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A New View on Treating Depression

by Jingduan Yang, M.D.

Depression is considered a world-wide epidemic. It knows no socio-economic boundaries and is currently the leading cause of disability among Americans ages 15 to 44 according to the Center for Disease Control and Prevention. Each year, approximately 17 million Americans are diagnosed with depression. A very common approach to treating this disease is with the use of psychotropic medications. One in ten Americans diagnosed with depression were prescribed anti-depressants. Although, this methodology can provide symptom relief to some, the side-effects can be as debilitating as the disease itself. In extreme cases, depression can result in suicide. Over 60% of people who die by suicide were diagnosed with depression. The annual cost of treating depression in our country is a staggering $150 billion.

The causes of depression are very individualized and so too should be the treatment. This is not to deny that antidepressants may play a key role in helping people become more functional and productive in their daily lives. However, the cost and effectiveness of this treatment option is not always predictable. Alternative therapies either in conjunction with medication or without have proven to be extremely successful in treating many types of depressive disorders.

Before depression can be properly treated, one must understand the root cause of illness. Depression describes a syndrome consisting of depressed mood, loss of interest and enjoyment in usual activities, reduced energy and decreased activity. It also includes reduced self-esteem and confidence, ideas of guilt and unworthiness, pessimistic thoughts, disturbed sleep and diminished appetite, and even ideas of self-harm. Stress, trauma, hormonal and seasonal changes can all be precipitating factors of depressive conditions. Depression also commonly co-exists with other symptoms such as headache/migraines, pain, irritable bowels and bladder, fatigue, and digestive dysfunctions.

Chinese medicine is a complete medical system we inherited from an ancient and probably more advanced civilization. It features knowledge of energetic anatomy, physiology and pathophysiology of the human being. Therefore, it has unique perspectives on illness and diseases like depression. Chinese medicine holds that depression is a prolonged state of excessive yin energy or lack of yang energy. The human body's self-balancing mechanism fails to restore its equilibrium. This energetic imbalance affects the internal organs of the human body.

In Chinese medicine, the internal organs are energetic centers that connect with other parts of the body including the brain through energetic channels that are far more comprehensive than the nerves or vascular system. The yin organs; the heart, lungs, liver, spleen, and kidney are paired with yang organs; the small intestine, large intestine, gallbladder, stomach and bladder. Therefore, when they are energetically unbalanced, both physical and mental functions of the involved organs are compromised and clinical symptoms ensue.

When excessive yin energy affects the heart/small intestines, people feel a lack of interest and enjoyment in life, are socially withdrawn, have trouble maintaining a clear mind, have restless sleep and are unable to concentrate. They may have a pale complexion, heart palpitations, cold extremities and poor blood circulation. A broken relationship can be particularly important precipitating factor.

When excessive yin energy affects the lungs/large intestines, people feel sad, experience a sense of loss and grief, become tearful or cry, have trouble maintaining routines and discipline, have a poor sense of self-image and lack physical stamina. They may also be susceptible to respiratory illnesses such as; allergy, sinus infection, asthma, and bronchitis. It can also cause difficulty with urination and bowel movements. The loss of loved ones can be the triggering factor for this imbalance.

When an over-abundance of yin energy affects the liver/gallbladder, people tend to feel angry, frustrated, disappointed and can experience panic attacks and nightmares. Disturbed sleep, poor judgment and planning and troubled relationships are common. These individuals often suffer from reflux, bloating, irritable bowels, joint and connective tissue pain, painful periods, clenching jaws, and migraines. A history of trauma with recent interpersonal conflicts can frequently exacerbate the condition.

When too much yin energy affects the spleen/stomach, people tend to worry about everything, exhibit obsessional behaviors, ruminate on negative thoughts, have a fuzzy brain and have poor self-esteem with feelings of worthlessness. Very often these individuals experience poor appetite or excessive eating and crave sweets and carbs resulting in a struggle with weight control. They tend to suffer from fatigue, heavy menstruation, bruising, diarrhea and muscle weakness and achiness. A history of having critical parents with a sense of insecurity is a common predisposition within this group.

When excesses of yin energy affects the kidney/bladder, people lack motivation and will power to do anything, have trouble with memory and concentration, have poor sleep, are fearful, and experience low libido. They also tend to have hair loss, tinnitus, lower back pain or knee soreness, and frequent urination or incontinence. Childbearing-age women may have trouble conceiving. Life events that generate fear can be the trigger of the episode. Patients can have more than one organ system affected resulting in more complex clinical symptomatology. One organ system imbalance can lead to the imbalance of other organ system imbalances.

Individuals suffering from severe and debilitating depression or who have thoughts of self-harm, may need medication, Transcranial Magnetic Stimulation (TMS) therapy, psychotherapy and perhaps inpatient treatment for safety purposes. Once the condition is stabilized and controlled, the addition of individualized acupuncture and Chinese herbal medicine can be very advantageous. Following a comprehensive Chinese medicine evaluation; nutritional therapy, chronic infection assessment and treatment, mind-body techniques such as neuro-biofeedback, Neuro-Emotional Therapy and Eye Movement Desensitization and Reprocessing therapy (EMDR) with continued psychotherapy may also be recommended and together can have very positive and lasting effects on identifying and treating the root cause of depression.

To summarize, depression is not a "one size fits all" disease and there is a lot that we can learn and benefit from Traditional Chinese Medicine in treating patients safely and effectively that far exceeds the boundaries of conventional therapies such as medication, Electroconvulsive Therapy (ECT) and Cognitive Behavioral Therapy (CBT) that are conventionally offered as the only options.

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