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How Acupuncture Can Help with Anxiety

Anxiety disorders constitute the most common type of mental illness in the United States, with approximately 19% of the adult population, or 40 million people, experiencing an anxiety disorder each year.  An estimated 30% of the population experiences an anxiety disorder at some point during their lives.1   

As defined by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), anxiety disorders encompass several different conditions including generalized anxiety disorder, panic disorder, agoraphobia, and social anxiety disorder, among others.2  Each syndrome has a specific set of defining criteria, but they often share the following signs and symptoms:

  • Restlessness, nervousness
  • A sense of impending danger, panic or doom
  • Increased heart rate
  • Rapid breathing
  • Sweating
  • Trembling
  • Fatigue or weakness
  • Difficulty concentrating
  • Trouble sleeping
  • Gastrointestinal problems
  • Excessive worry
  • Avoidance of things that trigger anxiety3

While 19% of the population experiences a clinically defined anxiety disorder each year, many more people experience a milder form of anxiety and/or stress, sometimes on a fairly regular basis.  This type of anxiety or stress might not fall under a clinical definition of mental illness, but the experience can still affect one’s quality of life.


Non-clinical anxiety

Anxiety is a normal and natural reaction to different types of events or circumstances we might encounter.  For instance, when we are faced with a threat, feelings of anxiety are part of our body’s fight or flight response which is a protective mechanism.  Even sometimes “good” events, such as a wedding or the birth of a child, can cause anxiety or stress. 

If anxiety is proportional to the degree of the problem, ends once the situation has resolved, and is a response to a realistic, not just imagined, situation, it is not a problem that necessarily needs to be treated.  However, seeking help for any type of anxiety can help improve quality of life and the ability to manage the stress more effectively. 

Importantly, when anxiety or stress occurs in the absence of an identifiable event or in response to an imagined problem, seems disproportional to the actual situation, does not go away once the situation has resolved, or affects one’s ability to work or perform daily functions, seeking help is important.4 


The COVID Pandemic and Mental Health

Recent data indicates that mental illness in general, and stress and anxiety in particular, have increased since the start of the COVID-19 pandemic.  A national survey by the American Psychiatric Association (APA) found that 36% of Americans say that coronavirus is having a serious impact on their mental health.5   Fears about contracting the illness, uncertainty about the future, increased isolation, job loss, and financial distress have all contributed to increased anxiety and other mental health problems.  Moreover, frontline medical workers are experiencing burnout and increased levels of depression, anxiety and insomnia.6  These responses are understandable given the severity of the pandemic and the drastic changes to daily life that many people have experienced.  Because we will likely be dealing with the pandemic into next year, it is more important than ever to try to find ways to deal with stress and anxiety and improve overall mental health. 

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Acupuncture for Anxiety and Stress

Traditional Chinese Medicine is individualized medicine that treats each patient according to his or her unique needs.  Treatments are tailored to each patient’s specific signs and symptoms, medical history, constitutional tendencies, and other relevant lifestyle factors.   Thus, two patients who have been diagnosed with Generalized Anxiety Disorder from a Western medicine perspective might receive different diagnoses from a Chinese medicine perspective and thus receive different treatments and advice.  An in-depth discussion of anxiety in Chinese medicine is beyond the scope of this article, but I am happy to discuss it more with anyone who is interested.  What is important is that you will receive a treatment tailored to your distinct condition and needs and not a protocol-based treatment used for everyone with anxiety.

Numerous studies have shown that acupuncture is an effective treatment for anxiety and stress disorders.  One study comparing acupuncture, conventional treatment, and a treatment that integrated acupuncture and talk therapy found that “both the integrative treatment and therapeutic acupuncture significantly, both statistically and clinically, reduced anxiety and depression compared to usual primary care in patients with psychological distress. Moreover, about half of the patients in the integrative and acupuncture groups with initial depression or anxiety achieved significant improvements after treatment.”7  Another study focused specifically on patients with “chronic, non-responding anxiety symptoms.”  The findings suggest that “acupuncture, using a standardized approach, is an effective tool in the management of patients who present with anxiety symptoms that have proven resistant to a number of other routine interventions.”8 

