Beyond Anti-Depressants: How Acupuncture and Chinese Herbs Can Help Depression
Depression is currently the second-leading cause of disability worldwide. 1 1. “Nine traditional Chinese herbal formulas for the treatment of depression: an ethnopharmacology, phytochemistry, and pharmacology review.” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5036551 × While we might have all had episodes of depression, the long-lasting feelings of sadness and isolation are not something an individual can just snap out of. Depression is complicated.
Typically, it does not have one cause. And with multiple contributing factors, an approach that addresses depression from multiple angles sounds smart.
Regarding acupuncture and Chinese medicine, depression management begins holistically, approaching an individual’s spiritual, emotional, mental, and physical needs. 2 2. “Using Chinese medicine for treating depression and anxiety.” https://muih.edu/using-chinese-medicine-for-treating-depression-and-anxiety/ × For millennia, Chinese herbal formulas have been utilized for depression symptoms.
Herbal formulas are utilized to mix herbs that can act on different pathological targets simultaneously. Additionally, by addressing qi, the physiological flow in your body, acupuncture can remove blockages behind the depression and restore proper healing.
Depression is often characterized as a feeling of being stuck. So removing those blockages makes sense, right? While conventional medicine recommends anti-depressive medications for depression, medication side effects can be quite disruptive and relapse rates are high. 3 3. “The drugs don't work? Antidepressants and the current and future pharmacological management of depression.” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3736946/ ×
Additionally, conventional antidepressants typically have single targets. While they may produce an effect, they might not truly restore an individual. 3 3. “The drugs don't work? Antidepressants and the current and future pharmacological management of depression.” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3736946/ × Ultimately, Chinese medicine’s approach to healing is to regulate the individual so that they no longer need medication or herbs. For each person, that journey may look different.
Acupuncture for Depression – Where is The Research?
Acupuncture research is not straightforward because, unlike a pill, acupuncture is difficult to standardize. Acupuncture is constitutional healing; it is personalized. Therefore, creating a protocol for a study for all those dealing with a condition like depression is difficult.
A lot of things can cause an individual’s depression. And while an SSRI, might help increase previously suppressed serotonin levels in an individual, the root cause of why the serotonin was suppressed in the first place is not addressed.
Acupuncture aims to target that “root.” Acupuncture has been around for approximately 3,000 years and only since the 1950s is research beginning on why it works. 4 4. “Acupuncture: Past, present, and future.” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4104560/ × For example:
One randomized clinical study evaluated acupuncture for the management of major depression in 33 women. After 8 weeks, the group that received acupuncture rated their depression symptoms significantly improved compared to the control group with nonspecific acupuncture treatments. 5 5. “The efficacy of acupuncture in the treatment of major depression in women.” https://journals.sagepub.com/doi/abs/10.1111/1467-9280.00074 ×
Another clinical trial assessed acupuncture for the management of major depressive disorder in 150 pregnant females. The study randomly assigned the participants to either receive acupuncture specific for depression, control acupuncture, or a massage. After 12 sessions over 8 weeks, the participants completed the Hamilton Depression Rating Scale (HDRS). The women who received acupuncture specific for depression experienced a greater decrease in symptom severity (p<0.05) compared to both control groups. 6 6. “Acupuncture for depression during pregnancy: a randomized controlled trial.” https://pubmed.ncbi.nlm.nih.gov/20177281/ ×
Could it Just Be a Placebo Effect?
One clinical trial in 2018, compared female patients in a control group with sham acupuncture to a similar group who received acupuncture. These participants had all met the criteria for depression.
Each group received their therapy once every 3 days for a total of 8 weeks. In the middle and at the end of the trial, each participant rated their depression on the self-rating depression scale (SDS) and Montgomery Asberg depression rating scale (MADRS). The SDS and MADRS scores were significantly lower in the acupuncture group than the control group (P<0.05). 7 7. “Acupuncture for female depression: a randomized controlled trial.” https://pubmed.ncbi.nlm.nih.gov/29696921/ ×
Could Acupuncture Be Combined With Anti-Depressive Drugs?
