resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
The Urinary Bladder Official
The Bladder Official is known as the Official Who Controls the Storage of Water. In Western medical terms, this organ collects the urine excreted by the kidneys.
Grape Seed Extract: A Multifaceted Herb for Promoting Healthy Circulation
One of my favorite herbs is grape seed. Modern research has identified some intriguing health benefits attributable to the seed of this ancient fruit. I particularly use grape seed as an extract standardized for OPCs (oligomeric procyanidins).
Using Facial and Scalp Acupuncture To Treat Neuromuscular Facial Conditions
As a practitioner and instructor of facial rejuvenation acupuncture I have gotten many calls over the past 10 years from individuals seeking help for various conditions affecting the facial muscles, nerves, and overall function of the face.
Qigong to Empower Our Youth
Qigong is an ancient form of exercise and meditation used to promote longevity and health. This practice has traditionally been used by adults to balance the body through mindfulness, focused breathing and gentle movements.
News in Brief
Patriot Project: Serving Those Who Served; CTCA Chiropractor Receives Clinical Innovation Award.
Embracing the Light
Four years, ago I was diagnosed with a labral tear in my hip that was excruciating and "required surgery" according to an orthopedic surgeon. I tried everything and although the symptoms had mostly abated, I had to give up Yoga practice and everything that could exacerbate the tear.
Weighing in on Weight Loss
If your practice trends anything like the U.S. population, you are probably noticing over two-thirds of your patients could benefit from weight reduction, particularly if their main complaints include chronic back or joint pain.
Ever Heard of the Lateral Raphé?
We have all had acute patients enter our offices listing laterally to the side at the level of the lumbar spine or expressing pain on lateral lumbar bending.
Managing Hallux Hypomobility Disorders (Part 2)
In part one of this series we discussed the unique properties and significance of the first toe in the propulsive phase of gait. In particular, we discussed the importance of the first metatarsophalangeal joint (MPJ).
Common Disorders of the Temporomandibular Joint
The evaluation and management of craniofacial pain is a complex endeavor, which often encompasses the presence of temporomandibular joint disorders.
An Alternate Method For Choosing The Right Formula For Your Patients
A constant question for us in the clinic is when to make adjustments and when to stay the course. A patient comes in and says, "Things are the same as last week."
VA Names Sites for Pilot Chiropractic Residency Program
The Veterans Administration has announced the five VA medical facilities that will serve as initial sites for the administration's recently established pilot chiropractic residency program.
Giving Testosterone Levels a Boost (Part 3)
Since testosterone and insulin status are inversely correlated, it's important to keep insulin low so testosterone will remain high.
The Power of Words: DCs Share Drug-Free Approach
There's no doubt that words are powerful and important – especially in the chiropractic profession, where we have been struggling for years to find the right words to describe who we are and what we do.
The Deficiency Myth
If you went to the same kind of medical school I did and took the same kind of licensing exam I took, you were trained to seek out and expect to find primary deficiencies here in the U.S.
Don't Believe It
One of our staff came into my office last week, very concerned about an article she had just read on a news media website. The article suggested researchers found "no health benefits" associated with taking multivitamins.
Gaining an Independent Occupational Code with the U.S. Bureau of Labor Statistics
One of the most important national activities currently taking place in relation to the development of the field of AOM profession is the Department of Labor's Bureau of Labor Statistics' (BLS) revision of the 2010 Standard Occupational Classification (SOC) system.
Preserving the Natural Resources and Culture of Chinese Herbal Medicine
As the world experiences unprecedented population growth and ever-increasing ecological pressures, the topic of preserving Chinese medicine's natural resources has attracted steadily increasing attention from practitioners.
Acupuncture Ambassadors: A Chat with Leader Anthony M. Giovanniello, MSAc,LAc
When you first meet Anthony Giovanniello, you realize he's a humble practitioner, yet is bursting with a type of dedication that you can't help but be overwhelmingly inspired by.
