Monday, September 26, 2011

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Monday, January 25, 2010

Heart Meridian and Mental Conditions

In Chinese medicine, mental activity is associated with the heart and therefore our memory, thought processes, emotional well-being, and consciousness are also attributed to the heart and fire element. This is a time to nourish and pacify our spirits, and to pay attention to our heart’s yearning as we find joy in our hot summer days and warm summer nights.

Your heart is also linked to sleep functions. At night, the heart stores the “shen,” a Chinese term for “spirit” or “conscious awareness” that refers to the mental, emotional, expressive, and organizing force within you. If your heart fails to house the shen at night, you will suffer from insomnia.

When the fire element is in balance, the heart is strong and healthy, the mind is calm and sleep is sound.

When the fire element is imbalanced, we may either lack joy (depression) or have an excess of joy (mania). Those who suffer from an imbalance in the fire element may experience agitation, nervousness, heartburn, or insomnia.

Tuesday, January 12, 2010

New Study Links DHA Type of Omega-3 to Better Nervous-System Function

http://www.apa.org/news/press/releases/2009/12/dha-omega.aspx

December 16, 2009

New Study Links DHA Type of Omega-3 to Better Nervous-System Function

Deficiencies May Factor into Mental Illnesses

WASHINGTON—The omega-3 essential fatty acids commonly found in fatty fish and algae help animals avoid sensory overload, according to research published by the American Psychological Association. The finding connects low omega-3s to the information-processing problems found in people with schizophrenia; bipolar, obsessive-compulsive, and attention-deficit hyperactivity disorders; Huntington’s disease; and other afflictions of the nervous system.

The study, reported in the journal Behavioral Neuroscience, provides more evidence that fish is brain food. The key finding was that two omega-3 fatty acids – docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) – appear to be most useful in the nervous system, maybe by maintaining nerve-cell membranes.

“It is an uphill battle now to reverse the message that ‘fats are bad,’ and to increase omega-3 fats in our diet,” said Norman Salem Jr., PhD, who led this study at the Laboratory of Membrane Biochemistry and Biophysics at the National Institute on Alcohol Abuse and Alcoholism.

The body cannot make these essential nutrients from scratch. It gets them by metabolizing their precursor, α-linolenic acid (LNA), or from foods or dietary supplements with DHA and EPA in a readily usable form. “Humans can convert less than one percent of the precursor into DHA, making DHA an essential nutrient in the human diet,” added Irina Fedorova, PhD, one of the paper’s co-authors. EPA is already known for its anti-inflammatory and cardiovascular effects, but DHA makes up more than 90 percent of the omega-3s in the brain (which has no EPA), retina and nervous system in general.

In the study, the researchers fed four different diets with no or varying types and amounts of omega-3s to four groups of pregnant mice and then their offspring. They measured how the offspring, once grown, responded to a classic test of nervous-system function in which healthy animals are exposed to a sudden loud noise. Normally, animals flinch. However, when they hear a softer tone in advance, they flinch much less. It appears that normal nervous systems use that gentle warning to prepare instinctively for future stimuli, an adaptive process called sensorimotor gating.

Only the mice raised on DHA and EPA, but not their precursor of LNA, showed normal, adaptive sensorimotor gating by responding in a significantly calmer way to the loud noises that followed soft tones. The mice in all other groups, when warned, were startled nearly as much by the loud sound. When DHA was deficient, the nervous system most obviously did not downshift. That resulted in an abnormal state that could leave animals perpetually startled and easily overwhelmed by sensory stimuli.

The authors concluded that not enough DHA in the diet may reduce the ability to handle sensory input. “It only takes a small decrement in brain DHA to produce losses in brain function,” said Salem.

In humans, weak sensorimotor gating is a hallmark of many nervous-system disorders such as schizophrenia or ADHD. Given mounting evidence of the role omega-3s play in the nervous system, there is intense interest in their therapeutic potential, perhaps as a supplement to medicines. For example, people with schizophrenia have lower levels of essential fatty acids, possibly from a genetic variation that results in poor metabolism of these nutrients.

