TCM for Anxiety and Depression: Evidence by Intervention
What reviews of acupuncture, Chinese herbal formulas, tai chi and qigong found for depression and anxiety, with urgent help first and clear limits on what the evidence shows.
Content last updated . This page has not been medically reviewed.
If you are in crisis, get help now
If you or someone you know is struggling or having thoughts of suicide, call or text the 988 Suicide & Crisis Lifeline at 988, or chat at 988lifeline.org. In life-threatening situations, call 911. [1] The 988 Lifeline is available 24 hours a day, every day, and conversations are free and confidential. [2] These are US numbers; this page does not list others.Depression is a medical condition that can be treated with conventional care, including antidepressants and certain types of psychotherapy. [3] Do not stop or swap a prescribed medicine for an herb or a treatment on this page. Ask a pharmacist before adding any herb to a prescribed medicine.
What the research found, by treatment
This page reports what trials of specific treatments measured. It does not test traditional ideas such as liver qi stagnation; those are described on The Seven Emotions and Health in Chinese Medicine and TCM Mental Health Practice.| Treatment and use | What the sources found | Label |
|---|---|---|
| Acupuncture for depression | A 2018 Cochrane review of 64 studies (7,104 people): versus sham acupuncture, a small reduction of 1.69 points on the Hamilton scale (low-quality evidence). Adverse events were not adequately reported in most trials. [4] | Insufficient evidence |
| Chinese herbal medicine for depression | A review of 40 trials (3,549 people) with a risk-of-bias filter found herbs beat placebo on the Hamilton scale (moderate certainty) and matched Western medicines. [5] | Promising but limited |
| Chinese herbal formulas ranked against antidepressants | A network analysis of 198 trials (8,923 people) ranked several formulas above standard drugs, but the authors said larger, methodologically robust trials are needed. [6] | Promising but limited |
| Acupuncture for generalized anxiety disorder | A 2025 meta-analysis of 14 sham-controlled trials (968 people) found lower anxiety scores; certainty was low to very low for patient-reported outcomes. [7] NCCIH notes a 2022 review of 27 trials favoring acupuncture, with a call for more high-quality trials. [8] | Promising but limited |
| Xiao Yao San for anxiety | A review of 14 trials (1,256 people): 8 were at high risk of bias; adding it to anxiety medicine did better than medicine alone. [9] | Promising but limited |
| Tai chi for depression | A review of 12 trials (731 middle-aged and older adults) found a large average benefit with high variation between studies, and the authors warned of lower-quality studies. [10] | Promising but limited |
| Tai chi or qigong in an exercise network analysis | Compared with active controls, tai chi or qigong gave a moderate reduction in depression; only one study overall met low risk of bias. [11] | Promising but limited |
| Acupuncture compared with psychotherapy for depression | Cochrane found it unclear whether acupuncture differs from psychological therapy for depression (low-quality evidence, 2 trials). [4] | Insufficient evidence |
Where this page fits
For the plain-language overview, see Anxiety Disorders and Stress vs Anxiety, Burnout and Depression. For movement practices, see Tai Chi and Qigong.Frequently asked questions
Can acupuncture treat depression?
A Cochrane review found only low-quality evidence of a small benefit over sham acupuncture, and adverse events were poorly reported. [4]
Are Chinese herbs a safe alternative to antidepressants?
Reviews report promising results, but they call for better trials, and herbs can interact with medicines. Do not stop an antidepressant without your prescriber. [6] [3]
Does tai chi help with anxiety or depression?
Reviews of small, varied trials found benefit, with limits in study quality. [10] [11]
Is St. John's wort the same as a Chinese herb?
No. It is a Western herb, and NCCIH says it is not consistently effective for depression and limits the effectiveness of many prescription medicines. [3]
What if I feel hopeless or unsafe?
Call or text 988 in the United States, or call 911 if life is in danger. [1]
More details: evidence, limits and cautions
The details behind this page: cautions, limits of the evidence and where sources disagree. Open any note to read it.
How to read these results
Many of the herb trials come from China, and NCCIH notes that many studies of Chinese herbal products have been of poor quality, so no firm conclusions can be made. [12] A ranking that puts a formula above fluoxetine does not mean it is better for you; it comes from comparing varied trials, and the authors of that review asked for stronger studies. [6] Trials of acupuncture and tai chi cannot be fully blinded, so expectation plays a part.
Safety
- Herbs and medicines: Chinese herbal products can interact with medicines and may be contaminated. [12] See Chinese Herbs With Antidepressants and Other Mental Health Medicines.
- St. John's wort is a Western herb, not a TCM staple, but it comes up often. NCCIH says it is not consistently effective for depression and limits the effectiveness of many prescription medicines. [3] The NHS says doctors do not recommend it because the amount of active ingredient varies between brands and batches. [13] See St. John's Wort Interactions.
- Acupuncture: serious problems such as infections or punctured organs can follow improper delivery. [8]
- Qigong: it is generally considered safe, but there have been reports of qigong-induced mental disorders linked to unrealistic expectations or inappropriate practice. [8] Tai chi is generally considered safe. [8]
- Antidepressant start-up: contact a clinician straight away if hopeless or suicidal thoughts begin or worsen after starting antidepressants. [13]
References
- National Institute of Mental Health (NIMH, US), Suicide Prevention. Read 2026-10-22.
- 988 Suicide & Crisis Lifeline (US), 988lifeline.org. Read 2026-10-22.
- National Center for Complementary and Integrative Health (NCCIH, US), Depression. Read 2026-10-22.
- Smith CA et al. Acupuncture for depression. The Cochrane database of systematic reviews 2018. PubMed 29502347. Read 2026-10-22.
- Wang Y et al. Efficacy and safety of Chinese herbal medicine for depression: A systematic review and meta-analysis of randomized controlled trials. Journal of psychiatric research 2019. PubMed 31326751. Read 2026-10-22.
- Dang C et al. Chinese herbal medicines for the treatment of depression: a systematic review and network meta-analysis. Frontiers in pharmacology 2024. PubMed 38633609. Read 2026-10-22.
- Jiang H et al. Efficacy of acupuncture versus sham acupuncture on generalized anxiety disorder: a meta-analysis of randomized controlled trials. Frontiers in neurology 2025. PubMed 41312341. Read 2026-10-22.
- National Center for Complementary and Integrative Health (NCCIH, US), Anxiety and Complementary Health Approaches. Read 2026-10-22.
- Wang Y et al. Efficacy and safety of the Chinese herbal medicine Xiao Yao San for treating anxiety: a systematic review with meta-analysis and trial sequential analysis. Frontiers in pharmacology 2023. PubMed 37905203. Read 2026-10-22.
- Zeng L et al. Effects of Tai Chi on depression of middle-aged and older adults: an updated systematic review and meta-analysis. BMC complementary medicine and therapies 2023. PubMed 37891569. Read 2026-10-22.
- Noetel M et al. Effect of exercise for depression: systematic review and network meta-analysis of randomised controlled trials. BMJ (Clinical research ed.) 2024. PubMed 38355154. Read 2026-10-22.
- National Center for Complementary and Integrative Health (NCCIH, US), Traditional Chinese Medicine: What You Need To Know. Read 2026-10-22.
- National Health Service (NHS, UK), Depression: treatment. Read 2026-10-22.
Education, not medical advice. This page is for general information. It does not diagnose or treat any condition and is not a substitute for care from a qualified health professional. Natural does not automatically mean safe. Ask a clinician or pharmacist before changing your care, especially if you take medication, are pregnant or breastfeeding, or have a health condition.