Asymmetrical Pronation: Effect on Adjustments
When your patients don't respond as well as expected to their chiropractic adjustments, oftentimes there is a source of interference in the pedal foundation – asymmetrical pronation.
The Importance of Staying Focused
Our world is so full of over stimulation and constant information. We live in a fast paced, ever-changing society. If you seek you will receive.
Gallop Confidently Into The New Year
Happy New Year! As you may know, this is the year of the Wooden Horse. I received a wonderful gift for Christmas. It is a beautiful glass sculpture of a horse, by Luili Gong Fong, a Chinese artist.
Peer Points: Spreading The Word
Pedram Shojai describes his venture into Traditional Chinese Medicine as a journey led by various "mystical experiences." Shojai decided to change the course of his career when he looked deeper into the basics of TCM.
Diagnosing Flexion-Intolerant Lower Back Pain (Part 2): Exercise Rehab
One of the things that has puzzled us for years is the presentation of the flexion-intolerant patient. We have realized there is a large overlap with sacroiliac indicators. In acute lumbar pain, the SI often twists, subluxes, goes haywire.
June, 2009, Vol. 09, Issue 06
By Elaine Stillerman, LMT
A friend of mine recently admitted that she suffered with postpartum depression (PPD) after the birth of her twins. It wasn't so much her emotional state that took her off guard, she said. But rather that her depression began when they were 5 months old.She was unaware, as are so many new mothers, that the onset of PPD can begin as long as a year after childbirth. All too often health care providers fail to connect a woman's depression with labor and birth after several months have passed since delivery - leaving the mother even more despondent.
It is not at all unusual for most new mothers to experience mood disorders after the birth of their child. The dramatic shift in hormones, the labor and birth, and general fatigue all contribute to fleeting feelings of sadness. As many as two-thirds of new mothers worldwide experience postpartum blues, also known as "baby blues." The onset generally occurs at about day three and the duration of these transient feelings of sadness is about a week or two. The blues are characterized by weeping, insomnia, fatigue, moodiness, and anxiety but is self-limiting. With some rest, support, sunshine, and compassion, these feelings recede without lasting effects.
Since the blues are short-lived, a nurturing massage can be profoundly relaxing and help speed up the emotional healing.
Points of a nuturing massage: Include stimulation to Spleen 3 (Sp 3), under the balls of each foot on the arch, to help balance hormones. Press this point for a count of 6 and repeat a total of 6 times. Sp 6, the uterine tonifier, should also be stimulated. Measure approximately 2 1/2 - 3 cuns (width of a fingertip) from the medial ankle bone posterior to the tibia. The point should be sensitive.
However, for 10 percent to 20 percent of new mothers, the emotional symptoms are more severe and can be debilitating. These women may suffer from postpartum depression, the most common complication of pregnancy, which has a later onset and more exaggerated symptoms. In these instances, massage practitioners should work together with a mental health professional to provide the most supportive environment for the new mother.
Symptoms of PPD
The etiology of PPD is unclear and is varied from woman to woman, but certain factors are suspected to contribute to its development: hormonal fluctuations, any preexisting medical problems, personal or family history of depression, marital dysfunction or general lack of support and social network, immaturity and low self-esteem, negative feelings about the pregnancy, lack of sleep, financial concerns, premature or special needs child, multiple pregnancy, traumatic birth, chronic stress factors, and neurotransmitter deficiencies.
Some important statistics: Teenage mothers are depressed 2.5 times more than older women and African American women suffer from PPD twice as often as white women. Nursing mothers may fare better in avoiding PPD or have less severe symptoms. And for celebrity mothers, PPD is often dismissed or overlooked; it takes a celebrity mother's willingness to discuss her depression before people acknowledge how serious it can be.
The symptoms of PPD almost seem like a typical reaction to childbirth: fatigue, sleep disturbances, and appetite and weight changes. But the red flag should go up when these responses are accompanied by feelings of anxiety, dysphoria, social withdrawal, cognitive disturbances, guilt, hopelessness, helplessness, a sense of worthlessness, or suicidal thoughts.
