Mental health and Trauma Care

Medications in mental healthFunctionPathwayRelated disoders
Neurotransmitterschemical messengers in brain that replay signals between neurons
play a roole in bodily functions, and emotions.
Serotoninregulates mood, appetite, sleep, memory, and learning.GI tract/Enteric N.S.,Depression, Anxiety disordes, OCD, types of migraines
digestion, sleep-wake cycle, and circadian rythms
feeling of well being and happiness
Norepinephrine (Noradrenaline)hormone and neurotransmitter, in brain for attentiveness, emotions,BrainstemDepression, Anxiety, ADHD, hypertension
sleep, dream, learn. Fight-flight, triggered in stress.
Dopaminereward and pleasure center, movement, emotional responsereward, motivation, and addictionParkinson’s, schizophrenia, addiction
pleasure and pain, high level- euphoria and bliss.
      
mechanismCommon examplesUsesSide effects
SSRI:Inhibit reuptake of seratonin, increases seratonin in synapseProzac, zoloft, Celexa, LexaproDepression, Anxiety, PTSD, OCDsexual dysunciton, nausea, headache, insomnia
Selective Serotonin Reuptake inhibitorsImprove mood, reduce depression
NDRI:block euptake of norephinephrine and dopamine, increasing theWellbutrinDepression, smoking cessation, ADHDseizures, insomnia, dry mouth, sexual (mild)
Norepinephrine-Dopamine Reuptake Inhibitorslevels in the brain, enhance alertness, energy, concentration
SNRI- Serotonin-Inhibit reuptake of serotnin and norephinephrineEffexor, Cymbalta, Pristiqmajor depressio, GAD, fibromyalgia, neuropathic painnausea, sexual dysfunction, increase BP
Norepinephrine Reuptake Inhibitorsaffects mood and attention in brain    
Top 25 psychiatric drugs of 2020
Substance name/Brand nameindicationMechanismSide effectcontraindicationmarket
Sertraline (Zoloft)DepressionSSRI (Selective seritonin reuptake inhibitor)sexual dysfunctionMAOi use38.22 million prescriptions
Escitalopram (Lexapro)Depression and AnxietySSRI (Selective seritonin reuptake inhibitor)dry mouthconcurrent pimozide work30.6 million prescriptions
Bupropion (Wellbutrin)DepressionNDRI (Norepinephrine-Dopamine Reuptake Inhibitors)InsomniaSeizure disorders28.9 million prescriptions
Amphetamine/Dextroamphetamine (Adderall)ADHDCNS stimulantincrease heart rateHeart conditions26.24 million prescriptions
TrazodoneDepressionSARI (Serotonin antagonist and reuptake inhibitor)DrowsinessRecent MI26.21 million
Fluoxetine (Prozac)Panic disorders and depressionSSRI (Selective seritonin reuptake inhibitor)InsomniaMAOi use23.4 million
Duloxetine (Cymbalta)Depression and AnxietySNRI (Serotonin-Norepinephrine reuptake Inhibitor)NauseaHepatic impairment22.5 million
Citalopram (Celexa)DepressionSSRI (Selective seritonin reuptake inhibitor)QT prolongationCongenital long QT syndrome18.55 million
Alprazolam (Xanax)Anxiety and panic disorderBenzodiazepinesedationacute glaucoma16.78 million prescriptions
Methylphenidate (Concerta)ADHDCNS stimulantInsomniasevere anxiety15.45 million
Venlafaxine (Effexor)Depression and AnxietySSRI (Selective seritonin reuptake inhibitor)NauseaRenal impairment15.02 million
Clonazepam (Klonopin)Panic disordersBenzodiazepineDrowsinessliver disease14.76 million
Buspirone (Buspar)AnxietyAzapironedizzinessRenal impairment14.75 million
Lamotrigine (Lamictal)Bipolar disorderAnticonvulsantRashhypersensitivity to lamotrigine10.8 million
Quetiapine (Seroquel)Bipolar disorder and SchizophreniaAtypical AntipsychoticsedationHepatic impairment10.6 million
Lorazepam (Ativan)anxiteyBenzodiazepinesedationrespiratory insufficiency10.56 million
Clonidine (Kapvay)ADHDAlpha-2 AgonistDrowsinesscoronary artery disease9.87 million
Amitriptyline (Elavil)DepressionTCA (tricyclic antidepressants)dry mouthrecent MI9.09 million
Paroxetine (Paxil)Depression, OCD, panic disordersSSRI (Selective seritonin reuptake inhibitor)sexual dysfunctionMAOi use9.03 million
Lisdexamfetamine (Vyvanse)ADHA, binge eatingCNS stimulantDecrease appetitecardiovascular disease8.64 million
Aripiprazole (Abilify)Depression and BipolarAtypical Antipsychoticweight gainMAOi use8.27 million
Mirtazapine (Remeron)DepressionNaSSA (Noradrenergic and specific serotonergic antidepressant)weight gainMAOi use6.6 million
Diazepam (Valium)Anxiety and alcohol withdrawlBenzodiazepinesedationrespiratory insufficiency4.97 million
Dexmethylphenidate (Focalin)ADHDCNS stimulantInsomniasevere anxiety4.8 million
Oxcarbazepine (Trileptal)Bipolar disorderAnticonvulsantdizzinesshypersensitive to oxcarbazepine4.28 million
Counseling and Psychotherapy
Freudian Psychoanalysis therapyUnconscious mind, dream analysis and transferenceFree association- talk freely in theapy to find issuesTransference- project feeling onto therapistEarly childhood experience shape us
(3) id- pleasure principle/desire, Ego- between id and super ego,Dreams are a road to unconsciusCountertransference
super ego- moral standards. 3 Unresolved leads to mental distress.
