Traditional Chinese Medicine, Western Medicine, and
Massage Therapy
Clinical Depression: How We View It and How We Heal It
“DSM-IV Criteria for
Major Depressive Disorder (MDD)
·
Depressed mood or a
loss of interest or pleasure in daily activities for more than two weeks.
·
Mood represents a
change from the person’s baseline.
·
Impaired function:
social, occupational, educational.
·
Specific symptoms, at
least 5 of these 9, present nearly every day:
- Depressed mood or irritable most of the day, nearly every day, as
indicated by either subjective report (e.g., feels
sad or empty) or observation made by others (e.g. appears tearful).
- Decreased
interest or pleasure in most activities, most of each
day
- Significant
weight change (5%) or change in appetite
- Change
in sleep: insomnia or hypersomnia
- Change
in activity: psychomotor agitation or
retardation
- Fatigue
or loss of energy
- Guilt/
worthlessness: feelings of worthlessness or
excessive or inappropriate guilt
- Concentration:
diminished ability to think or concentrate, or more
indecisiveness
- Suicidality:
thoughts of death or suicide, or has suicide plan”
-Diagnostic Criteria
for Major Depressive Disorder and Depressive Episodes, Diagnostic and
Statistical Manual of Mental Disorders (DSM) IV
A woman speaks –
“Depression is messy. It feels like sadness or guilt or
anger. It feels illogical and irrational. It doesn’t make sense. It hurts.
Depression makes you want to give in, give over, give up. It splits you from
yourself and turns on you with anger. Depression makes you angry with your
body, your self, your life but it never allows the anger to be released.
Depression despairs of hope and cannot see a light at the end of the tunnel.
Nothing can make you feel better when you are depressed.
Except maybe...
A soft and gentle hand on your back that asks for nothing and
gives only soothing. A quiet voice that gives you direction and helps you to
move. A deep release from the tension behind your eyes and the headache and
soul ache that wakes you every morning. The salve of kindness that eases low
back pain or massages the feet with warm lotion or oil. A respite. A break from
the isolation and pain. And after a while, if the dark clouds part and it’s
possible to see into the day again, the depression may lift, if only
momentarily. In that moment, the isolation fades and it may be possible to
connect with another human being – the person behind the hand on the back and
the fingers on the brow.”
- Lois
Pamela
Fitch, RMT, “Depression: How Can Massage Therapy Help”
Depression from a Western Medicine Point of
View
Depression can affect someone in many different ways and
does not have one specific cause. The range of causes include:
·
Chemical imbalance- Serotonin receptors do not
pick up correctly causing a lack of reuptake.
·
Environmental cause- hours of daylight per day
and seasons can have an affect on Seasonal Affective Disorder and the presence
of depression bouts.
·
Trauma- recovery from trauma can often induce an
inability to cope and overwhelming feelings of sadness and hopelessness.
·
Hereditary- the chemical balance of parents can
have an effect on the child’s ability to create and maintain proper serotonin
levels in the body. Parents also have a large influence on the way that a child
views life and the coping mechanisms the child develops in the face of
hardship.
·
Nutritional- a lack of proper nutrition can
result in worsened mood and an inability to maintain homeostasis in many ways,
including serotonin levels and mental state.
·
Social- problems maintaining a healthy mental
state can occur when the human need for a proper support group and a feeling of
being loved goes unmet.
·
Financial- in a world where money is a large
part of every day life, the inability to pay for basic human needs largely
factors into one’s mental state.
How Massage Therapy Treats Depression
Well-intended
human touch has a variety of positive benefits that treat symptoms of
depression. Decreased cortisol (also known as the stress hormone) levels allow
for lower presence of stress, whole body and mind relaxation, and better
quality and quantity of sleep. A person suffering from depression can benefit
greatly from knowing that there is someone there with them, decreasing feelings
of loneliness and helplessness. Human connection through touch can help a
person experiencing overwhelming negative emotions allow those feelings to
release, knowing they are safe. Focusing on the present moment, taking care of
the body, and mindfulness are all parts of massage therapy that are greatly
beneficial in decreasing symptoms of depression. Swedish massage therapy
techniques such as effleurage, petrissage, and compression focus on soothing
and relaxing tense muscles and relieving muscle knots. Temporomandibular joint
(TMJ) work helps with headaches that are caused by clenching the jaw and teeth,
a common side effect of increased stress that comes with depression. Cranio-Sacral
Massage techniques are also very helpful to release occipital-axial compression
that may cause dizziness, pain, brain fog, and headache. Proprioceptive
Neuromuscular Facilitation (PNF) and Passive Range of Motion (PROM) exercises
performed by the Massage Therapist help to ease muscle tension as well as
provide a simple self-care practice that the client can take home and work on
alone. Having a goal and set of exercises can be very beneficial to provide the
right amount of responsibility for one’s self that will boost the person’s
confidence in their ability to care and love themselves without being too
overwhelming. Exercises and stretches done at home, a regular schedule of
massage, human connection, and decreased mental and physical stress all provide
a perfect atmosphere to ease the symptoms of someone suffering with depression.
