USING CHINESE TRADITIONAL MEDICINE AND NATURAL THERAPIES TO RELIEVE DEPRESSION AND FUZZY THINKING

Misha Cohen, OMD, L.Ac.

Chronic illness often triggers mental dysfunctiondepression, fuzzy thinking, memory loss, lethargy, and mood swings. A person with HIV/AIDS, may become depressed as a result of anxiety, anger, and underlying worry about being ill, or from frustration with the limitations that side effects such as fatigue and neuropathies can impose on life.

Add to these factors changes in the brain related to HIVsuch as changes in serotonin levels, some specific AIDS-related complications, and side effects of HAART and other medicationsand youve got the formula for emotional upset or turmoil.

Allowing oneself to simply accept feeling depressed or confused for weeks or days at a time is not generally a good idea. It is important to consult a Western physician to make sure there is no AIDS-related infection or complication that can and must be treated with Western medicine immediately.

In addition, one may sometimes to consult a counselor, psychologist or psychiatrist for help in managing the stresses of living with chronic disease. HIV support groups can often help one to manage depression, anxiety, and life changes associated with an HIV/AIDS diagnosis or changes in health over the years of diagnosis and treatment.

Chinese traditional medicine practitioners also have many treatment choices to offer that are designed to resolve the disharmonies in the Shen (spirit) and organ systems that are associated with mental dysfunction.

There are two main Chinese traditional medicine diagnoses associated with depression and general mental dysfunction: Shen (spirit) disturbance and lack of Shen. (EDITORS NOTE: In Chinese medicine, Shen, Qi, and Xue refer to various essential substances that are thought to flow through the body, and illness is thought to result from a disturbance in these substances. See previous issues of Numedx for a more detailed understanding of Shen, Qi, Xue, and other traditional Chinese medical concepts.)

" Shen disturbance, when combined with the Chinese diagnosis of Qi stagnation, may lead to depression, forgetfulness, disorientation, insomnia, anxiety, digestive upset, chronic headaches and irritability. It can be associated with alcoholism and panic attacks. Even psychotic episodes can result from Shen disturbances coupled with Qi stagnation. To restore balance to Shen, various treatments are aimed at restoring harmonious flow of Qi and Xue and balancing the heart and liver organ systems.

" Lack of Shen produces different symptoms: The eyes are glassy, there is little engagement with the world, and in short, the lights are on but no ones home.

Acupuncture is a helpful intervention for depression. Two studies from the Journal of Traditional Chinese Medicine in 1985 and 1994 compared antidepressant medication to acupuncture as a therapeutic intervention for depression. The results in both studies showed that acupuncture was an effective alternative to amitriptyline for the treatment of clinical depression. They also concluded that acupuncture might be a particularly useful option for patients who experience side effects from antidepressants or who are unable to take antidepressants. In the case of HIV/AIDS, acupuncture is a way to treat depression without additional medications that may have interactions.1,2

Another acupuncture study published in 1998 showed an increase in cerebral oxygen saturation, adding to previous knowledge of the direct effect of acupuncture on brain chemistry and physiology.3

After consulting ones healthcare providers, a person living with HIV may want to try some of the self-care techniques that Chinese traditional medicine offers.

Self-Care for Depression and Fuzzy Thinking

The following are suggestions for creating a self-care program.

Step One: Food for Thought

Dietary therapy can have a big impact on how the brain functions. For example, when there is co-infection with hepatitis C virus, Western medicine recommends treating the brain chemistry changes associated with high ammonia levels and encephalopathy, in part, by altering protein consumption and eliminating red meat. Mental fuzziness associated with glucose imbalances, which may be associated with HAART therapy or HIV itself, also calls for dietary adjustments. Alcohol and unsupervised drug consumption can have a profoundly negative impact on mental function. For help in harm reduction techniques and in controlling intake of these substances, an HIV+ person may want to seek support groups, counseling, and/or acupuncture treatment for addiction.

In Chinese medicine, making dietary adjustments can ease Shen disturbances that cause imbalances in Qi and Xue.

