How Come They're Happy and I'm Not? (22 page)

In TCM, the heart is where the mind and spirit reside. The mind and spirit are also known as the
shen
of a person. So when you meet people who have obvious mental and emotional issues to the point that they seem disconnected from reality (as you might see in someone with psychosis), they have a shen disturbance. Many of these people require drug or psychiatric therapy. Rest assured, most people with emotional issues and depression are not shen
disturbed. If you are reading this book, you are likely not shen disturbed. However, we all may still experience some level of blockage of qi in the heart. Remember this is not actual physical blockage in most cases, but blockage of energy movement that relates to spirit in the Chinese medicine tradition.

Your heart is responsible for making decisions about what makes you happy. Many people with heart issues have a lack of dreams or are confused about life's direction. When people decide to follow a career that they know they are not really interested in or decide to do something that is not right for them, they are “going against the heart.” Sometimes, people become so accustomed to going against their heart that they do not even notice conflict. But the heart sustains damage every time, and slowly, depression sets in. Henry David Thoreau said, “Most men lead lives of quiet desperation.” I think he was referring to people disconnected from their heart.

If you want to work on your heart, a good practice is to review your day and check if you are making decisions that go against your heart. These could be big or small—but each one damages your heart spirit and contributes to depression. As you identify these decisions and start making new ones, you will see mood lift.

Your liver is affected greatly by stress and stagnant energy. But the liver is resilient—in fact, you can cut out practically the whole liver, and it will grow back! No other organ can do that. In TCM, the liver is considered the general of the body. It uses willpower to take the heart's instructions and carry them out.

People with a weak liver know what they want to do and what is right for them but cannot do it because the general is not strong. They experience little drive, no determination, lack of steadfastness, low enthusiasm, and minimal physical and mental power. I see this very often with patients who have depression. They know what is good for them and what makes them happy, but they are
not motivated to make the changes they need. I find that for these people positivity work, along with acupuncture, can motivate.

It's the intention of the TCM practitioner to use food, lifestyle, acupuncture, and herbal therapies to move blocked qi and to nourish deficiency when needed in order to return the body and mind to harmony. Although we do not know exactly how acupuncture works, Western medicine has studied it and finds it can stimulate afferent Group III nerves, a type of nerve that transmits impulses to various parts of the central nervous system and induces the release of serotonin, norepinephrine, dopamine, b-endorphin, and other emotion-supporting molecules called enkephalins and dynor-phins. Many of these are secreted in the hypothalamus, the middle part of the brain where the nervous, immune, and hormonal systems all meet and coordinate with each other. Hypothalamus changes affect mood. Acupuncture also influences changes in the autonomic nervous system (which governs the ability to get stressed or calm down), the immune system, inflammation, and hormones.

In truth, research studies conflict somewhat regarding the benefits of acupuncture. However, a recent and thorough 2008 metaanalysis of eight trials for 477 patients concluded that acupuncture could significantly reduce the severity of depression. In my own clinic, I find clear benefits using acupuncture in collaboration with conventional medicine. Acupuncture allows the pharmaceutical medications to work quicker and typically allows for a lower dose. Acupuncture is also excellent while a patient is weaning off conventional medications, and it is a very powerful adjunct to use with natural medicines.

One of the wonderful benefits of acupuncture is that there are virtually no contraindications to treatment, except for the occasional patient who is afraid of needles. Acupuncture does not adversely
interact with other medications or treatments and will not interfere with breast feeding in postpartum women. Two reviews including 350,000 treatments found side effects to be exceedingly rare. In very rare cases, when acupuncture is not administered properly, points used over the chest could cause a lung to deflate—this is something I have never seen happen in the thousands of patients I have worked with. I have seen people feel dizzy or have a panic attack occasionally after a treatment. More commonly, I see people have an emotional release, such as crying, which is often a good thing. For best results and to ensure safety, work with a trained, qualified, licensed practitioner, preferably one who has received a master's degree in acupuncture from an accredited three-year program.

Figure
4: Key Meridians and Points for Depression

Qi gong incorporates meditation with a purposeful attempt to nourish and heal the body. According to qi gong principles, you learn to cultivate, store, and move energy to relieve symptoms and encourage healing. So in a way, it's like doing acupuncture on yourself but without using needles. When you are anxious and depressed, you probably breathe in a shallow pattern, which affects the flow of oxygen and energy into your body. The qi gong exercise encourages deep breaths, increasing oxygen levels to your tissues.

In one study, thirty-nine subjects suffering from either major depression, dysthymia, or bipolar disorder were taught a qi gong technique called the Level One Spring Forest Qigong techniques in a one-day training session with two follow-up sessions one and two months later. Supportive audio and video recordings were also given to the volunteers to practice for at least forty minutes each day. Researchers determined that all subjects improved over the treatment period, with the severely depressed subjects improving significantly.

Massage therapy is one of the most ancient of health care practices. First recorded in Chinese medical texts more than four thousand years old, massage has been advocated outside Asia at least since the time of Hippocrates.

