The Treatment of Depression with Acupuncture and Chinese Herbs
Chief Complaint: depression
Western Diagnosis: depression, generalized anxiety disorder
Medical History: 42 year old female. Extreme despair every morning, characterized by great anxiety, terror of organizing her life, suicidal thoughts, fatigue.
Questioning exam: The patient revealed that she vomited bile on many mornings and she had had a cholecystectomy 3 years previously. She was intolerant of fat.She had struggled with weight gain and was overweight, gaining 60lbs. in three years.She had a very large scar under the right rib cage from the surgery.
Pulse exam: pulse was slippery bounding and full on the surface at the guan position and deficient in the cun and chi positions.
Palpation of the belly showed tightness around the Liver and at CV.14 and 15.
Tongue exam: The tongue was surprising in how normal it looked!
OM Diagnosis: Gall Bladder Qi Deficiency.
Gall Bladder Damp Heat.
Liver Qi Stagnation.
Heart Yin Deficiency
I don’t know if you can have both Gall BLadder Qi Deficiency and Damp Heat simultaneously in strict TCM thinking, but I think this patient had both! I think she was Gall BLadder Qi deficient giving rise to the extreme fear of Life and paralysing fear when having to decide anything. I think she had Gall Bladder Damp Heat as there was an urgent, excess, agitated quality underlying the depression with the suggestion of rash action. There was also the vomiting of bile 3-4 times a week and the wight gain and intolerance of fat.
Treatment Principle: Purge Gall Bladder Damp Heat, strengthen Gall Bladder functioning.
Point Prescription: Needling around the prominent cholecystectomy scar.every treatment.
GB 34 threaded 4″ to just below Sp.9 bilaterally every treatment.
CV.6, 12, 14
Herbal Formula: 7 Forests ‘Taraxogen’
which consists of:
Dandelion extract – Pu Gong Ying
Lotus Leaf extract – He Ye
Lysimachia extract – Jin Qian Cao
Artichoke leaf extract
This formula is very cholagogic i.e. it improves bile flow, and it aids in the elimination of fats, and it is cooling, so we can etrapolate that it clears Damp Heat.
I later put her on 7 Forests Lysimachia 3 in addition to the Taraxogen (contains Jin Qian Cao – Lysimachia, Hai Jin Sha Cao-lygodium spores
Ji Nei Jin – Gallus)
I used this formula, designed for dissolving Gall Bladder stones, as I figured that she probably had micro crystallizations of bile stone formation that were contributing to the three diagnoses. Obviously the cholecystectomy was just attacking the symptoms.
Fish Oil. 3-5 tablespoons a day.
Once she went on the two previous formulas she could tolerate the fish oil with no problems.
This last addition
Lifestyle Prescription: Moderate exercise. She tried to do some walking every day.
Her diet was pretty clean.
Results: For the first 5 weeks that I treated this patient I missed the obvious imbalance staring at me in the form of this giant cholecystectomy scar. I concenmtrated my treatments oon the patients Heart and Shen and Liver, to no very great effect. It was very hard to witness this patients extreme mental anguish and not to be able to help her very much. THe first breakthrough was the Taraxogen formula whish shifted her from breakdown and suicidal despair to holding her depression in the context of something she could get a handle on. The effect was dramatic. The Liver Qi Stagnation did not respond to the usual Xiao Yao variations, nor to Shu Gan etc. It responded dramatically to addressing the Bile function. THe next big breakthrough was putting her on a high dose of Fish oil. There is a lot of recent research into the anti-depressant effects of Omega three fatty acids and DHA oil, a component of fish oil. I suspect that her Gall Bladder blockage, or micro crystalization in the bile ducts of the Liver was impeding her ability to utilize fat, which gradually caused an underlying Heart Yin deficiency and Shen disturbance. Once fat reabsorbtion was facilitated the symptoms abated, and in this case, to a dramatic extent.