Jungian Psychoanalysis therapyCollective consciousness, archtypes, individuation.Archtypes to better understand our place in the worldTherapist as a guide to navigate unconscious material.
(analytical psychology)Balanace conscious/unconscious, personal growth and self-realizationDreams as guide for growth and self-awarenessUnderstanding our shadow/darker side for inner peace.
Adlerian therapyOvercome inferiotiry and achieve sense of belonging4 stages: theraputic realtionship, psychological dynamicEncouragement is emphasized for postive change.
compenation: from inferiority to mastery.self insight, re-educate self,Goal oriented therapy. Individual find insights.
Person Centered TherapyClient capacity for self-direction and personal growthdevelp a a positive and authentic self-conceptNon-directive, therapist does not give advice.
(Rogerian therapy)Individual inherent tendency toward self-actualizationempathy, positive regard, congruenceCompassionate and empowering approach.
Gestalt Therapyperonsli responibility, present moment, and human experienceAwareness key to growth and well beingEmpty chair therapy- talk to person or selfUnfinished business- 
aims to increase awareness, freedom, and self-directionaware of thoughts, feelings, actionsExperiements: role-pay, guided imagery, body movementto complete emotions by addressing them
Cognitive behavioral therapy (CBT)Thoughts, feelings and behaviors are interconnectedCognitive restructuring-challenging thoughts to balanced onesBehavior activate- depressed to engage in activities.
changing negative thought can lead to changes in feelings and behaviorExposure therapy- for phobiasHomewaork assignments.
helps wide range: depression, anxiety,eating, addiction, ptsdmindfulness and accptance based strategies.
Dialecticl Behavioral therapyfor borderline, eating, depression , addiction, PTSDEmotion regulation. Skills to manage emotionsDialectical: balance accpetiance of clients behavior
CBT and eastern mindfulness practices4: mindfulness, distress tolerance, emotion regulationand experiences and effort to change them.
Interpresonal effectiveness.
Mindfulness as psychotherapy.MBSR mindfulness based stres reductionFocus on present moment, break habitual patterns, stress,MBCT Mindful based cognitive therapy
patient more awar eof mind, thoughts emotions, bodily sensationsreduce symptoms of anxiety and depressionbody scan, sitting, mindful movment, eating, and walking.
ACT: acceptance and commitment therapy: accept thoughts/feelingsBest when tailored to the individual.
Creative Art therapyartisitic activty to support emotional, cognitive, social well being.Art therapy as communicationand self-explorationDance (DMT), good for those who cannot verbally express.Music: listening to music, singing, playing
(Art, Dance/movement, Music)facilitate healing and personal growthtrauma, anxiety , depression, safe space- self expressiongood for mental health, development issues,instruments, composing.
physical disabilites, depression/anxiety, body image,reduce pain, anxiety, mood, cognitive funciton
 self-esteem, social functioningAlzheimers- trigger memories, communication
Play therapyChildren explore feelings, express, make sense of lifeNon-directive: child leads the playVery effective for children
behavioral problems, anxiety, depresion, trauma, grief, conductDirective: therapist leads the palytherapist must build rapport an trust.
Animal-assisted therapyDogs, horses, dolphins animal bond to reduce stress and anxietyGood for Autism
lowr cortisol and increase oxytocinFosters emotional healing
      
Opioid Crisis
2017- 130 americans die each daymost common: oxycodone, hydrocodone, codein, and morphine21-29% of opioid users are addicted.
