Acupuncture is a form of ancient Chinese medicine that may offer many health benefits. Research suggests it may also help treat depression.
Acupuncture is a widely practiced form of traditional Chinese medicine (TCM) dating back to 100 B.C.
As a form of complementary and alternative medicine (CAM), acupuncture is traditionally used to treat a number of physical ailments.
In recent years, acupuncture has become recognized as a potential alternative treatment for mood disorders like depression.
According to TCM, a vital life force, or qi, flows through the body to maintain harmony, balance, and overall health. A blockage of qi could create an imbalance of yin and yang energy, and lead to various forms of illness and disease.
According to TCM, the human body has more than 2,000 acupuncture points, or acupoints. Each is connected by channels or meridians.
A licensed acupuncturist inserts thin metal needles into specific acupoints on the body to stimulate the flow of qi to increase blood flow to the organs. When qi is flowing freely through the meridians, the organs are “tonified” to improve health and well-being.
Once widely regarded as a pseudoscience, acupuncture has become increasingly accepted by Western medicine. In fact, it’s the most researched form of TCM.
Just before the turn of the century, the
Recent studies suggest that acupuncture may treat health conditions such as:
- chronic pain
- headache or migraine
- menstrual cramps
- nausea from chemotherapy or pregnancy
- stroke rehabilitation
Do acupuncture needles hurt?
Acupuncture needles are regulated by the Food and Drug Administration (FDA). The process of inserting acupuncture needles into the skin is minimally invasive and usually pain-free.
Many people feel a temporary dull or aching sensation upon insertion of the needles as stagnant or blocked qi starts to release, according to TCM. The needles should only cause prolonged pain if they are inserted incorrectly.
Some acupuncturists may use manual, heated, or electrical stimulation, while others will leave the room while the needles are in place. Treatments can range anywhere from 30 to 60 minutes per session.
Some acupuncturists may use other forms of acupuncture during treatment. These include:
- Auricular acupuncture. Colloquially sometimes known as “ear acupuncture,” needles are placed in specific points in the ear with this technique.
- Electroacupuncture. For this technique, needles are stimulated with an electric current.
- Distal acupuncture. In this form of acupuncture, needles are placed far away from affected areas of pain.
- Orthopedic acupuncture. Acupuncture is combined with myofascial massage or manipulation.
Many licensed acupuncturists are also skilled herbalists, and may recommend Chinese herbal formulas to their clients to supplement their treatment.
A growing body of research suggests that acupuncture may offer relief from symptoms associated with depression, but as a 2020 research review notes, large-scale rigorous studies are still needed.
Jon E. Walker, L.Ac, a licensed acupuncturist and herbalist at Bull City Acupuncture in Durham, North Carolina, treats a number of conditions with acupuncture. He says that comorbid anxiety and depressive disorder is a common complaint among people visiting his clinic.
To treat depression, acupuncturists like Walker target specific acupoints in the body to treat associated symptoms to release mood- and emotion-regulating hormones.
While scientific research questions the theory of qi stagnation, research from 2014 suggests that acupuncture releases endorphins and may help stimulate blood flow. An increase in endorphins may provide a boost for the mind and body, which could offer relief from some depression symptoms.
According to Walker, acupuncture may treat depression by regulating key components in the brain and central nervous system. These include:
- Endogenous opioids and opioid receptors. These become
dysregulatedin mood disorders like depression.
- Hippocampus. This part of the brain can shrink in people with depression.
- Hypothalamic-pituitary-adrenal (HPA) axis and neuroendocrine system. These are associated with the
pathophysiology of depression, or how depression may affect bodily function.
- Neuroinflammation. Inflammation can affect the HPA axis and serotonin synthesis.
- Neurotransmitters and their metabolites. These may be disrupted with depression.
Walker explains that in his acupuncture practice, people with mild to moderate depression may experience positive changes within 8 to 12 treatments over 4 to 6 weeks, but the duration and frequency of treatment can vary.
“It all depends on the [person], the severity of their symptoms, and how they respond to the treatment,” he says. “Some [people] start feeling better right away, others take more time.”
An acupuncturist chooses specific acupoints on the body to stimulate energetic channels or meridians to treat depression based on their assessment of the client.
“Each person and their depression are unique and are best treated as such,” Walker says. “There are some common patterns, but [individuals] are rarely textbook.”
Though treatment can vary, Walker says that common acupoints associated with depression symptoms include:
- Stomach 36
- Spleen 6
- Liver 3
- Large intestine 4
- Pericardium 6
- Si Shen Cong
Acupuncture needles may also be placed in the ear to stimulate the heart, liver, or lung, including two key acupoints:
- Shen men: the “spirit gate” to promote tranquility in the mind and access the spirit and emotions
- Point zero: The physiologic center to balance the brain, hormones, and energy to bring the entire body into a state of equilibrium
When combined with antidepressant medication, research shows that acupuncture may be effective. However, high-quality evidence is often lacking.
A 2018 research review indicates that acupuncture combined with selective serotonin reuptake inhibitors (SSRIs) may be more effective than antidepressants alone for mild to moderate depression, but the studies were largely biased.
Results suggest a reduction in side effects from medication and an improvement in quality of life, but the findings are also potentially biased.
Research suggests that acupuncture may be just as effective as psychotherapy to treat depression.
Results from a randomized controlled trial from 2013 don’t show a significant difference between acupuncture and counseling for treating depression, indicating that both interventions were beneficial at 3- and 12-month follow-ups compared with standard care.
A 2014 study indicates that when combined with psychotherapy, acupuncture can be an effective form of treatment for depression. Results suggest that people were more actively engaged with their treatment during the counseling process.
Of course, whether an individual should use acupuncture as the sole treatment for their depression, or as a substitute or complement for medication or therapy, will depend on their circumstances, how they respond to treatment, and any recommendations from their doctor or mental health professional.
“Some [people] do not respond well to medication or therapy or acupuncture,” Walker says. “We have to take it on a case-by-case basis.”
While studies show that acupuncture can be effective for treating chronic pain, some researchers have argued that improvements could be attributed to a placebo effect.
As research from 2019 points out, there may be a minimal difference in improvements in chronic pain from acupuncture versus “sham acupuncture” (acupuncture performed incorrectly), suggesting that acupuncture may have a “mega-placebo effect.”
At the same time, a 2020 research review found that acupuncture treatment for insomnia in people with major depressive disorder was effective, but not because of a placebo effect.
Rather, the review noted acupuncture significantly improved sleep quality in people with depression, compared with sham acupuncture.
Acupuncture is recognized as a safe alternative or complementary treatment for depression with few side effects. In general, there are no concerns with acupuncture and medication interaction.
The most common side effects include:
- soreness at the needle site
- slight bruising or bleeding at the needle site
- fatigue or lightheadedness following treatment
Acupuncture may be an effective therapeutic approach to treat depression when combined with medication, psychotherapy, or both.
Depending on the severity of your symptoms, acupuncture may offer a potential alternative to antidepressant medications, but it’s essential to always check with a healthcare professional first. Don’t stop taking any medication without their go-ahead.
Acupuncture treatment can be pricey, but many clinics offer sliding scale or community pricing. You can also check with your insurance provider, if you have one, to see whether acupuncture treatments are covered.
When looking for an acupuncturist, be sure they’ve obtained appropriate licensure.
“Acupuncture can be used as a safe, supplemental treatment to standard care,” Walker says. “It’s probable that the combination of medication, therapy, and acupuncture provides the best outcomes.”
Still, keep in mind that it ultimately depends on what works best for you.