Acupuncture for Anxiety

Acupuncture is known for its effectiveness at managing physical pain, but it can also be a valuable mental health support. Working for several years in a psychiatric practice showed me first hand that acupuncture is profoundly helpful at treating anxiety disorders, even for those diagnosed as treatment resistant (meaning low response to standard of care). And there is plenty of scientific research to support the safety and effectiveness of acupuncture in the treatment of anxiety.

Anxiety disorders are globally widespread mental health conditions that affect children and adults. They are considered the most prevalent mental health conditions in the world and patients newly-diagnosed increased by 50% worldwide from 1990 to 2019 [1]. Yet, even with such a high occurrence, it is still estimated that anxiety disorders are underdiagnosed and undertreated [2].

The common characteristics of all anxiety disorders is a persistent, excessive worry or fear in non-threatening situations [3]. Other symptoms of anxiety include but are not limited to insomnia, heart palpitations, increased heart rate, hyperventilation, nausea and other digestive complaints, sweating, fatigue, trouble concentrating, and trembling. Anxiety can seriously interfere with our ability to work, engage in healthy relationships, and take care of our basic needs.

Anxiety is a chronic condition, and it isn’t unusual for patients to have comorbidities such as depression or substance abuse; additionally, an individual may also experience a shifting of one anxiety disorder to another over time [4].

The standard conventional treatment of anxiety consists of pharmacotherapy and psychotherapy. Medications typically used to treat anxiety disorders include antidepressants, benzodiazepines, and antiseizure medications. Pharmaceuticals pose potential risks including side effects such as sedation, headache, insomnia, gastrointestinal upset, sexual dysfunction, weight gain, increased blood pressure, and blurred vision [5]. Habituation, drug interactions, and dependence are other concerns with medications used to treat anxiety [4]. Safer, effective therapy options to manage anxiety are needed [6].

A core tenet of Chinese Medicine is the recognition that there is no separation between the body, mind and emotions. Connection between psychological effects upon physical symptoms was first recorded 2200 years ago in an ancient medical text, the Huang-Di Neijing. An impressive amount of anecdotal evidence has been amassed over thousands of years regarding treating anxiety with Chinese Medicine.

Anxiety is a condition I have had extensive experience treating in my practice and I have found that acupuncture can be helpful in several ways. It can treat both the emotional and physical manifestations of anxiety; this is particularly useful for those taking medications who otherwise do not want to take more pills to address different physical components. Acupuncture is safe to use with medications so there is no concern of drug interactions. The support acupuncture offers can help keep dosages of medications lower than without. And acupuncture is a great option for those with a history of substance abuse as opposed to some medications that can be addictive.  

Acupuncture calms the autonomic nervous system which is a major biomechanism behind how it reduces anxiety; this makes it especially helpful for those who experience panic attacks, PTSD, and trauma related anxiety [7; 8]. It can help increase focus while decreasing anxiety making it useful to manage ADHD. People who are obsessional benefit from acupuncture because if you decrease the level of hyperarousal and anxiety then OCD symptoms can improve. Acupuncture support is incredibly adept at reducing cravings as I’ve seen regularly in practice.

Systematic reviews synthesizing data from randomized controlled trials in the management of anxiety disorders consistently conclude that acupuncture is a safe and effective therapy [9; 6; 10].

Research has shown that acupuncture has an equal therapeutic effect to antidepressants [11; 12].

One systematic review comparing 20 trials treating generalized anxiety disorder (GAD) with acupuncture found that acupuncture works more quickly than antidepressants [10]. It typically takes 6 weeks at a minimum to evaluate effects of antidepressants [10]. Therefore, the authors concluded that acupuncture is a great therapeutic option to provide symptom relief to GAD patients when starting or transitioning antidepressants [10].

Lastly, I commonly use acupuncture in my practice to treat side effects of medications to help make them more tolerable. Research supports the use of acupuncture to reduce side effects of antidepressants [13].

Integrative care is the best approach towards treatment and acupuncture could be a helpful addition to one’s healthcare regimen in the management of anxiety. Research suggests that patients would benefit should acupuncture be included as standard of care. And the overall balancing and promotion of wellness from a holistic perspective is an advantage for all those receiving care with Chinese Medicine.

