Working with Mental Health
Acupuncture is a well known body-based therapy for pain and injuries. By offering whole system health, Lee-Ana can offer a non-medicated therapy that may (or may not) involve mental health and can be used alongside medical treatment. Going into detail about mental health and revisiting past trauma is not necessary. It can be useful for Lee-Ana to know if there are certain emotions or states of mind that are fallen into more easily though.
In clinic Lee-Ana works with a number of associated symptoms that can come with mental health like insomnia, stress, chronic physical pain and fatigue. Promising evidence has been identified for acupuncture use in depressive disorders, migraine, opioid use disorders, and insomnia disorders with a call for funding for research in these areas (Lu et al., 2022).
Acupunture Evidence for Mental Health
Anxiety
Reviewed evidence suggests acupuncture is an effective treatment for anxiety. A summary of the evidence available for acupuncture use for anxiety is outlined by Evidence Based Acupuncture.
Depression
In the UK ACUDEP (acupuncture for depression) trial, acupuncture was reported to be as useful as counselling, with both interventions significantly reducing depression compared to usual care (MacPherson et al., 2013). Data from this trial also found fatigue and insomnia were relieved with acupuncture (Hopton, MacPherson et al., 2014) and suggested acupuncture for depression may encourage some people to be more active in their own healing (Hopton et al., 2014).
Cochrane reviews (the ‘gold standard’ research), give us an indication about the quality of the research, but not the quality of the intervention. Acupuncture research is inadequate in a number of ways from a traditional viewpoint in that the ‘intervention’ (being acupuncture), is often not used in a way that it would be traditionally (see notes on past acupuncture research below). One Cochrane review of acupuncture for depression found a lack of quality in research on acupuncture for depression (Smith et al., 2018). However, the quality of the interventions were not great from a traditional standpoint. If acupuncture does have similar results as some types of counselling as the ACUDEP trial found, which did use acupuncture in a more traditional way, it might be worth researching further to see if it could be another option for sufferers from mental health. Acupuncture is considered safe when administered by well-trained practitioners so it may be worth trying. Details of acupuncture safety.
Acupuncture for Mental Health During Pregnancy & Postnatally ~
Acupuncture for Mental Health During Pregnancy & Postnatally ~
There are limited trials available on acupuncture for depression during pregnancy but positive outcomes with no more adverse events than usual treatment have been reported (Manber et al., 2004, 2009; Ormsby et al., 2020).
In qualitative research, acupuncture use during pregnancy has been reported as supporting physical and emotional wellbeing (Smith et al., 2002), empowerment and optimism at doing something rather than ‘watchful waiting’ in cases of threatened miscarriage (Betts, Smith, & Dahlen, 2016), as well as benefits in mood, motivation, interpersonal relationships, enhanced coping abilities and increased positivity in pregnant women with depression (Ormsby et al., 2018).
Surveys and interviews with NZ midwifery acupuncturists also described acupuncture as having positive effects such as relaxation from stress, anxiety, depression, insomnia and enabling a change of outlook (Lowe & Betts, 2021, 2023).
Acupuncture for mental health during pregnancy shows great promise as a non medicated option for pregnant women . Some obstetric health professionals think it’s worth trying if it does no harm (Ormsby, Dahlen, Ee, et al., 2018). Acupuncture has been reported as safe during pregnancy when administered by well-trained practitioners (Clarkson et al., 2015; Ormsby et al., 2020; Park et al., 2014; Soliday & Betts, 2018)
References
Betts, D., Smith, C. A., & Dahlen, H. G. (2016). Does acupuncture have a role in the treatment of threatened miscarriage? Findings from a feasibility randomised trial and semi-structured participant interviews. BMC Pregnancy and Childbirth, 16(1), 298. https://doi.org/10.1186/s12884-016-1092-8
Clarkson, C. E., O’Mahony, D., & Jones, D. E. (2015). Adverse event reporting in studies of penetrating acupuncture during pregnancy: A systematic review. Acta Obstetricia et Gynecologica Scandinavica, 94(5), 453–464. https://doi.org/10.1111/aogs.12587
Hopton, A., Eldred, J., & MacPherson, H. (2014). Patients’ experiences of acupuncture and counselling for depression and comorbid pain: a qualitative study nested within a randomised controlled trial. BMJ Open, 4(6), 1–12. https://doi.org/10.1136/bmjopen-2014-005144
