Using Acupuncture and Chinese Medicine to treat Anxiety and Panic Attacks

Frequently acupuncturists are called upon to treat anxiety disorders in the clinic. When the acupuncture performs a skillful diagnosis and is able to create a proper treatment plan, our clients almost always respond powerfully and well. So true is this that it is quite common, at the Northside Holistic Center, to see physicians and psychologists refer their patients to us to address this concern. This happens most frequently when either the patient hasn't been responding to medication fully, has side effects from the medication that makes it undesirable, or simply would prefer not to be using drugs to influence their mental state. 

When treating any sort of anxiety disorder, diagnosis is key. Chinese medicine approaches anxiety, as it does most types of health issue, by taking the whole body into account. The first visit to our clinic would begin with a detailed intake form which asks the client for information on their health history. It is often surprising to clients that in treating anxiety, panic attacks, or even post-traumatic stress disorder (PTSD) that we care as much about their digestion, immune system, or skin as we do about the clearer signs of anxiety. This is because, from the perspective of Chinese medicine, all bodily systems are interrelated and can communicate a deeper truth about the disorder at hand. After we discuss the presentation of their anxiety issues I will examine the client's tongue and feel their pulse on both wrist. This gives an acupuncturist, trained in these arts, additional information to refine the treatment protocol. 

 

Articles/Research:

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 nice overview of how Chinese medicine conceptualizes anxiety and depression with reference to several good studies citing the benefits of acupuncture for both. It can be read here.

In a comprehensive literature review appearing in a recent edition ofCNS Neuroscience and Therapeutics, it was proved that acupuncture is comparable to cognitive-behavioral therapy (CBT), which psychologists commonly use to treat anxiety (Errington-Evans, 2011). Another study published in the Journal of Endocrinology in March 2013 discovered stress hormones were lower in rats after receiving electric acupuncture (Eshkevari, Permaul and Mulroney, 2013).

• A pilot study from the National Institutes of Health (NIH) demonstrated that not only was acupuncture very useful for treating PTSD but that the results persisted, once a postive effect had been achieved, for three months after the acupuncture was stopped. This is our goal with acupuncture: to take the client incrementally to a state where they are no longer experiencing symptoms and then gradually ween them off of the acupuncture as well.

• A tangential article from the Institute for Traditional Medicine on using acupuncture and Chinese Medicine to withdraw from anti-depressants. One of the frequent side effects from withdrawal from these drugs is anxiety, which is how it seemed to be a good match for this blog entry.

• From a Chinese Medical journal from China, Tian Jin Zhong Yi Yao comes an study evaluating acupuncture as an treatment for Generalized  Anxiety Syndrome (GAS). The results were very positive with more than 94% showing improvement. The English translation can be read here. 

• Another Chinese medical journal has an article called, A mechanism of endogenous opioid peptides for rapid onset of acupuncture effect in treatment of depression which attempts to look at the biochemical changes which underpin the dramatic effects that acupuncture has on depression and anxiety. The PubMed stub can be read here.

• Acupuncture Today has a very interesting overview of the use of acupuncture and Chinese medicine to treat anxiety using ear acupuncture, citing several studies which demonstrate dramatic results.

Based on their findings, the researchers concluded that auricular acupuncture could decrease anxiety levels in otherwise healthy subjects. They added that "the results of the study suggest that acupuncture may be an effective treatment for individuals experiencing intense levels of daily stress and anxiety," and recommended "a randomized controlled trial be performed to evaluate the effectiveness of this technique for the treatment of preoperative anxiety."

• The Department of Defense Live has an very interesting article on treating PTSD and brain injury amongst soldiers with acupuncture. I've posted about it here. It summarizes by saying,

As it turns out, PTSD symptoms are very similar to those of mild TBI [Traumatic Brain Injury] – insomnia, headaches, memory problems, attention problems, anxiety and irritability. Studies have shown that acupuncture is an effective treatment for PTSD, leading Navy Cmdr. (Dr.) Keith Stuessi, former director of the Concussion Restoration Care Center at Camp Leatherneck in Afghanistan to believe the treatment could be used for mild TBI as well.