For women, the symptoms of PPD are similar to major depressive episodes unrelated to childbirth. (New fathers can also experience a form of PPD, as we'll discuss later in this article.) It is also important for the care provider to rule out postpartum metabolic disorders, such as thyroid disease, when assessing PPD because many of the symptoms are similar. Autoimmune thyroid disease can affect up to 10 percent of all women and is often suppressed during pregnancy but is exacerbated during postpartum. Postpartum thyroiditis (PPT) initially presents with a transient hyperthyroid phase 6 weeks to 6 months postpartum. So it appears that the new mother is losing weight in a typical manner. However, this is followed by a hypothyroid phase that can last as long as 1 year. Nearly 6 percent to 9 percent of women develop PPT and manifest symptoms that can readily be construed as depression: fatigue, hair loss, depression, impairment of concentration, inability to lose weight, lethargy, and dry skin.
Both depression and PPT are common reactions to childbirth. As many as 38 percent of women with PPT are also clinically depressed, so it is understandable how difficult it is to determine the cause of the depression. While it is certainly beyond the scope of a massage therapist to make a diagnosis, suggesting that her depression might have hormonal causes that are readily resolved with proper medication may provide support and make her feel less helpless. Regardless of the cause, a client who is depressed should be referred to a doctor or mental health professional who can determine the most appropriate course of treatment.
In the United States, it is estimated that half million women suffer from PPD yearly and that most of them have a history of a mood disorder. The risk of recurrence in a subsequent pregnancy is 25 percent. It is vital that practitioners working with this population recognize the signs and intervene early by referring the client to a mental health professional. One study of PPD found that the depression was less severe for those women whose partners provided them with emotional support. That can extend to include a sensitive massage practitioner. It is interesting to note that in traditional societies where new mothers were celebrated with rites of passage and healing ceremonies, PPD was rare.
Sheila Kitzinger offers several suggestions for new mothers to help them treat PPD. First of all, don't be afraid to ask for help. Make a plan to get out of the house first thing in the morning when symptoms are usually worse; get some exercise, fresh air, and sunshine. Sleep when the baby does and don't try to get everything done all at once. Contact other new mothers and talk with them; seek help if needed.
Although it is not as common or known as women's mood disorders, some new fathers experience their own form of PPD after the birth of their child. These feelings are brought on by fears of becoming a parent, rigid expectations of themselves, feeling ignored by their partner in favor of the baby, and lack of sleep. Manifestations of male (this could also affect the non-birthing female partner) depression might be escaping into work, denying their emotions, outwardly expressing anger at the baby, or complete withdrawal from parenting and relationship responsibilities.
Fathers, often overlooked, also have an adjustment to make to the new member of the household and the better informed they are, the easier this period will be for all concerned. Fathers also need emotional support, for themselves and to be a better support for their partners.
Even more dire but less common is postpartum psychosis (PPP). Affecting 1 percent to 2 percent of the puerperal population, PPP is a clinical emergency requiring immediate intervention because of the heightened risk of infanticide or suicide (especially among young mothers). This psychotic condition has additional symptoms that include sleep disturbances, dissociative behavior, depersonalization, confusion and extreme disorganization, bizarre behaviors, delusions, and unusual visual and/or aural hallucinations. These symptoms can also be an underlying manifestation of bipolar disorder that has a high frequency during postpartum recovery. A woman who suffers from PPP has a 33 percent to 40 percent chance of experiencing it again with subsequent pregnancies. Early intervention dramatically improves the prognosis and prevention of this potentially devastating condition.
Practitioners who massage postpartum women must be on the lookout for any emotional signs that may be troublesome to the new mother. Recognizing these problems early can mean the difference between continued despair or a healthy new lease on life.
Click here for previous articles by Elaine Stillerman, LMT.
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