Treatment for Depression
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Treatment for depression? What are the results from 'orthodox' medicine? Frankly, not too bad,
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BUT! Not many people like it. They find the medication has unpleasant side-effects or they drop out of treatment before it completes. Others apparently recover then relapse unexpectedly.
So although it seems to work, its reputation long-term is not good. Research conducted under the USA National Institutes of Mental Health treatment showed that between one-third and two-thirds of those participating had no real symptom relief.
(Just to repeat: if the original condition was mild, and had persisted for less than two years, then the right medication might be very effective and not lead to relapse. That still doesn't answer the problem of the side-effects, however.)
Overall, comparisons of the results of the newer SSRIs (Selective serotonin uptake inhibitors) and the older TCAs (Tri-cyclic Antidepressants) shows that the former are about as effective as the latter. About one third of patients on them show improvements that would not have occurred while on placebo, for the second one-third of patients the drugs work about as well as placebo and for the final one-third of patients the drugs don't work at all.
Similar analyses of results show that psychotherapy is, overall, about as effective as drug-therapy. What is more, although drugs may start work faster, patients on psychotherapy don't have the same side-effects from drugs, relapse less, and may be better when the reason for the depression isn't internal: for example if you get depressed because of difficulties at work, not because of a sense of worthlessness that was there beforehand.
Relapse in the long-term
In the short-term, medication treatment for depression works quickly, if it works at all. (But it still takes several weeks to work, usually.)
If after a period of medication you stop taking it because you are better, or continue to take it in a smaller 'maintenance' dosage, what do surveys show you can expect?
Not so good. Up to one-third of patients who did well on initial medication fall back on continued medication. Long-term, with some drugs, the relapse rate is up to 70%. So once you have depression, it tends to recur. And cognitive or inter-personal therapy seems as good as anything at preventing relapse.
What are the causes of Depression?
Why do people get depressed, and when might acupuncture treatment for depression work?
There are lots of scientific theories about the causes of depression and there are lots of possible causes in Chinese medicine too. Few patients have just one absolutely clear cause. Often there is both a psychological and a biological cause.
First, what does Western orthodox medicine suggest might be the causes of depression?
a. Biological
- Daily cycles: depressed people show signs of disturbance of their daily cycles. They find they can't get up in the morning, or they can't sleep at night, or they can't eat at their usual meal-times, or they can only work in the middle of the night.
- Shifting patterns It's also known that shift workers, or those whose work is sometimes at night and sometimes in the day, are more prone to depression.
- A trigger, such as a shock or separation. Sometimes a trigger for depression occurs when something on which the patient depended is removed. A spouse dies, or a job is lost: the presence of either would have made the patient get up at the usual time, eat breakfast, go to work and return in the evening for more food and social interaction. Without the wife or the job, the impetus to carry on normally is lost, which can lead to the trigger for depression, and not looking after himself properly, the patient becomes depressed. (Of course, there will be grief and anger too, other triggers: but here we are just looking at the biological causes.)
- Genes play a part in several kinds of depression. If someone in your biological family has bipolar disorder, you are more likely to have it yourself - although this is not a foregone conclusion.
- Serotonin Regulation Serotonin is a neurotransmitter (not a hormone): it helps you feel good and maintain a good appetite. It also assists digestion, helps constrict blood vessels when a wound is clotting, and helps in learning and memory. Research seems to indicate that when your serotonin regulation system goes awry, you may start to get depressed or show some symptoms of depression. That's why Selective serotonin uptake inhibitors (SSRIs) (eg Prozac) are used to try to regulate your serotonin levels and get you feeling better. One of the ways to increase your levels of serotonin is by increasing exposure to light, especially sunlight. (See more on this below under forms of Qi that help.)
b. Psychological factors
- Social skills If you haven't got supportive friends, family, or colleagues who can help to keep you stable, you are more susceptible to depression. The main supportive person is often a close family member, or spouse. Even good support from others may not make up for the loss of that important individual.
- A sense of Helplessness If you don't feel you can improve your situation no matter what you try, you'll tend to get depressed. This can happen when you are in an uncontrollable situation, or if you realise that whatever you do, it will make no difference. The problem is worse if you develop this attitude in one situation but then apply it to all your situations. For example, if work imposes impossible demands on you and you start to feel helpless, you may start feeling helpless in your relationships outside work, even though no such problem exists there.
