The Upside to Feeling Down: The Metal Element & Depression (Part 2 of 6)

by Salvador Cefalu, M.S., L.Ac.

As we begin the exploration into some of the many underlying factors of depression, it’s critical to understand that Chinese Medicine is based on treating the individual to resolve a state of dis-ease. It is not about treating the disease itself. 

In other words, for Chinese Medicine to be most effective, it’s essential to evaluate each individual to tailor a treatment plan that matches his or her specific needs rather than rely on generalized established protocols that have been created to treat a specific disease condition. Only when a treatment plan is tailored to a patient’s specific needs can you expect to achieve optimal results. 

A Five Element Perspective on Depression

Cycles of depression can last months to many years, especially if there is a hereditary disposition. This Five Element Model will provide a comprehensive perspective on the primary factors that need consideration to restore health from debilitating periods of depression.

The five primary organs associated with each of the Five Elements are the Lungs (Metal), the Kidneys (Water), the Liver (Wood), the Heart (Fire) and the Spleen (Earth).

Through the assessment of these systems we can gain important insight on how imbalances in these organs are involved in depression and create strategies to restore mind-body harmony to overcome the challenges of chronic depression and its many related symptoms. 

My Recent Challenge with Depression

Depression can be insidious, zapping your zest for life little by little until you finally realize you’re depressed. This experience culminated for me at the end of last year with a feeling of emptiness that simply seemed to take my spirit away.

For about four months I would wake up periodically in the morning feeling irritable, lacking inspiration or motivation, with tightness in my chest and shortness of breath. My symptoms worsened after the holidays and then I slipped into four days of fever with the flu in late January after returning from Bali. These four days in bed were more emotionally than physically challenging as my spirit delved into what some describe as the dark night of the soul with severe despondency.

As I rested and took herbs to recover my Lungs, day by day my energy increased and my spirit lifted. My inner drive and inspiration started to reveal themselves again and I began to feel better than I had in the previous six months.

In hindsight, a chronic virus had been latent in my system, taxing my immunity and weakening my Lung Qi. It wasn’t until I got low enough for this virus to surface and get burned out of my system through the fever that my health became revitalized and I felt a renewed enthusiasm for life.

I present my story to show how conditions like depression have many causative factors. Was it just the virus or was my immune system depressed from something I was going through emotionally that allowed this virus to take root and depress my immunity?

We don’t always need to know the exact causative factor, but if we follow the signs of the body to restore balance to its energy systems, we can be confident that we can improve our psycho-emotional state as well.

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The Metal Element: The Lungs and Depression 

Since the Lungs relate to the emotions of sadness and grief, it’s essential to assess the status of the Lung Qi, or energy to evaluate depression.

Lung energy is most vulnerable during the Fall season, therefore, the Lungs are more prone to be in a state of weakness during this time, which allows for conditions such as depression to more likely occur during the Autumn months. This is especially likely for those who are sensitive to reduced sunlight from Autumn through Winter in the far northern hemisphere where light becomes very limited during this time.

Lack of light exposure makes many Individuals susceptible to SAD syndrome (Seasonal Affective Disorder) and the greater a person has Lung weakness according to Chinese Medicine, the greater their sensitivity to this pattern will be. Because of SAD’s relationship to the seasons of Autumn and Winter, it is crucial to support the Lung Qi as well as the Kidney Qi which relates to Winter. Optimally, it’s best to start strengthening these systems a few months prior to the season when the problem begins to occur.

A simple food remedy is Cod Liver oil, a concentrated source of vitamin A and D essential for supporting the Lung Qi to boost immunity and strengthen lung function overall.

Cod Liver oil is also a concentrated source of the Omega fats DHA and EPA which support brain neurological function. The brain is an extension of the Kidney Essence in Chinese Medicine and these Omega fats in Cod Liver oil have been found to be beneficial for depression, making this a super food for reducing depression and its related symptoms, insomnia and anxiety, as well.

The energy of the Lungs can be suppressed or weakened through any life circumstance that creates prolonged sadness or grief. In this scenario, herbal tonics such as Cordyceps, Ginseng and Astragalus can be used to boost both the Qi energy of the Lungs and Kidneys to increase vitality and enhance overall mood and mental disposition.

These tonic herbs in particular are MAO inhibitors so they can help reduce depression by mitigating the action of monoamine oxidase, an enzyme in the brain that breaks down the mood enhancing neurotransmitters such as dopamine, norepinephrine and serotonin.

Caution however must be used with the use of these herbal tonics if you are using any medication that it is also an MAO inhibitor. Therefore, please inform your doctor before introducing any herbal substances into your nutritional regimen. Furthermore, Qi tonic herbs are generally warming in nature so you need to know if your body has too much internal heat to avoid exacerbating inflammation.

