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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by Hombre on May 18, 2010, at 4:38:08
Depression, anxiety, neuroses, insomnia, agitation, restlessness, mania, and other mental illnesses/affective disorders are considered to be disorders of the Shen (spirit, as in spunk, vibrancy).
These symptoms often cluster together into a syndrome that may or may not be adequately understood or treated using antidepressants, anxiolytics, antipsychotics, etc. I figure the reason most of us are here is that we are searching for something that explains an often mystifying mix of physical, emotional and mental symptoms.
I am not making the claim that Chinese medicine is the answer. What I do find fascinating is the way Chinese medicine considered mood disorders/mental illness the same way it considers any other illness, that is, the physical, emotional and mental aspects can never be separated since a human being is a holistic entity. Although filled with archaic terms and metaphors for the functioning of the human systems, in a sense it doesn't matter because diagnosis and treatment are internally consistent and the explanations take into account clusters of symptoms.
Here is a long series of articles on Shen Disturbances in Chinese medicine:
http://www.itmonline.org/shen/index.htm
Here is a particularly interesting chapter that immediately made me think of P-Babble and the frustration we all feel trying to seek validation for our illnesses and finding a solution to illnesses that are still misunderstood:
http://www.itmonline.org/shen/chap6.htm
"Practitioners offering natural health care services often encounter patients who have, as part of their syndrome, a neurotic condition, characterized by worry, lack of clarity, and inability to control their emotions sufficiently to aid their health. They may present symptoms that are difficult to describe clearly, with some symptoms that vary or that appear to present conflicting characteristics (especially in terms of traditional Chinese categories such as hot/cold, dry/damp, etc.), and they may have unusual responses to therapies that have already been tried. Such patients are likely to have visited many practitioners in the past and felt unsatisfied with both the diagnosis given and the outcome of treatment. They usually display, upon further questioning, a close linkage between emotional, behavioral, and health problems.
Such patients have been given (or are able to find on their own) non-standard disease classifications, namely those that are not widely accepted in the practice of modern medicine. These diagnoses include candidiasis, multiple allergies, parasites, heavy metal or other toxicity, chronic fatigue syndrome, leaky gut, and others for which standard testing procedures do not confirm the disorder (though various alternative medicine methods may seem supportive). Finding a culprit to blame the condition on, something separate from the individual's emotions and behavior, is often deemed important. Thus, the diagnosis may include reference to a toxin or parasite or rare infection, or an impact from modern society, such as food additives, drugs, or environmental pollutants. Yet, these attributions can be very misleading because, whether or not they are present, they may have little to do with the symptoms.
A diagnosis for these patients such as "liver qi stagnation," "spleen weakness," or "heart fire," may be given by practitioners of Chinese medicine. These exotic terms do not carry the risk of labeling the condition with a term that merely stimulates the emotional reactions to it (e.g., neurosis, hysteria, or hypochondria). While the Chinese medical terms don't automatically convey such concepts as neurotic hypersensitivity or chronic anxiety, Chinese writers often translate the traditional terms in that way when producing translated text books. There is no question among medical doctors in the West-and those in the East-that physical problems exist in these patients; indeed, such patients may have one or more standard medical diagnoses along with the unexplained disorders. However, the patient also is recognized as having functional disorders associated with psychological problems and with behavior patterns that impair both physical and mental health. Doctors often find that sedative and anti-depressant drugs provide a certain degree of relief for the patients, though compliance with using the drugs is often poor because the patients worry about taking them or fear the side effects.
It is not always possible to separate organic diseases from others that might be termed psychosomatic, neurotic, or related to behavior and thought patterns. As an example, the condition known as chronic fatigue syndrome has been very difficult for medical researchers to study because there is such a diverse range of physical and mental conditions that are presented by those who claim to be suffering from it. Among them are persons who are simply depressed or living an erratic lifestyle that brings about fatigue, and there are others who have some kind of viral infection (or group of viruses) that may be identified as the culprit. The infectious agents can wreak havoc on the immune system and cause fatigue as a side effect, but so can emotional disturbances and the adverse effects of certain activities and difficult experiences.
