Depression and Low Mood

Condition & context

Depression can be felt as profoundly in the body as in the mind, yet the physical side of it is often the part that receives the least attention.

Sleep may change dramatically: waking too early and being unable to return to sleep, or sleeping for nine or ten hours and still waking exhausted. Appetite can disappear altogether or shift in the opposite direction, toward persistent hunger and cravings. Mornings can become especially difficult, with the prospect of the day ahead feeling disproportionately demanding. Even ordinary tasks may seem to require unusual effort. The limbs feel heavy, concentration becomes slow and indistinct, and the separation between physical fatigue and mental exhaustion can become difficult to draw.

Many of the people we see are already doing the essential psychological work — in therapy, taking medication, or both — and yet continue to live with these physical effects. That is where our treatment can be particularly useful. We work alongside existing care to address sleep, fatigue, appetite, tension, digestion, and the broader physical depletion that can accompany depression. Improving those things does not replace treatment for depression itself, but it can make an important difference to how manageable daily life feels. When sleep begins to return and the body is no longer quite so exhausted, there is often more capacity for everything else recovery asks of you.

What patients come to us for

• The physical burden — fatigue that rest does not remedy, heaviness, and the effort of ordinary tasks
• Sleep — early waking, unrefreshing sleep, or sleeping far too much
• Appetite and digestive changes in either direction
• Low mood and persistent depressive symptoms
• Difficulty concentrating and loss of interest in things that used to matter
• Postpartum low mood and anxiety — see our pregnancy and postpartum page
• Perimenopausal mood changes, when hormonal changes may be an important and sometimes overlooked contributor
• Low mood entangled with chronic pain or illness, where each can intensify the other
• Physical symptoms that persist despite psychiatric medication, including symptoms that may have emerged or changed after starting medication
• Support during a medication change, at whatever pace your prescriber sets

How Chinese medicine approaches it

Chinese medicine does not treat depression as one condition, and this matters clinically.

The presentation that is heavy, slow, and unmotivated and the presentation that is agitated, sleepless, and unable to settle are different pictures with different treatments — and both are called depression in English. One person may have no appetite and lose weight; another may feel persistently hungry and crave particular foods. One may sleep twelve hours and remain exhausted; another wakes every morning at four and cannot return to sleep. Some people experience depression as profound sadness or distress, while others describe something closer to numbness: an absence of interest, pleasure, or engagement with the world around them.

We work from the whole presentation: sleep, digestion, appetite, energy through the day, temperature, pain, menstrual or hormonal changes where relevant, and the other physical changes that have accompanied the depression. It is why two patients with the same diagnosis may receive quite different treatments.

What treatment involves

We generally begin with weekly acupuncture. Rather than looking only at whether your mood has changed, we pay close attention to the physical functions that depression has disrupted: whether sleep is becoming more restorative, mornings are becoming easier, appetite and digestion are more stable, energy is returning, or ordinary activity requires less effort.

These changes can be important in their own right. They can also create better conditions for the other work of recovery. When someone is sleeping more soundly, eating more regularly, experiencing less pain, or simply feeling less physically depleted, there may be more capacity for therapy, relationships, exercise, work, and the ordinary routines that depression can make extraordinarily difficult.

Chinese herbs may be added when appropriate, particularly when sleep, fatigue, appetite, digestion, or other physical symptoms are prominent. Because many people we see for depression take prescription medication, we review medications and supplements carefully before recommending an herbal formula.

If low mood follows grief, loss, trauma, or a prolonged period of stress, treatment may be particularly gentle. We may use fewer needles, shorter retention times, delicate hands-on work, and attention to breathing and physical guarding. Nothing needs to be forced, and acupuncture does not require you to recount experiences you would prefer to discuss only with your therapist. When appropriate, we may also incorporate our Emotional Release Treatment.

For an established pattern, eight to twelve sessions is a common initial course, after which we reassess. Some patients finish treatment or return when they feel they need support; others choose periodic maintenance because they find it helpful.

Working with the rest of your care

Our approach is emphatically integrative. Depression is often best cared for from more than one direction, and acupuncture and Chinese medicine can sit comfortably alongside psychotherapy, medication, and other forms of mental-health care.

Many of the people who come to us already have a therapist, psychiatrist, or both. We have long-standing relationships with therapists and physicians across the city and are glad to communicate with the rest of your care team when useful. If you are not currently seeing someone and would like to, we can also help you find appropriate care.

Tell us everything you take, prescription and otherwise. Herbs can interact with medications, including psychiatric medications, so we need a complete list before prescribing them. Decisions about starting, stopping, or changing psychiatric medication remain between you and the clinician prescribing it.

If depression becomes severe, you are having thoughts of harming yourself, or you are experiencing a mental-health crisis, acupuncture is not a substitute for immediate psychiatric or medical care. Please contact your mental-health provider, seek urgent medical attention, or call or text 988 for immediate crisis support.

Common questions

Will acupuncture help if I’m already on medication?

Many of the patients we see for depression are taking medication. Acupuncture can be used alongside it, with treatment shaped around the symptoms that remain most troublesome — often sleep, fatigue, digestive changes, pain, tension, or the physical depletion that can accompany depression.

Can I take herbs with an antidepressant?

Sometimes. It depends on the medication, the herbs being considered, and your individual circumstances. We need a complete list of your prescription medications and supplements before prescribing herbs and will coordinate with your prescriber when appropriate.

How many sessions?

Eight to twelve weekly sessions is a common initial course, but treatment is individualized. We reassess as we go rather than assuming everyone will need the same amount of care.

Do I have to talk about it?

Only as much as you want to. This is not psychotherapy, and we will not try to make it into psychotherapy. We need enough information to understand your health and the physical pattern we are treating; the rest is yours to share or not.

I’m doing everything right and still feel like this.

That is a very common experience. Depression can persist even when someone is actively engaged in therapy, taking medication, exercising, eating well, and doing everything they have been advised to do. Our role is not to tell you to try harder. It is to address the physical burden of depression alongside the care you are already receiving, so that daily life may begin to feel more manageable.