Does Acupuncture for Depression Work?

Jonathan Clogstoun-Willmott

May 4, 2020

Key Learning Points

When symptoms match a Chinese medicine syndrome, acupuncture greatly helps
Not much research, and mainly on ‘melancholic’ depression, for which acupuncture worked well
Depression often comes with other problems – helpful in diagnosis and would also improve with acupuncture
What you can do to help yourself

Acupuncture for Depression

In traditional Chinese medicine, treatment for ‘depression’ is a short-hand for a wide range of syndromes. Syndromes are descriptions of conditions in Chinese medicine.

Before starting treatment for depression, the acupuncturist would carefully take your case. What that means is you tell him your problems.

Then he would:

take your pulses
look at your tongue
examine painful areas
palpate your abdomen and
consider the results of previous treatments on the flow of Qi along your acupuncture channels.

(There’s more about this further down the page.)

Diagnosis via ‘Syndromes’

To help him plan your treatment he would then diagnose your condition in terms of syndromes. You could easily have more than one syndrome.

The following are only examples of what might be diagnosed. There are many possibilities and it’s not a complete list.

By the way, if you’re unfamiliar with Chinese medicine, the list won’t mean much, but still, here it is. In most cases by clicking on the syndrome you get to another page which explains it:

Qi stagnation
Qi deficiency, including Stomach Qi deficiency
Damp
Liver Qi stagnation
Lung Qi stagnation
Weak Shen
Gallbladder deficiency
Yang deficiency
Blockage (‘Bi’ syndrome) in a channel
Kidney and/or Jing deficiency
Pericardium deficiency or blockage

In addition, if you were in China you might need ‘re-education’. In the West we might call this counselling, but in the past some might have described it more like brain-washing. To be fair, however, the aim was to make society work better, and only secondarily, perhaps, to control dissent.

As you can see from the above list, there are many possibilities. Each requires a different acupuncture strategy, with different points.

Of course, the personalities of the patient and acupuncturist matter, but probably more in the West than the East, where the authority and skills of the acupuncturist matter more.

Still, if the diagnosis is correct and the acupuncture treatment for depression is performed properly, the syndromes in question should be put right, together with the ‘depression’.

For more on this click on acupuncture for depression points.

Qi stagnation is very common in depression. You can read my book about it below.

How Fast will Acupuncture Work?

If your condition is recent, mild, and easy to diagnose in Chinese Medicine, then the correct ‘acupuncture for depression’ treatment works fast: possibly very fast – in minutes perhaps.

What if you’ve had depression for years, been on many drugs, seen many specialists, and you feel suicidal? Here acupuncture for depression like yours will probably work only slowly. That’s not to say it won’t work, but it may take at least a year to see lasting progress.

But let’s not get gloomy.

The problem is this. There isn’t a specific acupuncture for depression treatment that would apply to everyone with depression. Even Western medicine chooses the medication according to the diagnosis, so nothing new there.

The difference is that in reaching the diagnosis in Chinese medicine, virtually every known symptom and factor about the patient might be needed to reach a diagnosis: probably far more than in Western Medicine. Also, you can only understood one symptom in relation to other symptoms: they aren’t separate – they work all together making the patient unique.

Been depressed? Not fun, is it? Admittedly few of us die from depression, at least compared to heart, circulatory and respiratory diseases. Still, depression and anxiety-like disorders affect 1 in 6 of us every year. That could be every sixth person in the street!

At least 2 out of every 100 people you know probably suffer from depression, and if anxiety is included, it’s up to 1 in 10 for men, and over a lifetime, it’s one in five for women. That’s a lot of misery.

And it’s costly too. The cost of depression to the economy exceeds that of high blood pressure and diabetes put together, and it affects relationships, work, and personal self-worth.

Acupuncture for depression, when used appropriately, could re-energize so many lives.

Symptoms

Western medicine diagnoses major depression when at least five out of nine possible symptoms occur daily during a given two-week period and are different from previous behaviour and functioning.

There has to be, in addition to five or more of the conditions listed below, a state of depressed mood every day, with loss of pleasure in almost all or all activities.

