Depression, which has become a social topic in recent years, is also called the "cold of the soul." The original intention of this metaphor is to emphasize that depression is a common and frequent affective mental disorder like a cold, and to use the metaphor of a cold to wipe away the shame and psychological pressure of related patients and their families, but it does not mean that the symptoms of depression are as mild as a common cold.
In my traditional Chinese medicine psychosomatic clinic, we often see patients with various depressive disorders, including bipolar disorder. The patient Xiao M described below is one of them.
Psychiatric patient Woman with psychiatric disorder
Xiao M’s medical record
Patient: Xiao M, male, 29 years old. Unmarried, Hong Kong resident. First visit: 2022-01-03. main complaint: has been emotionally unstable for more than 10 years, which has worsened in the past three years. Medical history: The patient seemed taciturn and nervous during the initial diagnosis. He was accompanied by his mother, who spoke mostly on his behalf. Little M recalled that he had a history of depression for more than 10 years, but had not received any medical treatment until two and a half years ago. Four years ago, I studied alone in England. I found it difficult to adapt to the local life and studies. My depression, anxiety, and excitement alternated and worsened. I dropped out of school two and a half years ago and was taken back to Hong Kong by my mother. I was diagnosed with bipolar disorder in a psychiatric department. I have been taking drugs such as the mood stabilizer lithium salt . However, since taking the medicine, I often feel tired, depressed, and sometimes anxious. The current living situation is to recuperate physically and mentally at home and participate in vocational training through the Internet. In the past, I had a long-term disorder in my life rhythm and sleep. In the past two years, my life rhythm and sleep were acceptable, and I slept 8 hours a night. Only if I have many dreams while sleeping, I must wake up once in the middle of the night. He goes out for exercise every day during the day. His mother observed that he has been a little excited recently, his appetite has become strong, and he has been chasing girls when he goes out. Dry stool, once every 2 days; yellow urine, often thirsty. The tongue is fat, the tip of the tongue is red and cracked, the fur is thin and greasy, and the pulse is smooth and strong. |
Chinese medicine diagnosis and treatment experience
Miscellaneous talk after diagnosis
For depression Judging from the clinical manifestations and characteristics of the attacks, the medical community roughly divides them into two categories: one is unipolar depression, which is what we usually call "depression" characterized by low mood, reduced motivation, and slow thinking; the other is called "bipolar depression" or "bipolar disorder" , also known as bipolar disorder or bipolar disorder , is actually what is commonly known as "manic depression" or "manic depression". The main clinical feature of "bipolar depression" is alternating or mixed episodes of mania or hypomania and depression. Among the famous people in ancient and modern times, such as US President Lincoln , Roosevelt , British Prime Minister Churchill , physicist Newton , painter Van Gogh , musician Schumann , Beethoven , writer Hemingway , Dickens, movie stars Marilyn Monroe , Vivien Leigh, writers Hemingway, Dickens and Gu Cheng, Sanmao and others were all deeply troubled by bipolar disorder. When we appreciate the poetry, novels, art, calligraphy, and music of some literary artists, we are sometimes surprised by the extraordinary passion or the almost paranoid, ingenious and meticulous carvings that overflow in them. The author's "extraordinary" exuberant passion and creativity are often indistinguishable from a "hypomanic" state. A contemporary and prolific Chinese writer once admitted that he suffered from bipolar disorder. She even believed: "People with great creative power, such as Woolf and Van Gogh, all have this kind of disease." . Winter and Storm in the Soul In recent years, with the increase in diagnosis rate, the number of patients diagnosed with bipolar disorder has also gradually increased. According to World Health Organization statistics, the global average incidence rate of the disease is 2%-3%, and it can be as high as 5%-7% in some countries or regions, which is not uncommon; China Mental Disorders Epidemiology Survey in 2019 showed that the lifetime prevalence rate of bipolar disorder in my country was 0.6%, and the 12-month prevalence rate was 0.5%, which means that there are at least 8.4 million patients with bipolar disorder in China. Studies have shown that most patients with bipolar disorder begin with depression. Depressive episodes last longer and are more frequent than manic episodes, and they are more harmful to patients. Patients spend almost three times as long in a depressed state as in a manic or hypomanic state; and during long-term treatment, the recurrence rate of depression is four times that of mania or hypomania. Whether unipolar depression or bipolar depression (manic depression), they are regarded as "mood diseases" in Hong Kong. However, severe bipolar disorder (bipolar disorder type Ⅰ) and schizophrenia (schizophrenia) that manifest mental symptoms such as hallucinations and delusions are classified as psychotic disorders. In fact, some patients with severe bipolar disorder (bipolar disorder type Ⅰ) are often difficult to distinguish from schizophrenia (schizophrenia), so we often see hesitation in the diagnosis of psychiatry. I once encountered a female patient who was initially diagnosed with schizophrenia and had been treated in a psychiatric department for a long time, but was eventually diagnosed with bipolar disorder. The patient's manic and depressive symptoms were mixed and severe, and he often cried and was restless, accompanied by auditory hallucinations and delusions. The age of first onset of bipolar disorder is usually between 16 and 30 years old. It is rare to develop bipolar disorder before the age of 15 or after the age of 60. The onset of the disease is closely related to genetic factors and stress factors in the environment. I met several impressive patients in Hong Kong clinics, both male and female. Most of them were similar to Little M. They developed the disease in their 20s while studying in the United Kingdom and the United States. Only about 1/4 of Hong Kong’s secondary school students can enter local universities after graduation. Every year, a large number of young students study abroad. For many young people who are mentally and physically immature, especially those whose minds are not yet mature, encountering cultural conflicts in a foreign land where people and land are far apart is like a sudden cold winter or a violent storm in the soul, which will bring huge psychological impact. It is not surprising that some people develop adjustment disorders or develop various psychosomatic problems, including bipolar disorder. Judging from my own knowledge and experience of working overseas for many years, it takes many years and long-term efforts for people's minds and bodies to adapt to the foreign geographical environment and humanistic environment, especially the language, culture, customs, diet and other living habits. . The treatment of bipolar disorder requires long-term persistence. The little M mentioned earlier was originally a bipolar disorder type II patient with alternating hypomanic and depressive states. Two and a half years ago, he started receiving mood stabilizers such as lithium carbonate and antidepressants such as serotonin. His symptoms have been relieved, but the effect is not satisfactory and his condition has not yet stabilized. Therefore, he sought treatment with traditional Chinese medicine and used a combination of traditional Chinese and Western medicine. It is precisely because Xiao M was able to persist in treatment that he achieved good and stable results. However, clinical studies have shown that most patients with bipolar disorder have recurring episodes that are difficult to recover from. Some experts even believe that there is only maintenance treatment for this disease and there is no cure. Patients usually have to live with the disease for life and take medication for life. No matter when they stop taking medication at any stage, they may face the risk of recurrence. For this reason, active and continuous treatment of bipolar disorder, which is prone to relapse, has become the key to controlling and improving its symptoms, preventing or reducing its attacks, and improving its prognosis. Judging from the author's diagnosis and treatment experience, the use of traditional Chinese medicine, acupuncture and other traditional Chinese medicine, combined with psychological treatments such as cognitive behavioral therapy, can play an important role in improving and stabilizing the curative effect.Through long-term treatment, many patients can manage and maintain a normal life, work and social life, and even achieve extraordinary achievements and success in academics and careers. American Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), 2013. Bipolar disorder is common among outstanding people References