Stuessi describes the Concussion Restoration Care Center as a success – treating more than 320 concussion patients thus far. Of the more than 20 troops he personally treated, almost all saw marked improvements in their sleep, anxiety levels and frequency of headaches. Cmdr. Earl Frantz, who replaced Steussi at Camp Leatherneck in March, continued the practice of using acupuncture on troops with symptoms of mild TBI.

The Department of Defense is putting its weight behind acupuncture. For example, the most recent Veterans Affairs (VA) clinical guidance recommends acupuncture as a supplementary therapy for PTSD, anxiety, pain and sleeplessness. The VA is even recruiting candidates for a formal study of acupuncture’s effectiveness on PTSD and mild TBI.

As it turns out, PTSD symptoms are very similar to those of mild TBI – insomnia, headaches, memory problems, attention problems, anxiety and irritability. Studies have shown that acupuncture is an effective treatment for PTSD, leading Navy Cmdr. (Dr.) Keith Stuessi, former director of the Concussion Restoration Care Center at Camp Leatherneck in Afghanistan to believe the treatment could be used for mild TBI as well.
Stuessi describes the Concussion Restoration Care Center as a success – treating more than 320 concussion patients thus far. Of the more than 20 troops he personally treated, almost all saw marked improvements in their sleep, anxiety levels and frequency of headaches. Cmdr. Earl Frantz, who replaced Steussi at Camp Leatherneck in March, continued the practice of using acupuncture on troops with symptoms of mild TBI.
The Department of Defense is putting its weight behind acupuncture. For example, the most recent Veterans Affairs (VA) clinical guidance recommends acupuncture as a supplementary therapy for PTSD, anxiety, pain and sleeplessness. The VA is even recruiting candidates for a formal study of acupuncture’s effectiveness on PTSD and mild TBI.

• The Department of Veterans Affairs published a study on PTSD and the various ways in which it can manifest and concluded that, among other things, 

For major depressive disorder (MDD), acupuncture showed greater effects than sham control on depressive symptoms

Treating Neuropathy with Acupuncture and Chinese Medicine

Because of the association that many people and their physicians make between acupuncture and nerve functioning, it is common for many patients to seek out an acupuncturist immediately upon being diagnosed with any type of neuropathy. For good reason, it turns out: acupuncture and, frequently herbal therapy, can be exceptionally useful in treating neuropathies originating from many disease processes.In broad terms, neuropathy is the manifestation of any disease which affects the peripheral nervous system leading to one or a combination of pain, tingling, 'pins and needles' sensation, numbness, or weakness in the hands and/or feet. Neuropathy can be caused by a large number of triggers ranging from diseases such as cancer, diabetes, or AIDS; nutritional deficiencies; or toxic overloading the body with either environmental poisons or prescription drugs. A large number of neuropathy cases  are termed, 'idiopathic', meaning that western medicine can not determine a specific cause of the problem.

An acupuncturist evaluates each person's case of neuropathy differently weighing the health history of the patient; the location of the problem; the drugs or environmental chemical exposure and, from this, weaves together a treatment plan that most effectively restores nerve function. Neuropathies tend to respond incredibly well to acupuncture and, occasionally additional herbal intervention, depending on the cause of the nerve issue. 

Research and Articles

 A study done by the Cancer Treatment Centers of America, and which can be read about here, found that acupuncture was extemely useful for treating chemotherapy related neuropathy, noting that:

 . . . all of the patients reported or had improvement in their CIPN grades after starting acupuncture.

The researchers note that using customized acupuncture point prescriptions in the TCM style produces superior patient outcomes when the use of distal acupuncture points are employed. The researchers emphasize the need for customization of the acupoint prescriptions per each patient’s differential diagnostics for maximum clinical efficacy. In addition, they emphasize that distal acupoints “increase blood flow” and therefore have an especially important role in the treatment of CIPN.

A British study recently confirmed that acupuncture can be useful in treating chemotherapy induced neuropathy, finding that 82% of the patients in the study received benefit. In a small related study, from Germany, 83% of the subjects enrolled in the study found sustantial benefit from acupuncture. Both can be read about here. In addition the patients found that,

. . . some patients derived additional benefits from the treatment including a reduction in analgesic use and improved sleeping patterns. 

