I want to start by saying that this is not a political post. This is a post about the stress, anxiety, and depression that is permeating our society right now and how it is treated with acupuncture and Functional medicine. If you get only one thing from this post I hope it would be that we should all be looking out for each other. Likely friends, loved ones, and co-workers are all feeling the acute impact of this election cycle. These feelings can give all of us some compassion and empathy for those people who struggle with anxiety, depression, panic, or other psychological disorders every day. It is not lost on me that I am wrapping up this blog on Veterans Day. We owe our veterans an incredible debt of gratitude and one of the ways we can honor them is to make sure that they are receiving the physical and psychological care that they need. Let’s all just look out for each other and encourage those around us to get help if they need it.
We have all been through the ringer in the last several months. No matter what your political affiliation the prolonged bitter media deluge culminating in a dramatic and emotion provoking election night has left many of us feeling reeled (myself included). I wanted to briefly write about how acupuncture and Chinese medicine and Functional medicine approach anxiety and depression. Within that discussion I’d like to explain treatment options for the unstable emotions many of us are feeling and a little bit about what you can do right now to feel better and minimize the physical repercussions of intense emotions.
Chinese medicine has a fascinating take on psychological health. The development of the medicine never saw the separation of mind and body, which was central to our Western medical model. There were no “psychiatrists” in the development of Chinese medicine, as different emotional states were seen as further manifestations of different physiological imbalances. This led to a much more refined differential diagnosis. Rather than just using broad diagnosis, like depression or anxiety, Chinese medicine looks at the actual quality, physically and emotionally, of the sensation and all the systems of the body affected. For instance does somebody present as agitated with a buzzy sensation in their chest, an inability fall asleep because of a racing mind, and poor digestion with loose frequent trips to the bathroom. Or perhaps they feel intensely sad and despondent, sleeping all day, a sensation of hyperventilating, and sweating through their t-shirt every night. Some people may feel extremely irritable and find themselves snapping at their spouse and children while at the same time feeling muscle tension in the shoulders that feels like two heavy boulders. Maybe we find that we wake for no reason at 2:36am every morning with a profound feeling alertness and dread, which passes at 5am just in time for us to have to get up and go to work. All of these examples would be diagnosed and treated differently.
Chinese medicine brings many tools to bare in the treatment of anxiety or depression. However, the two most profound and quick acting are acupuncture and Chinese herbal medicine. Acupuncture is an incredible tool for normalizing the body’s physiology. We have two aspects to our nervous systems, the sympathetic (fight or flight) and the parasympathetic (relax, digest, reproduce). Only one of these systems is supposed to be active at any given time. These two aspects of our nervous system probably served us well for millions of years, as life was probably extremely boring punctuated by moments of absolute terror. All of these stress hormones and neurological adaptations would surge forth to protect us and we would hopefully survive to, once again, settle into a parasympathetic state. But for many of us the stress of daily life (and prolonged vitriolic elections!) means that we are constantly in a state of low grade fight-or-flight. This sympathetic nervous state requires a lot of energy to maintain and the physiological cost taxes the other systems of the body. Acupuncture is a tool that can immediately reset the balance of these neurological states. There is no other medical modality that can so directly and quickly normalize that dysfunctional fight-or-flight system. This leads to an immediate sensation of calm and improved emotional balance. However, acupuncture does not introduce anything to the system. If the body has been expending large amounts of energy on stressed out physiology then often we need something to replenish our resources. This allows our body to maintain its proper nervous system function and this is where Chinese herbal medicine plays a strong role. Chinese herbs are always prescribed with a “root and branch” strategy. This means that some of the ingredients look to normalize specific systems of the body, such as the digestion, inflammation, etc., while other ingredients act on the symptom presentation, such as insomnia, mania, tightness in the chest, etc. There is also a class of formulas in the Chinese pharmacopoeia that are strong adaptogens, meaning they reduce the effects of stress on the body. They are not sedatives or hypnotics. There is nothing in Western pharmacology that is similar. They just make you feel normal! The combination of these modalities is not subtle and should lead to rapid improvement in all the various symptoms.