Insomnia (sleeplessness) or hypersomnia (can’t stop sleeping)
Fatigue, or feeling of worthlessness: loss of energy
Either weight loss (not due to dieting) or significant weight gain (over 5% of body weight in a month), with either a decreased or increased appetite every day
Recurring thoughts of dying or death or suicide
Reduced ability to think or concentrate, and indecisiveness
A sense of excessive guilt, or inappropriate guilt
Psycho-motor agitation or retardation nearly every day

Obviously, these symptoms should not arise from taking drugs or from a medical condition. Also, the symptoms must interfere or cause distress in terms of work or friendships (for example).

Co-morbidity of depression with other mental disorders

Like buses, problems don’t usually come alone. They come hand-in-hand with other problems, or one after the other. (In fact, in the USA, they did a National Co-morbidity Survey which concluded that having just one mental disorder was less common than having at least two together.) If depression comes with other problems, it may be harder to treat, whatever therapy is used.

For example, depression often accompanies dependence on alcohol, or panic disorders, or anxiety disorders, or what is called ‘borderline personality’ disorder.

Also, if you have a serious or chronic medical condition like cancer or stroke, diabetes or prolonged pain, you are more likely to suffer from depression.

When there is this co-morbidity, it could be because:

You have a long history of depression, or the depression arises from something other than the medical condition
You get depression as a reaction to the medical condition and the problems it gives you
The medical condition has a physiological effect on you causing depression.

What are the causes of Depression?

Why do people get depressed, and when might acupuncture treatment for depression work?

There are lots of scientific theories about the causes of depression and there are lots of possible causes in Chinese medicine too. Few patients have just one absolutely clear cause. Often there is both a psychological and a biological cause.

First, what does Western orthodox medicine suggest might be the causes of depression?

1 – Biological

- Daily cycles: depressed people show signs of disturbance of their daily cycles. They find they can’t get up in the morning, or they can’t sleep at night, or they can’t eat at their usual mealtimes, or they can only work in the middle of the night.
- Shifting patterns It’s also known that shift workers, or those whose work is sometimes at night and sometimes in the day, are more prone to depression.
- A trigger, such as a shock or separation. Sometimes a trigger for depression occurs when something on which the patient depended is removed. A spouse dies, or a job is lost: either would have made the patient get up at the usual time, eat breakfast, go to work and return in the evening for more food and social interaction. Without the wife or the job, the impetus to carry on normally is lost, which can be the trigger for depression: not looking after himself properly, the patient becomes depressed.
- Genes play a part in several kinds of depression. If someone in your biological family has bipolar disorder, you are more likely to have it yourself – although this is not a foregone conclusion.
- Serotonin Regulation Serotonin, a neurotransmitter (not a hormone), helps you feel good and maintain a good appetite and digestion. It constricts blood vessels as wounds clot, and helps in learning and memory. Research suggests that when serotonin regulation system goes awry, you may show symptoms of depression. So they give Selective serotonin uptake inhibitors (SSRIs) (eg Prozac) to regulate your serotonin levels and get you feeling better. One of the ways to increase your levels of serotonin is by increasing exposure to light, especially sunlight. (See more on this below under forms of Qi that help.)

2 – Psychological factors

- Social skills If you haven’t got supportive friends, family, or colleagues who can help to keep you stable, you are more susceptible to depression. The main supportive person is often a close family member, or spouse. Even good support from others may not make up for the loss of that important individual.
- A sense of Helplessness If you don’t feel you can improve your situation no matter what you try, you’ll tend to get depressed. This can happen when you are in an uncontrollable situation. Also if you realise that whatever you do, it will make no difference. The problem is worse if you develop this attitude in one situation but then apply it to all your situations. For example, if work imposes impossible demands on you and you start to feel helpless, you may start feeling helpless in your relationships outside work, even though no such problem exists there.
- Cognitive causes Here, you stop being able to look at things from more than one point of view. You become biased negatively and apply this attitude to everything that happens.

3 – Male/Female

There’s a difference between how men and women deal with depression.

Men often become more active, by doing more, working harder, taking more exercise – sometimes self-destructively.
Women tend to internalise it and do less physically, which makes them ponder their situation alone and to take less action. This brings up old, unhappy memories which reinforce seclusive habits and the tendency to depression.

Orthodox Treatment for Depression

Medication

Drug treatment for depression means anti-depressants like Tricyclic medications, SSRIs and (still) MAOI (Monamine oxidase inhibitors) antidepressants. All have side-effects, though so far SSRIs seem to have less of them.

For severe cases, ECT – electro-convulsive therapy is still used in some countries.