Depression in Women
Premenstrual Dysphoric Disorder (PMDD)Premenstrual Syndrome (PMS)
mental disorder is secondary to hormonal changesA hormone syndrome
Extreme Sadness to HopelessnessFeeling down or depressed
Suicidal thoughts are PresentNo suicidal thoughts
Mostly mental symptomsMosty Physical symptoms
Intense mood swingsMood changes
Affects interpersonal relationships, work, and hobbiesAffects the usual daily routine
Doubles the risk of Post Partum DepressionAround 9% more likely to be affected by postpartum Depression  
Premenstrual syndrome (PMS)
Symptoms begin 2 to 10 days before menstruation and disappear right before or after menstration
Repetitive and periodic physical, emotional, and behavioral symptoms
20-50% of reproductive-age women and about 10% of them have very severe symptoms
Symptoms startt o ease at 35 and disappear with menopause.
Physical symptoms:Fatigue, headache, low back pain, breast pain, swelling, indigestion, pelvic pain
Weight gain, Acne, Muscle pain, Craving salty and weet foods
Emotional and Behavioral Symptoms:Anxiety, Restlessness,  tension, depression, mood changes, isolation, hostility
 decreased concentration, aggressive tendencies, destructive impulses, suicidal attempts  
Premenstrual Dysphoric Disorder (PMDD) N94.3. DSM-5Mood lability, irritability, dysphoria, anxiety symptoms that occur repeatedly
 during the premenstrual phase and remit around the onset of menses or after  
Postpartum Depression (PPD)
About 15% of woemn after childbirth
4 weeks postpartum with symptoms improving approximately 3 to 6 months.
Symptoms:Depressed mood or severe mood swings, difficult bonding with baby,
 insomnia, sleeping too much, fatigue. Loss of appretite, eating too much
25% can persist up to a year, it can transition into Depression.
F53 Mental and Behavioral disorders associated with puerperium not elsewhere classified
F53.0 Mild Mental and Behavioral disorders associated with puerperium not elsewhere classified
F53.1 Severe Mental and Behavioral disorders associated with puerperium not elsewhere classified
F53.8 Other Mental and Behavioral disorders associated with puerperium not elsewhere classified
F53.9 Puerperium mental disorder, unspecified   
Postpartum Blues:
85% of women may experience feelings o f Depression.
2 to 3 days after childbirth, it improves in about 2 weeks, mostly in a few hours.
Mostly it naturally resolves, but there is possibility to transitioning into PPD.
Symptoms:Mild Dysfunction, No suicidal thoughts, lasts less than 10 days  
Depression   
PatternsSymptomsTreatmentAcupuncture and Herbal Notes
Liver Qi stagnationdepression, moodiness, frustration, feeling uptight, hypochondrial pain, insomnia, anxietyPc6, Liv3, GB34, TB3, GB13, BL47, GV20Liv3, Li4, HT7, PC6
muscles aches of neck, shoulders, abdominal distenson, iregular bowel, PMS, wiry pulseforumula- liver and sp stagnaiton, blood and qi stagnation. Deficiency
 Tx: soothe liver, move qi, elimate stagnationChai Hu Shu Gan Tang. Xiao Yao SanYu syndrome: also Jia wei xiao yao san (transfrom to fire qi). 10%
Phelgm-Heat harassing mindDepression, anxiety, agitation, restless sleep, dreaming, insomnia, palpitationsCV12, BL20, ST40, SP9, SP6, PC5, PC6, GB24, GB17, GB20
heaviness in head, dizziness, phlegm, nausea, bitter taste, red swollen, sticky coating tongueWen Dan Tang3%
Slippery-rapid pulse
 Tx: resolve phlegm, clear heat, open orifices  
Qi Stagnation with PhelgmDepresision, moodiness, throat blockage like foreign body, difficult swallow,ST40, Ren12, BL20, SP9, SP6, TB6, Liv3, Du21, Du20
signing, chest oppression, hypochondrial pain, PMS, neurosis, insomniaBan Xia Hou Po TangYu syndrome
 swollen tough/sticky coat, wiry or slippery pulse formula- actives qi, disprese stagnation, drive qi down, dissolve phlegm
Worry Injuring the Minddepression , mental confusion, feeling absent, anxiety, no desire, LU9, Lu3, Du12, Ren6, HT5, ST36, BL20, BL49, Du20HT7, PC6, Jaili in corner of rthe mouth
insomnia, sadness, worry, crying, stretching, yawnsing, baby night cryGan Mi Da Zao Tangyu syndrome, 12.9%, deficiency
pale tounge/sticky coat, wiry pulseformula: nourish HT, calm shen, harmonize middle jiao
 tx: Nourish the heart and calm the mind  
Heart and Spleen DeficiencyDepression, excessive thinking, palpitations, difficult falling asleep, pale faceST36, SP6, BL20, BL21, Ren15, PC6, BL15, HT7, Du14, Du20
