It seems weird right? Needles helping you feel calmer? It may sound strange, but yes, it’s true, acupuncture can help you manage your anxiety, even if you’re nervous about needles.
Firstly, let me start with the needles part because I know that anyone who’s not yet had acupuncture is wondering, doesn’t acupuncture hurt? In my opinion, no it should not hurt. But, it kind of depends on the practitioner–some acupuncturists are intense and it depends on what’s being treated. The same can be said of massage or physiotherapy or personal training. When I see new patients, I make sure to let them know that the acupuncture should not be painful and should not feel sharp like a needle. Sensations like warmth, heaviness, tingling, or “don’t know how to describe that” are normal, common, and expected, but I don’t want them to be painful. *For more on this, check out my blog, “Does Acupuncture Hurt?” In fact, most of my patients fall asleep on the table.
Don’t have a lot of time to read this whole article, but want to know the basics? Here is it in two quotes:
Does acupuncture hurt? No.
Asked by patients; answered by me.
Can acupuncture and Traditional Chinese Medicine help me with my anxiety? Yes.
Asked by patients; answered by me.
About Anxiety
Before we get into the treatment, let’s understand a bit about the condition and symptoms. The Western medical system likes its categories, classifications, and specific diagnoses, and one of the “bibles” for healthcare professionals diagnosing mental health disorders is the book, The Diagnostic and Statistical Manual of Mental Disorders (DSM). The most recent version is DSM-5.
Anxiety disorders have now been separated into three categories:
- Anxiety Disorders (separation anxiety disorder, selective mutism, specific phobia, social phobia, panic disorder, agoraphobia, and generalized anxiety disorder).
- Obsessive-Compulsive Disorders (obsessive-compulsive disorder, body dysmorphic disorder, hoarding disorder, trichotillomania, and excoriation disorder).
- Trauma and Stressor-Related Disorders (reactive attachment disorder, disinhibited social engagement disorder, PTSD, acute stress disorder, and adjustment disorder).
And, of course, because it’s possible to not fit into any of these categories, there’s the an “other” category for each of these, called “unspecified” or “other specified.”
Symptoms common to anxiety include:
- Feeling tense, edgy, or agitated
- Overthinking, worrying, and having problems controlling thoughts
- Difficulty concentrating or focusing
- Easily fatigued
- Sleep issues
- Headaches, body aches, or unexplained pains
- Digestive issues
Don’t you think that this could include most of us, at least some of the time?
Other anxiety symptoms include:
- Pounding heart or racing heartrate
- Rapid or shallow breathing
- Sweating when not active or when it’s not hot
- Trembling or tingling
- Chest pain or tightness in chest
- Feelings of impending danger or doom
- Feelings of being out of control
- Avoiding things that trigger anxiety symptoms
Feeling anxious in a stressful situation is normal and common. For example, if you don’t like public speaking, it’s okay if you feel your face flush, your heart race, and your breath get shallow while you worry that you might freeze and forget your words. You might take a few deep breaths, ask a friend for a pep talk, and mentally remind yourself that you’ve done a lot of work to prepare what you’re going to say.
But what if feeling anxious is a regular occurrence? What if it makes you avoid doing your regular activities? What if the symptoms are severe or enduring? What if you feel anxious even when you’re comfortable and at rest, with no obvious triggers?
Then it’s time to ask for help. Actually, ideally, you’ll ask for help before you get to this point, but either way, gets started ASAP. The process is like a retraining of the mind, so it takes time, depending on the severity and on underlying conditions. But, the goal is a return to the life you want.
Oh, and check out my blog with excerpts from my future (in the works still) TCM nutrition book for foods to address anxiety.
Acupuncture for Anxiety
So, how does acupuncture work for anxiety? One of the key things that acupuncture does is stimulate a release of essential neurotransmitters (chemical messengers to the brain), including endorphins, serotonin, dopamine. and GABA. It has also been shown to help improve the body’s ability to deal with stress by improving heart rate variability (HRV).
A higher HRV has been associated with better health in all domains, including mental health and low levels of anxiety
Evidence-Based Acupuncture site
Endorphins
Endorphins stem from the words “endogenous morphine.” This is because endorphins are natural molecules made by your body to relieve pain and make you feel better. The reason that morphine and opioids have an effect on us is that we have the receptors on our cells for our own endorphins. We are designed to produce our own feelgood chemicals! But sometimes we need help doing so.
Harvard Health Publishing recommends acupuncture as one of the ways to get your body to release its own endorphins:
Acupuncture. An effective way to release endorphin is with pressure points. Placing fine needles into the skin at specific points around the body triggers the release of endorphins.
Harvard Health Publishing
Other things that release endorphins include exercise, meditation, laughter, sex or intimate touch, playing or making music, and ultraviolet light/sunshine (just make sure to protect your skin).
