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Create Community and Grow Your Practice
Many healthcare providers are fortunate to enjoy the freedom and independence of owning their own businesses. However, the constant demands can lead to a lonely and isolating experience unless you make an effort to get out of your office.
Designing a Fitness Plan (Part 1)
It doesn't matter if you come to my practice for pain relief, weight loss, healthy aging or something else. The formula I talk about for each patient's fitness strategy is pretty much the same.
Breech Baby: A Scientific Approach
You learned a classic cookbook style treatment strategy in college for treating breech baby presentation. I'm sure you've used it. The main ingredient: moxa at Urinary Bladder 67.
F4CP Making a High-Impact Impression
The Foundation for Chiropractic Progress has released details of its 2016 strategy, certain elements of which are already in play. The strategy includes ads, posters and other resources available to all F4CP members.
Yo San University Receives $1 Million Gift
Long-time Yo San University supporter Thomas S. Blount recently gave a $1 million dollar gift to the University, it's largest charitable gift to date. Mr. Blount was a retired naval officer, aerospace consultant and philanthropist.
The Concussion-Subluxation Complex
In the Aug. 1, 2014 issue of Dynamic Chiropractic, I reviewed some of the literature demonstrating the role of the chiropractic adjustment in post-concussive care.
When I started to think about what I wanted to do, I toured different schools to choose where to pursue my original chiropractic education.
Pro-Con: Swaddling for Newborns
The practice of swaddling has been used for thousands of years and was popular until the 1700s, when it was slowly abandoned by many cultures that considered it old-fashioned or barbaric.
Making Sense of an Increasingly Obvious Conclusion
Where's U.S. health care heading? Like it or not, the list of telltale signs is growing to a point that stands out to even the most myopic observer. Consider this list of facts as you look into the future of health care in the United States:
Too Many to Remember: Tips to Revive Your Ortho / Neuro Test Skills
When I was at Palmer in the mid-1980s, we were given a set of notes in one of our diagnostic courses. The notes covered approximately 70 orthopedic and neurological tests for various regions of the body.
Targeting the Bad Apples in the Bunch
While everyone was focused on the conversion to ICD-10, the Office of Inspector General for Health and Human Services released a new report on chiropractic titled "CMS Should Use Targeted Tactics to Curb Questionable and Inappropriate Payments for Chiropractic Services."
Detoxification Demystified and the Crucifers that Help
"Let food be your medicine and medicine be your food," is a quote often attributed to Hippocrates, a philosopher of the 5th century BC.
Diagnose Sprain Injuries in MVA Cases With Dynamic X-Rays (Pt. 1)
Am I the only person to notice hospitals are doing a seemingly insufficient job lately in their initial radiological workup of motor vehicle accident (MVA) victims?
Are You a Stakeholder?
In today's world many new things are occurring, especially in the world of information technology. With these changes, comes an entire new set of vocabulary words and definitions.
The 2015 Nobel Prize Shines a Spotlight on TCM Research
Traditional Chinese Medicine continues to make it's presence felt on the world stage as the 2015 Nobel Prize in Physiology or Medicine was jointly awarded to William C. Campbell and Satoshi Omura for their work on combating parasites and YouYou Tu for her discoveries in combating Malaria.
How to Market to the Medical Profession
The world of health care is changing dramatically. When situations occur that cause expenses to increase, it is time for you to develop strategies that maintain and grow revenue.
Building Community: A New Way to Socialize Your Practice
Social Media can seem like a slippery slope when, in fact, it is fairly easy to understand. With social media platforms, you can connect with current and potential new clients, build strong customer loyalty and increase brand awareness.
Tailor-Made Knee Pain: The Sartorius Muscle
A patient was referred to my office after receiving treatment from various providers with no results. The patient was training for the Olympics as a marathon runner and was unable to run or walk without severe medial knee pain.
Cold and Flu Season: Expanding the Repertoire
As we move into the winter months, it is important for clinicians to have a solid working knowledge of effective herbal protocols for treating and managing clinical cold and flu presentations.
Born to Energize the Human Spirit: Recollections of Sig Miller
Sig Miller, longtime executive director of the Association of New Jersey Chiropractors (ANJC), passed away on Sept. 17 after a long battle with cancer.
December, 2003, Vol. 03, Issue 12
Depression and the Stress Response System, Part III
By Ruth Werner, LMP, NCTMB, Massage Therapy Foundation President
In the first part of this series, I introduced the concept of depression and its relationship to touch deprivation and a sluggish stress response system. Last time, I looked at different types of depression and the consequences of living with this disorder.This month, I will discuss treatment options, including, of course, massage.