In 2011 the University of Arizona examined acupuncture for HIV-related neuropathies, as well as mortality from that disease and found that:

Acupuncture was clearly effective in reducing attrition and mortality in this sample, especially when health status was taken into account . . . Moreover, these results replicated most of the findings that did not involve the  presence of amitriptyline from the initial independent study in this research project.  

The University Medical Center in Hamburg, Germany examining acupuncture for chemotherapy induced peripheral neuropathy (CIPN) found that,

The data suggest that acupuncture has a positive effect on CIPN. 

A Chinese study entitled, Fifteen-Day Acupuncture Treatment Relieves Diabetic Peripheral Neuropathy, evaluated the use of acupuncture in a diabetic population suffering from both sensory and motor nerve damage. It found,

... evidence that acupuncture may be clinically useful for the radical treatment of diabetic neurapathy.

The study compared:

 ... forty-two cases treated with acupuncture with 21 cases exposed to sham acupuncture and observed the effects on nerve conduction velocity and a variety of subjective symptoms associated with diabetic peripheral neuropathy.

Three of the six measures of motor nerves, and two measures of sensory function, demonstrated significant improvement (p < 0.05) over the 15-day treatment period in the acupuncture group, while no motor or sensory function significantly improved in the sham acupuncture group. There were also significant differences in vibration perception threshold between the groups (p < 0.05) and when compared to the baseline levels (p < 0.01) in the acupuncture group. Acupuncture was significantly more effective than sham for treatment of numbness of the lower extremities, spontaneous pain in the lower extremities, rigidity in the upper extremities and alterations in temperature perception in the lower extremities after therapy.

Athletes and Acupuncture

Recently an article was published on Yahoo News which was entitled, Three Health Benefits an Athlete Can Gain from Acupuncture, a segment of which I reprinted in the News section of this website and which is copied below. However, given that acupuncture is so often prescribed for sports injuries and to enhance endurance and performance among competitive athletes, it seemed appropriate to create a section to add research and articles to as they appeared in the scientific and mainstream literature.

Research and Articles

• A research study evaluation mechanism by which acupuncture improved athletic endurance and performance found that appropriate stimulation caused the body to release a potent cocktail of antioxidant compounds which dramatically increased the healing time of those muscles as well as enhance the performance of the athletes. A summary of this research can be read here and an excerpt is below:

The results measured specific results showing that electroacupuncture has beneficial effects on human health by intervening in the free radical metabolism process in athletes.

The researchers measured significant increases in superoxide dismutase (SOD) and significant decreases in serum malondialdehyde (MDA) for the endurance athletes. Superoxide dismutases are enzymes that have important antioxidant effects in cells. Superoxide dismutases protect cells from toxicity and exert powerful pharmacological anti-inflammatory responses. Acupuncture successfully increased this important biochemical in the bloodstream for the athletes.

Acupuncture was also shown to lower levels of malondialdehyde, an organic compound that is a marker for oxidative stress. Acupuncture lowers levels of this biochemical responsible for toxic stress in cells. Malondialdehyde is associated with pathologies such as disorders of the cornea and osteoarthritis. The researchers concluded that electroacupuncture decreases MDA and increases SOD in athletes undergoing “intensive endurance exercise, which may contribute to its effect in relieving athletic fatigue.”

• A Taiwanese study (readable here) compared groups of elite athletes using acupuncture to a placebo and found that, 

Auricular acupuncture (AA) can enhance athletes' recovery after strenuous exercise . . . Twenty-four elite male university basketball players were randomly divided into two groups; one received AA, and the other acted as a normal control group. All subjects in both groups then rode a stationary bike to exhaustion. The results showed that both maximum heart rate and blood lactic acid concentrations were significantly lower in the AA group, compared with the control group, at 30 and 60 minutes post-exercise. 

Yahoo News, and writer Jeanne Rose published a piece entitled, Three Health Benefits an Athlete Can Gain from Acupuncture in which the author gives a whirlwind overview of reasons that professional or amateur athletes might seek acupuncture intervention. A large excerpt from her article:

 

Here are three of the best health benefits that an athlete can gain from acupuncture therapy, which can improve his or her performance on the field.

