Treating Pain, Stress, Anxiety, and Depression with Acupuncture

by Christine Sotmary M.S., L.Ac., CPC

              Dancers aren't any different from the rest of us. Dancers get anxious. Dancers feel depressed. Dancers suffer with stress. Dancers have physical pain. Acupuncture can help support healing and create a nice balanced life again. But how? Finally some answers are coming out of a variety of research centers.

              The most common reason most of us go to the doctor is the desire to feel better. When you look at the research it shows that pain, stress, anxiety and depression are our most common complaints. Most common….yes. However, most doctors will tell you that these four conditions are the most difficult to treat with conventional modern medicine.

              The general public, including medical doctors, expect that acupuncture is primarily used to treat pain. They may already know that a reduction in pain comes from the release of endorphins. What may be less widely known is, when it comes to treating stress, anxiety and depression, acupuncture has also been shown to directly impact brain chemistry and nerve pathways.

              All medical specialties see patients who suffer with anxiety along with their other physical symptoms. As common as anxiety is, the real dilemma for doctors is in treating depression. Medications and talk therapy are not always successful and witnessing someone in such chronic emotional pain is difficult for any healthcare provider. Because acupuncture has been shown to reduce the stress response, it also aides in the treatment of depression by allowing conventional treatments to work better.

              The stress response is the root of many physical symptoms that bring patients to their doctors. What are some of these physical symptoms of stress? A patient can have any or all of the following: high blood pressure, headaches, reflux, indigestion, fast pulse, disrupted sleep, increased appetite with belly fat and hair loss.

              Acupuncture has been shown to decrease stress. It literally interrupts the stress response and reestablishes chemical and emotional balance. Stress, pain, anxiety and depression involve major nerve pathways in the brain.  Areas of the brain that are the most susceptible to stress are also involved with the mood disorders of anxiety and depression. Science has also shown that acupuncture fundamentally recalibrates the Central Nervous System(CNS), including the networks of nerve cells that account for the different types and severity of chronic symptoms involved in anxiety and depression. Through brain imaging and chemical tracing it has been shown that acupuncture directly corrects this failure to control stress.

              In addition when one system in the body is affected by stress it throws off the balance in other systems. This is how stress that affects the nervous system can also impact digestion, circulation, immunity and inflammation.  When a patient is overwhelmed by the stress in their lives, conventional treatments no longer are effective. Acupuncture has been proven to reduce the effects of complicated pressures in a person’s life, so that conventional treatments are better able to have their desired results.

SUMMARY

               Anxiety and depression affect nearly every other condition and complaint in the body. Overwhelming stress can render conventional treatments useless. Acupuncture can restore balance, reduce the stress response, disrupt the pathways of stress and reduce the effects of overwhelming burdens so that doctors are able to effectively treat even their most difficult cases.

References:

Allen et al., 2006 Allen, J.J., Schnyer, R.N., Chambers, A.S., Hitt, S.K., Moreno, F.A., and Manber, R. Acupuncture for depression: a randomized controlled trial. J. Clin. Psychiatry. 2006; 67: 1665–1673

APA, 2000 APA (American Psychiatric Association), 2000. Diagnostic and statistical manual of mental disorders: DSM-IV-TR. Washington, DC.

Barnes et al., 2007 Barnes, P.M., Bloom, B., and Nahin, R. CDC National Health Statistics Report #12. in: Complementary and Alternative Medicine Use Among Adults and Children. Center for Disease Control, United States; 2007

Barros et al., 2002Barros, H.M., Calil, H.M., Guimarães, F.S., Soares, J.C., and Andreatini, R. The brain decade in debate: V-neurobiology of depression. Prog. Neuropsychopharmacol. Biol. Psychiatry. 2002; 26: 613–617

Bunney and Davis, 1965 Bunney, W.E. Jr and Davis, J.M. Norepinephrine in depressive reactions.  A review. Arch. Gen. Psychiatry. 1965; 13: 483–494