Serotonin
You may have heard of this brain chemical, perhaps in the name of a medication offered by your MD. SSRIs (selective serotonin reuptake inhibitors) are a class of drugs often prescribed for treating depression, some types of anxiety, and some types of pain. You might also have heard of serotonin via the nickname, “feelgood hormone” because it’s probably the most recognized one.
When people are prescribed SSRIs, they are told that they need to be careful about combining with other medications and with stopping SSRIs too quickly. The good news is that you don’t have to worry about combining acupuncture and SSRIs–you can do them both. The goal is get help your brain and gut (yes, your gut produces about 95% of your serotonin!) to start to makes their own proper balance of this important messenger.
Exercise, exposure to bright light, and a healthy diet have all be associated with improved serotonin production. As mentioned about the gut, a healthy microbiome–good bacteria in the gut–is also key, so get taking those quality probiotics and including some fermented foods in your routine.
It has been determined that endomorphin-1, beta endorphin, encephalin, and serotonin levels increase in plasma and brain tissue through acupuncture application.
International Journal of Neuroscience
Dopamine
The “reward” chemical, it is another feelgood hormone that helps us feel pleasure. It’s also key in learning and attention, sleep, movement control, motivation, regulating blood pressure, and oh, so much more.
Dopamine is released when you do something you enjoy or complete a task. Eating a meal you enjoy, having sex, winning a game, shopping, and even checking a task off a to-do list are examples of dopamine-releasing activities. Unfortunately, it is also a neurotransmitter associated with addictions, so too much or too little creates problems.
Acupuncture can help regulate levels of dopamine, as it is useful for conditions of low dopamine, such as Parkinson’s, restless legs syndrome, and depression. It can also help lower elevated dopamine levels, such as with addictions.
“…acupuncture treatment may increase postsynaptic dopamine neurotransmission and facilitate the normalization of basal ganglia activity.”
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3222639/#:~:text=Moreover%2C%20acupuncture%20treatment%20mitigated%20MPTP,normalization%20of%20basal%20ganglia%20activity.
GABA (Gamma-aminobutyric acid)
GABA is known as a calming neurotransmitter, so it helps reduce cell overstimulation that is associated with anxiety, fear, and stress. Common drugs that target these receptors include the benzodiazepines like diazepam (Valium®), alprazolam (Xanax®), lorazepam (Ativan®), and clonazepam (Klonipin®), and in a 2015–2016 National Surveys on Drug Use and Health, 12.5% of U.S. citizens were estimated to be taking these medications.
It’s widely recognized that these drugs can pose risks, so while they may be used appropriately and safely, addiction, overdose, and issues with withdrawal mean that they need to both started and stopped appropriately, and that they are generally (seizure disorders is one example of regular, preventative use) meant to be used short-term to manage anxiety and insomnia.
Gabapentin is another drug that works with GABA, and it is often prescribed for nerve pain. So, if you also have nerve pain, pay attention to this section.
It’s unclear whether taking GABA as a supplement allows GABA to reach your brain, and the research needs to continue, but it’s possible it does. Foods rich in GABA include some fermented foods (miso, tempeh, kimchi), green tea, black tea, oolong tea, brown rice, mushrooms, cruciferous vegetables (broccoli, cabbage, Brussels sprouts, cauliflower), sprouted grains, chestnuts, soy and adzuki beans, and sweet potatoes.
I mentioned already that acupuncture also helps with the release of GABA, right? Yes, you can check back to this link on the Effect of Acupuncture on Neurotransmitters/Modulators.
“There’s no research on acupuncture”
Okay, so that might just be the most aggravating statement of all time for me. There is, in fact, a lot of research about acupuncture. For a variety of conditions and symptoms. I’ve put some of that in links throughout this article, but for more, check out this website! https://www.evidencebasedacupuncture.org/acupuncture-scientific-evidence/
And here’s the link for acupuncture specifically for anxiety. https://www.evidencebasedacupuncture.org/acupuncture-anxiety/
These folks have done a heap of work and put in hours of time to compile and continue to compile the evidence that those who say there is no research are too lazy to look into.
TCM and anxiety
But here’s the thing.
There is no “protocol” for treating anxiety with Traditional Chinese Medicine or acupuncture. That makes doing Western-style, protocol-based, randomized, double-blinded, expensive research tough to do.
Because everyone is different in how they experience anxiety as well as their overall health issues, medical history, and life experiences, you need to get a TCM diagnosis/assessment in order to get treatment. As a TCM doctor, I generally need to ask a number of questions to get to know you better. With that information, I can customize which acupuncture points to choose, while herbs to prescribe, which food and lifestyle recommendations to suggest.
But isn’t that what health and wellbeing should really be about anyway?