Tips for the Massage Therapist
Working on
a person affected by depression can be emotionally draining if the Massage
Therapist does not take proper measures to secure their own emotional
well-being. It is important to remember that counseling and psychiatric help
are to be performed by a professional in that field. Massage therapy work for
depression can be similar to working on someone with chronic pain- it is key to
keep in mind that the focus is to alleviate symptoms and provide a safe
atmosphere for healing rather than attempting to cure the condition.
Easing hypersensitivity through the use
of dim lights, weighted blankets (to promote the parasympathetic nervous
system’s “rest and relaxation” response), ear plugs or soft music, and relaxing
smells such as lavender and peppermint are great tools to utilize during the
massage.
Communication is key! Checking in with
the client and being open-minded about treatment options is a highly effective
way to ensure maximum comfort, relaxation, and healing.
Depression from a Traditional Chinese Medicine Point of View
Depression is described as
“Yu Zheng” in Traditional Chinese Medicine (TCM). Causes include:
·
Lung Qi Deficiency-
deficiency of lung qi is characterized with grief, inability to let go,
shortness of breath, and difficulty speaking what needs to be said.
·
Liver Qi Stagnation- liver qi
that cannot move can cause irritability and frustration, anger, and tension in
the muscles.
·
Kidney Yang Deficiency- irrational
fear and anxiety can be the result of an insufficient amount of yang energy in
the kidneys.
·
Presence of Phlegm- phlegm
creates a fog in the brain that makes it hard to think clearly and make decisions.
It makes the body feel heavy, fatigued, and sluggish.
·
Excess Yin- too much calm and
grounded energy can leave a person in a depressed state, unable to get the
energy that they need to function correctly and feeling lackluster toward life.
Yin is characterized as a feminine energy, explaining why depression affects
more women than men.
Yin Organs and Their Related Energies That Manifest in Depression:
Spleen-worry
Liver-anger
Kidneys-fear
Lungs -grief and anxiety
How Traditional Chinese Medicine Treats Depression
Through a variety of
treatment options including Qi Gong, herbs, moxa, acupressure and acupuncture
as well as energy work, the symptoms of depression can be addressed and treated
through TCM. Special attention to the water element, which is considered the
life source, aids in the building of zest for life and ability to function and
feel happiness toward one’s state of being. Water building exercises in Qi Gong
are a great tool for clients to perform with their Massage Therapist and at
home.
Tonifying the Qi in Yin organs mentioned above can ease the
negative symptoms that come from stagnation and deficiency. This can be done
through acupuncture and acupressure along the specific meridians and points as
well as herbal concoctions or burning moxa.
The 9 Points to Revive Yang treatment taught by Cynthia
McMullen is an excellent way to tonify yang and bring energy back to the person
experiencing symptoms of depression. Some herbs recommended for Yu Zheng
treatment in TCM include:
·
Suan Zao Ren and He Huan Pi
for balancing Shen
·
Bai Zhu, Huang Qi, and Wu Wei
Zi for tonifying Lung Qi
·
Chai Hu, Bai Shao, Bai Zhu,
and Dang Shen for moving Liver Qi stagnation
·
Ban Xia, Fu Ling, and Hou Po
for treating Phlegm and Phlem/ Qi clashing.
·
Gan Cao, Fu Xiao Mai, and Da
Zao for Yin and Blood Deficiency
The most important thing in
treating depression through TCM is to regain balance in whatever form is best
for the client. Many treatments can be used simultaneously and allow for a
multi-faceted approach to healing the body and mind.
Sources:
“Depression & Traditional
Chinese Medicine”, Stanley J. Swierzewski, III, M.D.
“Depression: How Can Massage
Therapy Help”, Pamela Fitch, RMT
“Depression: Causes and
Treatment by Traditional Chinese Medicine” by FEMTC of biomanantial.com
Diagnostic Criteria
for Major Depressive Disorder and Depressive Episodes, Diagnostic and
Statistical Manual of Mental Disorders (DSM) IV