklessly, leading to symptoms such as restlessness, high fever, and manic behavior. This pattern may also manifest with physical symptoms like nosebleeds or vomiting blood, illustrating the comprehensive nature of TCM diagnosis.

Another significant pattern in TCM that can contribute to mania is Heart Blood Stagnation. The Heart, in TCM, governs the mind and houses the Shen (Spirit or consciousness). When Blood stagnates in the Heart, it can lead to emotional disturbances, including manic episodes. This pattern often presents with symptoms like chest pain and a feeling of constriction in the chest, alongside the psychological manifestations of mania. It's important to note that TCM recognizes various other patterns that can contribute to mania, each requiring a tailored approach to treatment.

Explore below more details about what might cause Mania according to TCM.

Blood Stasis

Blood Stasis in TCM is a concept where the blood flow in the body is not as smooth or efficient as it should be. Imagine a river that's supposed to flow freely, but instead, it's getting blocked or moving too slowly in some parts. This can lead to various health issues, like pain that feels sharp or stabbing, dark bruises, and a complexion that looks purplish. TCM believes that good health relies on the smooth and vibrant flow of Qi and blood throughout the body, so when blood gets stuck, it's like a traffic jam in your body, leading to discomfort or health problems.... see more

Blood Stasis Patterns That Can Lead to Mania

Pattern Name	Relevant Symptoms	Relevant Formulas
Heart Blood Stagnation	Mania, Stabbing chest pain, Chest constriction, Stifling sensation in the chest	Xiao Tiao Jing Tang

Mind Disturbance

In TCM "Shen" refers to the mind or spirit, and a Shen disturbance is a pattern of disharmony that affects the mental and emotional state. This concept reflects the TCM belief in the deep interconnectedness of mind and body. Symptoms of Shen disturbance can vary widely but often include anxiety, insomnia, restlessness, confusion, or in severe cases, hallucinations or delirium. These symptoms indicate an imbalance in the body's energies affecting the heart, which in TCM is not only the center of blood circulation but also the seat of the mind and consciousness. The root of Shen disturbance can be traced to various factors, including emotional stress, physical illness, or an imbalance in fundamental substances like Qi, Yin, or Yang.... see more

Mind Disturbance Patterns That Can Lead to Mania

Pattern Name	Relevant Symptoms	Relevant Formulas
Heat victorious agitating Blood	Manic behavior, Restlessness, High fever, Mania, Macules, Vomiting blood, Nosebleeds, Hematochezia, Hematuria... see more	Xi Jiao Di Huang Tang

Heat

In TCM "Heat" signifies an excess of Yang energy, leading to an imbalance where heat predominates over the body's cool Yin aspects. This condition is metaphorically akin to an internal over-heating. Symptoms indicative of Heat can include feelings of warmth, fever, sweating, irritability, red face, thirst with a preference for cold drinks, and a rapid pulse. The tongue may appear red with a yellow coating. Unlike the common interpretation of heat in terms of temperature, in TCM, it represents a state of hyperactivity or inflammation in the body.... see more

Heat Patterns That Can Lead to Mania

Pattern Name	Relevant Symptoms	Relevant Formulas
Heat victorious agitating Blood	Manic behavior, Restlessness, High fever, Mania, Macules, Vomiting blood, Nosebleeds, Hematochezia, Hematuria... see more	Xi Jiao Di Huang Tang

Heart

In TCM the Heart is considered the "emperor" of all organs, primarily responsible for governing Blood and housing the mind, known as "Shen." It plays a crucial role in maintaining mental-emotional equilibrium and controlling the circulation of Qi and blood throughout the body. When the Heart is imbalanced or malfunctions in TCM, it can lead to a range of issues like heart palpitations, insomnia, dream-disturbed sleep, anxiety, and a flushed complexion. Emotional disturbances such as excessive joy or lack of joy are also seen as signs of Heart disharmony. These symptoms reflect not just physical heart conditions but also the state of one's Shen, indicating the interconnectedness of physical and emotional well-being in TCM.... see more

