Manic Depressive Disorder
Depressive disorder is manifested by mental dejection , reticence or
incoherant speech , while manic disorder by shouting , restlessness and violent
behaviours . As described in Classic on Medical Problems , depressive disorder is
caused by excessive yin , while manic disorder by abundant yang .
The most important etiological factor of manic - depressive disorder is
emotional injury . Pathogenetically , phlegm plays the primary role . Depressive
disorder is due to stagnation of phlegm combined with qi , while manic disorder
is due to phlegm fire . Although they are different in symptomatology , they are
related to each other . A prolonged depressive disorder , in which fire is
produced by phlegm stagnation , may change into manic disorder , while a
protracted manic disorder , in which the stagnated fire is gradually dispersed ,
but the phlegm is still existing , can change into depressive disorder .
Therefore , they are termed together as manic - depressive .
Etiology and Pathogenesis :
Depressive disorder :
In most cases it is caused by overcontemplation and emotional depression ,
which lead to dysfunction of the liver and spleen . There are stagnant liver
qi and accumulated fluid due to impaired transportation , which turns into
phlegm . Then the phlegm perversely goes upward to invade the mind .
Manic disorder :
In most cases it is caused by anger that injures the liver , leading to
its failure in dispersing . The stagnated qi transforms into fire , which
evaporates the body fluid to produce phlegm fire . The phlegm fire
pervertedly rushes upward and disturbs the mind .
In addition , this disease has a hereditary trend and often a positive family
history .
Differentiation :
Depressive disorder :
Main manifestations : Gradual onset , emotional dejection and mental
dullness at the initial stage , followed by incoherent speech , changing
moods , or muteness , somnolence , anorexia , thin , sticky tongue coating ,
string - taut , thready or string - taut rolling pulse .
Analysis : Overcontemplation and emotional dejection make the liver qi
stagnated and the spleen qi fail to ascend . The stagnated qi combined with
the phlegm disturbs the mind , leading to mental disorders . The stagnated
phlegm in the middle jiao gives rise to anorexia and thin , sticky tongue
coating . String - taut thready or string - taut rolling pulse is due to the
accumulation of phlegm and qi .
Manic disorder :
Main manifestations : Sudden onset , irritability , being easy to anger ,
insomnia , loss of appetite , followed by excessive motor activity with
increased energy and violent behaviors , yellow , sticky tongue coating .
String - taut , rolling and rapid pulse .
Analysis : Anger damages the liver . The liver fire flares up and agitates
the phlegm heat of Yangming to disturb the mind . Therefore , the patient is
irritable , unable to fall asleep and easy to anger . Because of the
disturbance of the mind by the phlegm heat , violent behaviours take place .
The limbs are the foundation of all the yang actions . Preponderant yang
makes the limbs more energetic , thus , the physical strength and motor
activity are increased . The combination of phlegm and heat , leads to yellow ,
sticky tongue coating , string - taut , rolling and rapid pulse .
Treatment
Depressive disorder :
Method : Even movement is applied to the points of the Heart and Liver
Meridians to soothe the liver , calm the heart and dissolve the phlegm .
Prescription : Xinshu ( B 15 ) , Ganshu ( B 18 ) , Pishu ( B 20 ) , Shenmen ( H 7 ) ,
Fenglong ( S40 ) .
Explanation : This condition is caused by the stagnation of phlegm and qi ,
which injures the heart , liver and spleen . Xinshu ( B15 ) is used to clear the
heart , Ganshu ( B 18 ) to remove the liver stagnation , Pishu ( B 20 ) to promote
the spleen qi circulation , Shenmen ( H 7 ) and Fenglong ( S 40 ) to dissolve the
phlegm for calming the mind .
Manic disorder :
Method : Reducing is applied to the main points of the Du Meridian and
Pericardium Meridian of Hand Jueyin to calm the heart , ease the mind , reduce
the heat and dissolve the phlegm . Prescription : Dazhui ( Du 14 ) , Fengfu ( Du
16 ) , Shuigou ( Du 26 ) , Neiguan ( P 6 ) , Fenglong ( S 40 ) .
Supplementary points : , Mania with extreme heat : Prick the twelve Jing - ( Well )
points on hand ( L11 , H 9 , P 9 . Li1 , Sj 1 , Si1 ) to bleeding for reducing
heat .
Explanation : Dazhui ( Du 14 ) and Shuigou ( Du 26 ) are used to reduce heat
for clearing the mind . Fengfu ( Du 16 ) is selected for mental disorders as
Miraculous Pivot states : The brain is the sea of marrow , its upper
part reaches the vertex of the cranium , and its lower part reaches point
Fengfu ( Du 16 ) . Neiguan ( P 6 ) is combined with Fenglong ( S 40 ) to
clear the heart and dissolve the phlegm .
Remarks
The condition described here includes the depressive and manic types of
schizophrenia in modern medicine .
Thirteen points for manic - depressive disorder : Prick to bleed according to
the order ofShuigou ( Du 26 ) , Shaoshang ( L11 ) , Yinbai ( Sp 1 ) , Daling ( P 7 ) ,
Shenmai ( B 62 ) , Fengfu ( Du 16 ) , Jiache ( S 6 ) , Chengjiang ( Ren 24 ) , Laogong ( P
8 ) , Shangxing ( Du 23 ) , Huiyin ( Ren 1 ) , Quchi ( Li11 ) , and Shexiazhongfeng ( an
extra point located at the midline of the under side of the tongue ) .
|