Chinese physicians have dealt with complex patients and difficult to diagnose diseases, such as those depicted above, for many centuries. Examples of relevant disease categories to be presented here include xue dao zheng (blood course syndrome), baihe bing (lily disease), and meihe qi (plum pit qi). These syndromes have an interesting underlying unity, which is the accumulation of damp or phlegm-damp.
It is hoped that by presenting an overview of the way the Chinese have interpreted such patterns and treated them, practitioners who prescribe Chinese herbs as a part of their practice will be aided in both understanding and developing therapeutic plans for the unusual syndromes. Specifically, instead of veering off into a variety of alternative medicine explanations and techniques, practitioners will find that such problems are amenable to the traditional Chinese medical approach with a focus on herbs. Acupuncture therapies that address these patterns are also potentially helpful."
(continued)
Posted by Hombre on May 18, 2010, at 5:03:24
In reply to Chinese Medicine: Shen Disturbances, posted by Hombre on May 18, 2010, at 4:38:08
http://www.itmonline.org/shen/chap8.htm
Withdrawing from SSRIs:
"APPENDIX 1: Guipi Tang and SSRI Withdrawal Syndrome
The problem of adverse reactions to withdrawing from the antidepressants known as selective serotonin reuptake inhibitors (SSRIs) is important to patients, especially since they already may suffer from problems of anxiety and fear which can exacerbate their concerns about symptoms that arise. A Chinese herbal therapy for this condition has not been established, but can be suggested from the typical symptoms of withdrawal. A listing of symptoms that have been repeatedly observed in patients withdrawing from SSRIs is arranged in the left column of the following table by general type, and paired with a potential TCM interpretation of the symptoms in the right column.
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Summing up the notes about TCM interpretation, the withdrawal syndrome may revolve around the problems of qi and blood deficiency, which may be accompanied by qi stagnation and dampness accumulation (and, in rare cases, also by internal wind). These deficiency syndromes of Chinese medicine are attributed primarily to the spleen (for qi) and liver (for blood); a Western interpretation of the same pattern might be a relative deficiency in serotonin availability or an imbalance of neurotransmitters that occurs when the drugs are removed.Key herbs that might be considered for SSRI withdrawal syndrome based on the symptom analysis include:
Atractylodes (white atractylodes): tonifies qi, resolves damp
Peony (white peony): nourishes blood, vitalizes blood circulation
Tang-kuei: nourishes blood, vitalizes blood circulation
Zizyphus: nourishes liver and heart blood and clams shen
Saussurea: circulates qi, calms shen
Ginseng: tonifies qi, calms shen
Astragalus: tonifies qi, raises yang qi
Polygala: resolves phlegm, calms shen
Fu-shen or Hoelen: resolves damp, calms shen
Pinellia: resolves damp, lowers stomach qi
Citrus: resolves damp, circulates qiA formula with these ingredients can be constructed from the traditional formula Gupi Tang, which includes most of the herbs. According to Giovanni Maciocia, who is widely respected for his knowledge of TCM, this formula is itself used for treating depression (11). He noted that: "The formula Guipi Tang tonifies spleen-qi and heart-blood and calms the mind: it is ideally suited to treat post-natal depression and insomnia. This formula is also recommended by Wu Qian in his Golden Mirror of Medicine for post-natal depression from worry, pensiveness, and sadness." The ingredients may be provided as a decoction ( Guipi Tang ), dried decoction, or in tablet form (Guipi Wan).
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While there have not been studies providing clinical evidence for efficacy of Gui Pi Tang, or any of the herbs mentioned, to alleviate SSRI discontinuation symptoms, it is a characteristic of modern Chinese medicine practices to select herbs on the basis of symptom patterns, with the expectation of attaining some level of effect. The symptoms are understood to be a manifestation of an underlying imbalance, whether described in ancient terms (e.g., qi and blood deficiency) or modern terms (e.g., neurotransmitter release and reuptake). That imbalance generates symptoms via common mechanisms that can be affected by the herbs. Starting an herbal formula along with gradual drug dose reductions may prevent or minimize the withdrawal symptoms."(continued)
Posted by Hombre on May 18, 2010, at 8:10:03
In reply to Re: Chinese Medicine: Shen Disturbances, posted by Hombre on May 18, 2010, at 5:03:24
http://www.itmonline.org/5organs/liver.htm
"Liver Disharmony Reflecting on the Emotions and Mental Activities: a deficiency of liver qi typically causes a person to be indecisive and adrift, with a marked inability to plan ahead effectively. If gallbladder qi is deficient, the person will be fearful, have a panicky disposition, and have difficulty making decisions.
