Depression is a group of disorders characterized by sadness, despondency, rumination, inability to experience pleasure, feelings of hopelessness, and inadequacy that are severe enough to interfere with normal function, interest in life and family, and social interaction. It can exist as a disease or as a normal reaction to difficult circumstances. True depression should be distinguished from low mood resulting from disappointment or loss, which is better described as demoralization. Unlike true depression, the negative feelings of demoralization typically fade when circumstances improve, lasting only a few days rather than weeks or months, and are less likely to be accompanied by suicidal thoughts or loss of function.

There are essentially two groups of people with depression: those with low mood as a response to specific circumstances, and those in whom no specific trigger can be identified. It is important to make this distinction because if a cause can be identified, the likelihood of a successful outcome is higher. Demoralization as a result of distressing or stressful stimuli can be a normal and appropriate response to the circumstances and will usually improve over time. In some cases, however, the response to the stimulus may be exaggerated, pathological, and indistinguishable from major depression.

Depression without an identifiable cause is more complex. It is typically diagnosed as major depression and is believed to be the result of a combination of constitutional factors, life habits, diet, and an exaggerated response to chronic stress, routine difficulties, and setbacks. This type of depression can be difficult to treat with a single therapeutic approach and may not respond well to Chinese medicine alone. In these cases, the fast-acting pharmacotherapeutic approach of psychiatry may be indicated. In all types of depression, however, Chinese medicine can be of significant benefit when used in conjunction with counseling, lifestyle modification, and other appropriate interventions. It can help the person to move through the process while supporting healthy organ function and maintaining qi and blood flow through the supportive, strengthening, and qi and blood-mobilizing effects of Chinese medicine.