Acupuncture anxiety depression support and post traumatic stress disorder (PTSD).

acupuncture anxiety depression

There is moderate level evidence supporting the use of acupuncture anxiety depression therapy for anxiety, depression and post traumatic stress disorder (PTSD).

What is the history behind acupuncture anxiety depression support

Acupuncture anxiety depression therapy is well covered in the classical texts which underpin Chinese medicine.

Broadly, these conditions are considered to be ‘mental-emotional’ disorders or disorders of the Shen.

The Shen is the Chinese medicine concept of accounting for the mind.

The long tradition in Chinese medicine of supporting Shen disorders includes Chinese medicine disease states like Dian Kuang (bi-polar disorder)  Yu Zheng (melancholy-depression) and Juan Dai (lassitude, which includes mental emotional disturbance).

Historically, Chinese medicine therapy would include herbal medicine and acupuncture anxiety depression therapy.

From a ‘Western’/biomedical perspective, how are mental health disorders classified?

The Diagnostic and Statistical Manual of Mental Disorders (DSM), currently in its fifth edition (DSM-5) is the work of the American Psychiatric Association.

The manual provides a common language around mental health and establishes diagnostic guidelines to aid doctors, mental health workers (for example, psychologists) and others in the field to diagnose mental health disorders.

There are other classification documents including the International Classification of Diseases and also the ICD-10 (produced by the World Health Organisation).

Psychiatrists, psychologists and other mental health workers assess patient symptoms according to the criteria established in these reference works.

The mental health conditions covered in those works, relevant to this discussion, include anxiety, depression and post traumatic stress disorder (PTSD).

The acupuncture anxiety depression practitioner also works on a system of classifying presenting signs and symptoms but uses traditional texts rather than the DSM-5 as their primary source.

How does the acupuncture and Chinese medicine practitioner approach acupuncture anxiety depression therapy?

The acupuncture and Chinese medicine practitioner is, initially, mostly interested in your presenting signs and symptoms.

The types of information, signs and symptoms your practitioner will be interested in might include:

  • the nature of your mood disorder:  do you feel glum and sad or do you feel worried and pensive?  Perhaps you sometimes feel highly elated and other times you might feel low and like life is worthless.
  • the timing  of your mood disorder:  do you notice your mood changes at certain times of the day (for example, is it worse in the morning or worse in the evening or is it the same all the time)? If you are female, does your mood disorder worsen leading up to or during your menstrual bleed?
  • the triggers of your mood disorder:  is there anything which can make your mood change?  For example, when you are tired are you more prone to experience your symptoms or are your symptoms triggered by external things like work or family relationship stressors?
  • the history of you mood disorder:  establishing a context, by way of timeline, is very important because it helps the practitioner to observe the progression of your condition and how that might tie in to other factors (like changes in circumstance or triggers).

The acupuncturist might also be interested in any biomedical diagnosis you have been given (for example, generalised anxiety disorder) but this will not be essential to the diagnostic process (as will be explained below) and will not affect the overall acupuncture anxiety depression treatment process.

Will the acupuncture and Chinese herbal medicine practitioner only ask questions about my mental health?

In short, no.

The great strength of the Chinese medicine diagnostic model is that is places your condition into a broader picture of your overall health.

So, while detailed questions about the nature, timing, triggers and history of your mental health condition will provide a sharp focus, there will also be questions around your respiratory and digestive health, sleep and gut health.

For women, questions are reproductive health and the menstrual cycle will also be covered.

The purpose of this style of questioning is to give the practitioner all they need to create a Chinese medicine diagnosis and develop an acupuncture anxiety depression treatment plan.

What happens once all this information has been gathered (the Chinese medicine diagnosis)?

Chinese medicine diagnosis relies on careful identification and classification of signs and symptoms often associated with mood disorders.  These signs and symptoms may include irritability, frustration and anger, worry and over-thinking (or rumination).

Traditional acupuncture texts refer to conditions like ‘dian kuang’ which broadly encompasses what is known in the modern world as bi polar disorder and manic depressive disorder.

Other relevant conditions include Yu Zheng (melancholy-depression) and Juan Dai (lassitude, which includes mental emotional disturbance).

Chinese medicine also covers a condition called ‘neurasthaenia’.  Neurasthaenia, in a modern context, covers anxiety-related disorders that might come from overwork and mental exhaustion.  It broadly corresponds with the idea of adrenal fatigue which may include anxiety and insomnia.

While the mood disorder remains the acupuncturist’s focus, the value of the Chinese medicine diagnosis is that it confirms itself by the presence of other, often seemingly unrelated, signs and symptoms.

It is for this reason the acupuncturist may also ask questions around sleep, the bowels and digestion, one’s susceptibility to cold, flu and allergies, back and other body pain and for women the menstrual cycle.

The very important thing to remember is that the Chinese medicine diagnosis does not replace any diagnosis given to you by your psychiatrist or mental health practitioner.

Rather, the Chinese medicine diagnosis sits alongside that diagnosis and is there to provide a framework which the acupuncturist can use to craft an appropriate, supportive acupuncture anxiety depression treatment strategy.

What evidence is there to support acupuncture pain relief therapy?

Across 2016 and early 2017, Australian researchers conducted a review of the highest evidence possible to support the use of acupuncture anxiety depression therapy 1

Contained within this evidence review are evidence summaries of systematic reviews and other ‘level I’ forms of evidence.