dizziness, poor appetite, anemia, anxiety, insomniaGui Pi tangYu syndrome, 2%, deficiency
Pale tongue/weak or choppy pulseformula: tonify qi, strengthen SP, nourish blood, calm shen
 tx: tonify spleen Qi, nourish heart-blood, calm the mind  
Yu SyndromeDepression: treatment is to regulate the Qi and releive stagnation.PC6, HT7, ST36, Du20, Liv3, SP6, Yintang,
Du24, GB20, Du14, Du11, Du9, sishencong
Liver and Gallbladder heat StagnationChai hu Jia Long Mu Li Tang7%
anxiety, insomnia, palpitatins, hypertension, headacheexcess
Gall Bladder Qi stagnationST40, GB34, Ren12
Calm the Liver and regulate liver qi and bloodYi Gan San2%
Regulate Qi and transform phlegmWu Zhu Yu Tang3%
Enrich Yin, Calm ShenTian Wang Bu Xin Wan6%
Liver and Kidney Yin DeficiencyKD3, BL18, SP6
 Fire rsing due to Yin deficencyKd3, Kd6 
Other Therapies
Qigongimproves depression, sleep scales, depressive symptoms, help physical and mental sx menopause
Meditationmindfulness without jedgement, MBCT for depression is validated
Relaxation therapyProgressive Muscle Relaxation (PMR) relaxes sympathetic nerve hyperactivity and manage stressqi and blood circulation
 Edmund Jacobson PMR and Johannes Heinrich Schultz Autogentic training  
Depression vs BiPolar disorder
depression in Bipolar people lasts longer and has high suicide rate compared to mania.
Bipolar has a physical factos rather than psychological, possible hereditary.
 Depression is higher in women but men and women both have equal in Bipolar.  
Anxiety and patternsSymptomsTreatments 
Heart and Gall Bladder deficiencypalpitaitons, anxiety, timid, frightened, lack of self assertion, discouraged, cannot sit or lie downHt7, Ht5, BL15, Ren14, GB40, ST36
insomnia, waking up early,An Shen Ding Zhi Wan
Pale tongue, weak pulse
 Tonify the heart and gall bladder, calm the mind  
Heart Blood DeficiencyPalpitations, anxiety, dizziness, pale face, insomnia, poor memory, tiredness,HT7, ren14, St36, Sp6
pale tongue, choppy /fine pulseGui Pi Tang
 Nourish heart blood, calm the mind  
Kidney and Heart deficiency with Empty heatPalpitations, Anxiety worse in evening, mental restless, insomnia, night sweat,HT7, Ren14, KD3, Ren4, SP6, HT6, KD7
heat in evening, 5 palm heat, dizziness, tinnitus,Tian Wang Bu xin Dan
Red tongue w/o coat, Floating-empty coat, rapid pulse.
 Nourish heart and kidney yin, clear empty heat, calm the mind  
Lung and Heart Qi StagnationPalpitations, anxiety, chest oppression, depression, throat lump, shortness of breathHT5, HT7, PC6, Ren15, Ren17, Lu7, ST40
sighing, sadness, epigastric distention, purples lips, pale complexionBan Xia Hou po tang
empty pulse
 Move qI in Heart and lung, relax the chest, calm the mind.  
Heart blood stasisPalpitations, anxiety, insomnia, agitation, memory poor, chest pain,HT5, PC6, Ren14, Ren14, Liv3, SP6
purple on sides of tongue, wiry-choopy-firm pulseTao Ren Hong Huan Jian
Invigorate heart blood, eliminate stasis, calm the mind.
Phlegm heat harassing the heartPalpitations, anxiety, insomnia, dreaming, chest oppression, sputum in throat, manic behavior,PC5, HT8, Ren12, ST40, ST8, GB13, Ren15, Du 24
 red and swollen tongue w/yelow coat, slippery-rapid pulse.Wen Dan tang 
Anxiety frequently usedDu20, PC6, HT7, sishencong, SP6, yintang, Du24, Liv3
Ear shenmen, heart, liver, endocrine
Qigong, meditation, relaxation therapy.
Yi Gan San: calm liver, relieve spasm, dispel heat, strengthen spleenanger issues, irritability, Dementia, Tic, menopause,
Wen Dan Tang: warm GB, regulate Qi, dissolve phlegm, clear heat GB, harmonize GB and ST“Treat mental problem” nourish GB, cold is something bad
Tian Wang Bu Xin Dan: nourish yin and tonify blood, tonify HT and KD, calm shen
 Chai Hu Gui Zhi Tang- harmonize and release shao yang, nourish blood, alleviates pain.poor appetite, sweating nausea, insomnia, ab pain w/stress 
DementiaSymptomsTreatment 
Kidney and Liver Yin Deficiencylow backand knee sore or cold, tinnitus, dream excessive, night sweats, visions decrease
eyes dry, hair losse, teeth decline, dizziness, 5 palm heat
Qi and Blood stasispersistem pain in one area of body, dark complexin and lips, easily irritated,
wake up from sleep easily, dry mouth, pain worse at night, bruise easil, skin rough and dry, peeling.
