Acupuncture for Anxiety and Stress

Introduction

Although distinct from each other, these two conditions are remarkably common, and a great many people will experience one or both at some point in their lives.

Definitions are broad, but on the whole, we might say stress is perceived when we feel under an unwelcome amount of pressure (time, commitments, work, money etc). It may cause symptoms ranging from brooding resentment to irritability, or headaches to indigestion.

Anxiety on the other hand, is an emotion often physically experienced in the region of the heart. It may be accompanied by an awareness of the heart beating, a rapid or pounding heart, a vague unease in the chest, or shallow, rapid breathing. Anxiety can undermine self-confidence, and people can be left feeling it is holding them back in their lives (career progression, travel, meeting new friends etc). The physical symptoms which come with stress and anxiety, can create worry which then leads to more stress and further worry.

Research Evidence

Anxiety

Research suggests acupuncture is an effective treatment for anxiety. Recent systematic reviews of the evidence have found consistently positive results in trials of acupuncture for anxiety. They were able to reach stronger conclusions than earlier UK reviews, due to more accumulated data. Hence acupuncture is seen as a promising treatment option that might help to reduce the use of drugs. Psychiatric health professionals have also rated it as effective and safe.

The British Acupuncture Council partnered with Anxiety UK, the country’s leading anxiety disorders charity, to launch a joint research project and increase awareness of how traditional acupuncture can help people with anxiety disorders. Preliminary results on 30 patients indicated that its effectiveness was at least as good as that seen with psychological therapies such as CBT.

Stress

When we are under stress on the other hand, an area of the brain called the hypothalamus releases certain neurochemicals, and research shows that acupuncture can calm this response. Acupuncture has also been shown to increase the release of endorphins, the body’s own ‘feel-good’ chemicals, which play a role in the regulation of stress responses such as pain, heart rate and blood pressure. These effects of acupuncture probably lie wholly or partly behind its ability to reduce anxiety.

Post-Traumatic Stress Disorder (PTSD)

There is also post-traumatic stress disorder (PTSD). In a systematic review of seven randomised trials, there were significant differences favouring acupuncture (versus any comparison group) on PTSD symptoms, at post-intervention and at longer follow-up. A before and after observational study demonstrated very large improvements in PTSD outcome measures, such that none of the patients completing the course of six sessions was still classed as having PTSD. The participants were all British forces veterans. Acupuncture is also much used for treating US veterans, and for serving personnel within the military.

Acupuncture for Stress

Acupuncture in Exeter for stress: find a relaxing and enjoyable activity to engage in a few times a week.

Taking stress firstly, I find it plays a role in quite a few conditions I see. It may have been a causal component in the development of a problem eg. chronic headaches which started during a particularly stressful year, or it may noticeably aggravate pre-existing conditions as diverse as back pain, IBS (irritable bowel syndrome), psoriasis or depression.

It helps if when you come, you are able to share as much as you can about the causes of your stress, whether it be work, caring for relatives, family tensions, lack of free time, or any other experience you are going through. I will be interested to learn how it is affecting you in all its manifestations eg. irritability, constantly upset by small things, poor sleep, digestive disturbances, headaches, raised blood pressure.

As usual, we will cover your health in the wider sense too, and take account of any other concerns or conditions. I will formulate a treatment plan, and together we will discuss some coping strategies appropriate to your circumstances. These may involve exercise, relaxation, delegation of some responsibilities etc, and we will monitor their success. My aim overall though, is that you shouldn’t just feel less stressed whilst you are having a course of treatment, but that you should actually carry away with you, new ways of living your life, which lead to a permanent change in the way you feel.

Acupuncture for Anxiety

Moving on to anxiety, you may well have identified particular situations which arouse it eg. knowing you are going to have to speak in a meeting at work. Anxiety, like stress, also has the capacity to affect sleep, and so this aspect of your life may need some help too. I shall ask all about how the anxiety began, and by combining this information with your answers to my questions about your general health, I can devise a treatment plan.

