Acupuncture for Depression and Anxiety
Chief Complaint: Difficulty coping with stress; depression & anxiety
Western Diagnosis: Depression & Anxiety
Medical History: 24 year old male PhD candidate. Exercises up to 6 times a week for 1-2 hours each session. Frequently eats take out and drinks 1 caffeinated beverage each day. Works long hours. Drinks 1-3 glasses of alcohol each week. Takes Lamictal (200 mg/day), Wellbutrin (300 mg/day) and Neurontin (300 mg/day) to treat depression and anxiety. Would like to utilize acupuncture to treat side-effects of medications and for overall wellness. Medications cause drowsiness and Wellbutrin specifically can cause agitation, irritability and anxiety after taking dosage.
Questioning exam: Migraines and sinus headaches; shaoyang area shoulder muscle tightness; high-pitched tinnitus; eye strain, blurry vision & floaters; yangming facial acne, red and superficial; sinusitis & and expectoration of white-yellow phlegm; tightness in chest; frequent nose bleeds; nausea, reflux, gas; difficulty falling asleep without neurontin; anxiety is described as a feeling of energy rushing up from his chest to his head; depression is described as “comatose” with very low energy. Patient feels highly-susceptible to stress and symptoms worsen with stress.
Pulse exam: Full, rapid, slippery and wiry with an irregularly irregular beat.
Tongue exam: Teethmarks, greasy coat white in the lower warmer and yellow in middle warmer. Purple sides with a red tip.
OM Diagnosis: Constrained liver-qi with heat as evident by the many “liver signs” as well as stress exacerbating symptoms; rebellious stomach qi and heat in the stomach meridian; phlegm-dampness; heat in the heart as suggested by shen disturbances and specifically the red-tip of the tongue; blood deficient signs (possibly a result of long-term heat).
Treatment Principle: Regulate stomach & liver-qi, transform phlegm-damp, clear stomach/liver/heart heat, nourish heart-blood
Point Prescription: Yintang
Cupping Therapy over upper back and shoulders
Herbal Formula: Herbal medicine wasn’t prescribed.
Dan zhi xiao yao san would have been a good formula for this individual.
Lifestyle Prescription: Suggested dietary changes consisting of avoiding foods that are “hot” in nature such as chillies, ginger, black pepper, alcohol, coffee, red meat, vinegar and excessive salt. Emphasis was on eating fresh vegetables and fruits, whole grains, and “cooling” proteins such as tofu, soy, and yogurt. Patient was advised to avoid eating foods that are deep-fried, BBQ, and roasted.
Results: By the 4th treatment (one month from intial session) patient had cut his Lamictal dosage under his doctor’s supervision from 200mg to 100mg a day. Next treatment was 1 month later and patient had been taken off Lamictal completely without any ill effects. He no longer felt the grogginess he associated with his medications. Treatments were given once per month due to patient’s schedule restrictions By the 9th treatment patient had stabilized at 1/2 the original dosage of Wellbutrin and discontinued Lamictal. Side-effects of his medications were no longer apparent and his depression & anxiety symptoms weren’t worsening. Patient was unable to sleep without Neurontin after several tries at reducing the dosage of this medication.
Synopsis: I suspect that treatments given more frequently then once each month would help this patient reduce his dependence upon Neurontin for a restful nights sleep. However, while receiving treatment once each month patient was able to reduce medications which reduced their side-effects and improved his quality of life. I worked with this patient for a little over 1 year until he relocated after graduating. Patient attributed his med reduction to acupuncture and intended to continue with treatments after moving by following up on referrals I gave him.