Heart Patterns That Can Lead to Mania

Pattern Name	Relevant Symptoms	Relevant Formulas
Heart Blood Stagnation	Mania, Stabbing chest pain, Chest constriction, Stifling sensation in the chest	Xiao Tiao Jing Tang

TCM Herbal Formulas for Mania

Traditional Chinese Medicine offers herbal formulas tailored to address the specific patterns underlying mania. For Heat victorious agitating Blood, Xi Jiao Di Huang Tang may be recommended. This formula belongs to the category of "Formulas that clear nutritive-level Heat" and features Water Buffalo Horns (Shui Niu Jiao) as a key herb. Shui Niu Jiao is known for its powerful cooling properties, helping to clear Heat and calm the agitated Blood.

For patterns involving Heart Blood Stagnation, Xiao Tiao Jing Tang might be prescribed. This formula falls under the category of "Formulas that regulate Blood" and includes White Peony Roots (Bai Shao) as a primary ingredient. Bai Shao is valued for its ability to nourish Blood and soothe the Liver, potentially helping to resolve Blood Stagnation and calm the Mind. It's essential to consult with a qualified TCM practitioner for proper diagnosis and personalized treatment, as the choice of formula depends on the individual's specific pattern of disharmony.

Explore below some TCM herbal formulas used to address mania, organized by cause and by formula type.

Top Formula for Blood Stasis:
Xiao Tiao Jing Tang

Suitable for Blood Stasis patterns that may cause mania, such as Heart Blood Stagnation

Learn more

Top Formula for Mind Disturbance:
Xi Jiao Di Huang Tang

Suitable for Mind Disturbance patterns that may cause mania, such as Heat victorious agitating Blood

Learn more

Top Formula for Heat:
Xi Jiao Di Huang Tang

Suitable for Heat patterns that may cause mania, such as Heat victorious agitating Blood

Learn more

Acupoints for Mania

Acupuncture plays a crucial role in TCM's approach to mania. Key points include Fengfu DU-16 on the Governing Vessel, known for its ability to expel Interior and Exterior Wind and calm the Mind. Benshen GB-13 on the Gallbladder Channel is valued for its capacity to calm the Mind, gather Essence to the Brain, and subdue Liver Yang Rising. In the Pericardium Channel, Neiguan P-6 is noted for its ability to invigorate Qi and Blood in the chest and calm the Mind.

Tianshu ST-25 on the Stomach Channel is recognized for regulating the Intestines, Stomach, and Spleen, as well as calming the Mind. Lastly, Tianzhu BL-10 on the Bladder Channel is known for its ability to pacify Interior Wind, subdue Liver Yang, and calm the Mind. These acupoints, when stimulated by a skilled practitioner, work in harmony with herbal treatments to address the underlying imbalances contributing to mania, offering a comprehensive approach to managing this complex condition.

Explore below some acupoints used to address mania, organized by meridian.

Shenzhu DU-12

On the back midline, in the depression below the spinous process of the 3th thoracic vertebra (T3).

Fengfu DU-16

Directly below the external occipital protuberance, in the depression between the origins of the trapezius muscle.

Naohu DU-17

1.5 cun above Fengfu DU-16 or 2.5 cun above the posterior hairline, in a depression superior to the external occipital protuberance.

Houding DU-19

On the head midline, 1.5 cun above Qiangjian DU-18 or 1.5 cun posterior to Baihui DU-20.

Shenting DU-24

On the head midline, 0.5 cun above the anterior hairline.

Taiyi ST-23

2 cun above the umbilicus, 2 cun lateral to the anterior midline.

Tianshu ST-25

2 cun lateral to the center of the umbilicus.

Zusanli ST-36

3 cun below Dubi ST-35, one finger breadth lateral to the anterior crest of the tibia, on the tibialis anterior muscle.

Jiexi ST-41

At the junction of the dorsum of the foot and leg, between the tendons of extensor digitorum and the extensor hallucis longus muscle. Approximately at the level of the tip of the external malleolus.