- Cognitive causes Here, you stop being able to look at things from more than one point of view: you become biased negatively, and apply this attitude to everything that happens.
c. Male/Female
There's a difference between how men and women deal with depression.
- Men often become more active, by doing more, working harder, taking more exercise - sometimes self-destructively.
- Women tend to internalise it and do less physically, which makes them ponder their situation alone and to take less action. This brings up old, unhappy memories which reinforce seclusive habits and the tendency to depression.
Orthodox Treatment for Depression
Medication
Drug treatment for depression means anti-depressants like Tricyclic medications, SSRIs and (still) MAOI (Monamine oxidase inhibitors) antidepressants. All have side-effects, though so far SSRIs seem to have less of them.
For severe cases, ECT - electro-convulsive therapy is still used in some countries.
Psychological treatment for depression
Cognitive therapy is the treatment of choice, although as explained above, other forms of psychological counseling have their part to play.
Often a combination of approaches is used.
For more on the psychological aspects check here.
Acupuncture Treatment for Depression
In traditional Chinese medicine, treatment for 'depression' is a short-hand for a wide range of syndromes. Syndromes are descriptions of conditions in Chinese medicine when there is an imbalance in, for example, your zang-fu energies, or when describing a condition recognised in Chinese medicine, like 'damp'.
Before designing a treatment for depression, the acupuncturist would, like any practitioner in other forms of medicine, carefully take your case.
In addition, the acupuncturist would take your pulses, look at your tongue, examine any painful areas in your body, palpate your abdomen and consider the results of previous treatments on the flow of Qi along your acupuncture channels.
Your condition would then be described in terms of syndromes. There might be more than one syndrome. However, the following are only examples of what might be diagnosed. There are many other possibilities:
- Qi stagnation
- Qi deficiency, including Stomach Qi deficiency
- Damp
- Liver Qi stagnation
- Lung Qi stagnation
- Weak Shen
- Gallbladder deficiency
- Yang deficiency
- Blockage ('Bi' syndrome) in a channel
- Kidney and/or Jing deficiency
- Pericardium deficiency or blockage
In addition, what might be called 're-education' treatment for depression might be required, if you were in China. In the West we might call this counselling, but in the past some might have described it more like brain-washing. To be fair, however, the aim was to make society work better, and only secondarily, perhaps, to control dissent.
As you can see from the above list, there are many possibilities. Each requires a different strategy when using acupuncture, with different acupuncture points being used.
Of course, the personalities of the patient and acupuncturist matter, but probably more in the West than the East, where the authority and skills of the acupuncturist matter more.
Still, if the diagnosis is correct and the acupuncture treatment for depression performed properly, the syndromes in question should be put right, together with the 'depression'.
For more on this click on acupuncture for depression.
Qi stagnation is very common in depression. You can read my book about it below.
Qi in Treatment for Depression
From the point of view of Chinese medicine, everything we are and can know about is a form of Qi.
The word 'depression' suggests a lowered state of vitality, which means a lowered state of Qi.
Raising your Qi level is therefore important in nearly all forms of treatment for depression! But some forms of lowered Qi, especially those caused by Qi Stagnation, seem as if depressed only because there are two warring factors at work in your mind or body.
- Put it this way. A country in a state of civil war will be less able to defend itself, let alone effectively counter-attack an invader.
- Alternatively, try holding your hands out in front of you. Now press them together with all your might. While doing that, you will have less energy available to do other things.
The Qi Stagnation type of depression is like that. Your body goes into a state of civil war, lowering your Qi. If that internal 'struggle' can be resolved, even temporarily, (acupuncture is very good at this!) then you may be able to stand back and reassess your situation. More important, you'll be more relaxed and have more energy.
Raising Qi - Treatment for Depression Self-Help
If Qi is depressed or deficient, there are many ways to raise it (assuming it's not due to Qi Stagnation, see above, or as described in my book, below).
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Here are some of the best ways you can give yourself a treatment for depression:
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- "If ever tempted by depression I repeat three things to myself: I am an Englishwoman. I was born in wedlock. I am on dry land." Blanche Warre-Cornish
- If you can't get good light - see above - consider a tanning bed, but take care to choose the right kind, which has an electronic ballast, not a magnetic ballast. Magnetic ballast sunbeds often make a loud buzzing and emit electromagnetic wavelengths that may not be beneficial.
