Chinese Herbs to Boost Mood and Energy

By Dr (TCM) Attilio D'Alberto | Traditional Chinese Medicine Practitioner, Wokingham

Persistent low mood, flat energy, anxiety on a low simmer, and the sense that something has gone out of life — these are some of the most common reasons people walk into my Wokingham clinic. Conventional treatment usually starts with antidepressants and CBT, both of which have their place. But for many people the underlying picture is not classical clinical depression — it is a mix of stress, broken sleep, hormonal change, postnatal recovery, post-viral fatigue, perimenopause, low B12, low ferritin, gut dysbiosis, lifestyle drift, and sometimes loneliness. Chinese medicine looks at this terrain in detail and prescribes a tailored herbal formula to lift mood and rebuild energy from the inside. Many patients see meaningful change in 4-6 weeks, often without needing antidepressants at all.

On this page

1. What we mean by "low mood and low energy"
2. Common causes
3. The TCM view
4. TCM patterns and what they look like
5. Single herbs that lift mood
6. Herbs that rebuild energy
7. Classical formulas
8. Acupuncture
9. Diet and gut
10. Supplements with evidence
11. Lifestyle
12. When to see a doctor
13. FAQs

What we mean by "low mood and low energy"

The clinical picture varies enormously between people. Some have classical depression — pervasive sadness, anhedonia, hopelessness, sleep change, weight change, suicidal thoughts. Others have a milder but persistent picture — flat energy, low motivation, mild anxiety, irritability, broken sleep, no spark. Both ends of the spectrum respond to herbal medicine, but the formula and approach are different. The first step in clinic is always to clarify which picture you are presenting with, what the timeline is, and what's underneath.

Common causes

• Chronic stress and burnout — the leading driver in working-age adults.
• Sleep loss — both as cause and consequence.
• Postnatal hormonal shift — combined with sleep loss and identity change.
• Perimenopause and menopause — oestrogen and progesterone fluctuations directly affect mood.
• Thyroid disease — hypothyroidism mimics depression closely.
• Iron deficiency — common in menstruating women; chronic fatigue and low mood.
• B12 and vitamin D deficiency — both classic mood-affecting nutrients.
• Post-viral and long Covid — neuroinflammation and autonomic dysregulation.
• Gut dysbiosis — gut-brain axis is real; SIBO and IBS commonly coexist with low mood.
• Chronic pain — under-recognised driver of low mood.
• Alcohol — even moderate intake worsens mood and sleep over time.
• SSRIs and SNRIs — paradoxically, "emotional flatness" is a common complaint on these drugs.
• Hormonal contraception — affects mood in a substantial minority of women.
• Loneliness, isolation and lack of purpose — particularly post-retirement, post-loss, post-children-leaving-home.

The TCM view

In Chinese medicine the spirit (shen) lives in the Heart, the will (zhi) in the Kidney, the intellect (yi) in the Spleen, the planning function (hun) in the Liver, and the bodily soul (po) in the Lung. When any of these organ-spirit relationships is depleted or stagnant, mood and energy are affected in characteristic ways. The good news is that the patterns are clinically reproducible and the treatments are well established.

TCM patterns and what they look like

• Liver qi stagnation — irritability, sighing, premenstrual flares, mood swings, breast tenderness, "frustrated" depression. Often stress-driven. The most common single pattern in low mood I see in clinic.
• Liver qi stagnation transforming into heat — Liver qi stagnation plus red eyes, headaches, irritability, insomnia.
• Heart blood deficiency — anxious depression, palpitations, broken sleep with vivid dreams, poor memory, pale tongue. Common in postnatal women, those with heavy periods, vegetarians.
• Heart and Spleen blood deficiency — combines tiredness, sugar cravings and loose stools with the Heart blood symptoms.
• Spleen qi deficiency — tired-all-the-time, foggy thinking, poor digestion, post-viral picture.
• Kidney yang deficiency — cold, low libido, low motivation, dark, weighty depression with cold extremities and low backache.
• Kidney yin deficiency with empty heat — anxious, restless, hot flushes, night sweats, perimenopausal depression.
• Phlegm misting the spirit — heavy, foggy, dull mood; sluggish, weight-gain picture; classical pattern in long-standing depression with sedentary lifestyle.
• Heart-Kidney disharmony — anxious-insomniac mood with palpitations, broken sleep and night sweats.

Most people present with a combination of two or three of these patterns. Treatment is tailored to the actual mix.