Phlegm turbidity obstructing the orificesHead heavy, abdominal rumbling, belching, nausea, palpitations, bloating, excessive saliva
lackluster complexion, fatigue, cough w/phlegm
Spleen and Kidney yang deficiencyPoor digestion, cold, limbs cold, pale face, fatigue, cold low abdoen, frequent diarrhea
difficult uringaiton, swelling in belly
Qi and bood deficiencyFatigue, dizziness, pale lips, loss of appetite, poor digestion, palpitaitons, shortness of breath
Increase of hair loss
Intense Fire heatQuick tempered, face flushed, restless, difficutl falling asleep, thirsty
 Dark urine, constipation, red eyes  
Dementia Prevention and managementEnjoy: Exercise, eating, reading
Abstain: moderate drinking, smoking,
actions: health check-ups, communication, early detection
Eat three meals a day, exercise as a lifelong hobby, becareful not to injure head
Treat depression, dementia prevention exercises, socialize frequently, get screened.
Management:Accient prevention, maintain good lighting, remove fall hazards, bathroom frequently to prevent
incontinence 2 hours, store medications in a safe place, kitchen safety, communication
 sexual behavior, get neighbors wupport contact info and key.  
AutismSymptomsTreatmentNotes
Kidney Essence Deficiencyweak body, fatigue organs, pale and thin, insufficient nutrition and language developmentDu20, sishencong, du24, gb13, Kd3
delayed growth, small stature, late fontelle closure, reduced intelligence, slow movementLiu wei Di huang tangenrich yin, nourish KD, clear deficiency heat, resolve damp
mental weariness, forgetful, insomnia, clear urinaiton, bed wetting, dizzines, expressionless,Ba zhen tang.
hearing impairment, weakness, sore low back
pale tongue, deep thin or wiry pulse
 Nourish yin, tonify kidney, replish essence and marrow  
Phlegm clouding the heart orificesDrooling, unclear speech, repetitive language, expressionless, unable to follw instructionsDu20, sishencong, Du24, GB13, St40, PC7
mental dullness,Jia Wei Wen Dan Tang
swollen tongue w/white greasy coating, slippery pulse.
 Tonify kidenyu and strengthn spleen, resolve phlegm, transform turbidity  
Heart and Spleen DeficiencyUnsociable, slow reaction, expressionless, dislikes socializing, appears to not hearGui Pi Tang
slow speech, repetitive speechand behavioirs, narrow interests, pale complexionBu Zhong Yi Qi Tangtonify middle jiao, benefit the qi, yang qi ascend, retrieve prolapse organs
cold limbs, spontaneous sweat, nightime anxiety/fear, delayed development, mental and physical
fatigue, dreaminess when wkaing, nightmares, taciturn/reserved speech, poor appetite
pale tongue w/thin coat, think and weak pulse.
 Strengthen spleen, benefit the Qi, nourish heart, calm shen  
Liver Fire Flaming UpwardImpatient, easily angered, stubborn, emotionally unstable, shouting, red face, dry mouth, deliriumChai Hu Jia Long gu Mu li tang
incoherent speech, restlessness at night, constipation, yellow urine, difficult to manage,Yi Gan San
appears not to hear, erratic running and jumping
Red tongue tip, w.yellow coat, wiry and rapid pulse.
 Clear heat, pacify liver, calm shen, settle the mind  
Liver Qi stagnationPoor emotional regulation with frequent mood changes, hyperactivity,Du20, sishencong, du24, GB13, Liv3, Gb34
reduced sleep w/sleep disorders, avoids conversations, difficult communicating,Xiao yao san
stiff joints and ligaments with reduced flexibility and motor skills,
pale tongue w/thin coat and wiry pulse
 Smooth the Liver, Regulate Qi  
Tui-Na for kids
Open heavens gateusing both thumbs rub from Yintang to Du24
Push the water palaceuse both thumbs, push from BL2 to TB23
Massage TaiyangRotate tai yang point using both middle fingers.  
