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Q: I think I have been suffering with anxiety and depression for 4 years. I am going to see a mental health doctor also I will be having a mri scan shortly to see if there is anything else wrong.I am wondering if acupuncture may help?
A: We have produced factsheets on both of these areas: http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/depression.html and
http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/anxiety.html which give some cause for optimism, as does a heavily publicised research trial by BAcC member Hugh Macpherson and colleagues published very recently http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001518
There is also a link on our home page today to a new study about anxiety
However, we could do worse than reproduce the text of a piece we provided for Anxiety UK some months ago.
ANXIETY AND ACUPUNCTURE
Anxiety is more than just being anxious. Just as migraine sufferers get righteously indignant when someone claims to be a fellow sufferer but can still get to work, eat and stand the daylight, so anxiety sufferers know that they bear only the slightest resemblance to people who feel a bit nervous or have ‘butterflies in the tummy.’ Clinical anxiety is a crippling affliction which can sometimes defy all of the medications and talking therapies that someone can throw at it.
Why, then, has acupuncture been found to be successful in treating it? The main reason is that in conventional medicine, there is no single treatment for each sufferer as each person has differing symptoms. However, in traditional acupuncture every patient is considered to be unique, and this means that the practitioners will be looking and listening very carefully to everything that the patient says to establish a diagnosis and find the specific keys to unlocking the patterns of the symptoms the patient is suffering. They will aim to identify the imbalances which cause the symptoms of anxiety, not just treat the symptoms themselves. This whole ‘package’ – taking the patient’s individual story seriously and giving them time to tell it, trying to hone precisely the diagnosis, and selecting the optimum way to use the least needles to achieve the greatest effect – has been found to be very effective.
The theory of traditional acupuncture is very straightforward. The free flow and internal balance of energy (Qi) is seen in eastern medicine as essential for good health. Any prolonged exposure to extremes or intense situations, be they physical, mental, emotional or spiritual, will cause the flow and balance to be affected. This disruption in balance then ripples through the whole system, causing symptoms which sometimes bear little apparent relation to the underlying causes. An acupuncturist’s skill lies in making sense of seemingly unconnected symptoms and understanding the unique nature of someone’s energies in such a way as to restore balance. A treatment plan may simply involve needles and moxibustion, the use of a warming herb, and tui na, a form of traditional Chinese massage, but can extend to address issues in someone’s diet, their exercise patterns and their lifestyle.
People sometimes ask why, if acupuncture is so successful, there isn’t much research to back up its claims and make it more freely available within conventional care. A major reason for this is the unique nature of treatment which resists putting people in pigeon holes and which changes as the person’s balance begins to improve. Both of these confound attempts to organise research according to western models where a named condition receives a single treatment and all other variables are taken out of the equation. In Chinese medicine the variables are called patients!
Where do our patients with anxiety come from? Word of mouth still remains the most common and most reliable form of referral, and more people have had acupuncture than you think. If you ask around your support groups you are almost certain to find someone who has tried acupuncture and found that it works. Perhaps this time it’s your turn!
People also usually want to know whether the treatment will ‘stick’, whether they have to keep on having acupuncture. Some don’t – a single course of treatment can set them on a good path which, as long as their life remains well-balanced and relatively stress-free, means that they will stay anxiety-free. Many, though, like to keep ‘tuned up’, and realise that spending a fraction of what they spend on keeping their cars roadworthy keeps the driver in good shape too.
As always, though, we still think that the best advice we can give is that you contact a BAcC member local to you to see if acupuncture would be appropriate for your own unique circumstances.
We think that this remains sound advice, although the fact that the doctor has ordered an MRI scan does leave open the possibility that were factors involved in the onset and not mentioned in your question which may point to a physiological basis. However, in cases where there is a clear external cause the problems tend to be self-generating, i.e. people who are anxious start to become anxious about being anxious, so even when a physical cause has been identified a pattern may have developed where the anxiety continues.
In any event, acupuncture treatment will certainly do you no harm and the style of the consultation, which usually allows patients a great deal of time to talk through the issues which affect them can often be very helpful in itself.
