Depression


 

Etiology

Depression affects 15% of the general population at some point of life. It is usually caused by the retardation of Qi and the accumulation of phlegm. It is more profound than the transient experience of discouragement, disappointment, sadness, grief, or despondency. Major depression is a psychiatric disorder that affects mood and neurovegetative functions (e.g. sleep, appetite, concentration). It is never a normal or appropriate reaction to a stressful situation and when left untreated, major depression decreases survival in general and increases morbidity and mortality from cardiac conditions. Aggressive treatment of depression with acupuncture and herbal medicine can improve a patient's sense of well being and change a demoralized, hopeless patient into an active participant in treatment. 

Clinical Features

The manifestations are affective, behavioral and cognitive abnormalities. Major depression is a syndrome characterized by a sustained period of depressed mood or anhedonia (i.e. a decrease in one's interests or drives in life) for 2 or more weeks and associated with four or more of the following seven symptoms: 

o        A change in sleep pattern - insomnia or hypersomnia.

o        A sense of guilt, self-reproach and worthlessness, helplessness.

o        A decrease in energy or fatigue, being slow down.

o        A change in appetite and/or change in weight.

o        A change in psychomotor activity-motor - agitation or   retardation.

o        Suicidal thinking or thoughts of death.

o        Persistent sad, anxious, or "empty" mood.

o        Feelings of hopelessness, pessimism.

o       Loss of interest or pleasure in hobbies and activities that were once enjoyed, including sex .

o       Difficulty concentrating, remembering, making decisions.

o        Restlessness, irritability.

o       Loss of interest or pleasure in hobbies and activities that were once enjoyed, including sex .

o       Difficulty concentrating, remembering, making decisions.

o       Persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders, and chronic pain


Traditional Chinese Medicine differentiates depression into three types:

o        Liver Qi Stagnation, the most common type.

o        Kidney deficiency

o        Yin & Yang separation


Differentiation

o    Drug induced depression

o    Depression caused by chronic illness.


Treatment

o     Acupuncture: Points from DU meridian and PC meridians are chosen as the main points to restore mental clarity and to calm the heart and mind. Mostly we apply needles with even method. In case of agitation, the reducing method may be employed.

      Prescription: DU26, LU11, SP1, PC7, UB62, DU16, ST6, REN24, PC8, DU23, and LI11.

     Explanation: DU26, LU11, and SP1 are effective for regaining mental clarity, expelling heat, and suppressing the agitation. The rest of the points are to reduce the heat and tranquilize the mind.

o   Ear Acupuncture: Sympathetic Nerve, Ear-Shenmen, Heart, Liver, Endocrine, and Stomach.

o   Infrared or moxibustion: I prefer to apply infrared or moxa on REN6  when there are significant amount of deficiency signs, such as fatigue, hypersomnia, and worthlessness feeling.

o   Tuina: I found that most of the depression cases have neck muscle tightness. Neck release treatment usually helps the depression a great deal.

o   A Depression Herbal Formula is designed to disperse the liver Qi, tonify the kidney and harmonize the Yin & Yang.

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