The Earth Element is the Mother of Metal

Earth energy is about digestion and therefore the health of the digestive system will have a substantial bearing on the function of the Lungs and any type of depression.

The Spleen (which also relates to the Pancreas) and Stomach are the Earth organs and control the transformation of food into energy and raw materials to rebuild the body.

If the function of the Earth organs is compromised or weakened in any way, then the body’s ability to transform is compromised and dampness will accumulate in the gastrointestinal system.

Dampness is a fungal terrain and fungus loves moist environments. As damp fungal terrain accumulates in the gut it can get pushed up into the lungs and into the sinus cavities leading to conditions such as chronic sinus congestion, snoring, allergies and ear conditions including excessive ear wax, pressure in the ears and ear infections. As the fungus migrates into the brain, it can lead to foggy thinking and more severe conditions such as dementia and even brain tumors.

The major factor that can weaken digestive function is consumption of food that is too damp. This can include excessive consumption of grains, especially refined/processed carbohydrates, sugar (including sweet tropical fruit), dairy, nuts, and fried/greasy foods.

Eating habits will also weaken the power of digestion such as eating while distracted such as when watching TV, reading, driving, or eating during a business meeting.

If the nervous system is activated to process information outside of eating, then the power to digest will be compromised and distracted from its role of transforming food into energy and raw material. 

Over time, these habits can weaken the Spleen energy and lead to a systemic deficiency of Qi throughout the body. 

Herbs to consider to support this relationship between the Spleen and the Lungs are substances that nurture digestion.

Cooking spices and digestive enzymes can be important to stimulate digestion. Hydrochloric acid may be necessary to support the digestion of protein, especially if the Stomach is weak.

Chinese Medicine uses sprouts and in some digestive enzyme blends you’ll find the use of Aspergillus oryzae, a type of probiotic fungus used to produce the enzyme amylase, to help the body break down the starches in carbohydrates.

Radish and radish seeds in herbal formulas (called Lai Fu Zi) help break down excessive dampness in the digestive tract and if this dampness has created a lot of mucous in the lungs then white mustard seed (called Bai Jie Zi) is used to break up phlegm and help reduce coughing and sputum. Both of these herbs aid in the digestion of fats.

Excessive dampness and fungus is usually present in the body when there is a very swollen tongue or thick coating on the surface of the tongue, making digestive support imperative for healing on any level in these cases.

As you can see, to support the health of the Lung’s energy, it is crucial to work with diet and eating habits so the digestive system can be a good mother for its child, the Lungs.

The Virtue of the Lungs - Forgiveness

Since the Lungs breathe in oxygen, which supports life, and release carbon dioxide through exhalation, the Lungs reflect our ability to receive life and let go of life through our breath.

If you find this basic respiratory function of the lungs is restricted, it may be necessary to release tightness in your body that may be inhibiting proper breathing. This can often be resolved through Acupuncture and Cupping as well as other forms of bodywork and physical therapy. The primary areas of the body that need to be released to support proper lung function are the Five Ancestral Sinews. (You can learn more in this article)

Freeing up the lungs on a physical level allows for the freeing up of the psycho-emotional aspect as well which involves the Lung’s ability to let go.

Letting go relates to your ability to release trauma, guilt, resentment, and anything that keeps your heart from opening. This metaphorical aspect of the Lungs’ function to let go is achieved through its virtue of forgiveness and forgiveness is experienced when we can let go of our judgements.

So ultimately forgiveness requires letting go of the very nature of what it means to be a Metal (Lung) type person which is to be very judgmental. (To learn more about a Metal type personality and Essential Oils for the lungs go here).

Just as we have control over our lungs to inhale and exhale, it is through our own choice and volition that we can allow ourselves to let go of our judgements to experience forgiveness. And through this process, as our Taoist and Classical Chinese Medicine teacher Dr. Jeffrey Yuen suggests, “we can achieve an inner cleansing and find redemption in our lives”.

Moreover, as you unburden your Lungs through forgiveness and less judgement of yourself and others, you will more easily breathe in life and experience the vitality that comes with being emotionally free.

It is then that one can move beyond depression and know what it means to have a peaceful heart.


Salvador Cefalu, M.S., L.Ac. is the Founder & Co-Director of A Center for Natural Healing in Santa Clara, California, a health and wellness clinic run by he and his wife, Setareh Moafi, Ph.D., L.Ac. that specializes in Classical Chinese Medicine. Salvador is a leading U.S. practitioner of Japanese Meridian Therapy, a rare form of non-insertion Acupuncture using Gold & Silver needles. More information at www.acenterfornaturalhealing.com.