• Acupuncture as a Treatment for Depression

    by Dr. Maura Scanlan
    on May 19th, 2016

In this series of articles I am looking at acupuncture and its uses in treating a variety of conditions, including some you might not automatically consider having acupuncture for. My aim is to share what I have learnt in my years of clinical experience and open your eyes to health problems that respond amazingly well to acupuncture. So far we have looked at what acupuncture is and how it can help in the treatment of shingles and, stress and insomnia. If you’d like to read them you can do so by reading the following:

Acupuncture – What Is It and How Does It Work?
Shingles – What Is It and How Can Acupuncture Help?
Acupuncture, a Powerful Treatment for Stress and Insomnia

Depression is another condition that many people don’t associate with acupuncture so, this week, I want to talk about how powerful a medicine acupuncture is for treating depression. I have worked with people to manage their depression using acupuncture either alone or in combination with pharmaceutical medication for over 20 years now and over the years I have observed time and again that the people who integrate acupuncture into their treatment of depression have a greater sense of wellbeing in the long term.

Causes of Depression

The Chinese medicine view of depression varies from the western medicine view; in Chinese medicine, depression is seen as being caused primarily by stuck energy (or qi) while in western medicine it is seen as biochemical due to imbalances of hormones and neurotransmitters. However, both schools of thought agree on the primary triggers of depression:

Emotional stress from the day-to-day grind of life
Too much work
Not enough sleep
Poor diet
Lack of exercise
Death of loved one
Genetics

The beauty of Chinese medicine is that it gives a poetic description to help refine the details of an illness. In a western diagnostic model there are a few categories of depression types but they don’t integrate all the symptoms someone is having into one holistic picture. For example there is a pattern in Chinese medicine where the liver is stagnant and over-acting on the spleen causing digestive symptoms. In this case a person can have depression, anger, poor digestion, diarrhea and malabsorption of their nutrients. This make perfect sense in a Chinese pattern but in a western model they would be diagnosed as different conditions and you would be sent to different doctors who would treat them as separate illnesses.

Chinese medicine works by primarily looking at the flow of qi (or energy) along meridians that connect certain organs, and determining if the qi is flowing smoothly is stuck, excess or deficient. Depression for example, regardless of the initial trigger, can affect the liver, spleen, heart or kidney. Each of these organs has a job to do in order to keep the body healthy and keep the qi flowing smoothly. When there is a block and the energy gets stuck, symptoms arise.

Chinese Patterns of Depression

There are six basic patterns of depression in Chinese medicine that can be broken down into excess or deficient patterns. All of the patterns share the symptom of generalized depression but each pattern is associated with more specific physical symptoms as well. When you connect all the symptoms and treat the body as a whole then depression symptoms improve.

Excess Patterns

Liver Qi Stagnation

Symptoms:
Depression, frustration, restlessness, stomach pain, fullness in the chest, heartburn, belching, indigestion, constipation.

Treatment goal:
To smooth the liver, balance the qi and clear depression.

Helpful acupuncture points:
Liver 3 – Good for depression with anger. Moves stuck liver qi.
Location – near the big toe on the web of the foot between the big toe and first digit.

Ren 17 – Good for a stuck sensation in the chest, chest tightness and palpitations. It also regulates qi and transforms phlegm.
Location – in the center of the chest between the nipples.

Qi Stagnation Turns to Heat

Symptoms:
Short tempered, lots of digestive problems, heartburn, chest pain, dry mouth with bitter taste, red eyes, tinnitus, headache and constipation, inflammation.

Treatment goal:
To clear the heat, smooth the liver and harmonize the stomach.

Helpful acupuncture points:
As above plus:

Ren 12 – Used to treat most digestive and stomach ailments. It harmonizes the stomach, nourishes the spleen and drains dampness.
Location – in the center of the abdomen, halfway between the bottom of the sternum (breast bone) and the belly button.

Stomach 36 – The most powerful point for building qi, especially from the digestive system.
Location – about 4 fingers below the knee on the outside of the tibia bone. If you feel around there is usually a place your finger easily lands on, this is stomach 36.

Qi Stagnation with Phlegm Accumulation

Symptoms:
Discomfort in the throat, feeling of something stuck in the throat, irritability, anger, digestive symptoms.

Treatment goal:
To regulate the qi, transform the phlegm and break up the stagnation (of qi and/or phlegm).

Helpful acupuncture points:
As above plus:

Ren 22 – Transforms phlegm. This point is useful for treating the feeling of stuck phlegm in the throat.
Location – in the center of the neck above the jugular notch.

Pericardium 6 – A common point for nausea, stomach problems and transforming phlegm. It also clears heat.
Location – 3 finger widths above the wrist in the space between the tendons.

Deficient Patterns

Depression Affecting the Mind

Symptoms:
Mental restlessness, spaciness, prone to being weepy and or grief, fatigue.

Treatment goal:
To tonify the heart and calm the mind.

Helpful acupuncture points:
Heart 7 – Good for calming the mind and spirit.
Location – inside of the wrist above the pinky.

Spleen 6 – Supports the spleen and builds yin and is also helpful for qi stagnation. It is easy to find since there is usually a slight indent that is tender to the touch.
Location – 3 finger widths above the ankle on the inside of the leg.

