Acupuncture in treatment of depression and anxiety
Depression and anxiety are medical illnesses characterized by both physical and psychological symptoms that can be detrimental to one's normal daily functioning. Patients usually complain of persistent feeling of sadness and a lack of interest in activities that they previously enjoyed, poor sleeping habits, crying spells, anxiety, worry, poor memory, inability to concentrate, head and body aches, stomach disturbances, and in extreme cases, thoughts of suicide or self-harm.
The etiologies of depression and anxiety are still not fully understood. The earliest theory relates to low levels of noradrenaline and serotonin in the synaptic clefts.(1) These two neurotransmitters remain the focus of subsequent research, but other neurotransmitters may also have a role.(2) Recent studies have investigated the potential role of various neuropeptides(3), the immune system(4) and genetic factors.(5)
The three most commonly treatments for depression are psychotherapy, psychiatric medication, and (in severe cases) electroconvulsive therapy. Because of the significant number of patients who do not respond to or cannot tolerate conventional treatments for depression, other options must be explored.
In 1973, Dr. Wen, a neurosurgeon from Hong Kong, learned that acupuncture may significantly reduce drug withdrawal symptoms. Scientists started to pay attention to the hypothesis that this ancient Chinese therapeutic technique may be beneficial to the treatment of mood disorders like depression and anxiety. Since 1980s, many studies over the world have published and found that treating depression with acupuncture has a positive and holistic effect on depressed individuals, particularly when used in combination with psychotherapy and herbal treatments.
A study at the Wayne County General Hospital in Michigan, USA, acupuncture treatment was given to 85 patients all suffering from psychological disorders (including depression). The treatment was shown to be beneficial in over 78% of the patients. (6) In theory, they have found that acupuncture produces an increase in brain chemicals that are believed to be in short supply in people who are depressed. Many researchers found that cerebral serotonin has antidepressant and analgesic effects(2) and that cerebral serotonin can be released by the stimulation of certain acupuncture points. (6)
In another double-blind, placebo-controlled study reported by a psychologist John Allen at the University of Arizona in Tucson, and an acupuncturist Rosa Schnyer,(7) 38 women were randomly assigned to 1 of 3 groups and received treatment that lasted 8 weeks: (1) specific acupuncture for depressive symptoms (n = 12), (2) nonspecific acupuncture for general feelings of “disharmony” (n = 11), and (3) wait-list controls (n = 10).9 Patients and acupuncturists were blinded using valid but different acupuncture points. All acupuncturists expected that the treatment they provided would be effective for depression.
Symptoms were reduced significantly more in the specific group (P < .05) than in the nonspecific group. However, the difference between specific acupuncture and wait-list groups was marginal (P < .12). These findings might be explained by the small sample size of the study. The remission rate (64%) was comparable to that for conventional treatments of depression.
The study findings suggest that using acupuncture alone could be as effective as other types of treatments for relieving depression symptoms typically used in Western medicine, such as psychotherapy and drugs.
The use of acupuncture for depression is of course still a little controversial. In 2010, Smith et al(8) found “insufficient evidence of a consistent beneficial effect from acupuncture” in treatment of depression, even though they found no evidence that medications are better than acupuncture in helping patients achieve remission or in preventing relapse.(9) Despite this, most studies have shown acupuncture to be a safe and promising therapeutic option, and to have a more favorable adverse effects profile than psychotropic medications. It is also associated with low attrition rates. As such, the World Health Organization has approved acupuncture as a treatment for depression. Overall, the data collected in the last four decades suggest that acupuncture deserves further research as an alternative option for the treatment of depression.
In our clinic, treatment of depression and anxiety is based on Traditional Chinese Medicine (TCM) approach. According to the TCM theories, health is maintained by the unobstructed flow of Qi that regulates the physical, mental and spiritual balance. In addition, the opposing forces of yin and yang regulate all organs. When the entire system is in balance, optimal health occurs. Depression and anxiety can be the result of an imbalance of yin and yang in liver and heart which causes blockage of related meridians. We use acupuncture to remove obstructions to the flow of Qi, and use herbal treatments to restore balance in organs. This is a holistic healing approach, which is not only effective in treating emotional problems; it also addresses the physical realm.
The video on the right is a testimonial from one of our clients, who sought treatment for her depression.
Reference
1. Bunney Jr, W.E., Davis, J.M., 1965. Norepinephrine in depressive reactions. A review.Arch. Gen. Psychiatry 13 (6), 483–494.
2. Barros, H.M., Calil, H.M., Guimarães, F.S., Soares, J.C., Andreatini, R., 2002. The brain decade in debate: V-neurobiology of depression. Prog. Neuropsychopharmacol. Biol. Psychiatry 26 (3), 613–617.
3. Madaan, V., Wilson, D.R., 2009. Neuropeptides: relevance in treatment of depression and anxiety disorders. Drug News Perspect. 22 (6), 319–324.
4. Miller, A.H., 2010. Depression and immunity: a role for T cells? Brain Behav. Immun. 24 (1), 1–8
5. Smoller, J.W., Block, S.R., Young, M.M., 2009. Genetics of anxiety disorders: the complex road from DSM to DNA. Depress. Anxiety. 26 (11), 965–975.
6. Chen A., 1992. An introduction to sequential electric acupuncture (SEA) in the treatment of stress related physical and mental disorders. Acupunct Electrother Res. Oct-Dec;17(4):273-83.
7. Allen JJ, Schnyer RN, Hitt SK. The efficacy of acupuncture in the treatment of major depression in women. Psychol Sci. 1998;9:397-401.
8. Smith, CA., Hay, PP., MacPherson, H., 2010. Acupuncture for depression. Cochrane Database Syst. Rev. Issue 1. Art. No.: CD004046. doi:10.1002/14651858.CD004046.pub3.
9. Smith CA, Hay PP. 2005. Acupuncture for depression. Cochrane Database Syst. Rev. (2):CD004046.