When we examine anxiety, depression, or other mood disruptions from a Functional medicine standpoint then we employ some sophisticated lab testing to measure the state of the body’s stress hormone production and examine the balance of neurotransmitter activity. We then use that data to create individualized therapeutic plans which leverage medical grade supplements and lifestyle modification. The three tests which are typically required to investigate the root of mood disruption are a urinary or salivary adrenal profile lab, a gastrointestinal pathogen lab, and a urinary organic acid test. The adrenal profile test allows us to see the function of the hypothalamic pituitary adrenal axis (HPA axis). This shows us if the body is producing adequate or excessive cortisol and DHEA and that the rhythm of that production is occurring properly. People often refer to dysregulated HPA-axis function as adrenal fatigue, but I don’t like that term, as it doesn’t actually reflect the physiology very accurately. But, a properly functioning stress response is paramount for proper mood and function of every body system. We do a GI pathogen screening because the GI tract is the biggest source of hidden inflammation. This inflammation is a significant stress on the body and erodes the proper function of our stress hormones. Plus, some of these common infections, such as H. Pylori, are directly related to mood disorders like anxiety. We learn more about the gut brain connection every day! Finally, what I would consider the “big daddy” of Functional lab testing: the urinary organic acids test. The complex ongoing chemical processes of the body create unique profiles of organic acids that are expelled in the urine. These can be measured and give us a very accurate picture of physiologic function. If one wants to get a direct look at neurotransmitter level in the brain there are two options: a spinal tap (which I don’t recommend!) or measuring the organic acids that are a by-product of their breakdown. We get a very accurate picture of what is happening with serotonin, dopamine, epinephrine, and norepinephrine. I have had the privilege and honor to mentor directly with Dr. Daniel Kalish, who is the leader in Functional Medicine when it comes to the artistry of interpreting this sophisticated lab. Once the lab results are interpreted we then create programs which restore normal function to the stress hormones and brain chemistry. This allows us to live a life free of ongoing pharmacological treatment that may have unwanted side effects.
But, what can you do right now?! Let’s talk about some simple strategies. At a macro level Chinese medicine views emotional shock, anxiety, and depression as issues of stagnation within the physiology. The whole body tightens up. The large muscles of the body contract and circulation of blood stagnates. We breathe shallowly with the top third of the lungs. But, the emotions also stagnate within this gripping of the nervous system. If the fundamental problem is one of stagnation then the other side of the spectrum provides relief. Get away from Facebook (even if you found this on Facebook!) and the constant media. Nothing is going to change right now! Stand up and shake out your arms and legs. Let your shoulders drop. Put your hands on your lower abdomen and count to 5 as you gently and deeply inhale, then count a slow 5 on the exhale. Repeat. Over and over. Do some gentle yoga. Go for a run. Get a massage. Splurge on some spa treatments. Take an epsom salt bath. Plan an evening out with friends. Move your emotions by watching some stand up comedy or rom-com or something. The point is we need to fight the temptation to stagnate in face of the media deluge and engage a wide variety of pleasurable activity. Self care is absolutely a priority. Money spent on pampering yourself now will come back in dividends from your health.
What have I done? I dusted off all my guitars and restrung them. I signed up for some online lessons and turned off the tv. I’ve re-engaged my meditation practice that has become far too intermittent since the birth of my son. I am getting acupuncture daily and I’m taking a strong adaptogenic herbal formula. I made a couple of donations to some charities I care about. Most of all I am trying to practice kindness and understanding to all those around me, in the clinic and out.
No matter if you’re a Democrat, Republican, or Independent we’ve been through a grueling ongoing emotional experience. People talk about the need to heal as a nation. Well, that starts by healing ourselves, so we can nurture the people around us. And if you are feeling overwhelmed seek help. We’re here to help you with an individualized plan of acupuncture, Chinese herbs, or Functional Medicine, whether you are local to our clinic or distant. I, also, can make excellent referrals for therapists, psychologists, and other medical professionals.