Depression is a prevalent mental illness in developed countries. In Western medicine, experimental\nand clinical investigations have demonstrated that depression is associated with the dysregulation\nof neurotransmitter signaling, and symptoms of depression can be alleviated by therapeutic\nintervention. However, patients taking antidepressant drugs often experience serious\nside effects and high relapse rates. On the other hand, traditional Chinese medicine (TCM) views\ndepression as a manifestation of liver qi stagnation. Practitioners of TCM have long been treating\ndepression with herbs that promote qi circulation in the liver. In this article, we offer a hypothesis\nstating the biochemical basis of the linkage between liver qi stagnation and depression. Liver qi is\ninvolved in the processing of macronutrients into molecules to fuel energy metabolism in brain\nneurons, as well as the synthesis of plasma proteins that maintain blood circulation to the brain,\nthereby enabling these fuel molecules to be delivered to the brain. In cases of liver qi stagnation,\nthe failure in delivering sufficient fuel molecules to the brain disrupts mitochondrial ATP production\nin neurons. Because neurotransmitter release and neurotropin transport are driven by ATP,\nthe deficiency in release and transport processes resulting from insufficient ATP production could\nlead to depression. Therefore, if liver qi stagnation is causally related to the pathogenesis of depression,\nthe promotion of liver qi circulation by Chinese herbs might offer a promising prospect\nfor the effective treatment of depression.
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