Single herbs that lift mood

• Chai Hu (Bupleurum) — the principal Liver-regulating herb. Relieves emotional constraint, lifts depression, reduces irritability, and is the lead herb in Xiao Yao San. See bupleurum benefits.
• He Huan Pi (Albizzia bark — "tree of happiness") — calms the spirit, lifts mood, and dissolves emotional stagnation. Particularly useful for grief, broken-heart and resentful types.
• Suan Zao Ren (Jujube seed) — nourishes Heart blood, calms anxiety, improves sleep. The principal herb for emotional instability from Heart blood deficiency. See jujube seed benefits.
• Bai Zi Ren (Biota seed) — gentler nourisher of the Heart and Liver; pairs well with Suan Zao Ren.
• Yu Jin (Curcuma) — moves Liver qi and clears heat; useful in stress with low mood, particularly when phlegm is also present.
• Yuan Zhi (Polygala) — opens the orifices and connects Heart and Kidney; useful in anxious cognitive impairment.
• Mei Gui Hua (rosebud) — gently moves Liver qi; lovely in tea form for mild PMS-driven mood.
• Hong Zao (red dates) — gentle blood-builder and Spirit-calmer; daily food-grade tonic.
• Saffron (Crocus sativus) — Persian rather than Chinese, but increasingly used in TCM-style prescriptions; multiple RCTs show antidepressant effects comparable to fluoxetine in mild-moderate depression at 30 mg daily.

Herbs that rebuild energy

• Ren Shen (Panax ginseng) — strongly tonifies original qi and the spirit. Improves physical and mental energy, reduces fatigue, supports the adrenal stress response. Korean red ginseng has the strongest research base for mental fatigue.
• Huang Qi (Astragalus) — gentler qi tonic than ginseng, more suitable for long-term use. Improves energy, immunity and resilience without overstimulating. See astragalus benefits.
• Wu Wei Zi (Schisandra) — adaptogenic; improves both mental and physical stamina, consolidates jing, and modulates the stress response. See schisandra benefits.
• Dang Shen (Codonopsis) — gentler ginseng substitute; tonifies Spleen and Lung qi; daily food-grade qi tonic.
• Tai Zi Shen (pseudostellaria) — particularly suited to women and to anyone with heat signs; tonifies qi and yin without warming too much.
• Yin Yang Huo (horny goat weed) — Kidney yang tonic; useful for cold, low-motivation, low-libido depression.
• Lu Rong (deer antler velvet) — strongest jing-and-yang tonic; expensive, used sparingly.
• Rhodiola rosea — Russian/Tibetan rather than Chinese, but adaptogen with good RCT evidence for fatigue, stress and mild depression.
• Ashwagandha — Ayurvedic; consistent RCT evidence for stress, sleep, anxiety and mood.

Classical formulas

• Xiao Yao San — Free and Easy Wanderer; Liver qi stagnation with blood deficiency. The workhorse formula for stress-driven low mood, particularly in women with PMS.
• Jia Wei Xiao Yao San — Xiao Yao San with added heat-clearing herbs (Mu Dan Pi and Zhi Zi); Liver qi stagnation with heat — irritability, premenstrual flushing, hot flushes.
• Chai Hu Shu Gan San — stronger Liver qi-moving formula; for premenstrual breast pain and emotional constraint.
• Gui Pi Tang — Heart and Spleen blood deficiency; the workhorse for postnatal and exhausted-anxious women.
• Tian Wang Bu Xin Dan — Heart yin and blood deficiency with anxiety, palpitations, vivid dreams.
• Suan Zao Ren Tang — anxious insomnia with day-time fatigue.
• Bu Zhong Yi Qi Tang — Spleen qi deficiency with profound fatigue, low motivation, post-viral picture.
• Liu Wei Di Huang Wan / Zhi Bai Di Huang Wan — Kidney yin deficiency, perimenopausal anxious-low mood.
• You Gui Wan — Kidney yang deficiency, cold-type heavy depression.
• Ban Xia Hou Po Tang — globus sensation in the throat and emotional constraint with phlegm.
• Wen Dan Tang — phlegm-heat with anxiety and palpitations.
• Gan Mai Da Zao Tang — three simple ingredients (liquorice, wheat, jujube); gentle Heart-calming for grief and emotional restlessness.

I prescribe pharmaceutical-grade granules from Sun Ten in Taiwan, blended individually for the actual presenting pattern.

Acupuncture

Several meta-analyses (including a Cochrane review) support acupuncture for depression, with effect sizes comparable to SSRIs in mild-moderate depression and additive benefit when used alongside SSRIs in moderate-severe disease. Acupuncture also improves SSRI side effects — reducing emotional flatness and sexual dysfunction. Typical points: GV 20, Yintang, HT 7, PC 6, LR 3, LI 4, SP 6, KI 3, ST 36, BL 23, BL 18, with auricular points (Shen Men, Heart, Liver) often added.

