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The Easy Way to Learn How to Document ICD-10
The 2015 Work Plan for the Office of the Inspector General (OIG) includes a focus on chiropractic services. This means chiropractors can expect to see more audits and reviews in the coming year because private payers pay attention to the OIG's focus as well.
Online Efforts That Convert Traffic Into Patients
Most chiropractors are using "dinner with the doc," "refer a friend," customer appreciation days, grand openings, health fairs, chamber of commerce meetings, and other networking events to get new patients.
Neuroscience: Where Western Medicine and Chinese Medicine Can Come Together
The recent advances in neuroscience are truly incredible. With this expansion of scientific knowledge, I would like to see even more research into the neuroscientific basic of acupuncture and Chinese Medicine.
It's Time to Create a Strong Acupuncture Footprint
Footprints in the sand. Footprints in the snow. Where do these footprints go? Some are big, some are small, but footprints are made by all.
The Top Seven Website Mistakes Clinics Make
The majority of acupuncture clinics finally have a website for their business. Having a website is crucial for being found online through Google, Facebook and review sites like Yelp.
Acupuncture and Homeopathy: Bioenergetic Brothers
Acupuncture and homeopathy share an important healing principle: bioenergetics. "Bio" means "life," so bioenergetics is literally "life energy."
Finding Balance in the Clinic
This past December, I celebrated 11 years in practice. I seriously don't know where the time went. I feel beyond blessed and grateful to be practicing our profound and beautiful medicine and to be helping guide my patients restore a state of optimal health.
Connections Worth Making
"If most doctors are like me, [they are] isolated physically and professionally. I do not make the time to connect with other doctors and also a lot of doctors do not want to be connected for a lot of reasons. Dynamic Chiropractic keeps me grounded and connected.
A New Era of Injury Awareness Means a New Focus on Prevention
Despite a dramatic Super Bowl last month, the National Football League has taken quite a few hits lately concerning player injuries, particularly concussions.
Are You Really a Healthy Eater?
I always giggle a little bit (to myself) when someone comes into my office and informs me that they are a healthy eater. What exactly does that mean? Does that mean they eat sugar in moderation? And what's that, exactly?
Old TCM Sayings: Treat the Front to Treat the Back
Chinese medicine college was, and always will be, a memorable time. It was a time of massive personal and professional growth.
Reflections: The Art of Teaching Asian Medicine
Over the past three decades, my global workshops have been translated into German, Swiss German, French, Romansch, Spanish, Lithuanian and Xhosa. Time to offer you new teachers a few tips!
Leg Length and Pelvic Fixations
A common component of low back pain is sacroiliac joint dysfunction. Signs of SIJ dysfunction can include fixation with reduced range of motion, and localized pain or joint laxity and inflammation.
We Get Letters & E-Mail
We Have Come a Long Way – But There's a Long Way to Go; Grounded and Connected.
Put the Social Back Into Social Media
Social media is more than a passing fad, it is definitely here to stay. Social media apps and channels of distribution may evolve, but the concept of social media is now big business and a part of all our lives.
Adjusting the Occiput on the Atlas
You may never see a particular set of patients in your office – the ones who are either afraid of neck adjustments or have had a bad experience. A vast majority of those who had a bad experience did not have a life-threatening vascular event.
It might have been a miserable start to the day in the heart of downtown San Diego. A heavy rain had soaked the large homeless population congregating near the intersection of Third Avenue and Ash Street as they waited for a free breakfast to be served at the First Lutheran Church on the corner.
The Conscious Evolution of Healing, Part 2
The idea of transmission is very important in the Chinese medical classics. According to author Claude Larre, the ancient Chinese were highly interested in the connection between things. Nothing was looked at as an isolated entity.
What's Triggering That Point?
An orthopedic friend recently saw a patient of mine. He felt an injection of a trigger point (TP) at the upper trapezius and surrounding areas was necessary, since that was the patient's area of chief complaint and there was a tender, radiating nodule.
Joint Supplements for Athletes (Part 1)
Maintaining joint health should be a daily focus for athletes. Joint health is a complex issue for everyone, but for athletes it poses a greater concern.
August, 2003, Vol. 03, Issue 08
Depression and the Stress Response System: Part I of III
By Ruth Werner, LMP, NCTMB, Massage Therapy Foundation President
Last time, we talked about adhesive capsulitis, and some of you shared wonderful information about this disorder. Conventional wisdom suggests that this disorder is lengthy, painful and debilitating, but that doesn't mean every person will suffer.Many massage therapists are having great success with their clients' "intractable" shoulder pain and restrictions!
