Treating adolescent depression with pattern of kidney deficiency and liver hyperactivity from the perspective of "nourishing water to nourish wood"

The risk of depression is relatively high among adolescents, which is related to their physiological characteristics of "inadequate kidney qi and initial flourishing of liver qi." Owing to kidney essence deficiency and failure of water to nourish wood (a traditional Chinese medical concept where kidney belongs to water and liver to wood, and water should nourish wood), it leads to hyperactivity of liver yang and a restless spirit and soul, resulting in pattern of kidney deficiency and liver hyperactivity characterized by kidney deficiency as the root cause and liver hyperactivity as the manifestation. Clinically, this presents as low mood, cognitive decline, anxiety, irritability, and various somatic symptoms. The therapeutic principle of "nourishing water to nourish wood and calming the liver to soothe the spirit" recommends, firstly, nourishing water to nourish wood and strengthen the innate constitution using herbs such as Ciwujia (root and vine of manyprickle acanthopanax) and Bajitian (morinda root) to replenish kidney essence. Furthermore, to subdue hyperactive liver yang and calm the spirit, heavy mineral and shell medicines like Qingmengshi (chlorite schist) and Shenglonggu (bone fossil of big mammals) are used to suppress the floating yang, along with Chaihu (Chinese thorowax root) and Huangqin (baical skullcap root) to disperse and clear liver fire. Lastly, to strengthen the spleen and harmonize the central pivot, auxiliary herbs such as Baizhu (largehead atractylodes rhizome) and Fuling (Indian bread) are used to regulate the spleen and stomach. This not only aids in the transportation and transformation of the medicinal effects but also prevents the stagnation caused by nourishing remedies and the damage caused by heavy sedatives. The synergistic application of these methods, which involve treating both the liver and kidney simultaneously and addressing the root cause and symptoms, provides a novel theoretical basis and clinical approach for preventing and treating adolescent depression.