Acupuncture for Depression

Introduction

In this article, I shall explain something about what to expect when you seek acupuncture treatment for depression. In a survey of 9000 UK acupuncture patients, 11% were presenting with psychological complaints; in many practices, depression represents a significant portion of this category. Additionally, the 2017 Global Burden of Disease Study (1), found that over 264 million people suffer from depression internationally. It is a common problem, and two-thirds of adults will at some time experience depression severe enough to interfere with normal activities.

What to Expect When You Come

Should you decide to come for acupuncture, I shall be interested in whether you have a history of depression previously, when and how it began (eg. identifiable events or disproportionate reactions thereto), and how it affects your daily life (eg. ability to work, family and social relationships etc). Your wider health is enormously important too. Do you feel the depression is a reaction to the burden of chronic pain or to limitations imposed by some other medical problem? Might it even stem from medication used to control that problem? Did it arise out of chronic stress, from say work, a difficult relationship or caring for relatives?

Have you had depression in the past which now seems to have recurred in response to a new health problem, a recent life event, or stressful circumstances? Perhaps you are only in your twenties, have studied hard for a job, but are now disenchanted by it. Is there any link with hormonal changes such as being pre-menstrual or peri-menopausal? Oestrogen levels fall at these times, in turn reducing serotonin levels.

A significant new trigger for depression, is lockdown measures imposed in response to the covid-19 pandemic. Factors could be loss of work, relationship stress, social isolation, or working alone from home, to name but a few.

Looking more widely still, I am interested in the full array of other symptoms which accompany your depression. These can encompass fatigue, poor concentration, sleep disturbance, appetite or weight changes, or feelings such as irritability, anger, anxiety, panic or guilt. I can then begin to re-frame the picture of your health from a Chinese medical perspective, and devise a plan of treatment. If it is practical, we can try to directly help obvious causes of your depression, such as stress or chronic pain. In other cases, the causes do not lend themselves to such an approach, in which case we just try to tackle the depression.

Lifestyle Advice

Lifestyle advice is often a particularly useful part of treatment. In Chinese medicine, the health of our physical body is considered important for our mental and spiritual health too. This gives our shen or spirit, a good home in which it can settle. We may need to discuss your diet, any possible nutrient deficiencies, sleep, exercise, social life, alcohol intake, and drugs both prescribed and recreational. Diet and nutrient considerations may include omega-3 oils, B vitamins, magnesium, zinc, gut health/biome and blood glucose control.

Rest assured, acupuncture can safely and effectively be used alongside other interventions like counselling or anti-depressant medication.

Please do contact me if you would like to discuss anything further. Below you will find the results of recent research, some into acupuncture for depression, and some which suggests worthwhile self-help measures. Scientists at the University of Bern for example, published a paper(2) confirming the benefits of exercise for patients with depression. We also nowadays consider whether inflammation might lie to some extent and in some cases, behind depression: scroll down below to my 2018 article on the beneficial effects of the Mediterranean diet.

(1) Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017.
(2) Effects of Exercise on Anxiety and Depression Disorders: Review of Meta-Analyses and Neurobiological Mechanisms. CNS & Neurological Disorders-Drug Targets, 2014.

Acupuncture Combined with Antidepressants is Effective

Acupuncture combined with antidepressants is effective. Acupuncture combined with antidepressants, is more effective for improving depression than antidepressants alone, reports an international team from the US and China. Sixty patients aged 18 to 70 with moderate depression were randomly assigned to receive either acupuncture (including some electroacupuncture) plus antidepressants, or just antidepressants alone. Acupuncture was given three times a week for eight weeks, with follow up for four further weeks.

Compared with the control group, the acupuncture group showed lower depression symptom scores at week 4 (17 versus 26), week 8 (10 versus 25), and week 12 (11 versus 27). Patients also had their urine screened for key metabolites. The significant differences found between the two groups, suggest say the researchers, that acupuncture may help depression by acting on metabolic pathways associated with neurotransmitter production.

(The effect of acupuncture on depression and its correlation with metabolic alterations: A randomized controlled trial. Medicine (Baltimore), 23 October 2020.)

Exercise benefits Depression

Acupuncture in Exeter: exercise benefits depression. Exercise benefits depression and can prevent its development, according to a major review by the Federal University of Santa Maria in Brazil and King’s College London. Highlights of the study include:

– Physical activity can confer protection from the development of depression in children and adults. These effects are observed across all continents.
– A robust body of evidence from randomised controlled trials demonstrates that exercise is effective in treating depression.
– The type of exercise should fit personal preferences, and be enjoyable or challenging eg training to achieve a 5km run. It would be a mistake to prescribe say, gym sessions for everyone.
– Encouraging patients to exercise with friends or family may increase the chances of treatment success, and the subsequent adoption and maintenance of exercise.
– The dropout rate in exercise trials for people with depression is about 18%. By comparison, that from psychotherapy is about 19% while that from SSRI medication (eg prozac, citalopram) is about 26%.
– Just like other interventions, exercise may not work equally for all.
– Evidence of the effectiveness of exercise is substantial and growing fast. Despite this, only some guidelines have included physical activity and exercise among recommended strategies for depression.

(The Role of Exercise in Preventing and Treating Depression. Current Sports Medicine Reports, August 2019.)

Mediterranean Diet Associated with Lower Rates of Depression

Mediterranean Diet and depression. A systematic review undertaken by researchers at University College, London, suggests an association between adherence to the Mediterranean diet and lower rates of depression. A total of 41 studies were included in the review. An array of dietary approaches were covered by the studies, but the most compelling link was that between the Mediterranean diet and depression. An anti-inflammatory diet was also associated with lower rates of depression.

Although the link has not yet been proven as causal, the authors speculate on possible biological mechanisms. These include the microbiome-gut-brain axis which is now believed to play a key role in neuropsychiatry.

(Healthy dietary indices and risk of depressive outcomes: a systematic review and meta-analysis of observational studies. Molecular Psychiatry, on-line 26 September 2018.)

Acupuncture helps Medication-Resistant Depression

Acupuncture helps medication-resistant depression.
A pilot study undertaken in Japan shows acupuncture can significantly help medication-resistant depression and improve autonomic nervous system function. Thirty in-patients received either true acupuncture or sham acupuncture. Treatment was given by the application of small, low-profile press needles for 72 hours. Compared with sham acupuncture, the true acupuncture patients showed significant improvement in depression scores, blood pressure and measures of vagal nerve function. The authors suggest that the latter may be associated with the therapeutic mechanism behind acupuncture’s effect on depression.

(Acupuncture-induced changes of vagal function in patients with depression: A preliminary sham-controlled study with press needles. Complementary Therapies in Clinical Practice, online 6 July 2015.)