Depression and its Treatment by Acupuncture and Chinese Medicine

This afternoon I was treating a new patient whose chief compliant was depression, which is something that we work with quite frequently at the Northside Holistic Center. In speaking with him, he commented that he had read my blog and had only seen postings about pregnancy-related depression as well as articles which I had written related to anxiety and Post Traumatic Stress Disorder (PTSD).

It struck me that I hadn't devoted an entire post to the subject of treating depression with Chinese medicine and acupuncture yet, and that it was important to address this, since many clients come to us with either depression as their main concern, or as a secondary issue that we can work on with them.

Treating depression is enormously satisfying to me because of the very high success rates and enormous improvements that the patients see in their lives. Moreover, depression frequently underlies other health issues and resolving it will often aid in the recovery from these other health complaints. People will seek out acupuncturists to work on their depression for one of three reasons: they either want to avoid medications altogether; the medications are not controlling the depression adequately, or they would like to reduce their dose of medication (in which case we strongly recommend that they let their MD know their plans).

Chinese medicine, of which acupuncture is a part, takes any condition and examines it through the prism of the whole body. That is, in coming up with a treatment plan, we take into consideration the person's current and past health history, as well as constitutional tendencies - those things which aren't a problem but define the person's experience of their body. These may include tendencies to run hot or cold, reactions to stress, bowel habits, complexion issues, etc. Thus, two people who have the same western medical diagnosis of depression may each receive a different acupuncture protocol and herbal formula. In this way we are able to taylor our treatment to the individual, which yields superior results.

Research/Other Articles:

An overview of acupuncture and depression along with a few research citations can be found here.

• Time Magazine covered some interesting research looking into the mechanism by which acupuncture treats anxiety, stress and depression. The scientists noted that,

  Rats who got acupuncture showed fewer symptoms of anxiety and depression than stressed-out rats who didn't get treatment. [and that] Acupuncture may work by targeting the same pathways that stress travels along, according to a new study in rats from Georgetown University Medical Center and published in the journal Endocrinology.

  “There was nothing in the literature about acupuncture for PTSD and chronic stress,” [the researcher said] says, so she decided to study it. To find out if acupuncture was affecting chronic stress, Eshkevari and a team of researchers looked at what happened in a key pathway in dealing with stress for both humans and rats: the hypothalamus-pituitary-adrenal axis (HPA). It’s the same pathway targeted by some anti-anxiety drugs and antidepressants, Eshkevari says, and the HPA is involved in the production of the stress hormone cortisol.

• A fascinating study from Britain suggests that when acupuncture is used to treat patients with depression, gene expression governing mood is also corrected. A synopsis of the study can be read here.

The research shows that depression causes “abnormal gene expression” in “a large number of genes” and this affects “multiple brain functions” and nerve cells. Depression causes pathological biochemical changes and these changes cause more depression. The researchers note, this “vicious circle makes it difficult to cure conditions such as depression.” The researchers note that this educational investigation indicates “that electroacupuncture at Baihui and Yintang modulates depression by regulating the expression of particular genes.”

• The Depression Clinical and Research Program at Massachusetts General Hospital in Boston has demonstrated that acupuncture is effective in the treatment of clinical depression for patients who are non-responsive to conventional pharmaceutical antidepressant therapies. The abstract can be seen here:

The Massachusetts General Hospital study documents that existing clinical evidence supports acupuncture as a stand-alone therapy for depression. This study researched the ability of acupuncture to augment conventional antidepressant therapy when patients did not respond to their medications. The study concluded that acupuncture is effective as an adjunct therapy to antidepressants for both partial and non-responders. Acupuncture was administered one to two times per week during the study and the researchers concluded that acupuncture was “safe, well-tolerated and effective” for patients suffering from depression.

