Anxiety is a debilitating, persistent feeling of unease, worry and fear that can interfere with an individual's daily life. The Mental Health Foundation discovered that one in five (21%) feel anxious most of the time, and a staggering four in ten adults (44%) in Scotland feel anxious but keep it a secret. Currently, there is a significant movement on getting people to speak up about their mental health and seek the support that they require. So, let’s dive into the potential benefits of acupuncture’s role in treating anxiety.
We have all heard of the ‘flight or fight’ response, which the sympathetic nervous system (SNS) controls. This mechanism has been built into us as our prehistoric ancestors will have required this system to flee from a sabre-toothed tiger. This response and anxiety are intrinsically linked as the SNS activation is closely tied to the physiological and emotional aspects of anxiety. This response will trigger the release of the stress hormones adrenaline (epinephrine) and noradrenaline (norepinephrine). These hormones trigger the body to make physiological changes such as increased heart rate, elevated blood pressure, dilation of the airways and heightened alertness. Chronic or excessive activation of the SNS can contribute to anxiety disorders, and prolonged stress can lead to a dysregulated SNS response, resulting in heightened states of arousal even in non-threatening situations. This can look and feel like an individual being in a state of hypervigilance, where they will remain alert and attentive to potential threats. This can become extremely tiring and agonising for an individual who suffers from anxiety, as you can imagine.
The parasympathetic nervous system (PSNS) and SNS work together to maintain balance and homeostasis in the body. While the SNS prepares the body for action, the PSNS is responsible for rest and digestion, promoting relaxation by slowing the heart rate, aiding digestion, and conserving energy. ThePSNS releases acetylcholine, a neurotransmitter that supports memory and involuntary muscle movement. An active PSNS has been linked to reduced stress and improved emotional well-being, making it vital for mental health and overall balance within the autonomic nervous system.
Acupuncture views the body, mind and spirit as interconnected aspects of a person’s well-being. In TCM philosophy, anxiety may be linked to imbalances in the flow of Qi or Yin and Yang within the body. By inserting the needles into specific acupuncture points, practitioners can restore the balance of Qi, addressing the root cause of anxiety rather than just its symptoms.
Amorim et al. (2022) conducted a double-blinded, randomised, controlled clinical trial with 56 participants who had been diagnosed with anxiety. One 30-minute acupuncture session was administered once a week for ten weeks. This study used manual acupuncture and electroacupuncture, and the results were analysed using anxiety scales and salivary cortisol tests. This study provided evidence that manual and electroacupuncture can be effective for the treatment of anxiety, with all anxiety scales dramatically decreasing after the fifth treatment and continuing to decrease until the tenth treatment.
Gol et al. (2021) investigated the additive effects of combining acupuncture with selective serotonin reuptake inhibitors (SSRIs). 112 participants with anxiety participated and were divided into three groups: one using just SSRIs alone, SSRIs with sham acupuncture and SSRIs with acupuncture. They were treated for four weeks, and to analyse the results, a state-trait anxiety inventory (STAI) questionnaire was completed, and serum levels of cortisol were measured. Although there was a decrease in cortisol levels in all groups, the reduction in the acupuncture group was the largest. However, the STAI questionnaire scores from the participants of the acupuncture group were significantly larger than all other groups.
Everyone knows what it is like to have that pre-anxiety exam feeling. Viera et al. (2018) studied the effects of acupuncture on this anxiety-triggering situation in 69 students 48 hours before the exam. The results showed a significant decrease in anxiety state values. A further problem that I am far too familiar with is pre-competition anxiety. A growing body of literature documenting acupuncture's benefits with psychological factors in sporting performance. The first recorded study in this area was in 2003 by Akimoto et al. and has been further investigated four times by Shayestehfar et al. (2015), Shu et al. (2017), Zarei et al. (2017) and Khojastefar et al. (2021) who all reported positive results.
There are many ways that anxiety can present itself, and it can be triggered by specific situations, as mentioned in this blog, or it could be present for no apparent reason. The studies that have been discussed above have shown the potential benefits that acupuncture could bring to anxiety feelings.
Akimoto, T. Nakahori, C. Aizawa, K. Kimura, F. Fukubayashi, T. Kono, I. (2003) Acupuncture and Responses of Immulogic and Endocrine Markers During Competition Medical Science Sports Exercise [Online] 35(8) pp.1296-1302 Available from: https://pubmed.ncbi.nlm.nih.gov/12900681/
Amorim, D. Brito, I. Caseiro, A. Figueiredo, J-P. Pinto, A. Macedo, I. Machado, J. (2022) Electroacupuncture and Acupuncture in the Treatment of Anxiety – A Double Blinded Randomised Parallel Clinical Trial. Complementary Therapies in Clinical Practice. [Online] Available from: https://www.sciencedirect.com/science/article/pii/S1744388122000093
Gol, A-S. Ardani, A-R. Farahmand, S-K. Dadgarmoghaddam, M. Ghorani, V. Rezaei, S. Khorsand, Al. (2021) Additive Effects of Acupuncture in Alleviating Anxiety: A Double-blind, Three-arm, Randomised Clinical Trial. Complementary Therapies in Clinical Practice. [Online] Available from: https://www.sciencedirect.com/science/article/abs/pii/S1744388121001651
Khojastefar, M. Self-Ghaffari, M. Memari, A-H. Halabachi, F. Seif-Barghi, T. (2021) A Randomized Crossover, Pilot Study Examining the Effect of Acupuncture in the Management of Competitive Anxiety in Athletes Journal of Acupuncture Meridian Study [Online] 14(4) pp.149-156 Available from: https://www.journal- jams.org/journal/view.html?uid=1060&vmd=Full
Mental Health Foundation (2023) Our New Research Reveals Anxiety is Gripping Scotland as Many People Suffer in Silence and Struggle to Cope. [Online] Available from: https://www.mentalhealth.org.uk/about-us/news/our-new-research-reveals-anxiety-gripping-scotland-many-people-struggle-cope#:~:text=One%20in%20five%20people%20(21,anxiety%20keep%20it%20a%20secret
Shayestehfar, M. Seif-Barhi, T. Zarei, S. Mehran, A. (2015) Acupuncture Anxiolytic Effects on Physiological and Psychological Assessments for a Clinical Trial. [Online] Available from: https://www.hindawi.com/journals/scientifica/2016/4016952/
Shu, S. Yuan, Y. You, Y. Qian, X. Gu, W. Zhou, S. (2017) Wrist-Ankle Acupuncture for Precompetition Nervous Syndrome: A Randomized Controlled Trial Neuropsychiatry Neuropsychiatry [Online] 7(6): 1053-1060 Available from: https://www.jneuropsychiatry.org/peer-review/wristankle-acupuncture-for- precompetition-nervous-syndrome-a-randomized-controlled-trial.pdf
Veira, A. Hinzmann, M. Silva, K. Santos, M-J. Machado, J. (2018) Clinical Effect of Auricular Acupuncture in Anxiety Levels of Students Prior To The Exams: A Randomised Controlled Trial. European Journal of Integrative Medicine. 20: 188 – 192 [Online] Available from: https://www.sciencedirect.com/science/article/abs/pii/S1876382018302658
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