ADHDLiver Qi stagnatin turing to Fire (19.8%)
DSM 5 and ICD 10Phlegm-fire Disturbing the Heart (15.5%)
Neurodevelopmental DisordersDeficiency of heart and Spleen (15.4%)
Attention Deficit/Hyperactivity disorderExhuberant Heart and Liver fire (15%)
F90.2, F90.0, F90.1Kidney Deficiency with Liver Hyperactivity (13.6%)BOLD is issue
Questions:1. how often do you have trouble wrapping up final details of a project once challenging parts are done?Never, Rarely, Sometimes, Often, Very often
2. how often do you have difficulty getting things in order when you have to do a task that requires organization?Never, Rarely, Sometimes, Often, Very often
3. How often do you have problems remembering appointments or obligations?Never, Rarely, Sometimes, Often, Very often
4. When you have a task that requires a lot of thought, how often do you avoid or delay getting started?Never, Rarely, Sometimes, Often, Very often
5. How often do you fidget or squirm with your hands and feet when you have to sit down for a long time?Never, Rarely, Sometimes, Often, Very often
6.How often do you feel overly active and compelled to do things, like you were driven by a motor?Never, Rarely, Sometimes, Often, Very often
 SymptomsTreatments 
Deficiency of Heart and Spleen BloodADD, poor memory and concentration, difficult sticking to the job at hand, difficult keeping time,HT7, Ren15, SP6, Ren12, BL20, Du20
 tendency to day dream, lack of attention, tiredness, insomnia, anxiety, poor appetite, loose stools palpitationsGui Pi Tang
Pale tongue, choppy or fine pulse
 Noursih heart and spleen blood, strengthen the mind.  
Kidney and Liver Yin deficiency with Liver Yang Risinghyperactice child or adult suffering from ADHD, night sweating, dry mouth, tinnitus, irritablity,SP6, Liv8,KD3, Ren4, HT7, Liv3, GB13, Du24
Propensity to outbursts of anger,Qi Ju Di Huang Wan
no coating on the tongue, floating-empty and slightly wiry pulse.
 Nourish the liver and kidney yin, subdue liver yang  
Heart and Spleen Qi DeficiencyChlld or Adult with ADD, the child is in his world, lack of concentration, daydreaming, quiet, slow movement,HT5, BL15, Ren15, Du20, Ren12, ST36, BL20, BL49
light sleeper, spontaneous sweating, picky eater,Gui Pi tang and Gan Mai Da Zao Tang
 Pale tongue, Weak pulse  
Liver and Heart FireChild or adult with ADD, restless and irritable child, propensity to outbursts of anger, lack of concentration.Liv2, liv3, GV24, GB13, Ren15
inability to focus on a task, dry mouth, insomnia, unpleasant dreams, headaches, bitter taste. Artistic child.Long Dan Xie Gan Tang
 Red tongue with dry-yellow coating. Wiry-rapid pulse.  
ADHD frequent TX.herbal formulasPoints
Wen Dn TangPc6, Du20, Li4, Liv3, HT7
Yi Gan San: calm liver, relieve spasm, dispel heat, strengthen spleen
Chai Hu Gui Zhi Tang- harmonize and release shao yang, nourish blood, alleviates pain.
Gui Pi Tang
Gan Mai Da Zao Tang
Jia Wei Xiao yao San
 Liu Wei di huang Wan  
Tic disordersTreatments:
DSM 5 and ICD 10DU, GB, and LI channels used most
Motor DisporderExcessive clumsiness and awkwardness as a minifested by poor learning and performance of coordinated skillsDU20, GB20, Liv3, LI4, SP6
with performance significantly below accepted age norms. Conditions’ onset is early in development.sishencong, PC6, HT7, LI4, ST36,
Tic disordersa tic is a sudden and rapid, recurrent, nonrhythmic motor movement or vocalization
Tourette’s Disorder F95.2
Persisten Motor or Vocal Tic Disorder F95.1   
Treatment Modalities
Red FlagsSuicidal attempts (thoughts), psychosis, bilological clock is broken
Psychotic disorders:delusions, hallucinations, disorganized thinking (speech), grossly disorganzied or abnormal motor behavior
(including cataonia) and negative symptoms
Delusionsfixed beliefs that are not amenable to change in light of conflicting evidence. Their content may vary:
Persecutory, referential, somatic, religious, grandiose
HallucintationsPerception-like experience that occur without an external stimulus. They are vivid and clear,
with the full force and impact of normal perceptions and not under voluntary control.
Diorganized thinking (formal thought disorder)Typically inferred from the individual’s speech. The individual may switch from one topic
to another (derailment or loose associations). Answers to questions may be obliquely related or
completely unrelated (tangentiality).
Grossly disorganziedor abnormal motor behavior may manifest itself ina variety of ways, ranging from childlike “silliness”
to unpredicatable agitation.
Two Negative symptomsare particularly prominent in schoizophenic: diminshed emotional expression and avolition (decreases inititive.  
