Bodywork’s Therapeutic Role in Depression

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A disorder of the central nervous system (CNS), clinical depression results in a person losing the ability to enjoy one’s life. Identification
The symptoms that help a physician identify depression, include:

• decreased interest or pleasure in usual activities or hobbies
• a change in appetite, with significant weight loss or weight gain
• a change in sleeping patterns, such as difficulty sleeping, early morning awakening or sleeping too much

Body Changes

Often resulting from a combination of factors, depression has no single cause. • Neurotransmitter imbalance – Three main neurotransmitters have been associated with depression: serotonin, norepinephrine and dopamine. • Hormone imbalance – An imbalance of neurotransmitters causes a disruption of regular hormonal secretion levels. The hormones most affected include progesterone, estrogen, endorphins and cortisol. • Pituitary-adrenal axis imbalance – This axis connects the central nervous and endocrine systems. Under the direction of the brain’s hypothalamus, the pituitary gland controls the adrenal glands via corticotrophin-releasing factor (CRF). Depressed people tend to secrete excessive amounts of CRF, meaning that they create long-lasting stress responses to minimal stimuli.

Western medicine traditionally approaches depression with a two-pronged method, involving physician-prescribed medication and psychotherapy.

1. Medications used for depression usually fall into one of three categories of antidepressants: selective serotonin reuptake inhibitors (SSRIs), monoamine oxidase inhibitors (MAOIs), or tricyclics. 2. To help patients improve coping skills and reduce the effects and recurrence of depressive episodes, psychologists and psychiatrists administer psychotherapy.

Massage Therapy

Aside from a general understanding that massage feels good, bodywork can have significant, therapeutic value in battling depression. Three physiological explanations for massage therapy’s tremendous positive impact on depressed people include:

1. Touch improves the efficiency of the pituitary-adrenal axis. Ironically, depression tends to cause people to isolate themselves even further from tactile stimulation, potentially worsening their depression.

2. Right and left lobe brain symmetry minimizes depression susceptibility. Research about how massage affects mood indicates a shift in electroencephalogram (EEG) activation from the right frontal lobe (usually associated with sad affect) to the left frontal lobe (usually associated with happy affect), or at least towards symmetry between lobes.

3. The balancing of hormones and neurotransmitters can be encouraged naturally with massage. In general, serotonin and endorphins function to make people feel good, while cortisol functions to transmit feelings of pain and stress. Nearly every clinical trial evaluating massage therapy reports that bodywork enhances serotonin and endorphin levels, and reduces circulating levels of cortisol.

Massage therapists must be cautious when working with depressed patients. Some clients receiving and enjoying massage may wish to stop taking their medication on their own accord. When working with depressed clients, you must remember that safety is paramount. If a client ever mentions thoughts about suicide, a therapist is obligated to note it in his/her chart and report the situation to the client’s therapist.

Depression often accompanies complex emotional issues that a client may bring into your session. Although considered an adjunct therapy for depression, massage is known to improve its symptoms. Research demonstrates ample physiological reasons for the mechanisms behind massage’s therapeutic value in treating depression. While practitioners should keep in mind the warnings of working with this population, the rewards that come from helping clients ease their depression are well worthwhile.

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