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Animal Acupuncture: A Case Study in the Treatment of Traumatic Injury in the Equine
The rise of animal acupuncture in the U.S. began in the early 1970's as a result of the work by members of the National Acupuncture Association in Westwood, Calif.
The Tide is Rising in the Acupuncture Profession
Former President Ronald Regan said, "When the tide rises all boats float." The tide is rising for the acupuncture profession. Many forces outside the profession are helping the tides to rise.
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.
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.)
5 Simple Steps to Create an Effective Marketing Calendar
In the educational experience of most healthcare practitioners, business and marketing are overlooked topics.
How Much Do You Know About the Benefits of Birds Nest?
Edible bird's nest is the nest made by the Swiftlet bird of Southeast Asia that is usually prepared as a soup and prized in Chinese culture as a healthful delicacy.
Term Limits: What's in a Word?
It was the French historian and philosopher Voltaire who once declared the Holy Roman Empire was neither holy nor Roman nor an empire.
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.
PCOM Granted Regional Accreditation
Pacific College of Oriental Medicine (PCOM) recently announce it has received regional accreditation from the Western Association of Schools and Colleges (WASC). This achievement reflects five years of hard work on the part of faculty, staff, and students.
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.
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.
Marijuana, Apathy and Chinese Medicine, Part 1
This article was written in response to the unheeded acceptance of marijuana as a harmless substance that potentially does good when used for the medical relief of pain.
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.
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.
The Challenges of Integrating Eastern and Western Medicine
My Masters thesis was titled, "The Challenges of Integrating Eastern and Western Medicine," which highlighted several reasons why it is hard for these two worlds to mix.
Integrating Art with Clinical Practice for Patients with PTSD: The Artemis Project
Are you restricted by those one-on-one clinic dynamics? Why not join colleagues and clients in experimental group settings? Three of us volunteered to do just that in Austin on behalf of women veteranss from all branches of the service.
5 Tips for Using Pinterest to Market Your Practice
Pinterest is a very popular, but often under-utilized, social media platform where people can bookmark, or "pin," fun and interesting things from all across the internet.
The Acupuncturist's Problem
I want share with you some observations and insights into what seems to be the most common problem my colleagues in the acupuncture profession struggles with. If you also struggle with this problem, I hope you get a valuable "aha" moment from reading this.
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.
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.
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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