Lowe, L.-A., & Betts, D. (2021). Midwives’ experiences of caring for women with antenatal anxiety and depression: A qualitative study with midwifery acupuncturists. New Zealand College of Midwives Journal, 2021(57), 20–26. https://doi.org/10.12784/nzcomjnl57.2021.3.20-26
Lowe, L.-A., & Betts, D. (2023). Midwifery Acupuncturists’ Management of Antenatal Anxiety and Depression: Data from a Survey in Aotearoa (New Zealand). Medical Acupuncture. https://doi.org/10.1089/ACU.2022.0062
Lu, L., Zhang, Y., Tang, X., Ge, S., Wen, H., Zeng, J., Wang, L., Zeng, Z., Rada, G., Ávila, C., Vergara, C., Tang, Y., Zhang, P., Chen, R., Dong, Y., Wei, X., Luo, W., Wang, L., Guyatt, G., … Xu, N. (2022). Evidence on acupuncture therapies is underused in clinical practice and health policy. The BMJ, 376. https://doi.org/10.1136/bmj-2021-067475
MacPherson, H., Richmond, S., Bland, M., Brealey, S., Gabe, R., Hopton, A., Keding, A., Lansdown, H., Perren, S., Sculpher, M., Spackman, E., Torgerson, D., & Watt, I. (2013). Acupuncture and counselling for depression in primary care: A randomised controlled trial. PLoS Medicine, 10(9), 1–13. https://doi.org/10.1371/journal.pmed.1001518
Manber, R., Schnyer, R. N., Allen, J. J. B., Rush, A. J., & Blasey, C. M. (2004). Acupuncture: A promising treatment for depression during pregnancy. Journal of Affective Disorders, 83(1), 89–95. https://doi.org/10.1016/j.jad.2004.05.009
Manber, R., Schnyer, R. N., Lyell, D., Chambers, A. S., Caughey, A. B., Druzin, M., Carlyle, E., Celio, C., Gress, J. L., Huang, M. I., Kalista, T., Martin-Okada, R., Allen, J. J. B. (2009). Acupuncture for depression during pregnancy. A randomized controlled trial. American Journal of Obstetrics and Gynecology, 201(6 SUPPL. 1), S19. https://doi.org/10.1097/AOG.0b013e3181cc0816
McDonald, J., & Janz, S. (2017). The acupuncture evidence project: A comparative literature review. Australian Acupuncture and Chinese Medicine Association Ltd, 1–83. http://aeacu.co.nz/wp-content/uploads/2017/05/The-Acupuncture-Evidence-Project_Mcdonald-and-Janz_Feb_2017_Reissued_April_2017.pdf
Ormsby, S. M., Dahlen, H. G., Ee, C. C., Keedle, H., & Smith, C. A. (2018). ‘Acupuncture for antenatal depression: It’s worth giving it a go’ — A qualitative study. Women and Birth, 31(3), 166–176. https://doi.org/10.1016/j.wombi.2017.09.018
Ormsby, S. M., Dahlen, H. G., & Smith, C. A. (2018). Women’s experiences of having depression during pregnancy and receiving acupuncture treatment—A qualitative study. Women and Birth, 31(6), 469–478. https://doi.org/10.1016/j.wombi.2017.10.009
Ormsby, S. M., Smith, C. A., Dahlen, H. G., & Hay, P. J. (2020). The feasibility of acupuncture as an adjunct intervention for antenatal depression: a pragmatic randomised controlled trial. Journal of Affective Disorders, 275, 82–93. https://doi.org/https://doi.org/10.1016/j.jad.2020.05.089l
Park, J., Sohn, Y., White, A. R., & Lee, H. (2014). The safety of acupuncture during pregnancy: a systematic review. Acupuncture in Medicine, 32(3), 257–266. https://doi.org/10.1136/acupmed-2013-010480
Smith, C. A., Armour, M., Lee, M. S., Wang, L. Q., & Hay, P. J. (2018). Acupuncture for depression. Cochrane Database of Systematic ReviewsCochrane Database of Systematic Reviews, 2018(3). https://doi.org/10.1002/14651858.CD004046.pub4
Smith, C., Crowther, C., & Beilby, J. (2002). Pregnancy outcome following women’s participation in a randomised controlled trial of acupuncture to treat nausea and vomiting in early pregnancy. Complementary Therapies in Medicine, 10(2), 78–83. https://doi.org/10.1054/ctim.2002.0523
Soliday, E., & Betts, D. (2018). Treating Pain in Pregnancy with Acupuncture: Observational Study Results from a Free Clinic in New Zealand. JAMS Journal of Acupuncture and Meridian Studies, 11(1), 25–30. https://doi.org/10.1016/j.jams.2017.11.005
note about past acupuncture research
There have been many challenges of past acupuncture research making it inadequate in many ways. One major factor that stands out is that most research uses acupuncture and points in a way that traditional acupuncturists don’t. For example choosing points based on symptoms alone rather than traditional diagnosis or using 1 point with acupuncture only, rather than a combination of points and techniques like cupping, moxa etc. Both the ACUDEP and trials on acupuncture for depression during pregnancy above attempted more traditional treatments in their research.
It is my hope that future research on acupuncture will bring more rigorous and real-life based methods and trial designs so there is a more true reflection of what the traditional medicine is capable of and how it could be used alongside western medicine for the benefit of everyone.