TCM perspective- mental emotional
Mind obstructedconfused thinking, irratinal behavior, clouded mind, loss of insight in mental illness
it is Qi stagnation, Blood stasis, phlegm
Mind unsettledInsomnia , agitation, mental restless and anxiety
blood and yin deficiency, empty heat, qi stagnation, blood stasis, fire, phlegm fire
Mind Weakenedcharacterized by depression, melancholy, mental exhaustion, physical tiredness
 qi deficency, blood deficiency, yang deficiency, yin deficiency  
AcupunctureSymptoms:
Lung channelSadness, worry. Grief. Lungs govern Qi and it points bring Qi to the brain and clear mind
Lu3somnolence, insomnia, sadness, weeping, forgetulness, talking to ghosts. Forgetfulness.
Lu7Psychological and emotion point, worry, grief, sadness, stimulate beneficial outpouring of repressed emotions.
Lu10calms the mind when agitated by heat- heart heat/lung heat.  
Large intestinesemotional problems due to heat pattern
Li4calms the mind, subdues rebellious Qi from head, good with Liv3, Du24, GB13
Li5calms the mind and opens the mind orifice when bright yang causes manic depression
LI7opens the minds orifices, inappropriate laughter, manic behavior, seeing ghosts.  
Stomachmental-emotinal problems due to heat patterns
ST25mental restless, anxiety, mania, stomach disharmony, phlegm fire
ST40calms the mind, opens the mind orfices, anxiety, fear, phobias, misting of the mind, rebellious qi.
ST41calms the mind, conducts heat down away from head
ST42Opens the minds orifices, mental illness due to phlegm obstructing the mind, heat in stomach
ST45calm the mind due to ST heat pattern like ST fire transmitting to heart causing heart fire.  
SpleenClears the mind and stimulates the intellect
SP1Mental restlessness and depression in excess patterns resulting in blood stasis. Calms mind and stops excess dreaming
SP3stimulate mind fatigued by excess mental work, stimulate brain, memory, and mental clarity
SP4,5Calms the mind, open mind orfices
SP6moves liver qi and calms mind, strong for insomnia from blood and Yin deficency
HeartAll Heart channel points affect the mind Deficiecy patterns: HT4,5,7, Excess patterns: HT8,9
HT3 drain heart-fire or clear empty-heat. Anxiety, mental restlessness
HT4,5Calms the mind for empty patterns of the heart
HT7Nourishes heart blood, calms mind, opens mind orfices. Any heart pattern involving the mind.
HT8Drain Heart-fire and clears Heart empty heat. Clears heat in the heart: excess, empty-heat, or phlegm-heat
HT9Clear heat, Calm mind, open orfices, excess patterns and heart heat.  
Small IntestinesMental-emotional function of dealoing with issues with clarity or not.
Si5clear heat and calm mind, clear the mind, take the right path.
Si7Calms mind and opens minds orficies, manic depression, fright, sadness, anxiety, mental restless.
Si16subdues rebellious qi from the head, regulates ascending and descending qi of the head and calms mind.  
Urinary BladderFull and Empty conditions of the patient
UB10Clears the brain and opens Mind orficies
UB13Calms the mind of manic behavior and suicidal thoughts/desire to commit suicide
UB15Calms the mind, nourishes the heart, stimulates the Brain
UB42Emotional problems related to Lung, sadnes, grief, worry.
UB44Calms the mind, heart related emotioanl and psychological problems
UB47For emotional problmes related to Liver: depression, frustration, resentment over long period of time
UB49Strengthen the intellect, clear mind, stimulate memory and concentration
UB52strengtehn the will power and determination mental-spiritual aspect of Kidenys.
UB62Calms the mind for insomnia and manic behavior  
Kidneymental emotion problem solving by drawing Qi downward or lifting spirit up by tonifying kidney
Kd1Strong calming effect on mind, severe anxiety, mental illness like manic behavior, empty fire mental restlessness.
Kd3Calms the mind, insomnia, excess dreaming, poor memory, tonify kidney and willpower kidney yin/yang deficiency
Kd4Calm and lift the mind, liften when patient is exhuasted and depressed from chronic kidney deficiency
Kd6Calms the mind for insomnia, yin energy to eyes to help them close.
Kd9Calm mind from Kidney yin deficiency causing deep anxiety and mental restlessness
Kd16Tonify Kidney to Tonify Heart, calm the mind in Heart Yin deficiency, nourish heart.  
PericardiumMental-emotional problems occuring with a background of heat
PC3Calms mnd with severe anxiety caused by heart-fire
PC4Strengthens the mind in Heart deficiency which causes fear, anxiety, insomnia
PC5Calms mind, opens mind orfices, resolves phlegm-heat in heart obstructing the mind’s orficies.
PC6Calms the mind, lifts spirit, promotes free flow of Liver qi, promotes sleep. women: PMS, irritiability.
PC7Calms mind, clears heart-fire, heart-fire mental problems like high anxiety, mental restless, and manic behavior
PC8Calms the mind, problems related to heart-fire.  
