A case of severe depression and agarophobia treated by acupuncture
L.K. is a 65 yr old divorced female who lives with her 30 yr old son. She complains of depression and emotional issues since 2005. She is presently being treated by a medical doctor for a thyroid condition. She is a nonsmoker and denies alcohol consumption, but admits to wanting a drink to help her get through her day. She uses marijuana to aid her depression, but did not report the frequency of use. Current medications include Lexapro and Cytomel, as well as a multi vitamin, fish oil, vitamin D and calcium. General health concerns include poor appetite, insomnia, poor sleep, fatigue, chills, cold feet, poor concentration, cravings, odd tastes, and she sweats easily. She complains of ringing in her ears, poor hearing, teeth problems, sores on her lips and tongue, sinus problems, night blindness, and admits to teeth grinding at night. Her eyes feel heavy, and she has pain in her fingers of unknown origin, which she reports at about a 6. She takes no medication for this pain and it is not under control. Her hands feel hot, and the pain is sharp, short term in duration, and extends from the proximal joints to the finger tips. She reports that her bowels vary from constipation to diarrhea.
She reported several very traumatic events in her life—her son was in a coma for one month following a MVA (motor vehicle accident) and continues to suffer from TBI (traumatic brain injury); his best friend died in the same accident. Additionally, she cares for her son who suffers as well from PTSD. The accident occurred when he was 16. He is now 30. She also went through a messy divorce, and still has no desire to date. She has few if any friends. She considers herself religious, but does not attend any church due to her agoraphobia.
Her major concern was depression and agoraphobia. She is afraid to go out, and it takes her 2-3 days to get up the courage to go to the grocery store. She cries most days and returns to bed after breakfast, liking to curl up on her side. She describes herself as clumsy, impatient, and irritable. She sought me out for acupuncture, as she had tried it for depression about 20 years ago and felt it was successful.
When I examined her, I noticed numerous skin tags, otherwise there was nothing remarkable. Her tongue was a light crimson, with a distinctive blue stripe down the center, and scalloped. Her pulse on the left wrist was muffled at the distal position, soft in the middle position, and hidden at the proximal position. The right wrist was soft, choppy and tight in the spleen, and thin in the proximal position.
When we discussed her diet, I discovered that she did not eat sometimes for days, and had absolutely no appetite. Occasionally she drank coffee and perhaps had a slice of toast. There was no mention of fruits, vegetables, whole grains, or water. However, she was of normal weight. She had modest muscle tone.
I diagnosed her as Kidney Yang deficient, with lack of communication between Heart and Kidney, resulting in Phlegm misting the Heart. Basic acupuncture treatments revolved around : Neiguan P-6,Gongsun SP-4,Baihui DU-20,Yintang (M-HN-3), ear points Zero Point, Shen Men and Liver, with additions of BaXie for finger pain. Moxa was used on Qihai REN-6, as well as Shuifen REN-9 to Zhongwan REN-12 on various visits to boost appetite and improve digestion. I found Daimai GB-26 along with Zero Point to be helpful in integrating mind/body connection, and in settling the mind. Back shu points along with pedal Bladder points (Kunlun BL-60, Shenmai BL-62, Jinggu BL-64) were employed to utilize internal Qi and bring it to the surface.
By the third visit, she reported better sleep, and an improved appetite. Her craving for sweets diminished as well. Her foggy head was beginning to clear. By the fourth visit her depression was virtually gone, as well as the agoraphobia. She reported feeling hungry for the first time in years, and her finger pain resolved by the eighth visit. The patient is now on maintenance treatments monthly.