Depression

Ms. Dubois, 38, mother of two and health home attendant, consults
            for general fatigue. Three months ago, she was
            sick leave from work by her doctor and, since then, she has taken
            antidepressants and undergoes psychotherapy. Despite this, she
            still feels tired, has difficulty
            concentrate and frequently suffer from insomnia. She consults in acupuncture,
            because she would like to have more energy and get back to work as soon as possible
            possible.

Ms. Dubois suffers from the most common mental illness today:
            depression which it seems will affect one in four people during
            of his life¹. This disorder can also be
            associated with burnout (burnout), at
            seasonal depression and anxiety. The
            Traditional Chinese Medicine (TCM), as a therapy
            energy, can act not only on physical health
            of the individual, but also on his emotional states.

The four stages of the examination

In the four-step approach, it is important for the acupuncturist to realize
            an in-depth case history. Depression does not happen overnight
            tomorrow, it is often the result of a long evolution which
            the source is not always clear. Our accelerated life rhythms
            sometimes prevent us from seeing what we are getting bogged down in …

It also very often happens that apparently early warning signs
            harmless (insomnia, physical pain, headache, palpitations, etc.)
            manifest before the depression is well and truly installed. In
            in such a case, the acupuncturist can detect the emerging imbalance,
            hence the great utility, in addition to a thorough interrogation, of
            taking the pulse (see Palper) and exam
            of the tongue (see Observe).

1- Question

The interrogation concerning the psychological imbalances carries
            on three important aspects, namely physical, cognitive and emotional signs.

Questions about signs physical relate in particular to
            vitality, digestion and sleep; they are part of the study
            of "ground" carried out using
            Ten Songs (see Questioning). The acupuncturist
            asked Ms. Dubois to clarify what she meant by fatigue. She
            reports general weariness and explains how they feel
            tiredness especially when getting up, and that she often goes back to sleep after lunch.
            In the past few weeks, she has resumed doing certain activities
            daily and resolved to take a walk every day.
            However, she is exhausted after a 15 minute walk
            and on some days she feels no motivation to do it. Sometimes,
            she manages to go to the grocery store or to her hairdresser,
            other days it empties her completely and she feels very tired,
            physically and mentally.

With regard to the digestive sphere – which will be decisive
            in the energy balance – Ms. Dubois actually has less appetite,
            but she says it's because she no longer tastes food. She
            often feels bloated after eating and tummy
            lots of annoying gurgles. Her stools are soft, whether she eats or
            not fibers, which discourages her.

Asked about her insomnia, Ms. Dubois says that it takes her hours to
            fall asleep because she thinks of lots of things. When the acupuncturist questions him
            on her thoughts, she mentions among other things that she does a lot of
            worries about her 15 year old boy who sometimes comes health home late at night. Moreover,
            that's how his fatigue started. Her boy came in
            late, she worried, didn't sleep … in the long run, tired,
            she went to see her doctor with the result that we
            know.

The acupuncturist completes his gathering of information using the
            Ten Songs, looking for signs like palpitations, numbness,
            dizziness, headache, back pain, etc. Mrs
            Dubois feels palpitations in the evening, which are mainly manifested
            sleepless nights. She also has dizziness, especially
            on days when she feels very tired.

The sphere cognitive is then examined. Ms. Dubois says to herself
            discouraged by the fact that she has difficulty
            focus on just reading an article in the newspaper. His ideas
            frolicking left and right and she must often read the same
            phrasing. Most of the time she gives up, exhausted. She also admits,
            embarrassed, that her children noticed that she sometimes forgot
            what she was doing or saying.

Finally, the acupuncturist tackles the story emotional of the patient,
            in order to trace the possible origins of depression. Ms. Dubois is
            invited to talk to her about her professional and family life, everything
            as a hobby. Adoring her work, Ms. Dubois explains that she worked
            sometimes more than 50 hours a week, one of his colleagues being
            on maternity leave. She had no choice, and could not leave
            plan beneficiaries. The relationship with her partner is going well,
            but the one with her "teenager", who asserts her independence,
            is more problematic. Finally, she finds her ten-year-old daughter particularly
            overwhelming since she was off work, feeling like a
            bee constantly revolves around it.

2- Auscultate
Auscultation is not used in this case.

3- Palpate

In such a case, palpation is generally limited to taking
            pulse. It turns out to be fine and weak, but we can also feel
            some points like the
back shu points on the Meridian
            bladder
            or Viscera.