Most types of depression can be treated successfully: Up to 90 percent of all depression patients eventually find a treatment that significantly improves their quality of life. A combination of medical intervention and psychotherapy appears to be the most effective way of treating most types of depression.
Antidepressants - Medications used for depression usually fall into one of three categories: selective serotonin reuptake inhibitors (SSRIs), monoamine oxidase inhibitors (MAOIs) or tricyclics. These classes of medication aim to make neurotransmitters more easily accessible in the mood-determining areas of the brain. SSRIs, such as Prozac and Zoloft, work by preventing the recycling of secreted serotonin into axon terminals. In other words, serotonin lingers in synapses for longer than it normally would, which reinforces its power to work. Tricyclic antidepressants, including amytriptaline, essentially do the same, although they do not focus specifically on serotonin. MAOIs, such as Nardil and Parate, limit the action of an enzyme that would normally break down and clear away secretions of neurotransmitters. Lithium is used specifically to treat bipolar depression. Rather than altering levels of neurotransmitter reuptake or recycling, lithium works simply to "smooth out" mood swings.
Antidepressants are effective for most people, but they have two major disadvantages: They take several weeks to establish any noticeable mood changes, and they tend to produce unpleasant side-effects during the initial adjustment period, including dry mouth, dizziness, constipation, skin rashes, sleepiness or sleeplessness, and restlessness. Side effects usually subside within four to six weeks - about the same time the medication starts to work.
St. John's Wort - This herbal extract has received a lot of attention as a mood enhancer without the side-effects that other antidepressants carry. Early experiments indicate that it might work like SSRIs or tricyclic antidepressants by preventing the reabsorption of neurotransmitters at the synapses. The National Institutes of Health recently began a three-year study of St. John's wort in comparison to amytriptaline for the treatment of mild dysthymia.
Psychotherapy - Psychologists and psychiatrists may also employ various types of "talk therapy" to help patients improve coping skills and reduce the effects and recurrence of depressive episodes. Three major approaches are useful, depending on the personality and needs of the affected individual. Cognitive-behavioral therapy focuses on the patient's skills at managing life and making positive choices. Interpersonal therapy focuses on how relationships color a person's life, for better or worse. Psychodynamic therapy examines how unresolved inner conflicts can affect the way a person makes choices and lives with those choices. Psychotherapy, combined with medication, often works better than medication alone, because it can help the patient take control of a situation - a feeling many depressive people do not often have.
Light therapy: Individuals living with seasonal affective disorder (SAD) do not need medication or therapy; they need sunlight. Exposure to broad-spectrum lights can help to reduce symptoms.
Electroconvulsive therapy (ECT): Some depression patients do not respond to medication, but the symptoms persist and make their lives miserable. ECT or "shock" therapy may be the best choice for these patients. While this may bring up disturbing memories of the movie "One Flew Over The Cuckoo's Nest," modern ECT is conducted under light anesthesia, and with muscle relaxants to limit uncontrolled contractions. It is not entirely clear why it works, but it can be a highly effective intervention for people who do not get relief from other options.
Massage: Most people suffering from depression will reap several benefits from bodywork. Touch improves the efficiency of the pituitary-adrenal axis. Receiving non sexual, nurturing, non threatening touch is one of the most important ways humans and other mammals have to keep a healthy stress response. Massage moves people from a sympathetic to a parasympathetic state. This brings about several physiological and chemical changes in the body, including an increase in serotonin secretion and a decrease in cortisol. Research about how massage affects mood indicates a shift in electroencephalogram (EEG) activation from the right frontal lobe (usually associated with sad affect) to the left frontal lobe (usually associated with happy affect), or at least to a symmetrical reading.1 Massage is one of the few distinctively pleasurable things people can do that is also really good for them. The act of receiving a massage is a step toward self-determination that depressed people can take with little risk of having it backfire.
Be cautious when working with depressed patients. Some clients who receive massage and enjoy its benefits may wish to stop taking their medication; well-meaning massage therapists may view this as a successful outcome and encourage their clients to try it, but balancing medication for depressive people is a difficult business. Only the patient and his or her doctor should be involved in this decision.
Depression often accompanies complex emotional issues that a client may have trouble sorting out. Client-therapist relationships run the risk, in some cases, of becoming distorted when boundaries are not carefully respected. If a massage therapist has a client who is depressive in connection with other problems (for instance, recovering from emotional, physical or sexual abuse), the relationship can be precarious, especially if the client is not getting adequate support outside the massage clinic. In these cases, therapists are obliged to refer clients for other kinds of help, and to prevent the client-therapist relationship from becoming more central to the client's life than it should be.
I will be taking a short break from my column until next May. Until then, many thanks and many blessings.
Click here for previous articles by Ruth Werner, LMP, NCTMB, Massage Therapy Foundation President.
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