Cherkin et al., 2009 Cherkin, D.C., Sherman, K.J., Avins, A.L., Erro, J.H., Ichikawa, L., Barlow, W.E. et al. A randomized trial comparing acupuncture, simulated acupuncture, and usual care for chronic low back pain. Arch. Intern. Med. 2009; 169: 858–866

Churchill et al., 2003 Churchill, R., Barbui, C., Furukawa, T., Gilbody, S., Hatcher, S., Hazell, P. et al. Depression, Anxiety and Neurosis Group. in: About The Cochrane Collaboration (Cochrane Review Groups (CRGs)), Issue 1. Art. No: DEPRESSN. ; 2003

Duan et al., 2008 Duan, D.M., Tu, Y., and Chen, L.P. Assessment of effectiveness of electroacupuncture and fluoxetine for treatment of depression with physical symptoms [Chinese]. Zhongguo Zhen Jiu. 2008; 28: 167–170

Duan et al., 2009a Duan, D.M., Tu, Y., Chen, L.P., and Wu, Z.J. Efficacy evaluation for depression with somatic symptoms treated by electroacupuncture combined with fluoxetine. J. Tradit. Chin. Med. 2009; 29: 167–173

Duan et al., 2009b Duan, D.M., Tu, Y., Chen, L.P., and Wu, Z.J. Study on electroacupuncture treatment of depression by magnetic resonance imaging [Chinese]. Zhongguo Zhen Jiu. 2009; 29: 139–144

Filshie and Cummings, 1999 Filshie, J. and Cummings, M. Western medical acupuncture. in: E. Ernst, A. White (Eds.) Acupuncture: A Scientific Appraisal. Butterworth-Heinemann, Oxford; 1999: 31–59

Fu et al., 2008 Fu, W.B., Fan, L., Zhu, X.P., He, Q., Wang, L., Zhuang, L.X. et al. Acupuncture for treatment of depressive neurosis: a multi-center randomized controlled study. [Chinese]. Zhongguo Zhenjiu. 2008; 28: 3–6

Fu et al., 2009 Fu, W.B., Fan, L., Zhu, X.P., He, Q., Wang, L., Zhuang, L.X. et al. Depressive neurosis treated by acupuncture for regulating the liver—a report of 176 cases. J. Tradit. Chin. Med. 2009; 29: 83–86

Halbreich, 2008 Halbreich, U. Systematic reviews of clinical trials of acupuncture as treatment for depression: how systematic and accurate are they?. CNS Spectr. 2008; 13: 299–300

Jorm et al., 2002 Jorm, A.F., Christensen, H., Griffiths, K.M., and Rodgers, B. Effectiveness of complementary and self-help treatments for depression. Med. J. Aust. 2002; 20,176

Krishnan and Nestler, 2008 Krishnan, V. and Nestler, E.J. The molecular neurobiology of depression. Nature. 2008; 455: 894–902

Leo and Ligot, 2007 Leo, R.J. and Ligot, J.S. Jr. A systematic review of randomized controlled trials of acupuncture in the treatment of depression. J. Affect. Disord. 2007; 97: 13–22

Li and Liu, 2007 Li, S.J. and Liu, T. Clinical observation on treatment of melancholia by acupuncture following principle of relieving depression and regulating mentality. [Chinese]. Zhongguo Zhong Xi Yi Jie He Za Zhi. 2007; 27: 155–157

Liu et al., 2009 Liu, L.-Y., Lu, Q., and Wang, L.-L. Influence of electro-acupuncture on the side effects of fluoxetine on depression patients. J. Tradit. Chin. Med. 2009; 29: 271–274

Luo et al., 2007 Luo, W.Z., Liu, H.J., and Mei, S.Y. Clinical study on “Jin's three-needling” in treatment of generalized anxiety disorder [Chinese]. Zhongguo Zhong Xi Yi Jie He Za Zhi. 2007; 27: 201–203