4- Observe

The acupuncturist, attentive to Ms. Dubois' non-verbal, notices that she is rather
            calm, that her facial expression is minimized and that she performs
            few movements when it moves. In other words, his organism
            is based on economy of resources. A few times during
            the interrogation, the acupuncturist must bring it back to the subject, because it tends
            to get lost in the little details. Finally, the observation of the face
            reveals a dull complexion, just like her lips. Language
            is pale, covered with a white coating, and has teeth marks on
            the sides (it is said to be "indented").

Identify the causes

On the energy side, we see that the
Qi of the
Spleen / Pancreas is physically drained by
            excessive demands on his professional life, and that he is affected by a
            excess worry (thoughts about her son). You have to know
            that the Qi of the Spleen / Pancreas, in association with the Qi of
Food, allows the production of Blood
            that nourishes the Heart.
            If the Spleen / Pancreas Qi is deficient, the Heart Blood will be
            also in the more or less long term. Often, as is the case here, anxiety
            thus not only affects the Spleen / Pancreas, but also disturbs the Mind,
            whose seat is the Heart. This disturbance, which can be caused
            by any Excess emotion,
            agitates and destabilizes the Heart which can no longer assume its role well
            of Blood, hence the Void
            of Heart Blood.

The energy balance

In TCM, mental aspects are an integral part of
physiology and are interpreted within the different
            analysis grids (see Questioning) which
            allow to pose a
energy balance. Since the
Spirits (or psychovisceral entities) are housed
            in the Organs,
            the energy state of these will influence the state
            emotional and vice versa.

Ms. Dubois shows physical signs of a lack of energy
            the Spleen / Pancreas (a Void
            of Qi).
            The general weariness she feels shows that this Organ
            does not adequately carry out its work of transporting the elements
            nutritious to all body tissues. The weak pulse and the fact that the
            patient performs few movements confirm this hypofunction. Tiredness
            is marked at sunrise, when the body must go from state
            Yin
            (the rest of the night) in Yang
            (daily activities). This moment is demanding for Ms. Dubois, because her
            Qi is so weak that he does not have the minimum spring to make the transition. And
            if she feels the need to go back to bed after lunch,
            is that the Spleen / Pancreas is then in full digestion and has no more energy
            for the rest of the body.

Ms. Dubois believes she has less appetite because she no longer tastes
            food, when in fact both of these are symptoms
            a weakened Spleen / Pancreas. The same goes for bloating with
            gurgling and loose stools: digestion is difficult
            and this has repercussions on all digestive structures.

In addition, unable to assume its role in the production of blood, the Spleen / Pancreas
            improperly nourishes the Heart, which causes all kinds of symptoms arising
            of a Heart Blood Void. So the blood cannot go to the head
            correctly, causing dizziness; the mind
            It is also a victim, hence mental exhaustion. Insomnia and
            constantly flowing thoughts are also signs of an impairment
            of bringing Blood to the Spirit. Indeed, the Blood gives it support
            material necessary to anchor; in deficit of Blood, it "floats"
            and its activity is dispersed. It’s for the same reasons
            that Ms. Dubois can't focus on just reading an article
            newspaper, that she frequently forgets and that her speech tends
            getting lost in the little details (see Yi and Zhi in
Spirits). Unfortunately this only adds to the troubles that disturb
            already the Spleen / Pancreas.

The Void of Blood from the Heart is also perceived by the fine pulse and palpitations,
            results of a Heart Qi Void underlying a Blood Void of the
            Heart. The heart pump is no longer well regulated, the Heart
            throbs. Finally, the tongue is pale and "indented"
            because of the Void of Qi of the Spleen / Pancreas which cannot bring the
            Blood; the white coating reveals the incapacity of the Spleen / Pancreas
            to circulate the
Organic liquids, which accumulate; and the complexion and the lips
            dull reflect the Void of Blood.

The treatment plan

Advice and healthy living

Dietary changes may prevent burnout
            of Spleen / Pancreas Qi and promote recovery
            of the patient. To avoid therefore, sweets, Foods of Nature
            cold or raw, and fatty. The exciting ones like tea, coffee and
            chocolate are also to be taken in moderation, as they create
            heat
            in the upper body and especially in the head, where
            the Spirit is already too dispersed (see
Food). Ms. Dubois should also persist in taking her walks,
            if only a few minutes a day, and reserve good periods
            rest (see Overwork). Finally, the
            meditation and energy exercises (Tai Ji and Qi Gong)
            could be beneficial in giving back to the Spirit a solid and serene foundation.