Can Relieve Muscle or Joint Pain

If an athlete is suffering from muscle or joint pain, he or she might decide to try acupuncture, since it can relieve these symptoms. Acupuncture has long been used to treat all sorts of pain, which can include pain coming from the muscles and joints. An athlete might have muscle or joint pain as the result of an injury, which can hinder his or her athletic ability. Acupuncture can help reduce the inflammation associated with the injury, and it can help treat the source of the pain or inflammation. If an athlete regularly participates in sports, then acupuncture therapy might help prevent pain or inflammation from starting in the first place. Acupuncture can help with spasms in the muscles, contusions under the skin, arthritis, osteoporosis, and a variety of different conditions that cause muscle or joint pain.

Can Ease Stress or Anxiety

An athlete that is suffering a lot from stress or anxiety should try acupuncture therapy, because acupuncture can basically eliminate stress or anxiety. Acupuncture helps unblock various energy channels within the body, which can eliminate stress or anxiety. An athlete is likely to become stressed or anxious at some point during his or her sport, especially right before an upcoming game. If an athlete is under too much stress, then he or she will likely perform poorly during the competition, and he or she is also more prone to injuries. An athlete that is always anxious is also more likely to suffer injury, since anxiety can hinder his or her concentration. Acupuncture is a great way to help an athlete overcome anxiety or stress related to his or her sport, and can help improve his or her overall mentality. Stress or anxiety can also cause an athlete to become depressed or feel worthless, so it is important that he or she treat these symptoms promptly.

Can Improve Circulation and Promote Healing

Acupuncture can also improve circulation, which can help speed up the healing process, and this is a huge benefit for an athlete. If an athlete has suffered an injury, which is bound to occur sooner or later, he or she will want to recover as fast as possible. Poor circulation throughout the body can hinder healing, because oxygenated blood is what helps repair damaged cells. If an athlete is trying to recover from an injury, then he or she will likely want to do everything possible to increase the circulation throughout the body. Acupuncture can help move blood throughout the body, which means that oxygenated blood is getting to vital organs to help promote healing. Since acupuncture can help reduce pain or inflammation, an athlete will heal faster because he or she will not suffer from muscle spasms as often. Acupuncture can help release and regulate hormones, which are important for healing, and endorphins will naturally be released within the body to also promote healing.

Here are three of the best health benefits that an athlete can gain from acupuncture therapy, which can improve his or her performance on the field.

Here are three of the best health benefits that an athlete can gain from acupuncture therapy, which can improve his or her performance on the field.Can Relieve Muscle or Joint PainIf an athlete is suffering from muscle or joint pain, he or she might decide to try acupuncture, since it can relieve these symptoms. Acupuncture has long been used to treat all sorts of pain, which can include pain coming from the muscles and joints. An athlete might have muscle or joint pain as the result of an injury, which can hinder his or her athletic ability. Acupuncture can help reduce the inflammation associated with the injury, and it can help treat the source of the pain or inflammation. If an athlete regularly participates in sports, then acupuncture therapy might help prevent pain or inflammation from starting in the first place. Acupuncture can help with spasms in the muscles, contusions under the skin, arthritis, osteoporosis, and a variety of different conditions that cause muscle or joint pain.An athlete that is suffering a lot from stress or anxiety should try acupuncture therapy, because acupuncture can basically eliminate stress or anxiety. Acupuncture helps unblock various energy channels within the body, which can eliminate stress or anxiety. An athlete is likely to become stressed or anxious at some point during his or her sport, especially right before an upcoming game. If an athlete is under too much stress, then he or she will likely perform poorly during the competition, and he or she is also more prone to injuries. An athlete that is always anxious is also more likely to suffer injury, since anxiety can hinder his or her concentration. Acupuncture is a great way to help an athlete overcome anxiety or stress related to his or her sport, and can help improve his or her overall mentality. Stress or anxiety can also cause an athlete to become depressed or feel worthless, so it is important that he or she treat these symptoms promptly.Can Improve Circulation and Promote HealingAcupuncture can also improve circulation, which can help speed up the healing process, and this is a huge benefit for an athlete. If an athlete has suffered an injury, which is bound to occur sooner or later, he or she will want to recover as fast as possible. Poor circulation throughout the body can hinder healing, because oxygenated blood is what helps repair damaged cells. If an athlete is trying to recover from an injury, then he or she will likely want to do everything possible to increase the circulation throughout the body. Acupuncture can help move blood throughout the body, which means that oxygenated blood is getting to vital organs to help promote healing. Since acupuncture can help reduce pain or inflammation, an athlete will heal faster because he or she will not suffer from muscle spasms as often. Acupuncture can help release and regulate hormones, which are important for healing, and endorphins will naturally be released within the body to also promote healing.