Reference:

Albert S. Yeunga, Victoria E. Amerala, Sarah E. Chuzia, Maurizio Favaa and David Mischoulon. A pilot study of acupuncture augmentation therapy in antidepressant partial and non-responders with major depressive disorder. Depression Clinical and Research Program, Massachusetts General Hospital, Boston, Massachusetts, USA.

• A research study in the journal, Complementary Therapies in Medicine, (an abstract of which can be found here) found that a group of women with major depression treated with acupuncture had the same relapse rate as another group treated only with conventional prescriptions. This study suggests that acupuncture may be as successful as drug therapy in helping control major depression.

• The Journal of Alternative and Complementary Therapies published a study in which patients were either given the drug, fluoxetine, at the standard dosage or a low dose of the drug with acupuncture therapy.  The study found that both groups did as well as the other. This suggests that patients may be able to use lower doses of their pharmaceuticals when using acupuncture. This would minimize side effects and drug interactions in those patients. An abstract of the study can be read here.

• Fox News has an article, accompanied by a video which can be seen here. In the article, the experts cited say,

"The functional MRI studies are showing that acupuncture has an influence over brain chemicals, such as dopamine and serotonin"  as well as "And so, what we’re finding is that for these patients that are suffering from mild to moderate depression, acupuncture is just as effective as these antidepressants,” and "Acupuncture is also a good alternative for women who are pregnant and for people who no longer want to rely on antidepressants."

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Autoimmune Disorders, including Rheumatoid Arthritis Well Treated by Acupuncture

Many recent article (a few of which can be read here and here) describes the use of acupuncture and TCM to treat a variety of autoimmune disorders. The autoimmune category is so vast that it is difficult to even approximate a meaningful overview of them except to say that we treat a lot of these types of problems and that quite a large number of them respond well to acupuncture and Chinese herbal intervention.

The article, in part, reads,

Autoimmune diseases are a group of disorders in which the immune system attacks the body and destroys or alters tissues. There are more than eighty serious chronic illnesses in this category including rheumatoid arthritis, type 1 diabetes, lupus, thyroid disease, inflammatory bowel disease, Addison's disease, pernicious anemia, celiac disease, multiple sclerosis, myasthenia gravis and Guillain–Barré syndrome. According to the American Autoimmune Related Diseases Association (AARDA) twenty percent of the population suffers from autoimmune disorders. Each disease appears uncommon on an individual basis but, as a group, the disorders make up the fourth-largest cause of disability among women.

Due to the complexity of treating autoimmune disorders, integrative medicine solutions including acupuncture and Oriental medicine have received much attention as successful therapies in their treatment particularly for use in providing pain relief, regulating the immune system, managing symptoms and improving overall quality of life.

Autoimmune diseases are a group of disorders in which the immune system attacks the body and destroys or alters tissues. There are more than eighty serious chronic illnesses in this category including rheumatoid arthritis, type 1 diabetes, lupus, thyroid disease, inflammatory bowel disease, Addison's disease, pernicious anemia, celiac disease, multiple sclerosis, myasthenia gravis and Guillain–Barré syndrome. According to the American Autoimmune Related Diseases Association (AARDA) twenty percent of the population suffers from autoimmune disorders. Each disease appears uncommon on an individual basis but, as a group, the disorders make up the fourth-largest cause of disability among women.Due to the complexity of treating autoimmune disorders, integrative medicine solutions including acupuncture and Oriental medicine have received much attention as successful therapies in their treatment particularly for use in providing pain relief, regulating the immune system, managing symptoms and improving overall quality of life.

The article concludes,

Clinical research has shown that acupuncture causes physical responses in nerve cells, the pituitary gland, and parts of the brain. These responses can cause the body to release proteins, hormones, and brain chemicals that control a number of body functions. It is proposed that, by these actions, acupuncture affects blood pressure, body temperature and the immune system. 

A recent Chinese study on rheumatoid arthritis and acupuncture in Chinese Journal of Integrative Medicine found that, 

. . . acupuncture can lower levels of pro-inflammatory cytokines in the blood and synovial fluid of rheumatoid arthritis (RA) patients. 