Massage therapy is shown to improve mood, reduce pain perception, balance electric patterns in the brain, and decrease cortisol. Although at this time no formal research has studied massage as a treatment for depression, I believe it's well indicated. Touch is essential to life. Review studies on babies who are held soon after birth versus those who are not showed that the second group went
on to have more physical and emotional challenges as children and adults. I believe receiving human touch is important to life from the first day through the last. Massage is a type of therapeutic touch that can be quite effective to help patients with depression and may bring a sea change in emotional health for some people, especially if touch is otherwise minimal in their life.

Based on the concept of freeing nerves for optimum health of the body, manipulative therapies like osteopathic and chiropractic work have been used to treat a host of conditions, including depressive illness. There has been relatively little research using manipulative therapies for mood disorder, although anecdotal evidence remains plentiful.

There's one eight-week study of osteopathic manipulative treatment used as an adjunct to standard psychiatric treatment of seventeen premenopausal women with newly diagnosed depression. In this study, 100 percent of the manipulation group and only 33 percent of the control group improved, while neither group had lower inflammation markers. It seemed the manipulation helped the patients feel better but likely not by reducing body inflammation. There's a single case report of a forty-six-year-old man with major depression who received specific chiropractic adjustments and found that his quality of life and wellness increased. Another study focused on fifteen depressed adults treated by a technique called orthospinology, which is a method of correcting upper neck subluxations. It found eleven subjects to have improved mood, while two had minimal improvement and two were worse.

If you are experiencing back and neck symptoms, it's probably worth visiting your chiropractor, naturopath, or osteopathic doctor to see if manipulation can help your mood as well as your back and neck symptoms. Manipulation may not be appropriate for people with low bone density or with advanced stiffness in the arteries of the neck.

Craniosacral therapy involves gentle manipulation of the head, back bone, and sacrum in order to release tensions and imbalances in the bones and membranes of the skull. While the previous section focused on manipulation with a stronger movement, craniosacral therapy is a much subtler and gentler technique safe enough for babies and osteoporotic women, who should not have regular manipulative work. Craniosacral therapy has shown some benefits for depression as well as for anxiety, headaches, neck and back pain, migraine, and even colicky babies.

Fibromyalgia is a condition characterized by pain, low mood, inflammation, and autonomic system dysfunction. Fibromyalgia and depression may have a number of similarities. In one study, eighty-four patients diagnosed with fibromyalgia were treated with craniosacral therapy for twenty-five weeks and found a significant improvement in their levels of anxiety, pain, quality of life, and sleep quality. More studies are needed, but given the gentle and non-risk nature of the treatment, I would recommend considering this as a mood-improvement option for anyone.

Emotional Freedom Technique (EFT) is a therapy that uses finger tapping on acupuncture points combined with a type of talk therapy in order to reprogram negative thinking patterns. In many cases, it can help accelerate the process of reaching underlying issues for patients. Successful application has been observed to treat phobias, and my personal experience with this simple technique has generally yielded mild to significant results in approximately 70 percent of patients experiencing grief, pain, guilt, anxiety, stuck emotion, and functional digestive illness.

This technique involves creating a particular phrase that addresses the emotional blockage and then moving through a series of repetitive statements around that phrase while simultaneously
tapping on acupuncture points. My first experience with EFT was as a student clinician in medical school. I was working with my colleague Dr. Fred Shotz, who had decided to become a doctor after years as an airline pilot. He learned EFT in order to help his passengers who had airplane phobias learn to traverse this fear and get on an airplane. During our first visit with a patient, I witnessed Shotz help a woman who had found nothing that would help her breathing problems. The EFT helped her realize her history as a questionable mother was a core problem, and I was very impressed with her physical results: she started breathing in a relaxed manner within a week, even after every steroid and drug had had no effect. I learned from that session that some issues are beyond the pharmaceutical realm. Even though I didn't fully understand why the EFT worked, I knew that this was powerful medicine.

Today, I use EFT with patients, and I teach many of them to continue to use it for their own self-care. To date, no formal research has studied EFT for patients with depression. More free information is readily available at
www.eftuniverse.com
.

There's an old Chinese proverb that says, “Tension is who you think you should be. Relaxation is who you are.” Biofeedback can help create relaxation out of tension. Founded in 1961 by experimental psychologist Neal Miller, biofeedback involves the practitioner using a monitoring machine to instruct patients on how to control the part of the nervous system that runs the stress and relaxation systems of our body (called the autonomic nervous system). Also known as applied psychophysiological feedback, biofeedback focuses on gaining control over involuntary functions such as heart rate, blood pressure, skin temperature, and muscle tension in order to improve health and well-being. Neurofeedback is a specific type of biofeedback that specializes in reading and altering brain waves (delta, theta, alpha, and beta) to achieve a therapeutic effect.

Two open-label (meaning the subjects knew the treatment they were getting) trials have shown positive results with depressed patients using biofeedback. One ten-week study from the University of Medicine and Dentistry of New Jersey found that eleven subjects had significant improvements in depression and in their heart's ability to adapt during the treatment period. Heart adaptability refers to the nervous system being balanced. A German open-label study showed mood elevation and much less depression. Additional benefits included reduced anxiety, lowered heart rate, and ability of the heart rate to properly adjust its rate after conduction of biofeedback. No changes were found in the control subjects.