More broadly, the typical American diet is much lower in all types of omega-3 than in omega-6 essential fatty acids, according to Salem. High intake of omega-6, or linoleic acid, reduces the body’s ability to incorporate omega-3s. As a result, “we have the double whammy of low omega-3 intake and high omega-6 intake,” he said.

Article: “Deficit in Prepulse Inhibition in Mice Caused by Dietary n-3 Fatty Acid Deficiency”; Irina Fedorova, PhD, Laboratory of Membrane Biochemistry and Biophysics, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health; Anita R. Alvheim, PhD candidate, Laboratory of Membrane Biochemistry and Biophysics, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, and National Institute of Nutrition and Seafood Research, Bergen, Norway; and Nahed Hussein, PhD and Norman Salem Jr., PhD, Laboratory of Membrane Biochemistry and Biophysics, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health; Behavioral Neuroscience, Vol. 123, No. 6.

Norman Salem Jr. can be reached by e-mail or at (443) 542-2370. He was with the National Institutes of Health until 2008, when he became the chief scientific officer and vice president of Martek Biosciences Corp. in Columbia, Md., an ingredient supplier of DHA. He states that he and his co-authors conducted this research while with the NIH.

The American Psychological Association, in Washington, D.C., is the largest scientific and professional organization representing psychology in the United States and is the world’s largest association of psychologists. APA’s membership includes more than 150,000 researchers, educators, clinicians, consultants and students. Through its divisions in 54 subfields of psychology and affiliations with 60 state, territorial and Canadian provincial associations, APA works to advance psychology as a science, as a profession and as a means of promoting health, education and human welfare.