Psychological treatment for depression

Cognitive therapy is the treatment of choice, although as explained above, other forms of psychological counselling have their part to play.

Often a combination of approaches is used.

For more on the psychological aspects check here.

Results of Orthodox Treatment for depression?

What are the results from treatment with ‘orthodox’ medicine?

Frankly, not too bad,

if you stick to it,
it’s the right treatment for you with no unpleasant side-effects and
you haven’t been depressed for too long.

BUT! Not many people like it. They find the medication has unpleasant side-effects or they drop out of treatment before it completes. Others apparently recover then relapse unexpectedly.

So, although it seems to work, its reputation long-term is not good. The USA National Institutes of Mental Health researched treatment which showed that between one-third and two-thirds of participants had no real symptom relief.

(Just to repeat: if the original condition was mild, and had persisted for less than two years, then the right medication might be very effective and not lead to relapse. That still doesn’t cover the problem of the side-effects, however.)

Comparisons …

Overall, comparisons of the results of the newer SSRIs (Selective serotonin uptake inhibitors) and the older TCAs (Tri-cyclic Antidepressants) shows that the former are about as effective as the latter. About one third of patients on them show improvements that would not have occurred while on placebo. For the second one-third of patients the drugs work about as well as placebo and for the final one-third of patients the drugs don’t work at all.

Similar analyses of results show that psychotherapy is, overall, about as effective as drug-therapy. What is more, although drugs may start to work faster, patients on psychotherapy don’t have drug-induced side-effects, they relapse less, and may be better when the reason for the depression isn’t internal. This applies if you get depressed because of work difficulties, not because of a sense of worthlessness that was there beforehand.

Relapse in the long-term

In the short-term, medication treatment for depression works quickly, if it works at all. (But it still takes several weeks to work, usually.)

If after a period of medication, you stop taking it because you feel better, or continue to take it in a smaller ‘maintenance’ dosage, what do surveys show you can expect?

Not so good. Up to one-third of patients who did well on initial medication fall back on continued medication. Long-term, with some drugs, the relapse rate is up to 70%. So once you have depression, it tends to recur. And cognitive or inter-personal therapy seems as good as anything at preventing relapse.

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What Happens when you have Acupuncture for Depression?

Acupuncture for depression treatment starts with a diagnosis. In reaching a diagnosis, your acupuncturist would consider not just your history and symptoms, but also your skin colour (we don’t mean racial colour, but hue arising from the blood underneath), the sound of your voice, your pulse qualities, your skin odour; even previous health conditions that appeared to have no connection might be important, and so on.

People who share a Western diagnosis, such as ‘depression’, might be diagnosed with a combination of patterns of disharmony in Chinese medicine.

Each such disharmony might require a different treatment, and it’s up to the skill of the acupuncturist in preparing a treatment to prioritize and harmonize treatments to suit the patient. There’s no ‘standard’ treatment. So, there’s no straight answer to the question ‘Does acupuncture for Depression work?’

(That makes it much more interesting for the acupuncturist of course and makes him or her possibly much more open to working with the patient anew each time. You, the patient, are never expected to be the same, requiring the same treatment as last time. You are seen as dynamic, changing, and your acupuncturist must adapt each time: much more interesting for your practitioner! The correct acupuncture for depression treatment for you is a new challenge every time.)

Research on Acupuncture for Depression?

Not much, as yet. It’s costly to do, takes ages, there aren’t enough people doing it, and what’s been done is in Chinese or Russian.

Still, there are abstracts of this research translated into English: they suggest that from the Western point of view, acupuncture for depressive symptoms and for depression can be effective. Possibly as effective as treatment with TriCyclic Antidepressant drugs (TCAs), but without the side-effects.

Nowadays, such drugs (ie TCAs) are being replaced by SSRIs and SNRIs, (Selective Serotonin Reuptake Inhibitors and Serotonin-Norepinephrine Reuptake Inhibitors) which don’t have such unpleasant side-effects: at least, not so far. But plenty of people are still prescribed TCAs.

Click here for an overview of research

Those Russian and Chinese trials really only tested acupuncture for ‘melancholic‘ depression. This is quite a severe form of depression, usually requiring antidepressants, psychotherapy in a supportive role, and sometimes electro-convulsive therapy, depending on which country you live in.

