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Ask an expert - neuro and psycho logical - Depression

8 questions

Can you advise if it is necessary to have a specialist for depression to treat with accupuncture. 

There is no need to seek out a specialist to treat depression with acupuncture. We are all generalists who treat people rather than conditions, and the huge strength of Chinese medicine is that it looks at the unique and individual presentation of every patient. It would not be unusual for twenty people with the same named condition to be treated in twenty entirely different ways. The practitioner will work to find out exactly what 'depression' means for someone - it's a name that covers a huge range of possible disturbances of the system - and then look at why these problems have arisen in these individuals.

 

There has been a fair bit of research into the use of acupuncture to treat depression, as our factsheet shows

 

http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/depression.html

 

but by far the most interesting result was a study recently conducted by one of our leading researcher/practitioners

 

http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1001518

 

which showed some very positive outcomes. Hugh has also written several follow-up articles looking at the data he and his colleagues collected, but these are a little on the scholarly side.

 

Most of us have treated people with depression as a primary referral because friends, family and colleagues who have come for a problem like backache or headache have found that acupuncture has helped depression too, and have referred on friends for whom depression is the main issue. The only time any of us might be cautious in taking on a case would be if someone's depression was linked to a serious psychiatric illness. Here we do recognise that there are special skills which might be needed, but there are very few patients in this category who present for treatment.

 

Sadly we can't recommend individual practitioners - we have no criteria to go for one over another - but also it follows from what we have said is that we think all of our members are suitably qualified to address the problem you have. If you use the postcode search facility on our home page you will find a number of people who are geographically closest, and most are willing to give up a little time, often without charge, to discuss whether acupuncture treatment is the best option for you. This also has the advantage that you can meet them and see where they work before committing to treatment. 

Q:  I am currently having acupuncture by a Chinese trained TCM practitioner for a respiratory infection. She has suggested taking Chinese herbs as a tea to boost my immune system in addition to acupuncture.

I have bipolar affective disorder (manic depression) and know that some immune supporting Chinese herbs are not suitable as they could trigger a manic episode. My previous acupuncturist would leave some herbs out of her immune mix - but I don't know which ones!

The Chinese acupuncturist I am currently seeing speaks fairly good English, but I am not sure she has understood why I am cautious about taking herbs as I'm not convinced she understands what bipolar is or the potential risks associated (psychotic episode requiring hospital admission).

Please could anyone provide a list of Chinese herbs that are not suitable for someone with bipolar (in Chinese and English if at all possible please). I would like to show the acupuncturist a list of contraindicated herbs in bipolar before agreeing to take Chinese herbs as tea.

A:  It is a rather anomalous fact that Chinese medicine, which is largely acupuncture and herbal medicine, is represented by two parallel sets of organisations in the UK. This has a great deal to do with the fact that there was a strong tradition of medical acupuncture and western herbs already in existence, and the separate elements of TCM grouped around them.

As a consequence, although we have a number of members who practise Chinese Herbal medicine their herbal medicine regulation is undertaken by the Register of Chinese Herbal Medicine, to which most of them belong. The expertise necessary to respond to your question lies there, and I am sure that if you contact them at http://rchm.co.uk/ they will be more than happy to oblige with the information which you need.

The RCHM is a smaller organisation than the BAcC, and not quite so well resourced, so it may take a few days before you get a response.

 

Q:  I am currently having acupuncture by a Chinese trained TCM practitioner for a respiratory infection. She has suggested taking Chinese herbs as a tea to boost my immune system in addition to acupuncture.

I have bipolar affective disorder (manic depression) and know that some immune supporting Chinese herbs are not suitable as they could trigger a manic episode. My previous acupuncturist would leave some herbs out of her immune mix - but I don't know which ones!

The Chinese acupuncturist I am currently seeing speaks fairly good English, but I am not sure she has understood why I am cautious about taking herbs as I'm not convinced she understands what bipolar is or the potential risks associated (psychotic episode requiring hospital admission).

Please could anyone provide a list of Chinese herbs that are not suitable for someone with bipolar (in Chinese and English if at all possible please). I would like to show the acupuncturist a list of contraindicated herbs in bipolar before agreeing to take Chinese herbs as tea.