The research, which can be read about here, describes the experiment:

Sixty-three RA patients were assigned to receive either EA or manual acupuncture (‘simple’ needling - SN). Points were selected mainly from yang meridians and local ashi points. EA or SN was applied every other day for a course of 10 treatments and each patient received a total of three courses of treatment. Blood and synovial fluid levels of the pro-inflammatory cytokines tumor necrosis factor-α (TNF-α) and vascular endothelial growth factor (VEGF) were reduced significantly after treatment in both groups. The lowering of VEGF after treatment was more significant in the EA group than that in the SN group. (Effect of electro-acupuncture on tumor necrosis factor-α and vascular endothelial growth factor in peripheral blood and joint synovia of patients with rheumatoid arthritis.

A tantalizing analysis of studies published on the NIH website showed benefit for multiple sclerosis patients using Chinese medicine. [readable here] Though the researchers concluded that the intervention,

could improve neurological signs, clinical symptoms and immune indexes, and reduce recurrent frequency. 

and that, 

The reported adverse events in the CHM (Chinese Herbal Medicine) group were less than those in the control group.

They also pointed out that,

further well-designed research is needed to evaluate the beneficial effects of CHM. 

A recent study published by Harvard researchers looks at the effects of one of many herbs which we may use in creating a tailored herbal intervention for our patients, chang shan. Chang shan, the scientists found, modulates the pathological aspect of the autoimmune process and may be useful in treating many of these types of diseases. You can read an article about this here, but an excerpt reads:

In an effort to better understand the therapeutic benefits of chang shan, the team evaluated its active components and observed that one component in particular, halofuginone (HF), blocks the development of T helper 17 (Th17) cells. Th17 cells are highly inflammatory cells that appear to play a primary role in the development of autoimmune disorders such as multiple sclerosis, psoriasis, juvenile diabetes, rheumatoid arthritis and Crohn's disease.

As a fairly substantial bonus, researchers from other universities have found many potent anti-cancer uses for the herb – again something that Chinese medicine has known for millienia, 

But chang shan's benefits do not stop there. In 2011, researchers from the University of Sao Paulo, the University of Brazil, and Tel Aviv University discovered that HF is capable of fighting leukemia. Not only does HF prevent leukemia cancer cells from spreading, but it also induces apoptosis, also known as cell death.

Similarly, a 2003 study published in the journal Clinical Cancer Research found that HF contains specific anti-tumor properties that are effective in treating a variety of other cancers besides leukemia. According to the findings, HF can inhibit the progression of both bladder carcinoma and prostate cancer tumors, and may even be a potential preventive treatment that blocks the initial development of these and other cancers.

More can be read on my site here (PKD), here (Crohn's), here (MS), and here (psoriasis). The number of autoimmune issues which I treat is quite a bit more vast than what has yet been written about on this site, but I will get to each of them as the site grows.

Crohn's Disease Treatable by Acupuncture, Study Says

A recent study in the Journal of Acupuncture demonstrates, yet again, the utility of Chinese medicine in treating Crohn's disease. The article, cited here, describes the study which looked at the treatment of several acupoints in managing the disease, which is characterized by chronic inflammation of the intestinal tract. This inflammation often leads to diarrhea, abdominal bloating and pain, vomiting, weight loss, eye disorders, arthritis, dermatological disorders, and fatigue.

Image courtesy of http://www.radpod.org/2006/12/02/crohns-disease-2/

There are many other studies, from around the world which demonstrate the utility of Chinese medicine in treating this digestive problem. Among them is a German study published in Digestion [abstract readable here], which concluded that, "...traditional acupuncture offers an additional therapeutic benefit in patients with mild to moderately active CD."

Acupuncture and Chinese herbal therapy have a long history of treating this disorder, often very successfully. At the Northside Holistic Center we frequently treat Crohn's, ulcerative colitis, and other chronic digestive issues.

