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Upper Cross Syndrome and a Guarded Heart: Posture in a Case of Depression

Journal: The AAO Journal Date: 2022/06, 32(2):Pages: 15-16. doi: Subito , type of study: case report

Free full text   (https://meridian.allenpress.com/aaoj/article/32/2/15/482674/LBORC-NUFA-Poster-Abstracts-2022-Students)

Keywords:

case report [514]
depression [48]
OMT [2951]
osteopathic manipulative treatment [2973]
posture [76]

Abstract:

Introduction/Background: Treatment-resistant depression requires innovative interventions. Care for the Body-Mind-Spirit axis can be delivered via osteopathic manipulative medicine (OMM) and may potentiate the healing process. Case: A 62-year-old male with 30 years of treatment-resistant depression and suicidality sought to discontinue psychiatric medications. A holistic inpatient regimen included medication changes, supplementation, sauna, exercise, and psychological therapy. OMM was employed to reduce biomechanical symptoms of upper cross syndrome and related behavioral restrictions. Direct inhibition was targeted to the coracobrachialis, pectoralis minor, levator scapulae, brachioradialis, and teres minor. Post-isometric relaxation was performed on the sternocleidomastoid, atlantoaxial junction, and the thoracic spine. Soft tissue techniques included occipitoatlantal release, contralateral cervical traction, trapezius release, and cervical myofascial release. Results: 20 mental symptoms were measured and linear regressions for inpatient stay and OMM period were plotted. Symptoms of depression, fatigue, resentment, suicidal ideation, pain, frustration, anxiety, insomnia, fear, and anger correlated to a trend of improvement. Worsening trends were seen in symptoms of weakness, disorientation, and confusion. There was no effect on self-harm ideation. Follow up at 470 days post discharge revealed improved mental health and appreciation of treatment. Discussion: An improvement in posture from “hunched and fearful” to “proud and confident” was apparent after treatment. Osteopathic medicine may have the ability to improve the symptoms of mental illness by improving physiologic movement of the musculoskeletal system with cascading effects in social, cognitive, and environmental interactions. Rigorous trials should be conducted to determine the safety and efficacy of OMM for psychiatric complaints.


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