A:  It is a rather anomalous fact that Chinese medicine, which is largely acupuncture and herbal medicine, is represented by two parallel sets of organisations in the UK. This has a great deal to do with the fact that there was a strong tradition of medical acupuncture and western herbs already in existence, and the separate elements of TCM grouped around them.

As a consequence, although we have a number of members who practise Chinese Herbal medicine their herbal medicine regulation is undertaken by the Register of Chinese Herbal Medicine, to which most of them belong. The expertise necessary to respond to your question lies there, and I am sure that if you contact them at http://rchm.co.uk/ they will be more than happy to oblige with the information which you need.

The RCHM is a smaller organisation than the BAcC, and not quite so well resourced, so it may take a few days before you get a response.

Q:  I have several health issuse's where i feel mainsteam medical isn't helping.  I have joint problems which are getting worse, depression ( and related illness to this such as stress etc).  I am  looking for advice reguarding this and to see if acupuncture or related treatments could help and advise as to where to go. 

A:This is not unique to Chinese medicine and the best of conventional medicine will offer the same. It was, after all, the great Canadian physician William Osler who said,' don't tell me what disease the patient has, tell me what kind of patient has the disease'. This, however, is at the heart of what we do as Chinese medicine practitioners, and informs how we work.

As such the best advice that we can offer is that you visit a BAcC member local to you and ask their advice about whether treatment could work for you. Most are more than happy to give up a few minutes without charge to give someone a better informed view, and most are honest enough to say that there may be other and better options if they believe this to be the case. You can find the nearest people to you simply by using the postcode search facility on our home page.

We think that acupuncture treatment may be an ideal starting place, though. The worst problem with having a number of conditions which all combine is that they feed on each other and create a downward spiral of discontent. If something can break that cycle then the body and mind can start to heal. Less stress can mean a better flow of energy and more chance for joints to recover, less pain can mean less depression and so on. With its track record for treating all three issues as a part of treating the whole person there should be some benefits, and the only issue would be likely to be how much benefit and how sustainable the effects of treatment would be.

Q:  My wife had a spinal fusion 3 years ago Although this was a success she is in severe pain due to scar tissue touching the nerves in the back In addition she suffers severe depression which is historical and increased by her continuous pain and lack of movement Can acupuncture help her?

A:  There is some increasingly good evidence for the use of acupuncture in the treatment of depression, as out factsheet shows

http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/depression.html
 
and as does a heavily publicised research trial by BAcC member Hugh Macpherson and colleagues published very recently

 
 http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001518

Where the depression is linked to a continuing health problem, however, the situation becomes a little more complex. We find that when someone has a chronic and unpleasant physical pain which does not yield it can become a great deal more difficult to deal with the depression that this causes and the underlying depression to which this has added.

If your wife's pain results from scar tissue, then this will take a finite time for the body to deal with. Evidence suggests that this can reduce in impact over time, but some does not. We are reluctant to commit ourselves on whether internal scarring is treatable with acupuncture. We have certainly a great deal of anecdotal evidence about helping with problems at a superficial level by reinstating the flow of energy across operation scars, but less clearly demonstrable evidence for the internal scarring which occurs after lower back operations or disc herniations.

However, as a general principle, traditional acupuncture is concerned with the maintenance of a good flow of energy in well-defined pathways in the body, and any major surgery or injury will interfere with this flow. Using needles to restore as much flow as possible to its original state can never do harm and may do a great deal of good. The term 'speeding up the healing process' is often used and this is what many patients believe that we achieve, but one has to be careful because trials designed to validate this are hard to construct, expensive and not always reliable.

Where there is an interaction between two problems such as these, we tend to believe that the best advice we can give is to visit a BAcC member local to you and get a brief face to face assessment of what may be possible. Nearly all of our members are happy to give up a small amount of time without charge to assess someone's suitability for treatment, and because we look at everything which is going on in the person we can often make some very rapid but valuable assessments of the context and backdrop against which the presenting problems have appeared. This can make a very substantial difference to the kind of prognosis a practitioner might offer. It is also possible to direct someone to other forms of treatment if that would be more appropriate, and this often allows for the kind of personal referral which helps prospective patients find their way through the very large number of complementary therapists practising in their area.

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