Menopausal Hot Flashes Respond to Acupuncture

It seems like every month or two a new study is published which demonstrates the utility of acupuncture and Chinese herbal medicine for hot flashes. One would think this would be common knowledge in the Western medical community, by now. The most recent study, reported on in Business Week, showed that, "After 10 weeks, the women in the traditional acupuncture group had significantly less severe hot flashes and mood swings than those who'd gotten the fake treatment."

There have been literally scores of studies which demonstrate the benefit of acupuncture and Chinese herbology for hot flashes (see here for a few more). Of course, this is nothing new to those of us who work with menopausal symptoms each day in our clinics or for the women treated by those acupuncturists over the last few thousand years. Still it is reassuring to see so many studies being performed which back up our empirical experience with results that will help to convince a gradually thawing western medical audience that we can offer substantial benefit to their patients.

Retinitis Pigmentosa May Respond to Acupuncture

Reprinted from Journal of Clinical Acupuncture and Moxibustion and as reported here. 

Mounting evidence suggests that acupuncture is an effective treatment for retinitis pigmentosa (RP), a degenerative eye disorder that may to lead to blindness. A recent study published in the Journal of Clinical Acupuncture and Moxibustionconcludes that acupuncture treatment protects the optic nerve from damage caused by intraocular pressure by alleviating stresses on retinal and optic nerve axonal ultrastructures.¹ The Chinese Journal of Integrated Traditional and Western Medicine published that the use of Chinese medicine improved retinal cone activity for patients with retinitis pigmentosa, even in cases of advanced retinal degeneration. Using electroretinograms for the investigation, the study also concludes that, “TCM (Traditional Chinese Medicine) treatment could also enhance the bioactivity of (the) nerve network and therefore have a definite significance in retarding the progression of disease and keeping the central vision.”² In another study, injections of She Xiang into acupuncture points UB18 and UB23 helped patients with retinitis pigmentosa. The study concludes that injection of She Xiang into Ganshu (UB18) and Shenshu (UB23) “can improve effectively the function and metabolism of optic cells, promote blood circulation of the retina, enhance the visual acuity, and protect the central vision for the patient of retinitis pigmentosa.”³ Yet another study of retinitis pigmentosa patients receiving acupuncture (ranging from ages 7 – 75 years) showed significant improvement and a halting of deterioration of the visual field.⁴

 We also treat many vision problems related to stroke, infection, trauma, glaucoma, and other forms of retinitis.

References:
1 Sun He , Zhang Hu. The Protective Effect of Acupuncture Treatment on Retinal and Optic Nerve Axonal Ultrastructure in Rabbit Eyes with Chronic Elevated IOP. Journal of Clinical Acupuncture and Moxibustion. 2010-05.
2 Wu Xing-Wei; Tang You-zhi. Study on Treatment of Retinitis Pigmentosa with Traditional Chinese Medicine by Flicker Electroretinogram. CHINESE JOURNAL OF INTEGRATED TRADITIONAL AND WESTERN MEDICINE. 1996-06.
3 Hao Xiaobo, Wang Guihong, Peng Changxin, et al. (Department of Ophthalmology, the First Affiliated Hospital of Guangxi University of TCM, Nanning 530023, China). Study on treatment of retinitis pigmentosa with acupoint injection of Shexiang Injection. Chinese Acupuncture and Moxibustion. 2003-4.
4 Reddy NS, Fouzdar NM. Role of acupuncture in the treatment of `Incurable' retinal diseases. Indian J Ophthalmol 1983;31:1043-6.
5 Wu Xing-Wei; Tang You-zhi. Study on Treatment of Retinitis Pigmentosa with Traditional Chinese Medicine by Flicker Electroretinogram. CHINESE JOURNAL OF INTEGRATED TRADITIONAL AND WESTERN MEDICINE. 1996-06.