Chances are, you know someone with anxiety — or have it yourself — especially since it affects nearly 1 in 5 people. While there are several treatment options available these days, from talk therapy to natural supplements, some people also get acupuncture for anxiety.
Yes, research has found that acupuncture can be very beneficial to those with chronic stress. Lijana Shestopal, founder of Sports Acupuncturist, explains. “Millions of people suffer from anxiety daily,” she tells TZR in an email. “While there are many treatments, acupuncture works wonders.”
Before we get into how acupuncture relieves anxiety, it’s important to first discuss how this Traditional Chinese Medicine (TCM) treatment works. You may see pictures wherein many needles are scattered all over someone’s body. These thin, metallic needles are then activated through particular movements from either the practitioner's hands or electrical stimulation. TCM practitioners believe there are more than 2,000 acupuncture points in the human body, connected by pathways or meridians that create an energy flow, qi (“chee”). If the energy flow experiences disruptions, health issues may occur, and acupuncture then aims to improve the flow.
Shestopal says that while acupuncture has been long known to alleviate conditions, such as pain, in her practice, anxiety is one of the top three things that she treats. “I always like to add a few acupuncture points for anxiety and stress management, even if someone comes in for pain, as I believe everyone can benefit from it.” She says that while there is not one consensus on how exactly acupuncture alleviates anxiety, there are a few theories.
One is that acupuncture promotes the parasympathetic zone, also referred to as “rest and digest.” “This is the zone one should be in for the body to heal,” she explains. “Most of the people in today’s world are in a sympathetic zone, which is also known as “fight-or-flight,” and can be triggered by something as little as watching something upsetting on the news, traffic, and so forth. When the body is in this zone, all the blood flow goes to the limbs, as your body perceives a threat, meaning that all other processes — such as digestion and healing of tissues/organs — are put on hold.” So, during acupuncture, your body goes from being in the sympathetic zone to the parasympathetic one. “This not only immediately calms you down, but also puts your body in healing mode,” she adds. “And this, in turn, also results in reduced anxiety.”
Dr. Tom Ingegno, doctor of acupuncture and Chinese Medicine and chief clinician at Charm City Integrative Health in Baltimore, Maryland, says that his clinic sees anxiety clients all day long, especially the last several years. “When someone receives acupuncture, there is a cascade of effects that can help reduce anxiety,” he tells TZR. Seconding Shestopal’s notion, he says acupuncture “flips the switch” from fight or flight into the rest and digest response — and quickly, within the first 15 minutes or so of treatment.
“While in the rest and digest mode, acupuncture appears to help regulate neurotransmitter levels, like serotonin, dopamine, oxytocin, and anandamide,” he explains. “This symphony of neurotransmitters controls our body's response to stress, and mediates levels of anxiety and depression. In this way, acupuncture ‘hits the reset button’ to allow these levels to balance.” He adds that while patients are lying on the table, they will also feel changes physically. “They will breathe slower and deeper, they will feel muscles relax, feel their stomach rumble, and they may even feel their heart rate slow — and often fall asleep,” he says. “It’s as if acupuncture reminds someone what ‘relaxed’ feels like, which they can then take home with them.”
Another theory is that acupuncture regulates serotonin levels, which improves mood and decreases anxiety, Shestopal says. Echoing Ingegno, she says acupuncture has been shown to stimulate neurotransmitters in the brain, increasing serotonin and reducing norepinephrine levels, a hormone that increases during stressful times. “Low serotonin levels have been shown to increase depression and anxiety,” she explains. “And, as stress levels go up, norepinephrine levels also go up, putting you in a fight-or-flight zone and causing issues like high blood pressure, increased heart rate, and anxiety.” And if someone is on an SSRI (a selective serotonin reuptake inhibitor), for their anxiety, research has shown that SSRI effectiveness is improved when combined with acupuncture.
Acupuncture Points For Anxiety
As far as acupuncture points for anxiety, they can be on the scalp, ear, and various body points, Shestopal says. “There is a specific treatment, which is very popular among veterans, for example, called NADA treatment,” she says. “It is a treatment which includes five points in each ear, and research has shown that it greatly relieves conditions like post-traumatic stress disorder (PTSD), anxiety, depression, and insomnia.” Robert Simon, founder of Chigong Therapy, elaborates. He says a tensed body can unconsciously contribute to an anxious state of mind. “To this end, there are many areas of the body that are highly reactive to stress, which can be relaxed through acupuncture,” he tells TZR.