Q: I get very emotional (start crying) when I see or hear of anything happy going on. My eyes just start to cry, even when I see or hear about sad things. It is affecting my work as a supervisor. Can acupuncture help?
This is the sort of problem which is not that well-researched other than in the context of something which admits of 'real' definition. Thus, you will find reports and studies of over-emotional reactions during pregnancy and over-emotional causes of sleep disturbance, but very few case reports for what you describe, simple 'over emotion'. We can imagine, though, that while in some Mediterranean cultures open displays of emotion are much more acceptable, in this country we tend to be a little uneasy when someone is easily affected in this way and this can cause them a number of problems.
To a Chinese medicine practitioner this would not seem at all unusual, however. In Chinese medicine theory, the correct balance of energies in the body and the interconnection between body mind and spirit lend themselves to a central idea that the body in balance responds appropriately to the circumstances in which it finds itself. On an emotional level, this would translate into being able to express the full range of human emotions congruently, i.e. the right emotion at the right time, and appropriately, at the correct 'volume level'. Someone still grieving excessively 20 years after the death of a loved one, or laughing hysterically at very little, or getting angrier than would seem OK for whatever appeared to be the cause would make us think that the balance of the system had been disturbed. The way in which the display of emotions came out, when it happened, what makes it better or worse, in short all of the questions which you might ask about a physical pain, all point a practitioner to an understanding of the patterns and then in turn to potential treatment.
A: That is not to say that you are guaranteed to get a good response. Even though someone may diagnose in Chinese medicine terms exactly what is going on, there can be an awful lot of what one might call 'habit energy' in the body - every time a particular event happens, we get the same reaction. This may not always be a comfortable reaction, but we are used to it and sometimes reluctant to let it go. This may sound silly, but many of us are resistant to change, even when it is beneficial. That is the reason why many practitioners are familiar with NLP, a technique for trying to 'unlock' these fixed patterns, and why they may consider referring you on to a hypnotherapist specialising in what is called Ericksonian hypnotherapy or just simply NLP to try to shift these problems.
We mention this only to alert you to the fact that there are a number of options, but we are pretty sure that traditional acupuncture itself may be able to offer you some benefit. The best advice we can offer, and usually do for cases where the personal circumstances of the individual may be integral to understanding what is happening, is to visit a BAcC member local to you for a brief face to face assessment of what may be possible and whether they believe that they are able to help you, and if not, what may be the best way of addressing this problem.
A: As you can imagine, we have been asked similar questions on several occasions, and a typical answer is:
A: The use of acupuncture for skin conditions is not particularly well researched, as our fact sheet shows:
There may be a number of reasons for this, one of which is that skin conditions form a 'fuzzy' set where the definition and location are not always precise enough to be testing like with like, a pre-condition of the randomised double blind control trial much loved by western science.
That said, there is a considerable amount of anecdotal evidence within the profession about good reactions to treatment, especially a reduction in the amount of itching and discomfort. One has to be cautious, however; a very common effect of initial treatment is a radical improvement followed by a settling back to nearly the same state as before. We have seen a number of people become even more disheartened when this has happened, even though we have said that short-term results are unlikely and if they appear usually unsustainable.
It has to be said, though, that the collective view inside the BAcC is that skin problems are usually best treated with a combination of Chinese herbal medicine and acupuncture. There is something about the precision with which the formulae are designed and the daily routine of treatment which clearly seems to evince powerful changes in the system. Most members of the Register of Chinese Herbal Medicine are also BAcC acupuncturists, and finding someone in your area who practises both may be a very good way forward.
Our best advice to you is to see if there are BAcC members local to you who also use Chinese Herbal medicine, and to see if they can offer you a brief face to face assessment of whether they believe tahat acupuncture and herbal treatment can help you.
We think that this remains the best advice that we can give. The only caveat which we sometimes add is that acupuncture is often used as a last resort, and before someone comes to us they have taken a large number of medications which can had added layer upon layer of secondary effects on the initial problem. The overall clinical picture can sometimes be a little more complex than one would hope to see. However, acupuncture treatment treats the person, not the condition, and the treatment is tailored to the needs of the individual to help their system restore its own balance and healing ability. The oldest forms of Chinese medicine were often asymptomatic, driven by the simple belief that a system in balance corrected symptoms. In clinical practice, an experienced practitioner can both treat the underlying cause and the symptoms at the same time to facilitate recovery.