Feel free to contact my office if you have any questions about how Chinese Medicine can help you or someone you know.

References:

[1] Yang, X. & Fang, Y. & Chen, H. & Zhang, T. & Yin, X. & Man, J. & Yang, L. & Lu, M. Global, regional and national burden of anxiety disorders from 1990 to 2019: results from the Global Burden of Disease Study 2019. Epidemiology and psychiatric sciences. 2021, vol. 30:E36. P. 1-11. Available at: doi: 10.1017/S2045796021000275.

[2] Bandelow, B. & Michaelis, S. Epidemiology of anxiety disorders in the 21st century. Dialogues in clinical neuroscience. 2015, vol. 17:3. P. 327-335. Available at: doi: 10.31887/DCNS.2015.17.3/bbandelow.  

[3] National Alliance on Mental Illness. Anxiety Disorders. 2017, December. Available at: https://www.nami.org/Home

[4] Bystritsky, A. & Khalsa, S. S. & Cameron, M. E. & Schiffman, J. Current diagnosis and treatment of anxiety disorders. P & T: a peer-reviewed journal for formulary management. 2013, vol. 38:1. P. 30-57.

[5] Hoang, M. & Deng, Y. & Hilmi, Y. & Langland, J. Treatment of anxiety and insomnia with acupuncture and Chinese herbs: A case report. Journal of Chinese Medicine. 2018, vol. 118. P. 32-35.

[6] Li, M. & Xing, X. & Yao, L. & Li, X. & He, W. & Wang, M. & Li, H. & Wang, X. & Xun, Y. & Yan, P. & Lu, Z. & Zhou, B. & Yang, X. & Yang, K. Acupuncture for treatment of anxiety, an overview of systematic reviews. Complementary Therapies in Medicine. 2019, vol. 43. P. 247-252. Available at: doi: 10.1016/j.ctim.2019.02.013.

[7] Tan, A. & Wang, M. & Liu, J. & Huang, K. & Dai, D. & Li, L. & Shi, H. & Wang, P. Efficacy and safety of acupuncture combined with western medicine for anxiety. Medicine. 2020, vol. 99:31. P. e21445. Available at: doi: 10.1097/MD.0000000000021445.

[8] Samuels, N. & Gropp, C. & Singer, S. R. & Oberbaum, M. Acupuncture for psychiatric illness: A literature review. Behavioral Medicine. 2008, vol. 34:2. P. 55-64. Available at: doi:  10.3200/BMED.34.2.55-64. 

[9] Amorim, D. & Amado, J. & Brito, I. & Fiuza, S. M. & Amorim, N. & Costeira, C. & Machado, J. Acupuncture and electroacupuncture for anxiety disorders: A systematic review of the clinical research. Complementary therapies in clinical practice. 2018, vol. 31. P. 31-37. Available at: doi: 10.1016/j.ctcp.2018.01.008.

[10] Yang, X. Y. & Yang, N. B. & Huang, F. F. & Ren, S. & Li, Z. J. Effectiveness of acupuncture on anxiety disorder: A systematic review and meta-analysis of randomized controlled trials. Annals of general psychiatry. 2021, vol. 20:9. Available at: doi: 10.1186/s12991-021-00327-5

[11] Zhang, Z. J. & Chen, H. Y. & Yip, K. C. & Ng, R. & Wong, V. T. The effectiveness and safety of acupuncture therapy in depressive disorders: Systematic review and meta-analysis. Journal of affective disorders. 2010, vol. 124:1-2. P. 9-21. Available at: doi: 10.1016/j.jad.2009.07.005.

[12] Luo, H. & Meng, F. & Jia, Y. & Zhao, X. Clinical research on the therapeutic effect of the electroacupuncture treatment in patients with depression. Psychiatry and Clinical Neurosciences. 2014, vol. 52:S6. P. S338-S340. Available at: doi: 10.1111/j.1440-1819.1998.tb03262.x. 

[13] Wu, J. & Yeung, A. S. & Schnyer, R. & Wang, Y. & Mischoulon, D. Acupuncture for depression: A review of clinical applications. The Canadian Journal of Psychiatry. 2012, vol. 57:7. P. 397-405. Available at: doi: 10.1177/070674371205700702.