- Also, if you can't get enough sunlight (or it is too weak for your body to make its own Vitamin D from the sunlight where you live) take Vitamin D3 or foods that contain it. If you take it as a supplement, there are other vitamins etc that help you absorb it better, including magnesium, vitamin K2, boron, zinc and vitamin A and healthy fats including animal-based with the emphasis on omega-3 fats ... a good, varied, diet comes to mind! ...
- Food. Depressed people often eat either the wrong food, or they don't eat enough food, or they eat it the wrong way. The wrong food or diet gives your body the wrong treatment for depression! Your body needs good food, at the right temperature and eaten right, to make Qi and Blood. Don't forget warm drinks as well as warm food.
- Support: friends, especially those who make you laugh. Both friendship and laughter circulate your Qi, giving you exactly the right kind of treatment for depression.
- Warmth: if you are cold, you won't be able to digest food, nor move around properly - see exercise, below. Warmth is a form of Qi, dispelling cold. Cold slows and drains Yang Qi. So, for most people, warmth makes a good treatment for depression.
- Reduce or stop any medication or drugs you take - not strictly a form of Qi, but a way of avoiding bad Qi - but do this only with the support of your medical advisers, and don't overlook how they were trained and are paid in deciding where their interests lie. Medications take energy to break down in your body; also they introduce toxic compounds that your body has to clear out. All that reduces your Qi.
- What about smoking? These are also medications, just socially accepted ones. They also have detrimental effects, like any medication, but in small quantities can temporarily help to un-stagnate Qi. There's the problem! Once you've had one, you need another to keep you feeling mellow: then it can be difficult to stop.
- What about alcohol? Like smoking, it is socially acceptable; it is relaxing; it helps to ease the flow of Qi. What's not to like? Well, the tendency not to be able to stop, for one thing; the side-effects; dependency; cost; affect on family and friends: as you know, just about everything is great within limits. Unfortunately, like smoking, those limits are hard to maintain, especially if you are or become depressed.
- Exercise: physical movement that gets you out of breath and makes your heart pump faster has a hugely beneficial effect on your endocrine glands, including those that help you to be cheerful. As you age, don't reduce the exercise you take, and make sure that the exercise you take includes not just movement to make you out of breath, but exercise to maintain your strength. Exercise also helps you to keep your appetite. Exercise moves your Qi and helps to increase it: wonderful as a treatment for depression!
- Take up meditation. It's not hard to learn, it doesn't take long to do, and if you do it regularly, say everyday after taking your pills for ten minutes, over time you may find it changes the whole way you think. For a method that has helped millions of people for thousands of years click on meditation. (By the way, I didn't say it was easy to do right, but you'll soon learn!) Done right, it helps your Qi flow more smoothly.
- Get some massage! Massage is a great way to move your Qi. All you need to do is just lie there!
- Acupuncture: this site is mostly dedicated to explaining how Chinese medicine and acupuncture can help you feel better. Chinese medicine is probably 3000 years old, and its origins came from people who lacked the benefits of subsequent thinkers and religions, but they still had moods and emotions. What they learned went on to help create the structure behind Chinese medicine, which is entirely based on the concept of Qi. Would it then be surprising that acupuncture can help as an excellent treatment for depression?
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Jonathan Clogstoun-Willmott Books
All the books in the 'Chinese Medicine in English' series should be fully accessible on Kindles and Kindle apps. (Or you can buy the softback print editions, of course.)
('Western Astrology and Chinese Medicine' published 1986, was never available in a Kindle version.)
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Here are some of the books I (Jonathan) have written.
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Qi Stagnation - Signs of Stress
Yin Deficiency - Burnout and Exhaustion
Yang Deficiency - Get Your Fire Burning Again!
Yuck! Phlegm! How to Clear Your Phlegm ...
Western Astrology and Chinese Medicine
Published 1986 and, amazingly, still selling. Was apparently used back then by at least one acupuncture college to help students understand Chinese medicine!
Four Reviews so far. (Despite the lurid cover, it explains the five main types of phlegm and what works best for each type. I hope it's easy to read and will be much more useful than all the websites on the subject.)
3000 years of Chinese being stressed, and at last, here's a book showing how all that experience can help you!
By the author of this website, it explains in simple English how to use stress to improve and enhance your life.
For the Latest Reviews of 'Qi Stagnation', click here!
NB You can also order 'Qi Stagnation - Signs of Stress' from your bookseller.
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