Read this before anything else
If you are in crisis
If you are thinking about ending your life, or you have a plan, or you have already harmed yourself, this page is not the help you need right now. Contact emergency services or a crisis line, and tell one person who is physically near you.
- US Call or text 988 Suicide & Crisis Lifeline, 24 hours
- UK and Ireland Call 116 123 Samaritans, 24 hours, free
- Canada Call or text 988 Suicide Crisis Helpline, 24 hours
- Australia Call 13 11 14 Lifeline, 24 hours
- Anywhere else Go to the nearest emergency department Or call your local emergency number
A crisis line does not require a diagnosis, and you do not have to be sure you qualify. If you are wondering whether it counts, it counts.
Read this first
When to worry
Low mood after a death, an illness or a bad year is ordinary and does not need a pattern. What matters is how long it has lasted, what it has taken away from you, and whether it has begun to move on its own. Depression is diagnosed by assessment, not by a questionnaire — but a small number of features should send you for that assessment this week rather than this year.
Get help now — same day or emergency
- Thoughts of ending your life, a plan, or having made preparations. This is a medical emergency, not a phase, and it does not improve by being waited out.
- Hearing voices, or holding a belief others find impossible — especially a belief that you are being watched, punished or monitored.
- Not eating or drinking for days, or being unable to get out of bed at all.
- A sudden calm after a long severe depression, especially with giving possessions away. This can be a warning sign rather than recovery.
- Low mood with confusion, a fever, a newly started medicine, or in the weeks after childbirth — these need same-day assessment.
Get it looked at within days
- Low mood most days for more than two weeks, with sleep, appetite or concentration affected.
- Loss of interest or pleasure in nearly everything, most days.
- Mood that swings between very low and unusually high, energetic or sleepless. Bipolar disorder needs different treatment, and an antidepressant alone can make it worse.
- Low mood with heavy drinking, or with using something to get to sleep.
- Low mood that began within weeks of a new medicine — steroids, isotretinoin, some blood pressure drugs, hormonal contraception.
- Low mood alongside a thyroid diagnosis, anaemia, or unexplained weight loss.
This page describes how the tradition reads low mood. It is not a screening tool and it cannot tell you whether you are depressed. If two or more lines above apply, that is a reason to see someone, whatever else you read here.
One rule for this whole list: if you are not sure whether a line applies to you, treat it as though it does — and get it checked. Uncertainty is a reason to be seen, not a reason to wait.
Four kinds of low mood that are not the same state
The English phrase covers at least four conditions with different causes and different responses. Which one you are in decides whether the tradition has anything useful to say at all.
Grief that has not finished
Low mood after a death, a diagnosis, a separation or a lost job. It comes in waves, is triggered by reminders, and eases over months. Function is largely preserved; the world is the problem, not the machinery.
Points to Bereavement and adjustment. Ordinary, and not a pattern question — though the tradition would call the stuck version 郁.
Melancholic depression
Low mood present on waking and worse in the morning, with early waking, weight loss, guilt out of proportion to events, and a flat inability to enjoy anything. Speech and movement may slow.
Points to Depression with melancholic features. Needs assessment and treatment; the tradition describes the picture and does not treat it.
Anxiety with low mood
Restlessness, a tight chest, a churning stomach, and worry that will not switch off — with the low mood following the worry rather than leading it.
Points to Mixed anxiety and depression. Very common, and the pattern reading usually centres on the liver and spleen rather than on the heart.
Low mood with a physical cause
Flat, heavy and slowed, with cold intolerance, constipation, weight gain, dry skin or a hoarse voice; or with a low blood count; or in the weeks after childbirth.
Points to Thyroid disease, anaemia, medication, postpartum. A blood test is cheaper than a year of the wrong reading.
What the patterns describe
The classical word that comes closest is 郁 — usually translated as constraint, or stagnation. It is not a synonym for depression. Its first sense is physical: something that should move is being held, so qi does not flow, blood does not circulate, food does not descend. Applied to mood it says the same thing at the level of feeling — something pressing inward with no outlet.