MacPherson and Schroer, 2007 MacPherson, H. and Schroer, S. Acupuncture as a complex intervention for depression: a consensus method to develop a standardised treatment protocol for a randomised controlled trial. Complement. Ther. Med. 2007; 15: 92–100

MacPherson et al., 2004 MacPherson, H., Thorpe, L., Thomas, K., and Geddes, D. Acupuncture for depression: first steps toward a clinical evaluation. J. Altern. Complement. Med. 2004; 10: 1083–1091

MacPherson et al., 2006 MacPherson, H., Sinclair-Lian, N., and Thomas, K. Patients seeking care from acupuncture practitioners in the UK: a national survey. Complement. Ther. Med. 2006; 14: 20–30

Madaan and Wilson, 2009 Madaan, V. and Wilson, D.R. Neuropeptides: relevance in treatment of depression and anxiety disorders. Drug News Perspect. 2009; 22: 319–324

Melchart et al., 2004 Melchart, D., Weidenhammer, W., Streng, A., Reitmayr, S., Hoppe, A., Ernst, E. et al. Prospective investigation of adverse effects of acupuncture in 97 733 patients. Arch. Intern. Med. 2004; 164: 104–105

Miller, 2010 Miller, A.H. Depression and immunity: a role for T cells?. Brain Behav. Immun. 2010; 24: 1–8 ([Electronic publication 2009 Oct 8])

Mukaino et al., 2005 Mukaino, Y., Park, J., White, A., and Ernst, E. The effectiveness of acupuncture for depression—a systematic review of randomised controlled trials. Acupunct. Med. 2005; 23: 70–76

Pilkington et al., 2007 Pilkington, K., Kirkwood, G., Rampes, H., Cummings, M., and Richardson, J. Acupuncture for anxiety and anxiety disorders—a systematic literature review. Acupunct. Med. 2007; 25: 1–10

Pohl and Nordin, 2002 Pohl, A. and Nordin, C. Clinical and biochemical observations during treatment of depression with electroacupuncture: a pilot study. Hum. Psychopharmacol. 2002; 17: 345–348

Qiao and Cheng, 2007 Qiao, Y.X. and Cheng, W.P. A clinical investigation on the efficacy of acupuncture on Baihui and Shenmen acupoints of depression. [Chinese]. Zhen Jiu Lin Chuang Za Zhi. 2007; 23: 52–53

Schroer and Macpherson, 2009 Schroer, S. and Macpherson, H. Acupuncture, or non-directive counselling versus usual care for the treatment of depression: a pilot study. Trials. 2009; 10: 3

Sha, 2005 Sha, Y. General situation of electro-acupuncture in treating depressive disorders: comparing the effect with that of drug therapy. Chin. J. Clin. Rehabil. 2005; 9: 181–183

Simon et al., 2004 Simon, G.E., Cherkin, D.C., Sherman, K.J., Eisenberg, D.M., Deyo, R.A., and Davis, R.B. Mental health visits to complementary and alternative medicine providers. Gen. Hosp. Psychiatry. 2004; 26: 171–177

Smith and Hay, 2004 Smith, C.A. and Hay, P.P.J. Acupuncture for depression. Cochrane Database Syst. Rev. Issue 3. Art. No.: CD004046. ; 2004

Smith et al., 2010 Smith, C.A., Hay, P.P.J., and MacPherson, H. Acupuncture for depression. Cochrane Database Syst. Rev. Issue 1. Art. No.: CD004046. ; 2010

Smoller et al., 2009 Smoller, J.W., Block, S.R., and Young, M.M. Genetics of anxiety disorders: the complex road from DSM to DNA. Depress. Anxiety. 2009; 26: 965–975

Song et al., 2007 Song, Y., Zhou, D., Fan, J., Luo, H., and Halbreich, U. Effects of electroacupuncture and fluoxetine on the density of GTP-binding-proteins in platelet membrane in patients with major depressive disorder. J. Affect. Disord. 2007; 98: 253–257 (Electronic publication 2006 Aug 17)

