After practicing acupuncture for well over a decade, I have long noticed the unmistakable effect that acupuncture has on anxiety and stress reduction. It isn’t uncommon to have new patients that are tense, wound up, and “on edge” show up as an entirely different person on the second visit--visibly more relaxed, and much more “comfortable in their skin”. The effects of acupuncture on anxiety aren’t usually dramatic; typically the effects are subtle and cumulative, with patients noticing a difference in their ability to relax and feel calm growing steadily over time.
So how does acupuncture have this effect? The two main branches of the nervous system are the sympathetic and parasympathetic branches. Called the “fight or flight” system, the sympathetic is the excitatory branch that is activated during times of stress (whether positive or negative). Activating the sympathetic branch leads to increased heart rate and blood pressure, shunting blood away from digestion and inner organs, and into the muscles so that you can “run from the bear”. The sympathetic branch is a normal, necessary part of the nervous system. However, too often when people lead stressful lives, they can get “stuck” in a sympathetic predominant state, that then can lead to chronic symptoms such as insomnia, anxiety or panic attacks, too much “mentalizing” or overthinking, and commonly to compromised digestive and endocrine function (such as adrenal exhaustion).
The parasympathetic nervous system, on the other hand, is the sedating branch that is activated during times of rest and relaxation. Activating this branch leads to decreased heart rate and pressure, aiding in digestion, rest and restorative processes in the body. Acupuncture has the effect of “re-setting” the body’s ability to regulate or moderate between these two responses, increasing its ability to readily access a parasympathetic state.
Acupuncture has additionally been shown clinically to release endorphins, the body’s “feel good” chemicals, as well as other endogenous chemicals which play a role in reducing the body’s physical and emotional stress responses, including lowering pain sensation, heart rate and blood pressure.
Along those lines, in 2013 researchers at Georgetown University Medical Center conducted some fascinating experiments evaluating the effect of acupuncture on stress in rats. After exposing the rats to stress (induced by cold), they found that acupuncture conducted on the rodents significantly reduced levels of a protein called neuropeptide Y (NPY), which is secreted in both rodents and humans by the sympathetic nervous system in times of stress. Also measured were blood hormone levels secreted by the HPA axis (Hypothalamus - Pituitary - Adrenal axis) during stress, which were also lowered with acupuncture.
There have been some interesting studies examining the effectiveness of acupuncture on mood, anxiety and stress levels in humans--including studies that have additionally examined whether or not its effect is merely “placebo”.
One 2017 study examined 62 participants with high self reported levels of stress in a large, urban public university in the southwestern United States. The participants were divided into two groups of verum (“real”) acupuncture and sham (“fake”) acupuncture, with both groups receiving acupuncture once a week for twelve weeks. The participants were asked to complete a standard questionnaire measuring perceived stress both before, at 6 and 12 weeks into treatment, and then 6 and 12 weeks post treatment. While initially both groups experienced a substantial decrease in stress, the verum group reported significantly greater treatment effect both at the end of 12 weeks, and 12 weeks after, than the sham group.
A study from the University of York in the UK recruited 755 people diagnosed with moderate to severe depression for a study that looked at the effects of acupuncture and counseling on their condition, versus just pharmaceutical approaches. About seventy percent of the people in this group were already on antidepressants, and they continued on the meds throughout the study. The study divided the participants into three groups: one group of 302 received 12 weekly acupuncture sessions, one group of 302 received weekly counseling sessions, and the remaining group of 151 received neither. In the beginning the 755 participants had an average depression score of 16 (from 0-27), indicating moderate depression. After three months, the acupuncture group score had dropped to 9 (indicating mild depression), the counseling group to 11, and the third group receiving neither treatment reported 13. More importantly, those receiving acupuncture or counseling saw larger improvements that lasted for an additional three months after treatments had stopped.
The key to success for those seeking acupuncture as a tool for both stress and anxiety management, is to initially commit to at least once weekly treatment over a two to three month period of time. Frequency can be decreased once the nervous system has “reset” itself through acupuncture; depending on the individual, many will then come in for a monthly “boost”.
Other factors that will determine how successful acupuncture is include whether or not the anxiety is physiological (unrelated to life circumstances) or situational (related to life circumstances). In general, both physiological and situational anxiety respond well to acupuncture. However, if someone’s life circumstances are intensely and unremittingly severe, then there is much more for acupuncture to overcome. In this case, two to three times a week initially may be necessary. With regard to physiological causes, there are certain health conditions that can cause, or contribute to, significant anxiety--some common ones including gut and thyroid disorders. These conditions may need to be additionally addressed, through the help of a qualified practitioner.
Regardless of cause, acupuncture has proven both clinically and scientifically to be a highly useful tool in the reduction of stress and anxiety levels. It can be successfully used in those seeking to manage anxiety, chronic elevated stress levels, and mild to moderate mood issues without the use of medication. In more extreme cases it can be combined with medication to lower dosage requirements.