We answered this question a while ago, and the answer we gave was:
As our factsheet says:
there has been very little research into the use of acupuncture for MS. There are many reasons for this, but very high up the list will be the fact that presentations of MS vary so differently and the outcomes are also difficult to measure.
One of the problems we often find in practice is that once someone has a disease condition with a label like MS or Parkinson's or Type 2 Diabetes, it is not uncommon to see this as the root of a great many physical and emotional problems, and in truth sometimes these conditions are, but there are times when a symptom is from an entirely different cause and eminently treatable.
From a Chinese medicine perspective, where each patient is unique and different, it is important to understand how each specific presentation arises from this same perspective. This does not mean that everything is curable if its start and progression can be plotted, but it might offer the possibility of slowing down the deterioration which can often result from these conditions. The ancient Chinese probably understood nerves, but not the microbiology of nerve structure and specifically the demyelination which characterises MS, so their attempts to understand the steady loss of function would have been understood in the changes in function of the Organs of the body as they, for example, no longer provided energy in the extremities, causing numbness and loss of sensation.
As we said, this does not mean that by switching perspectives one can find cures which conventional medicine cannot offer. It may, mean, however, that there may be treatments which can help to slow down the loss of function or even correct those symptoms which have arisen contingently and are not related to the MS.
Our best advice is always to contact a BAcC member local to you and seek their advice face to face; they will be far better equipped to offer options based on what they can see than we can at this remove.
We think that this still represents the best advice we can offer. However, since we published this answer there has been a systematic review of acupuncture treatment for MS
which is mildly positive, and if you look for outliers you can find occasional studies like this one
although it is only fair to point out that scalp acupuncture, like ear acupuncture, is a relatively modern development which has some roots in the classical tradition but owes more to empirical research in the 20th century.
Q: Is acupuncture good for overall health? I had acupuncture for IBS. However, I like using it once in a while now since I feel good overall. Is there any evidence indicating that going once every two months for example is good for overall health?
A: There is no evidence as such, at least in the terms in which we have to provide evidence to meet the requirements of the Advertising Standards Authority, but there are solid reasons for this. Most acupuncture research is condition based (does acupuncture help ?) and the gold standard of research, the randomised double blind control trial which is highly inappropriate for acupuncture treatment, is used as the criterion. This dismisses at a stroke hundreds of thousands of Chinese trials which are not as methodologically rigorous because they are less concerned with whether it works and more interested in what works better.
However, there are a number of researchers working in this field who use well-known outcome measures like the MYMOP scale which attempt to quantify patient satisfaction by converting qualitative statements of well-being into units which lend themselves to analysis. One of her recent publications, quoted here on a special interest group website
is particularly positive about the more general effects of acupuncture treatment, although mainly in the context of outcomes which were in addition to treatment of a main complaint. This is not quite the same as signing up for regular treatment in order to stay well, or better still, to improve overall. This was the aim of ancient Chinese acupuncture, where in fact the doctor was paid to keep the patient well, and the penalty for failing to do so was said to be to maintain the patient in the style to which he was accustomed. One of this expert's patients was strongly in favour of moving to this system until I pointed out that I had several millionaires on the books and in order to cover myself I'd have to raise my fees by a factor of ten.
The premise of traditional Chinese medicine was preventative. The ancient texts speak of the futility of 'digging a well when you are already thirsty or forging a spear after the battle had commenced', and in practice we often find that patients who have been attending for a long time on this basis get fewer illnesses and seem to recover more quickly than other people who are not maintained in this way. However, this is mainly an anecdotal finding; there is not a great deal of research to underpin it as a statement, and the outcomes may be entirely contingent.
However, the fact that you have benefited from treatment for a specific complaint probably means that regular treatment, both to avoid any recurrence of the problem and to feel better in yourself, may be well worthwhile.
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