Sometimes this might include some dietary advice, emphasising particular foods to include in your daily menu. We may need to discuss any possible nutrient deficiencies, sleep, exercise, social life, alcohol intake, and drugs both prescribed and recreational. Diet and nutrient considerations may include B vitamins, magnesium, zinc, gut health/biome, and dietary protein.

Additionally, since our ears have many useful acupuncture points on them, I might if you wish, affix a tiny seed over an appropriate point. It will often go unnoticed by others, or be covered by your hair, but when you locate it with your finger and squeeze it against the ear, you may find it quite calming. I frequently give these to people who have a fear of flying, to aid them at the airport and on board the plane.

Anxiety is often a fairly long-term pattern, and can range from mild to severe. It might have gone away for several years, only to re-appear at a point in life when you are vulnerable, such as in the year or so following pregnancy and childbirth. On the whole though, I expect to have to treat for two to three months, on a weekly basis. An exception would be the fear of flying example above, where if you have got as far as already booking a trip, then a few treatments beforehand might suffice to give you a holiday, as opposed to an ordeal.

For both stress and anxiety, I may well also offer you ear seeds. These are tiny seeds placed over acupuncture points on your ear, and held in place with a small square of translucent tape. They usually stay in place for up to a couple of weeks and you can stimulate them by squeezing them whenever you feel the need to regain your sense of calm.

6 Simple Self-Help Measures

When you are stressed, it may also be helpful to stop and take stock. There are six simple steps we can take, which have been found to make us happier, and some of these are helpful for anxiety too:

Acupuncture for anxiety: Notice the beauty all around you1) Be Curious  Notice that there is beauty, interest and novelty all around. Look out for the lambs in the fields as you drive by, or for that first bluebell in the spring hedgerow. Glance up at the hidden gems of architecture high above familiar streets.

2) Be Active  Physical activity has a positive impact on stress, depression and anxiety. Take up some exercise: walk to the station, take a lunchtime stroll, join a dance class etc.
Learn to play an instrument or study a foreign language
3) Continue Learning  Learn to speak a foreign language, play a musical instrument, or master a new hobby

4) Connect  Happy people have stronger social relationships. Invest a little time in friends, family and colleagues. Take a few moments to chat with the postman or the sales assistant in a shop you go to regularly.

5) Give  Look out for opportunities to give something to your fellow humans: you could express appreciation, do someone a favour, or even just give a smile.

6) Smiling improves our mood. It is an example of positive body language, which affects the brain and hence how we feel. Spend time with smiley people and you will naturally mirror their expressions.

Please feel free to call me to discuss your situation. Below you can read the results of some of the research which has been undertaken into acupuncture for anxiety and stress. The trials vary in quality, but systematic reviews and randomised controlled trials are generally considered to provide the highest quality evidence. If you would like to read more about evidence quality, I would refer you to the British Acupuncture Council’s description of the evidence pyramid.

The Brain-Gut Microbiome & Mental Health

Researchers at the David Geffen School of Medicine, UCLA, have identified brain-gut microbiome profiles associated with resilience to stress. They put the cost to the US economy of stress-related time off work and the necessary healthcare at $300 billion. Resilience includes positive acceptance of change, tolerance of challenges, tenacity and the ability to recover after stressful events.

Most research investigating resilience has focused on its correlations with personality traits. The microbiome has already been implicated in conferring stress resilience. The UCLA team set out to determine how resilience is related among other things, to microbiome function. Given the microbiome’s role in influencing psychological resilience, they hypothesized that high resilience would be associated with good microbiome function supporting gut health. Evidence for this would include the existence of pathways supporting gut microbial growth and diversity, and metabolites supporting anti-inflammatory processes and gut-barrier integrity.