Researchers from Japan have found that acupuncture inhibits muscular atrophy in the elderly, leading to potential benefits for the aged, as well as anyone immobilized by disease or injury. An article about this study can be read here.

A team of researchers from Japan have found that acupuncture therapy may benefit the elderly and patients who suffer from poor mobility due to loss of skeletal muscle mass, a condition known as skeletal muscle atrophy. Muscle atrophy is common in the elderly and patients who go through extended periods of inactivity, such as when a limb is put in a cast or being bed-ridden due to a prolonged illness. The condition can also be caused by many diseases such as cancer and liver failure.

Although interventions such as exercise and an improved diet are recommended, these are challenging to maintain as patients are often frail and have severe medical conditions.

The study, which was presented last week at the Experimental Biology 2012 meeting in San Diego, the team found that acupuncture can reverse muscle mass loss. Their findings also suggest a molecular mechanism for this effect.

“The main focus of this study is changes in the mRNA expression levels of muscle-specific atrophic genes such as atrogin-1,” said Onda.

They found that mRNA expression level of the E3 ubiquitin ligase atrogin-1 is lowered when muscle mass is loss, and this decrease is significantly reversed by acupuncture.

Onda hopes that her team’s findings will help pave the way for acupuncture to be recognized as an efficacious treatment for muscle atrophy. “Further investigations into its molecular mechanisms will help to decrease the medical community’s suspicion of acupuncture and provide us with a better understanding of how acupuncture treatment prevents skeletal muscle atrophy,” said Onda.

A study summarised here, found that acupuncture and herbology can rapidly restore range of motion and ease of motility in athletes after an injury. The article begins with the findings of the study:

Acupuncture and herbs restore motility for patients with motor impairments due to sports injuries. Researchers from the Physical Education Institute at Zhengzhou University investigated the effects of Traditional Chinese Medicine (TCM) style acupuncture and herbs on amateur and professional athletes suffering from motor impairments due to the demands of physical training. The researchers concluded that restoration of motility is significant as a result of applying acupuncture and herbs. However, an additive effect was discovered by combining acupuncture and herbs into a therapeutic regimen. The combination therapy produced superior patient outcomes.

Acupuncture and Herbology Cure Pelvic Inflammatory Disease, Study Confirms.

A recent Chinese study found that the combination of Chinese herbology and acupuncture was extraordinarily effective in treating chronic or acute Pelvic Inflammatory Disease (PID).

The group receiving acupuncture combined with herbal medicine had a 97.8% total effective rate. More lower abdominal acupoints. The herbal medicine only group had an 82.2% total effective rate. Only 1 patient in the acupuncture combined with herbal medicine group did not respond to treatment. In the herbal medicine only group, 8 patients did not respond to treatment. For the acupuncture combined with herbal medicine group, there was a 6.7% relapse rate. The herbal medicine only group had a 22.2% relapse rate. The researchers note that both groups showed significant improvements.
This study was a protocolized approach to care. In Traditional Chinese Medicine (TCM), acupuncture point selections and herbal formula ingredients are customized per each patient’s individual differential diagnosis. In this study, a standardized set of acupoints and herbs were selected for all patients. The protocolized approach is often used to reduce variables in the investigation.

Urinary Incontinence, Treated by Acupuncture

Of all of the many indignities which the human body may suffer through, bladder incontinence ranks quite high on the list. Happily, acupuncture and herbal medicine are usually extraordinarily effective in eliminating this issue. Here at The Northside Holistic Center, I treat this condition on a daily basis and derive enormous satisfaction from hearing of the quality of life improvements that my clients experience as a result of being able to trust their bladder function, once again.

Articles/Research

In an article entitled, Acupuncture Halts Urinary Incontinence, a study is summarized which finds that more than 93% of patients suffering Stress Urinary Incontinence experienced dramatic improvement.