Tianchong GB-9

Posterior and superior to the auricle, about 0.5 cun posterior to Shuaigu GB-8.

Wangu GB-12

In the depression posterior and inferior to the mastoid process.

Benshen GB-13

0.5 cun within the hairline of the forehead, at the junction of the medial two-third and lateral third of the distance from Shenting DU-24 to Touwei ST-8.

Zhengying GB-17

1 cun posterior to Muchuang GB-16 or 2.5 cun posterior to the anterior hairline.

Jianshi P-5

3 cun above the transverse crease of the wrist, between the tendons of palmaris longus and flexor carpi radialis muscle.

Neiguan P-6

2 cun above Daling P-7 on the transverse crease of the wrist, between the tendons of palmaris longus and flexor carpi radialis muscle.

Daling P-7

In the depression in the middle of the transverse crease of the wrist, between the tendons of palmaris longus and flexor carpi radialis muscle.

Laogong P-8

In the center of the palm, between the 2nd and the 3rd metacarpal bones, proximal to the metacarpophalangeal joint.

Yuzhen BL-9

First identify Naohu DU-17 which is on the superior border of the external occipital protuberance. Yuzhen BL-9 is 1.3 cun lateral to Naohu DU-17.

Tianzhu BL-10

1.3 cun lateral to Yamen DU-15 on the posterior midline, 0.5 cun above the posterior hairline, on the lateral side of trapezius muscle.

Feishu BL-13

1.5 cun lateral to the lower border of the spinous process of the 3rd thoracic vertebra (T3).

Shenmai BL-62

In the depression directly below the lateral malleolus tip.

Yongquan KID-1

In the depression between the 2nd and 3rd metatarsal bones on the sole when the foot is in plantar flexion, approximately at the junction of the anterior and middle third of the sole.

Dazhong KID-4

Posterior and inferior to the medial malleolus, in the depression medial to the Achilles tendon, superior to its insertion at the calcaneus.

Zhubin KID-9

On the line drawn from Taixi KID-3 to Yingu KID-10. It is located at the lower end of the belly of gastrocnemius muscle in the medial aspect, about 5 cun above Taixi KID-3.

Yangxi LI-5

On the radial side of the wrist. When the thumb is tilted upward, it is in the depression on the wrist joint space (wrist crease) between the tendons of extensor pollicis longus and brevis muscles.

Wenliu LI-7

When a fist is made, with the ulnar side downward and elbow flexed, the point is 5 cun above Yangxi LI-5 at the wrist crease, 1 cun distal to the midpoint of the line joining Yangxi LI-5 and Quchi LI-11.

Xialian LI-8

When a fist is made, with the ulnar side downward and elbow flexed, the point is 4 cun distal to Quchi LI-11 of the line joining Yangxi LI-5 and Quchi LI-11.

Yanggu SI-5

On the ulnar side of the wrist, in the depression between the styloid process of the ulna and the triquetral bone.

Tianchuang SI-16

In the lateral aspect of the neck, on the posterior border of sternocleidomastoid muscle, lever with the Adam's apple.

Tianjing TB-10

When the elbow is flexed, Tianjing TB-10 is in the depression about 1 cun superior to the olecranon.

Xiaoluo TB-12

On the line joining the olecranon and Jianliao TB-14, midway between Qinglengyuan TB-11 and Naohui TB-13, 5 cun proximal to the olecranon. It is just on the lower end of bulge of the lateral head of triceps brachii when the forearm is in pronation.

Shaohai HE-3

When the elbow is flexed slightly, Shaohai HE-3 is at the medial end of the transverse cubital crease, in the depression radius to the medial epicondyle of the humerus.

Xingjian LIV-2

Between the first and second toe, on the dorsum of the foot, 0.5 cun proximal to the interdigital fold.

Yuji LU-10

On the radial aspect of the midpoint of the first metacarpal bone, on the junction of the red and white skin (the junction of the dorsum and palm of the hand).