Unfortunately, the quality of research in the acupuncture field is variable and more high-quality research is needed, but some systematic reviews also show promising findings in terms of acupuncture as a treatment for anxiety.  For instance, a 2018 systematic review found that although more research is needed, “[o]verall, there is good scientific evidence encouraging acupuncture therapy to treat anxiety disorders as it yields effective outcomes, with fewer side effects than conventional treatment.”9

Research has also shed light on how acupuncture might affect the body and reduce anxiety on a physiological level.  For example, acupuncture can improve Heart Rate Variability, which is associated with lower levels of stress and anxiety.10  Additionally, acupuncture can stimulate the release of endorphins, which play a role in the body’s stress response.11  Finally, acupuncture has been shown to affect the nervous system and balance sympathetic and parasympathetic activities to help lessen the body’s fight or flight stress response.12

Overall, as research-based evidence reveals, acupuncture is a safe and effective means of treating anxiety and stress. 


Additional suggestions to help with stress and anxiety

 If you have a more severe anxiety disorder, seeking the help of a professional psychotherapist is a good idea.  Acupuncture works well in conjunction with therapy and has been shown to enhance the effects of traditional therapy and of pharmaceutical treatments.  

 In addition to acupuncture and psychotherapy, several lifestyle changes can help with anxiety.  Consider trying one of the following:

  • Prioritizing sleep
  • Physical activity
  • Spending time in nature
  • Meditation (I will be posting a blog on meditation soon)
  • Breath work
  • Journaling, including a gratitude journal
  • Talking to trusted friends or relatives


Next steps

 If you are interested in learning more about how acupuncture can treat anxiety and stress, or if you have any questions about other conditions acupuncture can treat, please contact me at [email protected]


Citations

1. https://www.nimh.nih.gov/health/statistics/any-anxiety-disorder.shtml
2. American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, 5th ed. Arlington, VA: APA Press; 2013.
3. https://www.mayoclinic.org/diseases-conditions/anxiety/symptoms-causes/syc-20350961
4. https://www.heretohelp.bc.ca/q-and-a/whats-the-difference-between-anxiety-and-an-anxiety-disorder
5. https://www.psychiatry.org/newsroom/news-releases/new-poll-covid-19-impacting-mental-well-being-americans-feeling-anxious-especially-for-loved-ones-older-adults-are-less-anxious
6. https://www.medscape.com/viewarticle/927581
7. Arvidsdotter T, Marklund B, Taft C. Effects of an integrative treatment, therapeutic acupuncture, and conventional treatment in alleviating psychological distress in primary care patients--a pragmatic randomized controlled trial. BMC Complement Altern Med. 2013;13(308).
8. Errington-Evans N. Randomised controlled trial on the use of acupuncture in adults with chronic, non-responding anxiety symptoms. Acupunct Med. 2015;33(2):98-102.
9. Amorim, D., Amado, J., Brito, I., Fiuza, S. M., Clinical, N. A. T. I., 2018. (n.d.). Acupuncture and electroacupuncture for anxiety disorders: A systematic review of the clinical research. Elsevier. http://doi.org/10.1016/j.ctcp.2018.01.008
10. Guo ZL, Longhurst JC. Expression of c-Fos in arcuate nucleus induced by electroacupuncture: relations to neurons containing opioids and glutamate. Brain Research. 2007;1166:65–76
11. Ribeiro SC, Kennedy SE, Smith YR, Stohler CS, Zubieta JK. Interface of physical and emotional stress regulation through the endogenous opioid system and m-opioid receptors. Progress in Neuro-Psychopharmacology and Biological Psychiatry. 2005;1264-1280.
12. Li, Q. Q., Shi, G. X., Xu, Q., Wang, J., Liu, C. Z., & Wang, L. P. (2013). Acupuncture effect and central autonomic regulation. Evidence-based complementary and alternative medicine : eCAM, 2013, 267959. doi:10.1155/2013/267959 

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