Certain emotional states can result from, or cause, liver qi disorders. For example, a state of depression brought on by an unexpected event can eventually cause physical symptoms attributed to liver qi stagnation; liver qi stagnation, in turn, can cause mental depression. An intense outbreak of anger can induce sudden headaches, dizziness, chest pain, and other signs of liver-qi flare up (as the Neijing points out: "When a person is angry, the qi moves up); liver qi flaring up can cause one to feel anger. Sometimes a person will suffer a stroke ("qi and blood rushing to the brain") during or shortly after an outburst of anger. Anger is a physiologically normal emotion and will usually not cause disease. The constant suppression of anger or putting oneself always in a situation that generates anger, on the other hand, can be the cause of long ranging problems, since it promotes a chronic state of internal qi stagnation."
"LIVER QI STAGNATION (gan qi yu jue): primary symptoms are tendency to get depressed; frequent sighing; impatient disposition and temper outbreaks; sensations of stuffiness; fullness or congestion in the chest, intercostal, or subcostal regions. Secondary symptoms include obstructed bowel movements; dry and distended eyes; feeling of something being stuck in the throat; self-doubts and crying; pain (especially intercostal and abdominal) that is characterized by moving, pulling, or penetrating sensations; in females; premenstrual breast distention; menstrual cramping and irregular menstruation. The tongue typically presents with a reddish body (especially at the sides) and a thin coating; the pulse tends to be wiry.
Representative Herbs: bupleurum (chaihu) with peony (baishao), cyperus (xiangfuzi), curcuma (yujin), cnidium (chuanxiong), blue citrus (qingpi), chih-shih (zhishi), corydalis (yanhusuo), melia (chuanlianzi).
Representative Formulas: Bupleurum and Chih-shih Formula (Sini San); Bupleurum and Cyperus Formula (Chaihu Shugan San)."
"LIVER FIRE BLAZING (gan huo shang yan): primary symptoms are pain and distention in the head; dizziness; ringing in the ears or sudden deafness; red face; red, swollen, or painful eyes; dry and bitter sensation in the mouth; marked impatience and tendency to throw fits of anger. Secondary symptoms include insomnia; vivid dreaming; throbbing or burning pain along sides of chest; dark urination; constipation. The tongue typically presents with a red body and a yellow coating; the pulse tends to be wiry and rapid.
Representative Herbs: gentiana (longdancao), prunella (xiakucao), gardenia (zhizi), chrysanthemum (juhua), aloe (luhui), antelope horn (lingyangjiao), bupleurum (chaihu), ch'ing-hao (qinghao), moutan (mudanpi), eriocaulum (gujingcao), celosia (qingxiangzi).
Representative Formulas: Gentiana Combination (Longdan Xiegan Tang); Tang-kuei and Aloe Pill (Danggui Luhui Wan); Purge the Green Pill (Xieqing Wan)."
Posted by StillHopefull on May 18, 2010, at 10:52:06
In reply to Chinese Medicine + Depression: Liver, posted by Hombre on May 18, 2010, at 8:10:03
Posted by janejane on May 18, 2010, at 12:25:42
In reply to Chinese Medicine: Shen Disturbances, posted by Hombre on May 18, 2010, at 4:38:08
Thanks for the links! Need to check out that site.
Posted by sigismund on May 18, 2010, at 16:50:47
In reply to Chinese Medicine: Shen Disturbances, posted by Hombre on May 18, 2010, at 4:38:08
Half the western world probably could get a diagnosis of spleen deficiency. I've been given that one and Heart Fire too.
I've had a lot of luck with baical skullcap, which is one of the herbs that would be indicated for this. I don't need steroid nasal sprays if I take it.