For example, there are a set of points located on top of the hands and feet used for calming the mind and are known as the "Four Gates.” And the hands and feet have lots of what are called “proprioceptors,” he explains, the nerves that tell us where our body is in space, so we can walk, balance, pick up things, and so on. “They are also highly reactive to stress, as are facial nerves,” he adds. “Likewise, two famous points used for anxiety are called Yintang and Taiyang, which are situated between the eyes and on the temples, respectively.”
Once the body becomes relaxed by stimulating these points, anxiety tends to reduce. “The term ‘body/mind’ is a bit of a misnomer,” Simon says. “The body doesn’t just influence the mind: It is a part of the mind. If the body is in a state of fight-or-flight, the psyche will be, as well. Additionally, acupuncture stimulates the production of endogenous opioids [molecules produced in the brain that circulate throughout all organ systems]. This is another reason acupuncture can have such a profoundly relaxing effect.”
How Often Should You Get Acupuncture For Anxiety?
Simon says that you don’t just get acupuncture once for anxiety. “Ultimately, we’re trying to train the nervous system to behave differently,” he notes. “Much like learning any new skill, this requires repetition to make a sustained change.” He also says each patient is different just like each practitioner is different. “And acupuncture is not monolithic: there are many, many different styles of acupuncture — some are ancient; some are less than 30 years old. Some styles might be better for one patient while another patient, with the very same Western diagnosis, may respond better to another.”
Shestopal agrees about playing the long game when it comes to acupuncture for anxiety. “While acupuncture gives great relief for a wide array of conditions, for the issue to get better and results to last, one will need a round of treatments,” she says. “A person may feel relief from the very first treatment, but to get long-lasting results, it may take six or 12 treatments. The number of treatments depends on how long-standing and severe the issue may be.” And Ingegno points out that, usually, people will feel calmer during their first treatment. “But that won’t mean they are ‘cured’ — acupuncture is a therapy and results are cumulative.”
At his clinic, Ingegno says many patients come in with anxiety disorders as their main complaint, particularly general anxiety disorders, panic attacks, and PTSD. “We are currently living in a time where the stress ‘feels’ particularly intense,” he says. “Patients may come in with a different chief complaint, like pain, but during the intake, anxiety symptoms will be discussed. These may manifest as a typical panic attack or social anxiety, but often may manifest as headaches, insomnia, or tightness in the chest.” He says that patients respond really well to treatment. “While there are several types of anxiety — and while any of them can vary in severity — they do share similar symptoms,” he says. “Any skilled acupuncturist would differentiate a person’s condition based on how their symptoms affect every aspect of their life, not just by a clinical label.”
Additional Anxiety Treatment Options Should Be Utilized, Too
Ingegno stresses the importance of using additional treatment options, too, alongside acupuncture. “Big factors that affect the outcome of any mental health treatment are consistency or treatment,” he says. Other therapeutic interventions (such as clinical counseling and medication), a support system (like support groups, friends, and family), and lifestyle changes can help, as well.” However, acupuncture is a “whole-being” medicine, he says, treating how the person is functioning. “Medications are great, but really focus on only increasing (or decreasing) the one aspect of the issue,” he explains. “And talk therapy is amazing, and should be included in any comprehensive treatment plan, but oftentimes it is difficult for a patient to discuss the root cause of their anxiety. Yet acupuncture provides a non-chemical, non-verbal approach to how anxiety impacts you as a whole person.”
Simon seconds that. “The goal of Chinese medicine is not to replace a function, but rather, to restore a function,” he says. “We’re not only trying to reduce the anxiety as a palliative measure, but to address the underlying cause. To do this, Chinese medicine looks at the entirety of a person and arrives at a pathological ‘pattern’ — so we’re treating the pattern, not merely the Western diagnosis.” Moreover, Chinese medicine doesn't treat “this type of anxiety” or “that type of anxiety,” he adds. Rather, it looks for what is out of balance: what is excessive and what is deficient. “Ultimately, the acupuncturist arrives at a treatment plan tailor-made for the patient based on that individual's unique presentation and constitution,” he says. “Acupuncture can be immensely helpful in balancing the body to alleviate anxiety.
However, if a person is engaging in unhealthy lifestyle choices that help to create or encourage an anxious state, there will be only so much acupuncture can do unless those harmful activities are addressed. Which is to say, the process of healing does not end when the needles are removed.” Herbal formulas, meditation, and qigong exercises (similar to Tai chi) are often prescribed for the patient to perform in between acupuncture treatments to reinforce a relaxed, grounded state of mind, Simon explains. “This also gives the patient agency and ownership over their own healing process, of which the benefits cannot be overstated.”