In light of the fact that I will be teaching a class on Working with Clients with Depression, I wanted to touch on a few aspects of this life challenge.
Most of us have experienced some level of depression at some point in our lives. You may have felt blue or sad, low energy, discouraged or fed up with life. These periods of low energy are typically short lived – and are influenced by life’s happening such as the loss of a job, death of a loved one, relationship challenges, financial stress, or illness.
Clinical Depression is when you’re persistently in a low mood or you lose interest in life and its pleasure for a long duration. Negative thoughts about yourself and the world persist and you can’t seem to find your way out of these blues. Often a sense of powerlessness accompanies depression. You may start to feel it affecting your physical health. Clinical Depression is an illness of the whole body. It involves your mood, your thoughts and your body.
I would like to share some statistics about depression – some of them I find quite startling.
- Depression is one of the most common mental disorders affecting 340 million people in the world today.
- No one is immune from depression – it occurs in people of all social classes, all countries and all cultural settings.
- About 10-15 per cent of depressed people take their own lives.
- The World Health Organization predicts that by the year 2020 depression will be the greatest burden of ill-health to people in the developing world, and that by then severe depression will be the second largest cause of death and disability.
- Depression in its various forms (insomnia, fatigue, anxiety, stress, vague aches and pains, etc.) is the most common complaint heard in doctors’ offices.
- About half of all cases of depression are unrecognized and untreated.
Major depression is marked by the person’s inability to function. A clinical diagnosis of depression must include five of the following symptoms that occur simultaneously over a two-week period:
- Fatigue, loss of energy
- Feeling worthless or feelings of guilt
- Inability to concentrate
- Significant change in weight or appetite
- Depression lasts all day or most of the day
- Lack of interest or enjoyment in everyday activities
- Excessive sleep or daily insomnia
- Suicidal thoughts
There are many aspects and causes of depression that are intertwined together – ranging from life stressors, altered brain and body chemistry, insufficient blood flow and oxygen supply to the brain, structural misalignment, altered blood glucose level, fluctuation in hormones, food sensitivity, and low Qi. Many things can alter our brain chemistry.
Various biological abnormalities have been found in the brains of depressed people such as decreased levels of the neurotransmitter serotonin, raised levels of the enzyme monoamine oxidase, loss of cells from the hippocampus (an area of the brain involved in mood and memory) and abnormal patterns of neural activity in the amygdala, and parts of the prefrontal cortex.
Many people who are depressed may not be aware that they are. They may have always felt low energy, dimmed down, introverted or insular, so they do not consider it abnormal. It often runs in families and because of that and social reasons, many depressed people are never given appropriate care.
We as Craniosacral Workers are in a unique position to address some of these issues with our clients and to help turn their light back on and facilitate better health. Many Craniosacral Workers understand that the treatment of brain anatomy and function is crucial along with the treatment of bones, suture and membranes. As one of my teachers Benjamin Shield states “We know that brain waves can be entrained through external influences. Cultures that tone, such as “om-ing” measurably affect brain waves and function, as does listening to Mozart. If sound can have a profound influence on brain function, it is very possible that touch and manual therapy can have a direct influence”.
I would like to address one aspect of depression that we, as manual and craniosacral therapists can have direct inroads. A common finding in depression is a decrease of blood flow to the brain. Most of us are quite familiar with a very common area of tension and distress – the base of the skull. This is the atlanto-occipital joint, where C1 and the occiput meet (AO Joint). We have many layers of muscles covering this area -trapezius, splenius capitus, semispinalis capitus and the highly innervated suboccipitals. Under these muscle layers are the cervical vertebrae. Running through the transverse processes of the vertebrae are the vertebral arteries.
Look at the image to the right, and take note of the vertebral arteries. They take a couple of crazy turns as they make their way from C2 to C1 and then up and on through the foramen magnum. If you add some hypertonicity to the muscles in this area – a very common human condition due to stress, poor posture, or injury, you get may get the effect of squeezing 2 garden hoses thereby diminishing the blood flow to the brain.
When the vertebral arteries are constricted, the brain “down regulates” because of lack of O2, glucose and nutrition. It goes into “safe” mode to conserve energy. It affects the brainstem, cerebellum, occipital lobe, posterior parietal lobes (especially the interaction/association area).
Heart rhythms, sleep, respiration, and basic functions will slow down because of lack of oxygen. It has the effect of “dimming down” our light. This is an “automatic sequella” for endogenous depression and withdrawal.
A common technique in massage therapy to release this area is called “the picket fence”. A common Craniosacral hold to address this area is the “AO Decompression”. The practitioner places their finger tips against the body of the atlas at the base of the occiput and waits for the muscles to release and the atlas to settle.
These can feel really good and most clients like the way it feels. I would, however, like to add some caution to these holds. It is common for the practitioner to be too vigorous with this hold, to be in the incorrect position (like not on the atlas at all) or imbalanced in this hold. It is not uncommon for clients to react negatively to this hold. They may develop a headache or experience reactive muscle tightening later. In worst cases they may feel nausea, dizzy or have vertigo.
With this technique it is crucial that you pay attention to your set-up. Your finger tips intend toward C1 in an anterior direction and your finger pads MUST remain in contact with the occiput. Always move slowly and always stay present listening to the response of the tissue and the energy field.
When C1 and the occiput lock down they usually lock in an anterior direction. A traditional AO Decompression can potentially drive the atlas/occiput anterior and further into its lesion pattern.
I have been fortunate to have had the opportunity to study with Benjamin Shield and Alain Gehin. They shared two alternative AO release techniques. I frequently use these techniques with my clients. One technique leaves the occiput neutral while the atlas is encouraged to move inferior. The other technique stabilizes the atlas while the occiput is encouraged into extension (CS extension). We will cover these techniques in depth in the upcoming class on Depression.
Above all, your caring, compassionate presence where you are able to meet and accept your client as they are is the biggest gift. As you allow your light to shine it allows others to shine too.
That’s the thing about depression: A human being can survive almost anything, as long as she sees the end in sight. But depression is so insidious, and it compounds daily, that it’s impossible to ever see the end. The fog is like a cage without a key. ~Elizabeth Wurtzel
For more information or to register for the upcoming Class “Working with Clients with Depression – Going Deeper with your Craniosacral Work” please call 541-390-3191 or email.