The Role of Acupuncture and Herbal Medicine with Emotional Stress
With so much uncertainty in the world, following on the heels of the Covid-19 pandemic, people are increasingly struggling with conditions such as anxiety, depression and many forms of post-traumatic stress disorder (PTSD). Conventional western medicine most often treats these conditions with pharmaceuticals and psychotherapy, and while these methods can be effective for some people, others tend not to tolerate them well due to their side effects, leaving folks with very few options for treatment. As East Asian Medicine practitioners, we have so much to offer these patients, as an adjunct therapy for some patients or a stand-alone for those that can’t tolerate the side effects of western pharmaceuticals.
Without treatment the overwhelming stress that many people feel on a daily basis can eventually develop into a myriad of more serious issues, including deepening depression, anxiety, panic, irritability, insomnia, hopelessness and grief. The longer these feelings are present, the more
imbalance there is in the body, often leading to more chronic health conditions. Acupuncture and herbal medicine can provide great relief to people that suffer emotionally. The most common patterns we see with depression and anxiety are:
- Liver Qi and blood stagnation with Spleen qi deficiency.
- Liver Qi and blood stagnation with Spleen qi deficiency with heat.
Acupuncture and herbal medicine can provide great relief to people that suffer in this way.
One of the more researched formulas for emotional imbalance resulting in depression and anxiety is Xiao Yao San and it’s modified form Jia Wei Xiao Yao San also known as Dan Zhi Xiao Yao San. Xiao Yao San is made up of the following herbs:
- Chai Hu (Rx. Bupleuri)
- Dang Gui (Rx Angelicae Sinensis)
- Bai Shao (Rx. Paeoniae)
- Bai Zhu (Rz. Atractylodis Macrocephalae)
- Fu Ling (Poria)
- Zhi Gan Cao (prepared Rx. Glycyrrhizae)
- Wei Jiang (Rz. Zingiberis)
- Bo He (Hb. Menthae Haplocalycis)
Xiao Yao San (XYS) releases constraint of the liver, spreads the liver qi, strengthens the spleen qi and nourishes the blood. Jia Wei Xiao Yao San (JWXYS) has the same herbs as Xiao Yao San with the addition of 2 herbs and a different form of ginger:
- + Mu Dan Pi (Cx. Moutan)
- + Chao Zhi Zi (dry-fried Fr. Gardeniae)
- +Sheng Jiang (Rz. Zingiberis)
JWXYS is for liver constraint with spleen qi deficiency accompanied by heat symptoms such as irritability, short temper, sweating, palpitations, red, dry and irritated eyes. Fever is not present with this type of heat.
In a study of 26 randomized controlled trials including 1,837 patients with depression, both XYS and JWXYS combined with antidepressants were found to be superior to antidepressants (selective serotonin reuptake inhibitors, trycyclics and/or tetracyclics) alone in alleviating depression based on the Hamilton Depression Rating Scale (HAMD). (https://ascopost.com/issues/april-10-2022/use-of-traditional-chinese-medicine-herbal-formula-xiao-yao-san-to-relieve-depression-and-anxiety/ )
Studies have shown when XYS or JWXYS have been used alone or in conjunction with antidepressants that the herbal formulas have lessened the side effects of the pharmaceutical drugs used to treat depression and anxiety. Another study with JWXYS proved to have similar improvements as the drug Sertraline for treating patients that suffer from anxiety and depression and people that took JWXYS alone experienced fewer side effects. Another small study suggested that sleep was also improved among subjects when using JWXYS alone or with Benzodiazepene. (https://www.ons.org/publications-research/voice/news-views/01-2022/what-evidence-says-about-traditional-chinese )
Acupuncture is generally prescribed along with the above herbal formulas. Below are some points to choose from when treating the 2 different patterns.
- Acupuncture with the use of XYS for depression- Du 20, Liv 3, Li4, PC6, Bl18, yin tang
- Acupuncture with the use JWXYS for depression and anxiety- Du 20, Liv3, Li4, Liv 2, PC6, Bl15, Bl18, Bl 44, yin tang
- Auricular Acupuncture points- heart, spleen, liver, sympathetic, point zero
In China, XYS and JWXYS are commonly used alone or integrated with conventional medicine for the best outcome for the patient. For patients who experience negative side effects from western pharmaceuticals, the combination of herbal formulas and acupuncture offer the likelihood of positive results.