Song et al., 2009 Song, C., Halbreich, U., Han, C., Leonard, B.E., and Luo, H. Imbalance between pro- and anti-inflammatory cytokines, and between Th1 and Th2 cytokines in depressed patients: the effect of electroacupuncture or fluoxetine treatment. Pharmacopsychiatry. 2009; 42: 182–188 (Electronic publication 2009 Sep 1)

Wang et al., 2006 Wang, Z., Li, Y., and Lin, H. Acupuncture treatment of generalized anxiety disorder. J. Tradit. Chin. Med. 2006; 26: 170–171

Wang et al., 2008 Wang, H., Qi, H., Wang, B.S., Cui, Y.Y., Zhu, L., Rong, Z.X., and Chen, H.Z. Is acupuncture beneficial in depression: a meta-analysis of 8 randomized controlled trials?. J. Affect. Disord. 2008; 111: 125–134

White, 2004 White, A. A cumulative review of the range and incidence of significant adverse events associated with acupuncture. Acupunct. Med. 2004; 22: 122–133

Whiting et al., 2008 Whiting, M., Leavey, G., Scammell, A., Au, S., and King, M. Using acupuncture to treat depression: a feasibility study. Complement. Ther. Med. 2008; 16: 87–91 (Electronic publication 2007 Sep 29)

Witt et al., 2009 Witt, C.M., Pach, D., Brinkhaus, B., Wruck, K., Tag, B., Mank, S. et al. Safety of acupuncture: results of a prospective observational study with 229,230 patients and introduction of a medical information and consent form. Forsch. Komplementmed. 2009; 16: 91–97 ([Electronic publication ahead of print 2009 Apr 9])

Xie and Li, 2009 Xie, Y.C. and Li, Y.H. Observation on therapeutic effect of acupuncture at Zhongwan (CV 12) and Si-guan points combined with reinforcing-reducing manipulation of respiration for treatment of depression [Chinese]. Zhongguo Zhen Jiu. 2009; 29: 521–524

Yuan et al., 2007 Yuan, Q., Li, J.-N., Liu, B., Wu, Z.-F., and Jin, R. Effect of Jin-3-needling therapy on plasma corticosteroid, adrenocorticotropic hormone and platelet 5-HT levels in patients with generalized anxiety disorder. Chin. J. Integr. Med. 2007; 13: 264–268

Zhang and Zhao, 2007 Zhang, L.J. and Zhao, H. The clinical efficacy of acupuncture in the treatment of depression and association with serological and cytological profiles [Chinese]. Zhong Guo Zhong Yi Yao Xin Xi Za Zhi. 2007; 14: 15–16

Zhang et al., 2007a Zhang, C.P., Huang, Y.G., and Chen, Z.X. A comparative study of electroacupuncture versus paroxetine in the treatment of depression. [Chinese]. Shi Yong Yi Xue Za Zhi. 2007; 23: 2949–2950

Zhang et al., 2007b Zhang, G.-J., Shi, Z.-Y., Liu, S., Gong, S.-H., Liu, J.-Q., and Liu, J.-S. Clinical observation on treatment of depression by electro-acupuncture combined with paroxetine. Chin. J. Integr. Med. 2007; 13: 228–230

Zhang et al., 2010 Zhang, Z.J., Chen, H.Y., Yip, K.C., Ng, R., and Wong, V.T. The effectiveness and safety of acupuncture therapy in depressive disorders: systematic review and meta-analysis. J. Affect. Disord. 2010; 124: 9–21

Zhang et al., 2009 Zhang, W.J., Yang, X.B., and Zhong, B.L. Combination of acupuncture and fluoxetine for depression: a randomized, double-blind, sham-controlled trial. J. Altern. Complement. Med. 2009; 15: 837–844

Zhou and Wu, 2007 Zhou, S.H. and Wu, F.D. Therapeutic effect of acupuncture on female's climacteric depression and its effects on DA, NE and 5-HIAA contents [Chinese]. Zhongguo Zhen Jiu. 2007; 27: 317–321