My next three columns will focus on depression. This first piece will focus on the definition and etiology of this disorder, with emphasis on the Stress Response System and its influence on mood. The second section will address five common types of depression, including major depressive disorder; dysthymia; bipolar disease; seasonal affective disorder; and post-partum depression. I will conclude the series with a discussion of treatment options, and a look at the interaction between massage, the disease process and the medications commonly prescribed for it.
What is Depression?
Depression is a term used to classify a group of disorders that causes debilitating changes to one's emotional state. I found a wonderful description of depression in one of my favorite books about stress and disease, Why Zebras Don't Get Ulcers, by Robert Sapolsky. He classifies depression as "a genetic-neurochemical disorder requiring a strong environmental trigger whose characteristic manifestation is an inability to appreciate sunsets."1
Depression is a central nervous system (CNS) disorder that involves a genetic predisposition, chemical changes, and often a triggering event, that results in a person losing the ability to enjoy life. It is more than a temporary spell of "the blues"; it can be a long-lasting, self-propagating and debilitating disease. Statistics on the incidence of depression are hard to gather. Most estimates suggest that between 10 percent and 20 percent of the U.S. population experiences an episode of depression every year, amounting to 11 to 19 million people. Women seem to be more susceptible to depression, as well as more likely to seek help. Incidences of diagnosed depression among women are twice as frequent as they are among men.
Etiology of Depression: What Happens?
No one really knows how depression starts. Several distinctive features have been noted in the brains and endocrine systems of depressed individuals, but whether these features cause the problem or are caused by the problem, is still a mystery. Nonetheless, as we learn more about the chemical changes associated with depression, we also learn new ways to treat it:
Many contributing factors collide to initiate a depressive episode. Some of them are controllable; many are not. Whether or not someone will end up feeling depressed depends on his or her own personal chemistry, genetics, and something much harder to quantify: personality.
Depression and the Stress Response System
The Stress Response System (SRS) is the link between the CNS and the endocrine system that allows humans to respond to short-term and long-term stressors. It is controlled by the hypothalamus-pituitary-adrenal axis (HPA): the communication between the hypothalamus, the pituitary gland and the adrenal glands. A healthy SRS allows reactions that are appropriately gauged to the circumstances: big reactions to big threats; small reactions to small threats.
When the SRS works well, the chemical changes it brings about are transitory and quickly neutralized, once the threat has passed. A person with a healthy SRS will have a rapidly beating heart; dilated pupils; dry-mouth; heightened blood sugar; and increased blood pressure when he or she narrowly dodges a drifting car on the highway, but won't blow a gasket when his or her 10-year-old leaves the bike in the driveway again.
Sometimes the SRS doesn't work well. The chemical messages issued first from the hypothalamus, then by the pituitary gland, are slow to leave the brain and reach the adrenals. This takes longer to have an effect on the body, which slows reactions and decreases the ability to respond quickly to threat. The stress reaction is tenacious, and its after effects can linger longer than for someone with a healthy SRS.
Furthermore, people who have a sluggish SRS also tend to have more stress responses, more often, to less threatening stimuli; those responses have longer lasting effects on the body. This type of person fumes in a long checkout line, frets in heavy traffic and explodes when the dog gets into the garbage. This person may have a sluggish, but overreactive stress response and a tendency to develop depression.
What Determines the Health of the SRS?
Studies on animals reveal one reason for a sluggish stress response: lack of tactile stimulation, or touch. Under stimulated animals have consistently slower, longer lasting and more frequent stress responses than animals that have been regularly handled. Consider what this means for the average under-touched person in our society. Touch deprivation and depression might especially affect those who live in isolation, away from the tactile and emotional stimulation of a partner or extended community. Ironically, depression tends to cause people to isolate themselves even further from their communities, which can exacerbate and elongate their problems.
There is some good news: The health of the SRS can be improved with an abundance of healthy, nurturing touch. Next time, we'll look at different types of depression, along with their distinctive signs and symptoms.
If you work with depressive clients, I'd like to hear from you about: the type of depression your clients have; if they take medication; the type of bodywork you do with them; the length of time you have worked together; and the results you are seeing. I will take your input and incorporate it into the next two articles, so get busy!
Many thanks and many blessings.
Click here for previous articles by Ruth Werner, LMP, NCTMB, Massage Therapy Foundation President.
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