Integrative Acupuncture Center

Treating depression with Acupuncture and Chinese Medicine

The diagnosis of depression is based on the following list of symptoms:

• depressed mood for a majority of the day;
• markedly decreased interest or pleasure in all or almost all activities for a majority of the day;
• significant unintended changes in weight or appetite;
• insomnia or hypersomnia;
• psychomotor agitations or retardation;
• fatigue or loss of energy, and feelings of worthlessness or excessive or inappropriate guilt;
• diminished ability to think or concentrate; and
• recurrent thoughts of death, suicide, or attempted suicide.

At least five of the above symptoms must be present nearly every day for a two –week period for person to be diagnosed as experiencing depression.

Mood stabilizing drugs are the treatment of choice in the treatment of depression or anxiety. Most of these are SSRI’s (selective serotonin re-uptake inhibitors) and include Prozac, Zoloft, Paxil, Celexa, and Lexapro. Serotonin, is a neuro-transmitter that allows communication between the central nervous system and, if deficient, can elad to depression. Western medicines hope to keep existing serotonin in circulation without being reabsorbed. Other pharmaceutical strategies include tricyclic antidepressants, which inhibit the re-uptake of serotonin and norephinephrines and include Adapin, Elavil, Norpramin, and Pamelor; MAO depressants, which inhibit monoamine oxidase and thus deteroriote nerutransmitters and include Marplan, Nardil and parnate. Finally “second generation” medicine, each working with unqiue mechanisms, including Desyel, Effexor, Remeron, Serzone, Cymbalta and Wellbutrin.

Success rates for the treatment of depression by all types of Western meds are controversial. One study claims a success rate of 70%, which another claims it is low as 18%. Also, many of the neurotransmitter medicines have side effects (nausea, insomnia, headache), and the MAO antidepressants, in particular, are responsible for the highest iatrogenic death rate of any class of pharmaceutical medicines.

Long term benefits are questionable these medicines do not build or create neurotransmitters, but act to keep existing neurotransmitters in circulation longer. Often, the clinical effectiveness of a single medicine loses it’s effectiveness and stops working over time. Medical doctors will then rotate medications to try and recreate this effect. Its short term effects for example, saving people with suicidal tendencies has made it a valuable treatment method, but for longer treatments can there be another avenue?

The research done on neurotransmitters have shown that two neurotransmitters in particular are important in treating depression. Norepinephrine and serotonin get depleted. The western approach is to keep these neurotransmitters n circulation. The problem is that the use of the SSRI’s will reduce the overall supply of serotonin and norepinephrine over time. More effectively, using amino acids and cofactors to build up these neurotransmitters as well as Chinese herbs to help the feelings of depression has been used. Can Chinese medicine help clinically in treating depression?

According to Chinese medicine, there are fourteen (14) main meridians channels which can be described as rivers of energy (referred to as “qi” which means “vital energy”). The channels connect with each other and run through every part of the body forming a network that can send circulation to all parts of the body. Just like we have a nervous system that circulates messages through nerve impulses, and a circulatory system that circulates blood, there is a meridian pathway system which can help these other systems function better.

More importantly, these meridians connect to 12 organ systems / energetic constructs which are responsible for physical as well as mental functioning. Depression is attributed to two organs in particular the energetic functioning of the Liver and the Lung organs. The liver organ is responsible for “coursing and moving” which refers to the ability of the body to maintain a mode of operation in the body that “ is not stagnating not overly agitated and continuously flowingⁱ” . This translates into mental health as well. A well functioning liver helps one to keep one outward moving, in contact with his present reality, the ability to make plans for the future and to enjoy things. Following this idea, depression is caused by the lack of coursing and moving function of the liver. In this case the energy of the Liver is said to be stopped, or blocked so there will be failure to maintain feelings of inner peace and harmony. As a result depression occurs.

Causes for depression, traditionally, were due to unregulated emotional states. Emotions such as over thinking situations, putting too much emotional effort in work tasks, unfulfilled expectations, over thinking, excessive anger unexpressed or turned inward in a self destructive fashion, unfulfilled desires, and disappointment and failure.

The Lung organ in Chinese medicine is the second major organ implicated in depression. Grief, sadness, and melancholy harms the lungs and can cause a gloomy state of mind. A particularly sad experience, moreover, may cause a person to adopt a pessimistic attitude toward life.

Acupuncture works to help depression by unblocking the emotional and physical feelings associated with these organ problems. On the surface are these acupuncture points, (over 365) which can be described as light switches which tap into these meridian pathways to send messages to the body to self regulate or heal itself. Basically, what we are doing when we place a needle into a point is increasing blood flow to different areas of the body. The image of unblocking blockages to increase blood flow help to explain how this works.