朱丹溪 reduced it to six in the 丹溪心法: qi, blood, phlegm, heat, dampness, food. The line that gets quoted is his opening — when qi and blood are harmonious no illness arises, and once there is pent-up constraint illness follows. The important move is that he treats 郁 as a mechanism rather than a mood, which is why one word can cover a stuck chest, a stuck stool and a stuck mood without straining.
Two later pictures are worth knowing because a reader with low mood will recognise them. 百合病, from the 金匮要略, describes someone who wants to eat and cannot, wants to lie down and cannot settle, wants to walk and has nowhere to go: apathy, restlessness and indecision in one paragraph, written around 200 CE. 脏躁 describes crying that comes without a cause, sadness that looks disproportionate, and constant sighing and stretching. Both are descriptive achievements. Neither is a treatment plan.
Which patterns it belongs to
These are the patterns this symptom is conventionally grouped under. They are not competing diagnoses — most people meet one, and the point of the list is to show you which questions separate them.
Low mood with tightness in the chest or throat, frequent sighing, irritability, rib-side distension that moves, a wiry pulse, a tongue that is otherwise unremarkable.
The commonest reading for low mood with tension — a tight chest, sighing, and a mood that reacts to events.
Read the pattern page →Low mood with palpitations, poor memory, difficulty falling asleep, pale lips and nail beds, dizziness on standing, a pale tongue, a thin pulse.
Where the low mood comes with flat exhaustion, broken sleep and a sense of unreality rather than tension.
Read the pattern page →Low mood with fatigue on minimal exertion, a low voice, breathlessness on stairs, spontaneous sweating, a pale tongue with teeth marks, an empty pulse.
The flat, heavy version: no tension and no restlessness, just no drive.
Read the pattern page →Low mood with a heavy muzzy head, chest oppression, a sensation of something stuck in the throat, copious phlegm, a greasy tongue coat, a slippery pulse.
The foggy version, where thinking itself feels thick and slow.
Read the pattern page →The signs behind it
Each line below is one entry in the sign table — the same table the self-check draws its follow-up questions from. The tier says how strongly that sign points at the pattern: a defining sign is expected, a common one is usual, a supporting one is optional.
- Quiet low mood with little drive Qi deficiencysupporting ·Spleen qi deficiencysupporting ·Kidney yang deficiencysupporting
- Loss of interest in things you used to enjoy Liver qi stagnationcommon ·Qi deficiencysupporting
- Crying easily, often without a clear reason Liver qi stagnationsupporting ·Qi deficiencysupporting
- Frequent sighing Liver qi stagnationdefining ·Qi deficiencysupporting
- Difficulty falling or staying asleep Blood deficiencycommon ·Kidney yin deficiencycommon ·Liver yin deficiencycommon ·Liver yang risingcommon ·Liver qi stagnationsupporting ·Damp-heatsupporting
- Poor appetite Spleen qi deficiencydefining ·Spleen yang deficiencydefining ·Phlegmsupporting ·Liver qi stagnationsupporting
- Chest tightness or oppression Phlegmdefining ·Liver qi stagnationcommon ·Liver yang risingsupporting
- Pale lips and nail beds Blood deficiencydefining ·Qi deficiencycommon
Not every sign listed here will apply to you — a sign only counts alongside the others. The self-check is the place to weigh them against your own answers.
Telling them apart
Four questions do most of the work. Each one splits the field in half, and after two or three the pattern is usually clear enough to act on — or clear enough to know that the answer is medical rather than traditional.
| Question | If yes | If no |
|---|---|---|
| Does the mood lift at all, even briefly? | It lifts with company, sunlight or something absorbing, even for an hour → closer to 郁 in the classical sense, and the measures are movement, company and daylight. | It does not lift at all, not even for something you used to love → that is a depressive symptom rather than a mood, and it belongs in an assessment. |
| Do you wake early, and feel worst in the morning? | Yes, with weight loss and guilt out of proportion → the melancholic picture. Get assessed; the pattern reading is not the first thing you need. | Worst in the evening, better after activity, mood still reactive → the pattern reading is more likely to earn its keep. |
| Is there tension — a tight chest, sighing, a lump in the throat? | Yes → liver qi stagnation leads, and the useful measures are about movement and expression rather than rest. | No tension, but flat exhaustion and broken sleep → blood or qi deficiency, and the measures are food, rest and earlier nights. |
| Did it start with a physical change — a thyroid diagnosis, a new drug, childbirth, heavy periods? | Yes → have that checked first. Reading a pattern while a thyroid is untreated helps nobody, and the two can be done in parallel. | No physical trigger and a clear psychological one → both readings can proceed at once without competing. |
What you can do at home
None of this treats a named condition, and none of it replaces assessment. These are the ordinary measures attached to this symptom — low risk, and worth doing while you work out what is actually going on.