When approaching depression, an individual may want to utilize multiple forms of management. Some patients who prefer to stay on anti-depression medications, such as serotonin-norepinephrine reuptake inhibitors (SNRIs), may still benefit from acupuncture.
A meta-analysis published this year evaluated 71 studies comparing acupuncture with SNRIs to pharmacological interventions alone. The analysis found that the combination of acupuncture and SNRIs were found to be more effective than SNRIs alone. HDRS scales rating depression determined each therapy’s effectiveness. 8 8. “A network meta-analysis on the effectiveness and safety of acupuncture in treating patients with major depressive disorder.” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8129113/ ×
What About Chinese herbs?
Traditional Chinese herbs are increasing attention due to demands for solutions for depression that carry fewer adverse effects, reduce remission rates, and are faster acting. Combinations of these herbs are often utilized to target multi-pathway mechanisms. Let’s zoom in on a couple.
Chiahu shugansan (CSS) is a traditional formula whose chemical constituents include quercetin, benzoic acid, hesperidin, ferulic acid, and more. Now those are not the easiest things to pronounce however, a couple of them might look familiar.
Quercetin is a plant chemical commonly found in apples and berries. It acts as an antioxidant and can decrease lipid peroxidation, which is a fancy way of saying damage to fats in our cells. 9 9. “Inhibition of lipid peroxidation by quercetin and quercetin derivatives: Antioxidant and pro-oxidant effects.” https://pubs.rsc.org/en/content/articlelanding/2000/p2/a910183g#!divAbstract × And this is not a good type of damage.
An in vitro study found that the antioxidant activity of CSS could play a role in its antidepressant effect. 10 10. "In vitro and in vivo antioxidant effects and the possible relationship between the anti-depression efficacy of traditional Chinese medicine formulation Chaihu Shugan San.” https://www.sciencedirect.com/science/article/pii/S1875536410600428 × Antioxidants capture free radicals in our body, which when left free to roam, can cause damage.
A meta-analysis of 10 randomized controlled trials with 835 subjects found that CSS, with or without combined antidepressant pharmaceuticals, significantly improved symptoms of depression, with better efficacy and recovery rate than the antidepressant pharmaceuticals alone. 11 11. “Meta-analysis of the clinical effectiveness of traditional Chinese medicine formula Chaihu-Shugan-San in depression.” https://pubmed.ncbi.nlm.nih.gov/21933701/ × So not only could CSS help manage depression on its own, it can do so at a higher efficacy than commonly prescribed anti-depressive medications.
Ganmaidazao decoction (GMDZD) is another traditional formula with constituents such as glycyrrhizic acid and the extract of jujube, a Chinese red date. A clinical trial with 86 participants with menopause-associated depression randomized half to take GMDXD and the other half melitracen-flupentixol, a combination of two antidepressants. This was specifically for depression related to the onset of menopause.
The study found both GMDZD to be equally effective in menopause-related depression to melitracen-flupentixol but GMDXD to be more effective in improving sleep quality. The scientists hypothesized that the improved sleep quality is due to more balanced levels of serotonin, estradiol, and follicle-stimulating hormones.
These hormones are all involved in depression. This study highlights that GMDZD is not only potentially a safer therapeutic option, but potentially an equally effective one to pharmaceutical alternatives. 12 12. “Effects of modified Ganmai Dazao decoction on neuroendocrine system in patients with climacteric depression.” https://pubmed.ncbi.nlm.nih.gov/25911823/ ×
The above information is only the tip of the iceberg when it comes to the research behind Chinese herbs for depression. Even the single molecules in these herbs prove mechanisms of action involved in depression. 13 13. “Traditional Chinese Medicine in depression treatment: From molecules to systems.” https://www.frontiersin.org/articles/10.3389/fphar.2020.00586/full ×
No two people experience depression the same. And therefore, an individual experiencing depression deserves a practitioner who will personalize their treatment. Acupuncture and Chinese herbs address the underlying issues in your body.
While the research might provide you with some information, there is nothing like experiencing the medicine yourself.
If you are curious to learn more about acupuncture for anxiety and depression, you should read “Acupuncture for Anxiety and Depression – 5 Awesome Ways It Can Help”