Modern Research: Acupuncture and Neuron Signaling

Modern research supports the acupuncture theory suggests that stimulation of specific acupuncture points help existing neurons work better. Stimulation of neurons send better bioelectric signals to the brain through the sensory nervous system. These signals may positively affect an imbalance in brain biochemistry. Neurons (are the specialized cells that make up the body’s nervous system) communicate based on chemical and electrical signals that travel within and among these neurons. Each neuron, on average, makes more than 1000 synaptic connections with other neurons. In total there may be between 100 trillion and a quadrillion synapses in the brain. These synapses are far from random and they give rise to intricate “circuits” in the brain. When depression occurs it may be because neurons cannot correctly transfer the electrical signals to one another. Acupuncture is able to help the neurons signal better helping to stabilize moodsⁱⁱ and having a more immediate effect.

Studies on Acupuncture and Depression:

In 1998 the National Institutes of Health conducted a 16 week study in relation to Acupuncture for the Treatment of Depression. The study which was funded by the NIH’s office of Alternative Medicine was conducted at the University of Arizona under the direction of John Allen PhD, and with the co-operation of Acupuncturist Rosa Schyner.

The 16 week trial was based on the treatment of 34 diagnosed clinically depressed women. The test was conducted using two treatment protocols, one using targeted and specific acupuncture points used in Acupuncture for the Treatment of Depression and a series of unrelated dummy points with no known function.

The group was divided in three with one receiving the Anti-Depression Acupuncture Treatment, the second group was given the dummy treatment and a final third group received no treatment and put on a waiting list for 8 weeks.

The results were remarkable. Published in the September 1998 issue of Psychological Science, a journal of the American Psychological Society, as “The Efficacy of Acupuncture in the Treatment of Major Depression in Women.”, they listed the following…

As a direct result of the Anti-Depression needling treatment the first group experienced a 43 percent reduction in their symptoms. When compared to the small 22 percent reduction experienced by the dummy group (this can be attributed to a natural placebo effect), this is an excellent indication of the benefits of Acupuncture for the Treatment of Depression. Furthermore more than half of the ladies no longer met the criteria for clinical depression.

Perhaps even more interesting is the drop rate. Only five people dropped out of the study – two because they moved away, one due to pregnancy and the final two just didn’t like needles. This is a far lower drop out rate then conventional medical drug treatments.

This study is by no means alone. In 2002 the World Health Organization released it’s findings and cited that Acupuncture for the Treatment of Depression was one of the most beneficial of treatments and was in fact MORE effective in depressive patients with decreased excretion than anti-depressant drugs such as 3-methyl-4-hydroxy-phenylglycol.

They sited several studies that supported this including;

Hou DF et al. [Clinical observation of therapeutic effect of baihui (GV20)-yintang (EX-HN3) electro-acupuncture in 30 cases of post-apoplectic depression.] Chinese Acupuncture and Moxibustion, 1996, 16(8):432-433 [in Chinese].

Li CD et al. Treating post-stroke depression with “antidepressive” acupuncture therapy: A clinical study of 21 cases. International Journal of Clinical Acupuncture, 1994, 5(4):389-393.

Yang X. Clinical observation of needling extrameridian points in treating mental depression. Journal of Traditional Chinese Medicine, 1994, 14:14-18.

Zhang B et al. A control study of clinical therapeutic effects of laser-acupuncture on depressive neurosis. World Journal of Acupuncture-Moxibustion, 1996, 6(2):12-17.

Luo HC et al. Electro-acupuncture vs amitriptyline in the treatment of depressive states. Journal of Traditional Chinese Medicine, 1985, 5(1):3-8.

Luo HC et al. [Clinical observation of electro-acupuncture on 133 patients with depression in comparison with tricyclic amytriptyline.] Chinese Journal of Integrated Traditional and Western Medicine, 1988, 8(2):77-80 [in Chinese].

So what are the benefits of Acupuncture for the Treatment of Depression?

In all the studies conducted several things were shown very clearly –

• A clear reduction in the symptoms of Clinical Depression

• More cost effective than pharmaceutical or drug based treatment

• No side effects

• Longer lasting results

• Treatment focused not just on alleviating the symptoms but on tackling and treating the underlying root cause.

Herbal Medicine in treatment of Depression:

In Chinese medicine there are many herbs that can be helpful in treating people with depression. Radix Polygala, Albezzia, Curcumae, and Salivia among other herbs are usually constructed in herbal formulas in pill form that can be taken by depressed patients to help stabilize their mood. Their effects are metabolized differently than SSRI’s so they won’t conflict with current antidepressant treatments. Other herbs to support your energy can include tonics like astragalus, ginseng and rhodiola can also be added to the treatment regimen. A careful analysis of your medication lists and your symptoms are necessary in order to tailor your treatment to your condition so you can get the clinical effective results.

If you would like to learn more , I invite you to call me and we can discuss your particular case.