Diet and gut

• Mediterranean-style diet — best evidence for protecting against depression.
• Oily fish 2-3 times weekly — DHA/EPA supports neuronal membranes.
• Fermented foods — kefir, yoghurt, sauerkraut, kimchi — gut-brain axis support.
• Reduce ultra-processed food, refined sugar and alcohol — all worsen mood.
• Don't skip breakfast — blood sugar instability worsens mood.
• Iron-rich foods — particularly important for menstruating women.
• Treat any IBS or SIBO — gut symptoms often improve mood markedly.

Supplements with evidence

• Vitamin D3 — deficiency strongly associated with depression.
• Omega-3 (EPA-rich, 1-2 g) — RCT evidence for adjunctive antidepressant effect.
• Vitamin B12 (methylcobalamin) — deficiency mimics depression.
• Methylfolate — particularly useful in MTHFR variants.
• Magnesium glycinate — supports stress and sleep.
• Saffron (30 mg standardised extract) — comparable to fluoxetine in mild-moderate depression.
• SAMe — antidepressant effect; can interact with SSRIs.
• Curcumin (highly bioavailable) — modest antidepressant effect.
• Probiotic with L. helveticus + B. longum — psychobiotic evidence for mild depression and anxiety.
• 5-HTP — useful but should not be combined with SSRIs.

Lifestyle

• Daily exercise — strongest single non-pharmacological antidepressant; 30+ minutes most days.
• Strength training 2-3x per week — testosterone, muscle mass, body image.
• Sleep 7-9 hours — regular bedtime; phone out of the bedroom.
• Daylight in the morning — circadian regulation; particularly useful for SAD and perimenopausal mood.
• Time outdoors and in nature — measurable mood benefit.
• Reduce alcohol — under-recognised driver of low mood.
• Connection — loneliness is one of the strongest correlates of depression.
• Purpose and meaning — work, hobby, volunteering, family.
• Meditation, breathwork, yoga — RCT evidence for depression.

When to see a doctor

See your GP urgently if you have:

• Suicidal thoughts or thoughts of self-harm.
• Symptoms of severe depression — pervasive hopelessness, weight loss, inability to function.
• Mania or hypomania (suggests bipolar rather than unipolar depression).
• Psychotic symptoms.
• Sudden onset depression in older adults — needs investigation for organic causes.

Useful baseline blood tests: full blood count, ferritin, B12, folate, vitamin D, TSH, free T4, HbA1c, U&E, calcium, LFTs.

Frequently asked questions

Can Chinese herbs really treat depression?

Yes, particularly mild and moderate depression. Multiple meta-analyses of formulas like Xiao Yao San and Chai Hu Shu Gan San show effect sizes comparable to SSRIs in mild-moderate disease. Severe depression usually needs combined treatment — SSRIs plus herbs and acupuncture — under medical supervision.

Can I take Chinese herbs with antidepressants?

Most combinations are safe. Avoid combining 5-HTP, SAMe and St John's wort with SSRIs because of serotonin syndrome risk. Always tell your prescriber what you are taking.

Which is the best Chinese herb for low mood?

It depends on pattern. Chai Hu and Xiao Yao San for stress-driven mood. Suan Zao Ren and Gui Pi Tang for anxious-tired mood. Ginseng and Bu Zhong Yi Qi Tang for fatigue-driven flatness. He Huan Pi for grief and broken-heart picture. A pattern-tailored formula is always more effective than any single herb.

Does saffron really work for depression?

Yes. Multiple RCTs show 30 mg of standardised saffron extract is comparable to fluoxetine 20 mg in mild-moderate depression. Useful adjunct or alternative.

What about ashwagandha and rhodiola?

Both have good evidence for stress, fatigue and mild depression. They combine well with Chinese herbs and are particularly useful for burnout-type pictures.

How long before I notice a difference?

Energy and sleep often improve within 2-3 weeks. Mood typically takes 4-6 weeks to shift meaningfully. Long-standing or severe cases take 8-12 weeks for full effect.

Is St John's wort the same as these herbs?

St John's wort is European, not Chinese, and has good evidence for mild-moderate depression. However, it has significant interactions with many medications including SSRIs, the contraceptive pill, warfarin and anticoagulants. The Chinese formulas listed above have far fewer interactions.

To discuss low mood, fatigue or anxiety, contact me or book a consultation at my Wokingham clinic.

Related reading: Herbs for cognitive function | Natural antidepressant herbs | Depression

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