Sunday, November 1, 2009

The TCM Diagnosis and Treatment of Bipolar Disorder, Part One

Acupuncture Today
September, 2003, Vol. 04, Issue 09
The TCM Diagnosis and Treatment of Bipolar Disorder, Part One
By Yong Ping Jiang, DOM, PhD
The "Ask Dr. Jiang" column is designed to explore corners of Chinese medicine that may not be easily understood by American practitioners or are underrepresented in American clinical health literature.
Dear Dr. Jiang:
I haven't been able to find anything about manic depression / bipolar disorder in the modern Chinese reference books. Does Chinese medicine recognize this illness, and if so, what are its causes, and what are the guidelines for diagnosis and herbal treatment?Qi Healer
Chicago, Illinois
Dear Qi Healer:
This is a big question, so I'm going to have to answer it in two installments. You're quite right; it's difficult to find any mention of bipolar disorder in the Chinese medical literature, particularly in the older classics. While there are abundant references to mania (kuang) and depression (dian) as separate entities, it is hard to find a clear description of a disorder involving mood swings between the two. While chapter 22 of the Ling Shu is titled "Dian Kuang," this chapter is really about mania, not depression; its description of dian being more suggestive of epilepsy than a mood disorder. We are left with the impression that the authors of the Nei Jing were much more concerned with mania than with depression, perhaps because of its more destructive manifestations. It is perhaps because of this that they never felt the need to describe a combined syndrome of manic depression.
The Chinese description of mania refers to a patient with abnormally outgoing, aggressive and excited behavior; who is easily angered, with a tendency to talk loudly or shout. The body movements are restless and forceful, and in extreme cases, the patient may strike things or even expose themselves in public. This is pretty close to the Western descriptions of the manic stage of bipolar disorder. In the case of depression, the behavior is the opposite: quiet, withdrawn, a low voice, and being untalkative, easily frightened or saddened. In extreme cases, patients may close themselves away from all social contact or mutter to themselves incoherently. In the simplest sense, we can say that mania belongs to yang and depression belongs to yin.
In spite of their obvious differences, mania and depression are both disorders of the spirit mind (shen zhi), and so it is possible in some cases for the two conditions to share the same etiology. Both mania and depression can be caused by excess emotions, for example. This is an important concept I explained in the January 2003 issue. Sometimes emotional disorders are caused by emotions themselves. Even if the root cause of an emotional disorder is physical in nature, extreme emotions can make the condition worse. Chapter 8 of the Ling Shu, for example, states that mania can be caused by extreme anger; by excessive joy, which damages the "inferior mind" (po); and by sadness, which damages the "soul" (hun). Another potential cause of both mania and depression is disorder of the heart and liver, the two body organs most responsible for generating emotions.
Some etiologies, however, are exclusive to one or the other. Yang heat excess, for example, can give rise to mania by disturbing the shen. Chapter 74 of the Su Wen states, "All mania belongs to fire." This fire is often caused by other pathogens stagnating in the body, such as blood stasis or phlegm, or by extreme emotions such as anger, joy, or even sorrow - the latter emotion causing stagnation which leads to fire.
In Clinical Guide to Case Studies, Ye Tian Shi wrote in the Qing dynasty that long-term worry can cause the qi to stagnate, which allows the phlegm to accumulate and "cloud" (hun xiao) the shen, causing depression. According to Ye Tian Shi, therefore, depression is essentially a disorder of yang qi. We can take this a step farther and say that there are two types of yang qi disorder that can lead to depression: excess and deficiency. Depression of yang qi, which we nowadays refer to as liver qi stagnation, is the more excess cause, and the one most often described in Chinese textbooks. Liver stagnation can cause stagnation by itself, or it can combine with phlegm. But depression can also be caused by yang qi deficiency, which leads to an overly yin constitution and an exhausted individual that wants to withdraw from social contact. Yang qi deficiency can cause depression in and of itself, or it can lead to phlegm accumulation causing the clouding effect described above. These various etiologies are compiled in the table below.
CAUSES OF MANIA
Fire transformed from stagnation
CAUSES OF DEPRESSION
Yang qi deficiency (+ / - phlegm)
Yang qi stagnation ( + / - phlegm)
CAUSES OF BOTH MANIA AND DEPRESSION
Extreme emotions
Disorders of the liver and heart
It's fairly easy to see how depression might transform into mania. According to Chinese medicine, anything that stagnates can turn into heat; the process is something like the warmth generated in the center of a compost pile. If the disease process causing the depression is yang qi stagnation, the stagnation will eventually transform into heat and this will produce mania - but transformation to excess fire is less likely to happen if the disease process causing the depression is yang qi deficiency. This helps to explain why not all patients with depression develop bipolar disorders; very deficient patients will lack the yang qi necessary to cause transformation to excess fire. If a patient's depression is caused by yang qi deficiency, therefore, additional pathologies are needed to cause mania. If there is phlegm accumulation or food stagnation, for example, transformation to fire may still occur, or the mania can develop directly from extreme emotions as described above.
It's a little bit harder to explain how mania might transform into depression. In fact, the process has never been formally described in the Chinese medical literature. Allow me, therefore, to offer my own opinion: the extreme yang of the manic state exhausts the body and damages the qi and blood, leading to the relatively yin state of depression. During the manic phase, the patient is extremely active, rarely sleeps, and often goes without eating. It's only a matter of time before the yang qi "runs out" and the patient's spirit is forced back into the more yin state of depression. If the yang qi should become stagnant again, the whole process starts all over again. The result is what modern medicine calls bipolar disorder.
I believe this explains the etiology of bipolar disorder. In the next installment, I will explain its differential diagnosis and treatment.
Edited with the assistance of John Pirog, MSOM.

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Wednesday, October 28, 2009

FW: Interesting article on BPD



Alan Tang (sent via mobile Outlook)




From: Dr. Alan Tang <drtang@familycarewellness.com>
Sent: Sunday, October 25, 2009 5:18 PM
To: dralantang.hbm@blogger.com
Cc: dralantang@gmail.com
Subject: Interesting article on BPD

Zanarini, Frankenburg.  Omega 3 fatty acid treatmentwith women with borderline personality disorder:  a double blind, placebo-controlled pilot study.
Am. J. Psychiatry 2003 Jan 160(1):167-9