Case: Insomnia, Depression

Thorough investigation on the initial visit

 

First visit: 4th of March, 2019

TH represented clinical Insomnia and depression. It started from Sep, 2018 with waking up in the middle of night in the beginning. It then slowly progressed to a point that she can not fall asleep at all unless taking sleeping pills.Which was the last thing she wanted to do because she knew she would become dependent on sleep pills. 

Depression was also developed around the same period, she is an elemental school teacher. She loves her job. But as the situation got worse, even the idea of going to work would overwhelm her. She was prescribed 6 months of sick leave from her doctor as well as psychotherapy.

 

During the first visit, we also went through other health related concerns.

She had developed an allergy to dust and cats a few years back. Her skin is dry. The ears were the most and felt itchy as well. For years her urination had been very frequent, every one to two hours with inability to hold it. Her hands and feet often felt cold but she sweated very easily at the same time. In other words, she had high sensitivity to temperature. She could hardly find a comfortable temperature no matter when and where, either too cold or too hot.

Her digestion, bowel movements didn’t bother her.

TH started taking birth control pills a year and half ago, partly because her periods were heavy and lasted 7-8 days, which was very inconvenient. With birth control pills, her period had been 3 days long with light flow most of the time.

Recently she was diagnosed with HSIL, a condition characterized by overgrowth of cervical intraepithelial cells, possibly caused by HPV infection, which also adds up the amount of stress on her.

Formation of initial hypothesis and put it into real test

From western medicine point of view, both insomnia and depression are associated with hyperactivity of the sympathetic nerve system, which is part of ANS(Autonomic Nervous System). High sensitivity to temperature indicates dysregulated hypothalamus function, which again is the control center for ANS. By the same token, allergy is also a form of hypersensitivity, the difference is the things that the body is sensitive to, either external or internal factors. The responsive mechanism is tightly regulated by the hypothalamus.

The HSIL and heavy bleeding history together indicates there is high level of inflammation in her reproductive system. 

Based on these hypotheses, I proposed a treatment composed of two branches, the primary one working on re-regulate the hypothalamus function, the secondary one working on the inflammation control. There are many classic formulas in Kampo Medicine for me to choose from for these tasks.

 

TH agreed with my analysis and treatment plan. She went home with two weeks of herbs.

 

The stone that can hit many birds

 

Luckily, the progression of the treatment was fairly smooth without too many bumps. TH 

bravely stopped sleeping pills all at once right at the beginning. And she fell asleep with no time on the first day of taking the herbs. And the insomnia never really came back since. What was even more surprising, before the insomnia started, she still had to get up twice at night to pee. Short after she was on the herbs, she was able to sleep right through the night without any trip to washroom, just like her 9 year old son! Because the result past above the previous mark, it is very unlikely from the placebo effect, which was my original suspect for such a quick response to treatment. 

In the meantime, as both of us were celebrating the initial success, other aspects of TH’s health were also undergoing positive changes. Years of frequent urination was back to normal in the middle of the course of treatment. Her hands and feet no longer freezing cold and she started to feel more comfortable with temperature. She stopped the birth control pills at the end of March. After that her period had been regular with 5 days of normal flow. PMS were minimal to none. Her skin got less dry. The dry and itchy ears are much less bothersome. (Add followup on allergy)
 

She went to see her gynecologist in Sep, 2019. The test showed her cervix seems normal. There was no need for any intervention for her HSIL, according to her gynecologist. 

 

In terms of the herbs she was taking. From June, the dosage was cut to half. In July, everything was going so wel so I took the formulas for inflammation out of the batch, only the formulas that regulate hypothalamus stayed in.

In October, I instructed TH only take the herbs ten days before her period with the half dosage. 

She was back to school from September. The once overwhelming job was no longer a thing to her. 

 

Her last visit in January, 2020

Everything was good and regular. She said she hadn’t got sick the whole falls and winter, while all her family members, husband, two kids all got sick at least once or twice during the same period, which was another “abnormality” to her, considering her job is dealing with roomful “germ bombs”.

 

Conclusion

I

nstead of aiming at the level of symptoms taken place. Kampo Medicine always tring to tackle the deeper mechanism. TH’s case seems to be quite straightforward, at least hypothetically. The fact that this case was solved successfully in a relatively quick and easy manner, are contributed by a few factors. First the condition was fresh, only 6 months old; second her reluctance to take on drugs that mostly manage the symptoms. Because of that, I can assume the pathological adaptional change hasn’t fully taken place, therefore made it possible to correct the underlying dysfunction. otherwise it would be harder to get everything straight. Last, TH’s full compliance with my treatment, the determination and willingness to get her normal health back by natural means is the key to success.

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