The following conditions have ‘strong’ evidence to support acupuncture as a primary form of treatment:

ANXIETY DISORDERS

Anxiety disorders may include generalised anxiety disorder (GAD), obsessive-compulsive disorder (OCD), panic disorder and social phobias.

The  United States Department of Veterans Affairs (2014) concluded that acupuncture showed a ‘potential positive effect’ in the treatment of anxiety. 2

Since then, a narrative review 3 concluded acupuncture may have a ‘potential use’ in the treatment of anxiety disorders.

A more comprehensive systematic review of nineteen studies, ranging from moderate to high quality evidence, concluded acupuncture produced positive and mostly significant effects for managing anxiety 4

DEPRESSION

The USVA evidence review (2014) listed acupuncture as a therapy for depression as demonstrating a ‘potential positive effect’.

One systematic review since then 5 compared the effect of acupuncture when taken alongside selective serotonin re-uptake inhibitors (SSRIs) with SSRIs alone.  Results demonstrated better outcomes for the group receiving acupuncture.

The review also demonstrated, within the acupuncture group, better outcomes for those receiving electroacupuncture over manual acupuncture.

Another systematic review 6 sought to assess acupuncture’s effectiveness while establishing the mechanism of action underpinning acupuncture.

For major depressive disorder this systematic review demonstrated improved quality of life (QoL), improved sleep and improved mood.  The SR concluded this improvements were possible due to acupuncture’s modulating and normalising effect on the limbic-paralimbic neocortal network (LPNN).

In this systematic review, acupuncture was deemed safe and effective and in another study, acupuncture was found to be cost-effective when compared with counselling or usual care. 7

POST TRAUMATIC STRESS DISORDER (PTSD)

The USVA evidence review (2014) ranked acupuncture as a therapy for post traumatic stress disorder (PTSD) as having a potential positive effect.

Since that review, one small randomised controlled trial compared usual care plus acupuncture to usual care alone (counselling).  The acupuncture group performed better for reduction of symptoms. 8

A word about the importance of counselling and other therapies

Nothing replaces effective counselling and often people experiencing anxiety and/or depression may also benefit from counselling from a qualified health professional.

On its own, the evidence supports acupuncture helping with anxiety and depression.  Counselling should sit alongside acupuncture anxiety depression treatment.

I feel as though I need to know a little more about understanding evidence.

For those not familiar with it, interpreting evidence can be daunting and confusing.

There is an extensive discussion around the use of evidence in supporting acupuncture over on this FAQ page.

What if my condition isn’t listed on this page?

All that means is that there hasn’t been enough research to officially say, “yep it helps”.

Before deciding whether acupuncture anxiety depression is for you, feel free to give Peter a call to chat about your individual circumstances and his experience or knowledge of your problem.

There is moderate level evidence supporting the use of acupuncture anxiety depression therapy for anxiety, depression and post traumatic stress disorder (PTSD).

Ready to book your first consultation?

Peter Kington, Brisbane acupuncture practitioner, offers a range of days and appointment times for your first and follow-up consultations. Call (07) 3367 1150 or contact Peter here and he or an associate will call you back, have a quick chat about your needs and find a mutually convenient time for your first appointment.

  1.  MacDonald J, Janz S.  The Acupuncture Evidence Project:  A Comparative Literature Review (revised evition).  Brisbane:  Australian Acupuncture and Chinese Medicine Association Ltd;  2017.  [accessed 21 February, 2018.
  2. Hempel S, Taylor SL, Solloway MR, Miake-Lye IM, Beroes JM, Shanman R, et al. VA Evidence-based Synthesis Program Reports. Evidence Map of Acupuncture. Washington (DC): Department of Veterans Affairs; 2014.
  3. Bazzan AJ, Zabrecky G, Monti DA, Newberg AB. Current evidence regarding the management of mood and anxiety disorders using complementary and alternative medicine. Expert Rev Neurother. 2014 Apr;14(4):411- 23.
  4. Goyata SL, Avelino CC, Santos SV, Souza Junior DI, Gurgel MD, Terra FS. Effects from acupuncture in treating anxiety: integrative review. Rev Bras Enferm. 2016 Jun;69(3):602-9.
  5. Chan YY, Lo WY, Yang SN, Chen YH, Lin JG. The benefit of combined acupuncture and antidepressant medication for depression: A systematic review and meta-analysis. J Affect Disord. 2015 May 1;176:106-17
  6. Bosch P, van den Noort M, Staudte H, Lim S. Schizophrenia and Depression: A systematic Review of the Effectiveness and the Working Mechanisms Behind Acupuncture. Explore (NY). 2015 Jul-Aug;11(4):281-91.
  7. Spackman E, Richmond S, Sculpher M, Bland M, Brealey S, Gabe R, et al. Cost-effectiveness analysis of acupuncture, counselling and usual care in treating patients with depression: the results of the ACUDep trial. PLOS ONE. 2014;9(11):e113726.
  8. Engel CC, Cordova EH, Benedek DM, Liu X, Gore KL, Goertz C, et al. Randomized effectiveness trial of a brief course of acupuncture for posttraumatic stress disorder. Med Care. 2014 Dec;52(12 Suppl 5):S57-64.