Depression – Basics

Depression is both a diagnosis and a symptom which includes other diagnoses such as, but not limited to, manic depression, seasonal affective disorder (SAD) and dysthymia.

Depression – Diagnostic Patterns

The Chinese Medicine treatment of depression generally involves arriving at the appropriate TCM diagnosis or pattern. This pattern within the individual is what treatment is based on not the general condition The following patterns may represent the underlying contributing factors for the development of depression:

Blood stagnation, Heart yin deficiency, Kidney yin deficiency, Liver fire, Liver qi stagnation and Spleen qi deficiency.

The commonly used acupuncture points include Tongli HT5, Yinbai SP1, Sanyinjiao SP6, Fenglong ST40

The commonly used herbs include Chaihu Jia Longgu Muli Wan, Ganmai Dazao Tang, Gui Pi Wan and Xiao Yao Wan.

Research

Acupuncture plus SSRIs superior to SSRIs alone, with an early onset of action and was safe and well- tolerated; Electric Acupuncture had greater effect than manual acupuncture (Chan 2015 – SR of 13 RCTs: 1 high quality trial, 5 moderate, 7 low) (1)

Effective and safe for major depressive disorder, especially in improving sleep, mood and QoL by modulating and normalizing the limbic–paralimbic–neocortical network (LPNN), including the default mode network (DMN); ‘promising evidence’ (Bosch 2015 – Review of SRs & MAs)(2)

Acupuncture is cost-effective compared with counselling or usual care alone, although the ranking of counselling and acupuncture depends on the relative cost of delivering these interventions (Spackman 2014 –cost-effectiveness in one RCT)(3)

References

1. Chan YY, Lo WY, Yang SN, Chen YH, Lin JG. The benefit of combined acupuncture and antidepressant medication for depression: A systematic review and meta-analysis. J Affect Disord. 2015 May 1;176:106-17.

2. Bosch P, van den Noort M, Staudte H, Lim S. Schizophrenia and Depression: A systematic Review of the Effectiveness and the Working Mechanisms Behind Acupuncture. Explore (NY). 2015 Jul-Aug;11(4):281-91.

3. Spackman E, Richmond S, Sculpher M, Bland M, Brealey S, Gabe R, et al. Cost-effectiveness analysis of acupuncture, counselling and usual care in treating patients with depression: the results of the ACUDep trial. PLOS ONE. 2014;9(11):e113726.