The team took 116 healthy subjects aged 18 to 60, recruited from the Los Angeles community through advertising, of whom 44 were identified as high resilience and 72 as low resilience. Through clinical and psychological questionnaires, stool samples and MRI scans, a neurological and gut health assessment was made.

The results showed that the high resilience group, in addition to possessing the ability to be more psychologically adaptive, also had a microbiome which supported gut barrier integrity.

The researchers conclude by saying “Some clinical implications to explore are whether dietary modifications, prebiotics, probiotics or other clinical interventions (for example, faecal transplantation) may improve coping and resilience to stress. Collectively, our findings suggest that features of the brain and the gut microbiome work together to build stress-resilience.”

(Stress-resilience impacts psychological wellbeing as evidenced by brain–gut microbiome interactions. Nature Mental Health Journal, 21 June 2024.)

Acupuncture reduces Preoperative Anxiety & Anaesthetic Use during Surgery

Acupuncture reduces preoperative anxiety. Italian researchers at Santa Maria del Carmine Hospital, Rovereto, have concluded that acupuncture is a safe and well-tolerated procedure that can reduce preoperative anxiety. They randomised 120 patients undergoing cholecystectomy or hernia repair surgery, to one of three groups: body acupuncture; ear acupuncture; or a sedative drug group receiving midazolam. Acupuncture was given 30 minutes prior to surgery.

Anxiety reduction was measured by consumption of propofol (anaesthetic and sedative) and fentanyl (anaesthetic). Body acupuncture was more effective than midazolam, with patients showing lower fentanyl consumption. Both acupuncture groups had lower propofol consumption compared with the drug group, and had no adverse events or local complications.

(Preoperative anxiety management: acupuncture vs. pharmacological treatment – A prospective study. European Review for Medical & Pharmacological Sciences, February 2022.)

Ear Acupuncture & Aromatherapy help Preoperative Anxiety

Preoperative anxiety: acupuncture and lavender can help. Ear acupuncture combined with lavender oil aromatherapy, can reduce preoperative anxiety in coronary angiography patients, according to German researchers.

The study was undertaken in the Department of Cardiology & Angiology at University Hospital Bergmannsheil. Data from 80 consecutive patients undergoing diagnostic coronary angiography, with or without additional procedures such as valve repair/replacement, was gathered. Patients were prospectively randomised to receive either pre-surgical ear acupuncture plus lavender oil aromatherapy, or sham acupuncture and placebo oil. Oil was applied to the chest, and needles were left in for thirty minutes.

After treatment, the true acupuncture group showed significantly decreased anxiety scores compared with the placebo group. This group also reported greater perceived surgical success (87%) compared with the placebo group (66%).

The authors say that such a worthwhile reduction in preoperative anxiety is especially important in this often fragile patient group, and that acupuncture and aromatherapy could reduce the need for conventional sedative drugs which can have serious side-effects for these patients.

(Efficacy of Auricular Acupuncture & Lavender Oil Aromatherapy in Reducing Preinterventional Anxiety in Cardiovascular Patients: A Randomised Single-Blind Placebo-Controlled Trial. Journal of Integrated & Complementary Medicine, January 2022.)

Auricular Acupressure Helps Prevent Burnout in Healthcare Staff

Acupuncture in Exeter: an illustration of auricular acupuncture American researchers have found that auricular acupressure can help reduce the negative impacts of occupational stress on frontline healthcare staff. In a randomised trial, 117 staff in a paediatric trauma centre, received either auricular acupuncture, auricular acupressure, or auricular massage delivered over a three week period.

The acupressure, given using ear seeds, was associated with a significant reduction in measures of psychological burnout and secondary traumatic stress. The team concludes that auricular acupressure is a safe, effective, and practical strategy to reduce burnout and secondary traumatic stress and may support health care workers’ ability to develop caring relationships with patients and families.

(Effects of Acupuncture & Acupressure on Burnout in Health Care Workers: A Randomized Trial. Journal of Trauma Nursing, Nov-Dec 2021.)