Also, bear in mind that to test this they had to use a strict protocol of acupuncture points, rather than adapting the treatment to the patient’s individual needs. That limits acupuncture ability to help. That’s because a strict protocol means they use the same points on everyone, whether or not a skilled acupuncturist would use them.

What are the symptoms of melancholic depression?

The symptoms of melancholic depression often include weight loss, inability to find pleasure even in positive things, sleeplessness and/or waking in the early morning, and psychomotor agitation or retardation.

(What’s Psychomotor agitation? This is when, because of mental anxiety or tension, you show unintentional or purposeless motions, like repeatedly rubbing your hands together, or picking at things, or taking off then putting on clothes, or pacing around: even chewing fingernails or lips until they bleed. Retardation is when your thinking processes slow down and you move less: you react and speak more slowly.)

Where Acupuncture for Depression Doesn’t Work so well

Where acupuncture for depression seemed less effective (in the few trials undertaken), was with anxious and apathetic depressions or where there was psychosis.

That doesn’t mean acupuncture can’t help these conditions, but that the strict treatment protocol, with prescribed acupuncture points, that worked on melancholic depression wasn’t effective in these other kinds of depression. But then, you’d hardly expect them to, would you?

After all, if you’re making pudding, you can use fire, water, freezing, baking, stirring and whizzing (to name a few methods). But if someone said they’d tested all these and the only ones that worked were stirring and freezing, you’d be a bit surprised, until they said they were making ice-cream. So it is with depression: acupuncture protocols that work for one kind won’t necessarily work for another!

In other words, the points which work for melancholic depression aren’t the same as the points which work on anxious depression. So, really, they weren’t trying to see if acupuncture worked on other kinds of depression.

As I said earlier, the acupuncture for depression points have to be chosen according to the particular symptoms of the patient. There is no one-size-fits-all, even for melancholic depression.

As mentioned above, that means that each patient treated with acupuncture in those trials might have fared much better if acupuncture points had been chosen appropriate to the individual patient’s condition, instead of a fixed group of points, same for everyone, making results easy to compare.

Qi in Treatment for Depression

Now for a bit of theory that helps you understand how you can help yourself.

From the point of view of Chinese medicine, everything we are and can know about is a form of Qi.

The word ‘depression’ suggests a lowered state of vitality, which means a lowered state of Qi.

Raising your Qi level is therefore important in nearly all forms of treatment for depression! Some forms of lowered Qi, especially those from Qi Stagnation, get depressed because there are two warring factors at work in your mind or body.

Put it this way. A country in a state of civil war will be less able to defend itself, let alone effectively counter-attack an invader.
Alternatively, try holding your hands out in front of you. Now press them together with all your might. While doing that, you will have less energy available to do other things.

The Qi Stagnation type of depression is like that. Your body goes into a state of civil war, lowering your Qi. If that internal ‘struggle’ can be resolved, even temporarily, (acupuncture is very good at this!) then you may be able to stand back and reassess your situation.

More important, you’ll be more relaxed and you’ll certainly have more energy!

Raising Qi – Treatment for Depression Self-Help

If Qi is depressed or deficient, there are many ways to raise it (assuming it’s not due to Qi Stagnation, see above, or as described in my book, below).

Here are some of the best ways you can give yourself a treatment for depression:

Yang factors

Light: natural if possible, and sunlight in particular. If you live in climates that get little sunlight, think about using light-bulbs that emit light at the same frequencies as sunlight (‘full-spectrum’ light).

Inspiration for Yang Deficiency the Book — The Sun – Photo by Daoudi Aissa on Unsplash

If you can’t get good light – see above – consider a tanning bed, but take care to choose the right kind, which has an electronic ballast, not a magnetic ballast. Magnetic ballast sunbeds often make a loud buzzing and emit electromagnetic wavelengths that may dangerous. Also, important, is that it should emit UVB light which stimulates the production of Vitamin D in your skin, whereas while UVA light tans you, it also burns you. However, if you use sunlight or the tanning bed to get the benefit you need, don’t shower too soon afterwards, because the vitamin D is manufactured on the surface of your skin, and showering would wash it off. Leave it there to be absorbed over the next 48 hours before showering!

