resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Asking Patients the Right Questions
When was the last time you asked a patient a question? Maybe 30 seconds ago? But, are you asking the right questions to elicit valuable and useful information? As a healthcare provider, you've likely spent hundreds of hours learning to ask the right questions to gather critical health information from your patients.
Specialized Pro-Resolving Mediators: 21st Century Inflammation Fighters
Specialized pro-resolving mediators, or SPMs, are a portion of the omega-3 fatty-acid spectrum that have been shown to have a powerful effect on reducing inflammation.
Let's Streamline Your Front Desk
Your front office can be your greatest source of efficiency or a constant bottleneck. Increasing the productivity of this area without sacrificing the quality of patient interaction can be a little tricky.
Filling the Gap: The Role of Alternative Practitioners in a Broken Health Care System
I have been asked many times what got me into alternative medicine. My answer is simple: I want to truly help and make a difference in people's health.
Designing a Fitness Plan (Part 4): Blending Pain Relief With Healthy Aging
Pain relief is still the No. 1 reason patients come to my office. However, most of my patients have other goals as well, such as: "I want to lose 10 to 20 pounds"; "I feel old and want to slow down the aging process"; "My doctor says I am becoming a diabetic and need to exercise"; or "I'm tired and want more energy."
How Many of Your Patients Have Sarcopenia?
Figure 1 demonstrates the typical appearance of sarcopenia in the paravertebral muscles. Have you considered evaluating your patients for this problem? Sarcopenia is the progressive loss of skeletal muscle mass and function that affects the older population.
Energy: For Life and For Death
Energy is a deep topic in Traditional Chinese Medicine. Qi is understood to underlie all of existence, animated or not, and the qi of the living is studied with special attention.
Day in the Life of an Advanced-Practice DC
Can you tell us a little about your background in the profession? Why did you want to become a DC? I studied at Boston University from 1968-1972 as a pre-med student majoring in biology.
The Art of Listening
One of the most important clinical concepts for me was voiced by the legendary physician William Osler. "Listen to your patient, he/she is telling you the diagnosis." After treating literally thousands of patients, it can become almost second nature to quickly discover clues which reveal the underlying diagnosis.
Excited to Share the Science of Chiropractic: An Interview With Dr. Heidi Haavik
Dr. Heidi Haavik has become known in the circle of chiropractic researchers as not only a rising star, but also one willing to do research that can have a major impact in the scientific world and how chiropractic is perceived.
Health and Wellness Partnership
Yo San University of Traditional Chinese Medicine and The Wellness Center at the LAC + USC Historic General Hospital recently joined forces to extend care to the residents of Boyle Heights area of Los Angeles.
F4CP Launches New Social Media Campaign
The Foundation for Chiropractic Progress has launched a new service to help member doctors: a social media campaign called "Accelerator."
An Alarming Lack of Accountability
Accountability seems to be a lost quality today. The simple act of taking responsibility and doing the right thing just doesn't happen as often as it should. Maybe it is the litigious nature of our society.
Building Relationships and Referral Networks with Allopathic Practitioners
Dr. Doug, an orthopedist of 20 years, had heard stories from patients who tried acupuncture. While he was able to address many of their complaints effectively, some appeared to gain additional benefit when their care included TCM.
Constructing Our Reality: The Primary Channels and Perception, Part 1
My favorite topic of discussion within Chinese medicine is the acupuncture channel systems. First of all, each of us have them. They are part of our bodies; not something external to us. To learn about the acupuncture channels is to learn about ourselves.
The Rest of the Patient Story
I've written previously about allowing a patient to tell you their story – about taking the time to listen and engage all the aspects of their case history, the injury in question, and the related issues.
The Value of Melatonin in Breast Cancer Prevention and Adjunctive Treatment
Although melatonin (MLT) is best known for its sleep-aid properties and as a natural remedy to prevent jet lag, extensive experimental studies suggest it possesses anticancer activity through several biological mechanisms.
Transparency is Key at ASA First Annual Meeting
On March 4th and 5th the American Society of Acupuncturists (ASA) held a successful first annual meeting in Albuquerque, New Mexico.
NCCAOM Launches New Membership Organization
The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) recently launched a new national membership organization, the NCCAOM Academy of Diplomates.
News in Brief
Northwestern Student Honored for Addressing Concussions Head-On; Northwestern Announces New CFO; Life U. to Provide Unique Opportunity.
Misconceptions & Opportunities With Medicare
As I speak around the country on how to properly document Medicare patient encounters, I get questions regarding opting out of Medicare. There are many misconceptions about opting out of Medicare, including just what it means to opt out.
Identify & Adjust the Apex Posterior Sacrum
Low back pain involving an apex posterior sacrum (+θX-axis misalignment) typically presents with signs of lumbosacral joint impingement or facet syndrome.
Roots in the Community, Branches Far Beyond
The Jung Tao School of Classical Chinese Medicine (JTS) was founded in 1998 by Sean Christian Marshall in Sugar Grove, North Carolina, a small community near Boone in the state's westernmost mountains.
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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