36 years old Female: Infertility, Depression, Uncontrollable Emotion
This female patient was so stressed out about having a child. Her emotion has been always sensitive and depressive side, and this devastation of not being able to get pregnant was overwhelming her. She had feeling of hopelessness, lack of purpose in her life, and obsession about getting pregnant. She did not go to see a doctor about her emotional challenges, however, it was definitely troubling her. When She came to see me, she gets sad by watching a woman with a baby.
Main Concern 1: Infertility
She has been trying to conceive for a year without any success. No history of miscarriage.
Main Concern 2: Depression, Negative feeling, uncontrollable emotion.
She feels grief, anger, disconnection, no sense of belongingness. She feels there is no meaning in her life and no purpose in her life. She was not suicidal; however, she often felt she wish she were dead. She had done some self harming with uncontrollable rage. Emotion is worse after menstruation.
This emotional disturbance is a result of Yin and Yang imbalance in her.
The Dampness and Phlegm that was produced in the digestive system have sent up to the brain to mist the mind. This cause inability to see the future clearly. The overwhelmingness is due to body fluid depletion. She easily cries, and this is also caused by the lack of body fluid.
- Ache in arms, wrists, hands, fingers due to overuse. They are better with resting.
- Ankle pain on the right. She often fells and twists her ankle.
Other relevant symptoms:
- Dislike wind, draft, cold, damp, summer heat
- Occasional runny nose
- Mild tinnitus
- Desire to drink warm, but cold in night time
- Vegetarian diet
- Frequent urination
- Frequent bowel movement, every time she urinate some pieces of stools come out
- Stools can be formed, loose, undigested rice. Hard stool before menstruation.
- No issues with sleep
- Irregular menstruation
- PMS includes sore and enlarged breast, mood, lower abdomen bloating
- Bleeding for 3 days (not enough?) and there are clots
- Pulse – Rapid and thready
- Tongue – Red with white coating
Diagnosis: Tai Yang, Shao Yang, Yang Ming, Tai Yin, Blood and Body Fluid deficiency with minor blood stasis
- Tai Yang – Ankle pain, aversion to wind, occasional runny nose
- Shao Yang – Emotional disturbance, fertility issues, PMS, tinnitus
- Yang Ming – This Yang Ming heat is due to Blood and Body Fluid deficiency. Irritability, vexation.
- Tai Yin – emotional disturbance, frequent urination, frequent bowel movement
- Body Fluid deficiency – emotional sensitivity, easy to cry
- Blood Stasis – clots in menses
*** I could not really pinpoint why she cannot get pregnant. however, the too frequent bowel movement is an indication of weak Intestine. Wellness of one’s Intestine realistically determines one’s health and longevity. I am certain that it is difficult for her to get pregnant unless the bowel movement is corrected.
Formula: Chai Hu Jia Long Gu Mu Li Tang + Dang Gui Shao Yao San, – Da Huang, – Ze Xie, + Zhi Zi + Yi Yi Ren, + Ai Ye
- Chai Hu Jia Long Gu Mu Li Tang is a Shao Yang formula which treats Shao Yang and Deficient Yang Ming. Exterior syndrome, Tai Yang in this case, cannot be treated without resolving Shao Yang syndrome. The patient has Deficient Yang Ming, so this formula is perfect. Da Huang is omitted due to her frequent bowel movements.
- Dang Gui Shao Yao San is Tai Yin formula which nourish and move Blood and expel Dampness at the same time. Blood and damp often get stagnate together. Also, when the Blood is nourished, often it also aaccumulates dampness. Therefore, in Jing Fang, Dang Gui Shao Yao San is more often used than Si Wu Tang. Ze Xie is removed die to her frequent bowel movement.
- Zhi Zi is added for her negative way of thinking.
- Yi Yi Ren is added to nourish body fluid and expel Damp Heat.
- Ai Ye is added to nourish Blood, and calm the fetus.
Chai Hu 12, Huang Qin 10, Ban Xia 20, Dang Shen 10, Sheng Jiang 15, Da Zao 20, Gui Zhi 12, Long Gu 15, Mu Li 15, Fu Ling 20, Dang Gui 10, Bai Shao 15, Chuan Xiong 6, Cang Zhu 20, Zhi Zi10, Sheng Yi Ren 30, Ai Ye10
Result: After 2 doses, the patient felt noticeably improvement in her emotional stability. Bowel movement seemed to be better. She still finds struggle here and there, so she continue taking the formula.
She is quite pleased that the negativity seemed to be subsided. Small matters don’t shake her emotion as much as used to. She is more grateful for the life. However, after the menstruation, with Blood depletion, her emotion is a lot more shaky.