- Daylight before screens. Thirty minutes outdoors in the morning has the most consistent evidence behind it of any single measure on this page, and it is free.
- Move, even badly. Ten minutes of walking counts. The classical advice for 郁 is 疏 — to loosen and get things moving — and the modern advice for low mood arrives at the same place from a different direction.
- Fix the wake time before the bedtime. Early waking is usually the first symptom to shift, and it shifts in response to a consistent morning rather than an early night.
- Say it out loud to one person, or write it down. The tradition's logic for 郁 is that what has no outlet presses inward; naming it is the plainest possible outlet, and it is also the step most often skipped.
- Keep alcohol out of the evenings. It shortens the time to sleep and wrecks the second half of the night, which is the half that low mood is most sensitive to.
- Do not treat this with diet alone. Food matters for the spleen and blood pictures; it does not lift a melancholic depression, and waiting for it to do so costs weeks you do not get back.
Classical sources
Quoted in the original, with our own translation and the chapter it comes from. We do not reproduce existing English translations — they are someone else's reading.
怒则气上，喜则气缓，悲则气消，恐则气下……惊则气乱……思则气结。 nù zé qì shàng, xǐ zé qì huǎn, bēi zé qì xiāo, kǒng zé qì xià... jīng zé qì luàn... sī zé qì jié
Anger sends qi upward, joy slackens it, grief disperses it, fear drives it down... fright scatters qi... worry knots it.
气血冲和，万病不生，一有怫郁，诸病生焉。故人身诸病，多生于郁。 qì xuè chōng hé, wàn bìng bù shēng, yī yǒu fú yù, zhū bìng shēng yān. gù rén shēn zhū bìng, duō shēng yú yù
When qi and blood are harmonious, no illness arises. Once there is pent-up constraint, illness follows. Thus the illnesses of the body mostly arise from constraint.
百合病者，百脉一宗，悉致其病也。意欲食复不能食，常默默，欲卧不能卧，欲行不能行。 bǎi hé bìng zhě, bǎi mài yī zōng, xī zhì qí bìng yě. yì yù shí fù bù néng shí, cháng mò mò, yù wò bù néng wò, yù xíng bù néng xíng
In lily disease all the vessels share one source, and all of them fall ill together. The person wants to eat and cannot eat, stays silent, wants to lie down and cannot lie down, wants to walk and has nowhere to go.
百合病 and 脏躁 are the two classical passages closest to what is now called depression, and both are quoted here as description rather than prescription. The 金匮要略 gives a formula for 脏躁; it is not reproduced as a recommendation and no formula on this site is. Note also that the 丹溪心法 line is about 郁 as a mechanism of illness — extending it to mood specifically is the work of later writers, and reading it back into the original overstates what 朱丹溪 claimed.
Terms used on this page
One concept, several names. The standard term comes first; pinyin and characters are there so you can search and cross-check; older aliases are what you will meet in other people's writing.
| Standard term | Pinyin | 中文 | Also written as |
|---|---|---|---|
| Constraint | yù | 郁 | The umbrella term — first a mechanism (something held that should move), later also a mood |
| Lily disease | bǎi hé bìng | 百合病 | A classical description of apathy, restlessness and indecision, not a modern diagnosis |
| Visceral agitation | zàng zào | 脏躁 | Crying and sadness without an adequate cause; a picture, not a condition |
| Six stagnations | liù yù | 六郁 | Qi, blood, phlegm, heat, dampness and food — 朱丹溪's six mechanisms |
Check your own pattern
Low mood is a symptom, and symptoms appear in several patterns. The self-check weighs twelve questions against all twelve patterns and shows you what fits — and what doesn't quite.
Start the self-checkAbout four minutes. No account, nothing stored on a server, and an address for the printable report is optional.