Clinic cases

Lifelong bipolar disorder, now stable most of the time

G.K. · Female, age 62

This case was written by Dr. Laura Cowburn, Doctor of TCM and Registered Acupuncturist in Alberta.

Mental Health & Sleep Anxiety & depression Bipolar

At a glance

Lifelong bipolar disorder became manageable, and the patient now stays in a stable mood (euthymia) most of the time.

Presentation

A 62-year-old patient constantly swung between manic and depressive episodes. During depressive episodes she had persistent sadness, overwhelming fatigue, loss of interest in activities, feelings of worthlessness, trouble concentrating and thoughts of self-harm. During manic episodes she had anger, racing thoughts, insomnia, and impulsive or risky behaviour such as overspending or unsafe activities.

Diagnosis

  • During depressive episodes, she was Yang deficient.
  • During manic episodes, she had Liver Qi stagnation, sometimes with Liver fire, with excess energy rising to the head while the lower burner was deficient.

Treatment

Treatment changed with the phase she was in.

During depressive episodes:

  • Ear seeds — Dr. LiChun Huang’s auricular medicine combination for depression
  • Acupuncture — a combination to tonify Yang [DU-20 (Baihui), LI-4 (Hegu), SP-6 (Sanyinjiao), ST-36 (Zusanli)], plus [LU-7 (Lieque), KD-6 (Zhaohai)] to tonify Yin and the Kidneys. Tonifying Yin can indirectly tonify Yang.
  • Herbal medicine — formulas to tonify Yang

During manic episodes:

  • Ear seeds — Dr. LiChun Huang’s auricular medicine combination for calming the mind
  • Acupuncture — Dr. Tan’s LR-8 (Ququan) and GB-34 (Yanglingquan) to soothe Liver Qi; UB-60 (Kunlun) and LR-3 (Taichong) threaded to KD-1 (Yongquan) to draw excess energy down from the head; the “Buddha’s triangle” [PC-6 (Neiguan), HT-7 (Shenmen), LU-9 (Taiyuan)] to calm the mind; and TW-10 (Tianjing) to clear phlegm. Together these include Dr. Tan’s [Jueyin, Shaoyang] global balance to reduce stress.
  • Herbal medicine — formulas to soothe Liver Qi and tonify the lower burner, at times also clearing Liver fire or inflammation

Home care:

  • Outdoor exercise, such as walking on sunny days, especially when she senses a depressive episode coming, because sunlight can boost Yang energy and outdoor exercise can reduce depression
  • Pressing the acupuncture points LR-3 and UB-60 when she senses a manic episode coming
  • Daily meditation, especially when she senses she may be moving out of a stable mood
  • Getting enough sleep and rest, cooking nutritious food, and trying not to drain herself. When body and spirit are well nourished, she is less likely to swing into a depressive episode.

Result

She now stays in a stable mood (euthymia) most of the time, and swings into manic or depressive episodes much less often than before.

Additional notes

Seven sessions over three months brought her to a stable state. Since then she has come in once every three months for maintenance.

This reflects an individual patient experience, not clinical trial data.

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