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TCM Congress in Rothenburg is Largest in Western World
In the medieval town of Rothenburg, deep set within the Bavarian countryside in Southern Germany, the TCM Kongress Rothenburg each year draws around 1.200 participants from more than 40 different countries to attend the biggest TCM conference in the Western world.
Recreational Cannabis Use and TCM
Many people are drawn to cannabis for its effects physically, mentally and emotionally. Medically, cannabis has some legitimate uses, however the scope of this article is limited to the recreational use of cannabis.
Synergy Doesn't Happen in Silos: Acupuncture in Hospitals and Other Healthcare Settings
As acupuncture and traditional East Asian medicine continue to intersect and integrate with biomedical approaches, the conversation about integration expands and becomes richer.
Turning a Blind Eye to History – and Reality
The American Medical Association is taking the Supreme Court's Feb. 25, 2015 decision exactly as it always does – by turning a blind eye to history, legal precedent and reality.
Low Back Pain in Professional Golf: A Common Muscular Relationship
Every sport creates its own unique demands on the body. Some sports require such a myriad of body positions that assessing pathology is often difficult and unpredictable.
Applying the Thin Skull Principle
The "thin skull" principle, also known as the "you take your victim as you find them" principle, is a legal principle that can be summed up by the following statement.
An Excerpt from TCM Case Studies: Pediatrics
This excerpt is reprinted with permission from Jamie Wu. TCM Case Studies: Pediatrics was released in 2014 by People's Medical Publishing House.
Sleep, Less Sleep or No Sleep?
I had a dream I wasn't getting enough sleep. It was a very realistic dream, even though I was probably slightly awake and not really deep dreaming. Most likely I had been dozing, caught in that twilight of sleep and wakefulness.
Talking to Patients About Lumbar Facet Denervation (Medial Branch Neurotomy)
Lumbar facet denervation, more appropriately termed medial branch neurotomy (MBN), is a procedure that may be considered when patients suffer from recalcitrant non-radicular axial back and/or leg pain.
Optimism = Compassion = Trust
A randomized clinical trial recently published online in JAMA Oncology examined how patients viewed their doctor based upon how the practitioner presented bad news to the patient.
Treating Beyond Pain
More often than not, when a patient presents to the office, it is for a pain complaint. Headache, neck pain, low back pain, sciatica, carpal tunnel... The pain is often the focus of the patient's mindset, and they don't often have any thought of what comes after the pain.
Converting More Patients to Your Practice
In 2013 and 2014, the theme was "the money is in the list." This meant that if you had a big email list, you were really making some "cha-ching." Unfortunately, having thousands of emails doesn't equate to thousands of dollars in profit.
The Need for a New Medical Model: A Challenge for Biopsychosocial and Ecopsychologica Medicine
Chinese medicine speaks of alignment between humans, heaven and earth. It is a complex view with a focus upon relationship. These are comprehensive ideas with no specific terms in contemporary medical practice.
The Dietary Supplement Research Dilemma
I do not care what the truth is, one way or another; I just want to know it. And when it comes to dietary supplements, the truth can be hard to find for a number of reasons.
A View From the ER
The University of Western States has inked an innovative agreement with local nonprofit health system Legacy Health whereby UWS sports-medicine fellows can experience observational clinical rotations in emergency-room settings within the Legacy system.
There Really is No Room for Sexism
Recently, Matteo* (a transgender male) approached me during a break in an advanced shiatsu class in Berlin where he was one of two men in a group of 20 women. "Pamela. Don't forget to remind the translator to include male endings."
A House Divided?
The American Chiropractic Association's House of Delegates voted on 30 resolutions at its annual business meeting in Washington D.C., but two in particular took immediate center stage due to their controversial nature.
Will You Be an Amplifer or a Mute?
These times are changing, and changing quickly. There have been many challenges to this profession throughout the past few years. The challenge is to talk, then talk and talk some more about this medicine.
A Well-Kept Secret: 5 Element Acupuncture, Part II
Supervising acupuncture interns at a TCM college, it has always struck me how funny it is to hear the clinic manager tell the patients that the Five Element clinic specializes in treating emotions, as if patients with physical pain have no emotions!
Functional Hip Impingement (Part 1)
Every time I sit down to write an article, I realize how much more there is to know about musculoskeletal pain. I also learn something new every time. (I want to give special thanks to Lucy Whyte Ferguson for assisting with this article.)
The Way We Are Designed: A Conversation with Gil Hedley, PhD
I was first introduced to the work of Gil Hedley by Tom DiFerdinando. He gifted me Gil's DVD series.
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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