" To regulate Qi and create energy flow, your diet should contain: basil, beets, black pepper, cabbage, chicken livers, coconut milk, garlic, ginger, kelp, leek, nori, peaches, and scallions.

" Your diet should not contain foods that stagnate Qi: alcohol, fatty foods, food additives, unnecessary medicines, overindulgence in sweets.

" To sedate excess liver activity, your diet should contain: beef, chicken livers, celery, kelp, mussels, nori, and plums.

" Your diet should not contain: coffee, fried foods, excessively spicy foods, heavy red meat, sugar and sweets.

" To ease Xue deficiency, your diet should contain: oysters, sweet rice, liver, chicken soup, Dang Gui Chicken (see recipe in sidebar).

" Your diet should not contain: raw fruit and vegetables, cold liquids, or ice.

Step Two: One Step Forward

" Qi Gong exercise and meditation soothes Shen and balances Qi and Xue. You should practice the breathing routines and exercises recommended by your practitioner for 20 minutes per day.

" Longer Qi Gong meditation may be practiced three times or more per week.

" Whenever you feel anxiety or tension, try this five-minute

meditation.

1. Lie down in a comfortable

position with your eyes closed

half way.

2. Imagine a beautiful scenea meadow, the mountains covered in snow, a tropical isle.

3. Let yourself smell the air,

feel the sun on your face,

hear the sounds of nature.

4. Using a deep smooth breath, breathe in the beauty of the

imagined surroundings.

5. As you exhale, feel tension

exit your body on your breath.

6. Wander through the scene in your mind. Breathe in the lovely details. Breathe out bad feelings. Continue for five minutes.

" Add 30 minutes of aerobic activitywhich includes vigorous walkingto your exercise routine if it does not cause fatigue. Exercise is one of the single most effective remedies for depression.

Step Three: Relieve Pressure with Acupressure Massage

Self-acupressure massage helps dispel stagnant Xue and Qi and evens out your mood. On the following acupuncture points use a firm, not a poking or a rough, touch. When pressing on an acupoint, hold steady for the count of ten to 30 seconds, then move your finger around the point without lifting it from the skin for another count of ten.

Concentrate on the following acupoints:

" Liver 3 (in the web between the big toe and second toe)

" Pericardium 6 (three finger widths from the wrist crease on the inside of the arm between the tendons)

" SiShenCong (the four points circling the crown of the head)

" Yintang (directly between the eyebrows).

For ear acupressure massage, you can press the following points: Ear-Shen Men, brain, heart, sympathetic, and liver points. See the accompanying ear acupuncture chart for point locations.

Step Four: Consult a Trained Herbalist

All herbal preparations should be taken only under the supervision of a trained practitioner or medical doctor. If you have any adverse reaction, discontinue use of herb formula immediately.

An herbalist trained in Chinese herbs may prescribe the following formulas, among others, for Shen disturbances. Some formulas are used for depression alone, some for depression and anxiety together, some for insomnia, and some to relieve negative overall stress responses.

" Calm Spirit, a blend of Chinese and Western herbs and Western supplements to pacify the heart and calm the spirit.

" Aspiration, which nourishes the brain and calms the spirit.

" Bupleurum and Dragon Bone to dispel dampness and purge heat.

" Ease Plus to dispel dampness and purge heat.

" An Mien Pian to pacify the heart and calm the spirit.

" Ginkgo biloba extract has proved beneficial for memory loss in controlled studies5

For more detailed information, please see The HIV Wellness Sourcebook,

Henry Holt, 1998 and The Hepatitis C Help Book, Misha Cohen and Robert Gish, St. Martins Press, 2000.

Misha R. Cohen, Doctor of Oriental Medicine and Licensed Acupuncturist, is an internationally recognized practitioner, lecturer and leader in the field of traditional Chinese medicine and is the author of The Chinese Way to Healing: Many Paths to Wholeness (Perigee, 1996), The HIV Wellness Sourcebook (Holt, 1998) and The Hepatitis C Help Book (St. Martins Press, 2000). POZ Magazine named her one of the Top 50 AIDS Researchers in the Country in 1997.