Triple Burner
TB3Promotes free flow of Qi and lifts spirit
TB10Calms the mind when mental-emotional problems are occuring against a background of heart-heat.  
Gall BladderImportant points for serious mental-emotional problems.
GB9Calms the mind, fright, fear, palpitations, and manic behavior
GB12Calms the mind for insomnia, Liver yang and Liver Fire.
GB13Calms mind, Clears brain for mental and emotional problems, resolves phlegm in mental-emotional disorders. Epilepsy.
GB15Calms the mind. Obessive thoughts, pensiveness, oscillation of moods.
GB17Mental-emotional effect of opening the orifices and resolving phlegm
GB18Calms the mind and opens the minds orficies. It has a deep effect on mental problems: obessive thoughts and dementia
GB19Calms the mind for dullness, mania, fright, palpitations
GB40Free flow of Liver Qi, lifts the spirit and strengthens deciisveness.
GB44calms the mind in cases of insomnia and agitation deriving from Liver-fire  
Liver Channel
Liv2Calms the mind and clears heat, fire
Liv3has a profound calming effect on the mind, for tense people with short temper, repressed anger, enhanced with Li4.  
Ren MaiMental emotional problems based on deficiency
Ren4Calms mind by strengthening kidney, source Qi and rooting the mind
Ren8Calms mind, lifts spirit, use moxa on salt, no needle.
Ren12Calms the mind for worry, anxiety, and pensiveness.
Ren14Calms the mind, Phlegm-heat, mental symptoms heart-fire leading to insomnia, agitation, anxiety.
Ren15Nourises the Yin organs, calms the mind, deficiency yin and blood. Severe anxiety, worry, upset, fears, obsessions  
Du MaiDu channel points on the head help treat mental-emotional problems
Du4Clears the mind, lifts spirit, strengthens will power, for depression and mental confusion
Du11Nourishes the heart, calms the mind dor sadness, depression, anxiety
Du12Calms the mind, opens the mind orficies.
Du14Clear and strengthen mind, tonify heart and kidney yang, stimulates brain when person is depressed and confused
Du16nourishes the marrow, benefits the brain, calms the mind, opens minds orficies
Du17Benefits the brain, calms the mind, opens the mind orifices, manic behavior point
Du18Opens the minds orficies and calms the mind, regulates Liver-blood, severe mental restless, agitation, confusion
obessive thoughts, from a mind obstucted due to blood stasis.
Du19Open mind orficies and calms the mind, anxiety, combine with Ren15 for stronger effect
Du20Benefits the brain, clears mind, lifts spirit, lifts yang to promote clear yang to brain and mind
Du24Calms and lifts the mind and opens the minds orifices. Calm the mind strongly for anxiety, insomnia, depression, sadness.  
SishencongCalm mind, clam wind, benefit the eyes and ears, alleviate pain, concussion.
YintangCalm shen, benefit nose, eliminate wind, open the channel, alleviate pain
AnmianCalms the shen for sleep/ insomnia  
Liver qi stagnation- chai HuXiao Yao San
Chai Hu Jia long gu Mu li tang
Chai Hu Shu gan San
Yi Gan San: calm liver, relieve spasm, dispel heat, strengthen spleen
Phlegm- Ban XiaWen Dan Tang: warm GB, regulate Qi, dissolve phlegm, clear heat GB, harmonize GB and ST
Ban Xia Hou Po Tang
Heart and speen deficiency- Ren shenGui Pi Tang
worry injuring Mind- Fu xiao maiGan Mai Da Zao Tang- nourish heart and calm shen, harmonize middle jiao
KD and HT Yin def w/empty heatTian Wang Bu Xin Dan- nourish KD, tonify blood, tonify heart and calm shen
Sheng Di Huang   
Psychotherapy in TM
Ijung Byunki Therapychanges in mind is expressed in changes in Qi. Change the patients mood with aromatherapy, music, stabalize mind.
converstaion, light, acupressure, massage, breathing, meditatin, reflection.
Jium goron therapyconversation, persuasion, reassurance, re-education to eliminate worries,, boost will, change consciousness
Empathy, patience, warm interest in patient, professional knowledge.
Oji Sangseung therapy5 element mutual overcoming
Earth – Water: fear
Metal- wood: Anger
Wood- Earth: anxiety
Kyungja Pyungyi therapyPsychological method that treats symptoms of anxiety exposing patient to strong stimuli.
 Help them get accustimed to what startles and frigtens them.  
PTSDTai chi, yoga, mindfulness, martial arts.benefits greater than counseling.  
Lastly
taiji becomes yin and yang, and yin and yuang transform into various forms like the 4 seasons.
yin and yang is one taiji, and taiji is absolute nothing. Wuji, “no end” and no boundaries, no closure.