Warmth and the Sun

Also, if you can’t get enough sunlight (or it is too weak for your body to make its own Vitamin D from the sunlight where you live) take Vitamin D3 or foods that contain it. If you take it as a supplement, there are other vitamins and minerals that help you absorb it better, including magnesium, vitamin K2, boron, zinc and vitamin A and healthy fats including animal-based with the emphasis on omega-3 fats … a good, varied, diet comes to mind! … How much Vitamin D3 to take? Answer: enough to keep your vitamin D blood levels at 40 – 60ng/l, and the only way to find that out is to have a blood test. Serious and respected researchers in the field often take 3000-5000 IUs of D3 pd. Healthy D levels will boost your immunity and inhibit many diseases. Take vitamin K2 at the same time. (Look it up! Too complicated to explain here!) But sunlight is definitely best, if you live in a climate and at a latitude where you can get enough daily.
Warmth: if you are cold, you won’t be able to digest food, nor move around properly – see exercise, below. Warmth is a form of Qi, dispelling cold. Cold slows and drains Yang Qi. So, for most people, warmth makes a good treatment for depression. In fact, recent research backs this up! I found an article quoting research saying that hot baths in the afternoon twice a week raised the spirits of depressed people. (But I doubt this would work for all syndromes causing depression.)

Humour is a yang factor

Laughter: watch films that make you laugh. The act of laughing increases and spreads your Qi. Read books by funny writers.

“If ever tempted by depression I repeat three things to myself: I am an Englishwoman. I was born in wedlock. I am on dry land.” Blanche Warre-Cornish

Yin factors

Food Depressed people often eat either the wrong food, or they don’t eat enough food, or they eat it the wrong way. The wrong food or diet gives your body the wrong treatment for depression! Your body needs good food, at the right temperature and eaten right, to make Qi and Blood. Recent research also showed that a wide range of foods is important to provide the resources your body needs to produce the right ‘positive’ chemicals in your brain. So if having vegetables, have many different kinds, not just the same kind, let us say, of cabbage everyday. Don’t forget warm drinks as well as warm food.

Friendship often assists acupuncture for depression — Photo by Roberto Nickson on Unsplash

Support: friends, especially those who make you laugh. Both friendship and laughter circulate your Qi, giving you exactly the right kind of treatment for depression.
Take up meditation. It’s not hard to learn, it doesn’t take long to do, and if you do it regularly, say for ten minutes every day, over time you may find it changes the whole way you think. For a method that has helped millions of people for thousands of years click on meditation. (By the way, I didn’t say it was easy to do right, but you’ll soon learn!) Done right, it helps your Qi flow more smoothly.

Stop destructive stuff

Reduce or stop any medication or drugs you take – not strictly a form of Qi, but a way of avoiding bad Qi – but do this only with the support of your medical advisers, and don’t overlook how they were trained and are paid in deciding where their interests lie. Medications take energy to break down in your body; also they introduce toxic compounds that your body has to clear out. All that reduces your Qi.
What about smoking? These are also medications, just socially accepted ones. They also have detrimental effects, like any medication, but in small quantities can temporarily help to un-stagnate Qi. There’s the problem! Once you’ve had one, you need another to keep you feeling mellow. Then it can be difficult to stop.
What about alcohol? Like smoking, the drug is socially acceptable. It is relaxing. iI helps to ease the flow of Qi. What’s not to like? Well, the tendency not to be able to stop, for one thing; the side-effects; dependency; cost; effect on family and friends. As you know, just about everything is great within limits. Unfortunately, like smoking, those limits are hard to maintain, especially if you become depressed.

Move Qi

Exercise: physical movement that gets you out of breath and makes your heart pump faster has a hugely beneficial effect on your endocrine glands, including those that help you to be cheerful. As you age, don’t reduce the exercise you take, and make sure that the exercise you take includes not just movement to make you out of breath, but exercise to maintain your strength. Exercise also helps you to keep your appetite. Exercise moves your Qi and helps to increase it: wonderful as a treatment for depression, especially the kind caused by Qi stagnation!
Dancing is rhythmic and enjoyable, and definitely moves your qi!

Massage moves Qi, assists acupuncture for depression — Photo by Emiliano Vittoriosi on Unsplash

Get some massage! Massage is a great way to move your Qi. All you need to do is just lie there!
Acupuncture: this site explains how Chinese medicine and acupuncture can help you feel better. Chinese medicine is probably 3000 years old. Its origins came from people who lacked the benefits of subsequent thinkers and religions, but they still had moods and emotions. What they learned created the structure behind Chinese medicine, based on the concept of Qi. Is it surprising that acupuncture is an excellent treatment for depression?