Posted by Hombre on May 18, 2010, at 19:30:02
In reply to Re: Chinese Medicine: Shen Disturbances, posted by sigismund on May 18, 2010, at 16:50:47
Chinese herbs are never prescribed in isolation. Traditional formulas can be modified to fit nuances of one's condition by the addition and/or substitution of herbs. It's pretty amazing that formulas created hundreds if not thousands of years ago still form the basis of many of today's effective formulas.
Spleen deficiency is a very serious thing. I had it pretty bad after a period of overworking. The symptoms completely fit the description according to Chinese medicine. Loose, watery stool for several days. Bloating. Headache. Weak muscles, I felt like there was no strength in my hands. Fatigue. I took a patent formula designed for the condition and saw improvement. It's not something you want to have.
Here's a look at some modern formulas that may help with depression, anxiety and insomnia:
http://www.drjakefratkin.com/pdf/AT-Neurotransmitters.pdf
The thing is that I've been using an either/or exclusive type of thinking. Only meds can help me (well, diet and exercise too). But there's no reason why I can't look to Chinese medicine to help with some of the nagging complaints I have which my doctor ignores, i.e. night sweats, inconsistent effects of Seroquel on sleep and anxiety, the weight gain and hyperlipidimia that I normally have and that may be aggravated by Seroquel, the dry mouth and consipation that I get from Effexor, and so on.
Posted by sigismund on May 18, 2010, at 19:41:26
In reply to Re: Chinese Medicine: Shen Disturbances, posted by Hombre on May 18, 2010, at 19:30:02
>Chinese herbs are never prescribed in isolation.
Well, that's right, but I felt baical skullcap was way better than steroids, so I went down to the herb shop and bought some. The language barrier meant I could never have had them prescribed.
Actually, my logic was as follows......
Valium leads to reactivity leads to steroids. Use Zizyphus (for nerves) use less Valium, take baical skullcap and eliminate steroids if possible.
I thought that made sense.TCM is wonderful. I suppose some herbalists are better than others, as with acupuncture
I need some kind of plugin for your link.
Posted by Hombre on May 19, 2010, at 4:12:04
In reply to Re: Chinese Medicine: Shen Disturbances, posted by sigismund on May 18, 2010, at 16:50:47
Very cool about the skullcap. I didn't mean to sound dismissive of your success with that, BTW.
Posted by sigismund on May 29, 2010, at 21:23:39
In reply to Re: Chinese Medicine: Shen Disturbances » sigismund, posted by Hombre on May 19, 2010, at 4:12:04
No problem at all.
That is a tremendous link.
I love Taoism (then you could be no one drifting lazily beside it!!), and copied this from it.......
'I have a big tree,' said Hui-tzu to Chuang-tzu. 'Its huge trunk is so gnarled and knotted that no measuring string can gauge it, and its branches are so bent and twisted they defy compass and square. It stands right beside the road, and still carpenters never notice it. These words of yours [referring to the stories of Chuang-tzu recorded in this chapter], so vast and useless, everyone ignores them the same way.'Chuang-tzu replied [after giving examples of his point]: 'Now, you've got this huge tree, and you agonize over how useless it is. Why not plant it in a village where there's nothing at all, in a land where emptiness stretches away forever? Then you could be no one drifting lazily beside it, roam boundless and free as you doze in its shade. It won't die young from the axe. Nothing will harm it. If you have no use, you have no grief.
Posted by Hombre on May 29, 2010, at 23:35:18
In reply to Re: Chinese Medicine: Shen Disturbances » Hombre, posted by sigismund on May 29, 2010, at 21:23:39
Man, I think there is a lesson in there that I desperately need right now. All these years of depression and struggling have really made forget that not everything in life is to be measured by standards of usefulness or any standard at all. I used to be good at being useless. Somehow I turned on myself and denied myself that joy.
Thanks.
Posted by sigismund on May 30, 2010, at 3:09:27
In reply to Re: Chinese Medicine: Shen Disturbances, posted by Hombre on May 29, 2010, at 23:35:18
A hundred years ago I read "Chuang Tsu" and laughed myself sick in parts.
This is the end of the thread.
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