Acupuncture for Depression

NOTE: Before we get to talking about acupuncture for depression, there’s a few serious bits. Firstly, if you are experiencing any thoughts of self-harm or suicide call Lifeline on 131114. I also want to be clear that ceasing anti-depressant medication is a big step and you should first discuss it with your doctor, nor am I promoting acupuncture as an anti-depressant alternative. There’s a note at the end about that, and why. Now that’s done, read on!

Depressive type disorders are one of the most common psychiatric disorders in the world and can lead to loss of quality of life for the sufferers and an increased chance of suicide or self-harm. Considering the prevalence of the condition and the increased awareness of the need to discuss mental health, I thought we might talk about acupuncture for depression.

Common symptoms of depression are:

• Depressed mood
• Insomnia or sleeping difficulties
• Fatigue
• Irritability
• Anxiety
• Poor appetite
• Poor concentration

There are several common types of medication for depression:

• Selective serotonin reuptake inhibitors (SSRIs)
• Serotonin–norepinephrine reuptake inhibitors (SNRIs)
• Tricyclic antidepressants (TCAs)

Plus a few others, all with their own efficacy rates and side effects.

In Traditional Chinese Medicine (TCM), emotional and psychological functions of a person are viewed a bit differently to western medicine. The different organ systems all have different emotional and psychological parts to play.

The first and most important organ in acupuncture for depression is the Liver. In TCM, the Liver is responsible for the free-flowing of qi (often translated as energy, pronounced “chee”) and emotions. The Liver is easily affected by stress, anger, and emotional constraint (It’s fine in TCM to be angry sometimes; it’s when you have way too much of an emotion or are unable to let that emotion out that it starts to become a problem). This means the Liver is usually the first organ affected and the primary organ to be treated. Liver qi stagnation symptoms include depression, low moods, sense of oppression in the chest with frequent sighing or lack of appetite.

The next organ frequently involved in emotional disorders is the Heart. In TCM the Heart is important in terms of sleep/wake cycles, and also a person’s “normal personality”. Symptoms of the Heart being involved are insomnia or palpitations. More serious Heart symptoms may include mania, incoherent speech, delirium or psychosis.

Other organs can also be involved. The Lung is affected by excess grief and leads to heaviness or oppression in the chest. The Spleen is affected by excess worrying and leads to low appetite, dwelling on upsetting events, and diarrhoea. The Kidneys are affected by excess fear and leads to a constant state of anxiety, or the sense of impending doom for no reason.

So that’s a brief look at acupuncture for depression, and I hope you find it interesting. Now, a brief bit about evidence: When you want to do a study about a treatment for a medical condition, you first have to obtain ethics approval – that is, someone makes sure that you’re not going to cause somebody harm during the course of the study. When the study involves something like depression, the risks involved are too high to use somebody not getting any treatment as a control. A control is a group against which you are comparing your results – usually this would mean not getting any treatment, so you can compare your treatment against somebody not doing anything about it. Consequently, you’ll find that the evidence will instead be comparing normal treatment versus normal treatment plus acupuncture. This means that the evidence I use shows acupuncture being effective as an adjunct (or additional) treatment to normal medication. Not as a substitution. Got it? Good!

Now, here’s a meta-analysis and systematic review of a bunch of trials. It found that combining acupuncture with normal medication got better results.

 

Chan, Y.Y., Lo, W.Y., Yang, S.N., Chen, Y.H. & Lin, J.G. 2015, ‘The benefit of combined acupuncture and antidepressant medication for depression: A systematic review and meta-analysis’, J Affect Disord, vol. 176, pp. 106-17.