Stomach 36 (see above)

Heart and Spleen Qi Deficiency

Symptoms:
A tendency to worry a lot, difficulty sleeping usually because of ruminating thoughts at night, poor sleep, dizziness, palpitations, pale complexion, poor appetite, loose stools or diarrhea, bloating, poor memory, increased food allergy symptoms.

Treatment principle:
To tonify the heart and spleen, tonify qi and nourish the blood.

Helpful acupuncture points:
Similar points will be used in all of the deficient patterns but this pattern will include more points to support digestion and the absorption of nutrients such as:

Urinary Bladder 15 – Nourishes the heart and calms the spirit, clears heat and regulates qi.
Location – about 2 finger widths out from the 5th thoracic vertebra along the spine.

Urinary Bladder 20 –Strengthens the spleen, transforms phlegm and drains dampness.
Location – about 2 finger widths out from the 11th thoracic vertebra along the spine.

Yin Deficiency with Empty Fire

Symptoms:
Irritability, mental restlessness, palpitations, poor sleep, dizziness, back ache, irregular menstrual periods, running hot with possible night sweats. This pattern usually occurs after years of depression and will have more anxiety mixed with the depression.

Treatment principle:
To nourish the yin, clear the deficient fire and calm the mind.

Helpful acupuncture points:
Spleen 6 (see above)

Heart 7 (see above)

Urinary bladder 23 – Builds kidney yin and strengthens qi.
Location – about 2 finger widths out from the 2nd lumbar vertebra along the spine.

If you have been having symptoms for many years then patterns can start to overlap –  there may be an excess and a deficiency of qi at the same time resulting in tightness in the chest and irritability (excess) as well as loose stools and difficulty sleeping (deficiency). The goal of treatment is to bring your energy back into balance by moving what is stuck, nourish what is deficient and clear what is excess. This can be done with a combination of acupuncture, herbs and, diet and lifestyle changes.

Treatment of Depression – Blending the Medicine

Depression is a spectrum health condition; you can have mild, moderate or severe depression. In addition, there are often multiple other conditions or diagnoses that overlap with it. For example, you might have a history of post-traumatic stress disorder (PTSD) and have depression as well. Everyone who suffers from depression needs to have their own individual treatment plan that may include the following treatments:

Counseling or psychotherapy
Bio-feedback
Diet and lifestyle changes
Exercise
Botanical herbal medicines
Nutraceutical support (vitamins and minerals)
Pharmaceutical intervention

Naturopathic Support

As a Naturopath I will always want to make sure you are taking the correct vitamins and minerals at the right therapeutic dose for you in order to regulate your mood and energy.

I may also recommend doing a couple of tests to help ascertain the best treatment approach for you.  Genetic testing will show us if there is a genetic defect that is contributing to or causing your depression. I use the 23 & me genetic test, a saliva test that only needs to be done once to map out your genetic pathways. As an example of how your genetic make-up may be contributing to your depression, the 5-MTHF defect, one of the most widely understood pathways, reduces your body’s ability to convert folic acid into the active form 5MTHF (5 methyltetrahydrafolate) that the body can use. If you have this genetic defect, taking the active form of folate (5MTHF) in addition to the other cofactors, like Vitamin B6 & Magnesium, you can improve energy and mood. This can make a direct improvement on depression.

Neurotransmitter testing tells us about your levels of neurotransmitters such as epinephrine, norepinephrine, histamine, dopamine, serotonin, GABA and taurine. There are the compounds that allow the brain and the nervous system to talk to each other. If your neurotransmitter levels are too low or too high this can result in depression. By testing neurotransmitter levels we can see which amino acids, vitamins and minerals you need to take to improve your mood and treat depression. Many of the pharmaceutical anti-depressant medications target certain neurotransmitters, commonly they increase serotonin, epinephrine or norepinephrine. Even with all the fancy genetic and specialized lab testing which plays a role in treating depression this does not outweigh the benefit of acupuncture treatment. Acupuncture has the ability to connect all the pieces of the puzzle in terms of the health of your body and get to the source of the imbalance.

When you nourish the roots of the tree, the branches grow.

This is very much the case with acupuncture – the cause of your depression doesn’t matter, acupuncture can support the body and mind, and helps manage your depression.

Conclusion

The beauty of acupuncture is that you can treat the source of your depression and bring your body back into balance with or without pharmaceutical medicines – and it has an immediate effect, you feel better both during and after a treatment. And, when you feel better immediately, making the lifestyle changes that will improve your depression in the long-term is that much easier to do. As I said at the beginning of this article, depression can fall on a spectrum from mild to severe. If you have mild depression then acupuncture, healthy diet, exercise and counseling may be all that is needed to keep you feeling happy and healthy.

For those with more severe depression and/or depression mixed with anxiety, acupuncture blends well with all of the above as well as anti-depressant or anti-anxiety medications. One of the difficulties with anti-depressant medications is that, over the years, some people becomes less sensitive to them and the medications lose their effectiveness. I find that those of my patients that integrate acupuncture into their lives have better long-term management of their depression.

If you are in the Seattle area and would like an acupuncture treatment, my clinic is in Issaquah. I also offer naturopathic appointments in person or on the phone. You can book any of these by using the book online tool above.

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Author Dr. Maura Scanlan

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