Lets talk about depression

Depression in Australia is a serious problem, particularly  given that 20% Australians are currently or have in the past been affected. Tragically, every second, there is someone, somewhere in the world with depression so severe that they will have attempted- or committed- suicide in the time that you have finished reading this sentence.

When I talk to my patients who have been diagnosed with depression, they almost all think that mental health is equally or more important than physical health. Because as a sufferer of depression, they know clearly how the unhappy negative feelings that they start out with, gradually erode their physical health away too. It is a classical vicious circle, in that the resultant physical problems made their situation worse and in turn made them more depressed.

According to TCM pathological theory “Affect damage” (the seven affects) is one kind of cause of disease. Every person alive would have ‘affects’ like joy, anger, sorrow, fear and so on; these are normal mental and emotional responses to our environment. When excessively intense or persistent, the affects may disturb the yin-yang and qi-blood balance and also the balance among the inner organs, and this gives rise to organ dysfunction. This is known as “internal damage”. This internal damage to different organs, are manifest as different symptoms. The internal damage may start with one organ. Other organs could be affected later. So the longer the time delay in the patient received the appropriate treatment, the greater the damage that is done. As a practitioner, I can tell you that your case would become more complex to treat. As a patient, it means that your symptoms become more severe and your recovery takes progressively longer.

Depression is the most common mental illness. At the beginning, the “internal damage” is to the liver. It may take the form of “binding depression” of liver qi characterized by mental depression, irascibility or rib-side pain. If the affective disturbance continues to the heart, lungs, spleen and stomach, bowels, gall-bladder and kidneys,…more symptoms result. These can include insomnia, headache, fatigue, belching, nausea, reflux, abdominal pain or stuffy/ bloated stomach, diarrhea / constipation or IBS, poor appetite or beige eating,  bitter-tasted in mouth, dry coughing or cough with phlegm / blood, chest pain, dizzy or high blood pressure, poor immunity that could ultimately cause cancer. In women, this condition may give rise to breast pain or lumps, period pain, menstrual irregularities (heavier or lighter period, a longer or short cycle), or menstrual block.  It also is one of the causes of infertility. In men, it may give rise to sexual dysfunction, and prostate gland problem later on. Some patients may end up committing suicide or unsuccessful suicide with disabling consequences.

Seeking a natural therapy is the main reason that depression patients came to see me. When I treat the illness involving “Affect damage” (again, in TCM the “the seven affects”), I know it is necessary to gain a full view and understanding of the relationship between the psychological factors and disease, including how those symptoms started and developed and in what order.  I am always patient in listening and questioning, I try to encourage the patient to take appositive attitude and instill the optimistic spirit. The initial consultation for patients with depression  normally took me more than one hour. On the other hand, a conscious and thorough analysis would be performed of the state of yin-yang, qi and blood, to find out which organs had been effected and how severe the damage had been. Only after this, an appropriate treatment plan would be provided. Generally, acupuncture and/or Chinese herbal medicine comprise the appropriate treatment and it is natural without side effect. It could be used both in combination with anti-depression tablets or alone. The TCM treatment result is very efficient.

Depression is all about the state of balance having been broken. If we ask the question(?) – Is the body’s balance between yin-yang and qi-blood, and among the organs so fragile that it is so easily broken ? Absolutely NOT. Before this collapse, the body’s own self-repairing ability and self-adjusting ability would struggle to keep the balance. Whether this rescue work is going to work or not depends on the body’s own health constitution. My patients were surprised to know that depression could also be caused by a physical problem that they might never had noticed or it was not severe enough to be diagnosed by any medical doctor. Some patients’ health constitution decides that they have a greater tendency for the balance to be broken. Depression is a step closer to them.

This state of ‘balance’ that we talk about is relative, not absolute. No one has a perfectly balanced health constitution. There is always a point of weakness formed before birth (congenital) or by an unhealthy lifestyle (environmental). Such a point of weakness is a key to the state of balance being broken. Until this point of weakness was strengthened up, and the health constitution improved, depression would be harder to treat successfully. Even the anti-depression tablet won’t work so well in such cases.

Recently, my patient, Tania, who is a police officer, was suffering from depression and anxiety for 2 years. She couldn’t go through the normal physical work training. She fainted several times when she was on duty because of anxiety and fatigue. She was very depressed. The anti-depression tablet made her feel over-calmed. She described her feeling under medication by using the word ”mentally dead numb “. She lost her self-confidence and felt anxious about work all the time. She is only 26, she was exhausted, developed a poor appetite, bloated stomach, period pain and an unusually light period,… She couldn’t help her tears in front of me. After the consultation, I found the key point of weakness. She seldom ate breakfast, never ate well since she moved out of her mother’s place. Food, proper food, is the resource for the body to make the qi and blood. If the body didn’t get enough food, gradually the qi and blood would become weak, the health constitution would go down, the digestive system would be damaged by running on empty. The other organs couldn’t get nourished properly and so couldn’t work well in cooperation. When Tania needed support to perform well at work, her body tended to be tensed up, to go on strike and shut down. Her “poor performance” and frequent sick leave made her and her boss both upset. Then came depression. I asked her to maintain a good diet — at least 3 healthy meals a day — and prescribed her some herbal medicine to cheer up the digestive system, unblock the live qi,  nourish her blood, ease her nerve. Two weeks later, she stopped taking the herbal medicine. Another two weeks, she dropped in to say “Hello”. She said she ate breakfast every morning, she felt very well that time. She looked happy, confident, so handsome in her uniform.

So for any medical practitioner concerned with treating depression, it is very important to provide adequate treatment and break the vicious cycle of depression-causing-sickness and sickness-causing-depression. And realise that sickness also could be the start of depression. The human body is more complicated than any machine. Health problems are not always visible or able to be found through routine examination.