Stress & Emotional Conditions (such as Anxiety, Depression, Insomnia)

THE SEVEN EMOTIONS: Internal cause of disease.

Emotions occur in everyday life as normal reactions to external events, good and bad.  When these emotions become extreme or are missing all together, they are seen as pathogenic factors and the precursor to internal disease.

According to apart of the 5 element theory in Traditional Chinese Medicine, seven defined emotions are linked to five major organs of the body. Any upset in a persons emotions (excess or deficient) or natural flow of qi, can affect it’s corresponding organ respectively. Below is a summarized explanation of this. By scrolling further to the bottom, you will see just HOW acupuncture manages emotional disorders from a western medicine pathophysiological perspective.

Emotion                         Corresponding Organ                        Details

Joy                                     Heart                                                       Joy (xi). Associated with the heart, it is a very beneficial emotions as it encourages the circulation of qi &blood. On the other hand, an excess of the joyful emotion to the point of being over- exuberant is seen as verging on mania. An example of this could be bi-polar disorder.

Anger                                 Liver                                                      Anger (nu). Extreme  or ongoing feelings of anger take it’s toll on the Liver’s important function of storing the blood & regulating the qi. When the flow of liver qi is disrupted, it upsets the communication between vital organs and overall circulation and directions flow of qi & blood creating a snowball effect of disharmonies.

Symptoms typical of disruptive ascendant Liver qi include, irritability, dizziness, headaches, flushed face, red eyes and a bitter taste in the mouth. Symptoms may also include feelings of suffocation and depression. An example of this can be related to pre- menstrual syndrome and menstrual irregularities in women. Normalising Liver qi is an important approach in treating various gynecological problems.

Sadness                           Lung                                                      Sadness (bei). The lungs are linked to feelings of excessive melancholy interrupting the normal flow of Lung qi and progressing to stagnation with feelings of oppression in the chest and depression. When Lung qi becomes stagnant for too long, it can lead to fire, harming the giving & receiving of its vital essence and qi to the Spleen. Examples of this disruption would cause digestive problems with loss of appetite, insomnia and weight loss.

Worry                               Spleen                                                   Worry (si), pensiveness and over-thinking are linked to the Spleen. Damage to Spleen qi effects the distribution of nutrients and water through the body. Pensiveness originates from the heart and governs concentration. Therefor prolonged overthinking can lead to stagnation of Heart qi. Some examples of this are seen in people with anxiety, sleep disturbances, forgetfulness and in severe cases, dementia.

Fear                                   Kidney                                                    Fear (kong). Fear injures the Kidneys by causing the normally upward flow of Kidney qi to reverse and descend. This leads to lumbago, increased urination, incontinence, lethargy, listlessness and a desire for solitude. In woman it can cause excessively long periods & irregular menstruation. Bed wetting in children can also be explained in these terms with severe shyness, insecurity, or timidity leading to internally generated fear, which in turn causes incontinence.

Grief                                  Lung                                                         Grief (you). The Lungs are responsible for controlling the qi flow throughout the body. Therefor like sadness, if there is excessive grief say from a recent death of a family member, this can result in a more generalised qi stagnation throughout the body with reduced functionality among the internal organs.

Fear differs from shock or Fright, in that Fear originates from timidity within the body – linked to reduced internal organ functionality whereas Shock comes from external sources. It manifests with symptoms such as pallor, breathing difficulties, a sensation of suffocation in the chest area, lethargy, depression, constipation and difficulty urinating and frequent sighing. Breathing problems and bronchial asthma are frequently connected with this.

Shock / Fright               Kidneys & Heart                                  Shock (jing). Shock is due to external factors rather than internal and can be described more like a state of panic than an internal nagging fear. It firstly impacts the Heart qi and sends it loosly translated as ‘wandering frantically’ in the body. Symptoms include strong & continual palpitations, mental restlessness, cold sweats & a tendency to be easily startled. In western medicine, this could be labelled as a ‘panic attack’.

A final note on the summary of Chinese medicines perspective on the seven emotions. Look after you Heart & Liver. The Heart plays a pivitol role in emotional disorders because it houses the consciousness & governs all of the major organs. Emotional stimuli attack the Heart first before moving on to the associated organ.

The information above shows the impact of different emotions on the body, specifically the disruption of the normal flow of qi. Anger causes qi to flow upwards while Fear causes it to descend and Worry leads to qi stagnation. Both the Heart & Liver are especially susceptible to emotional disorders.

INSOMNIA

Norepinephrine, GABA, endogenous opiates and melatonin are all neurotransmitters involved in sleep and can be manipulated with acupuncture. A realm of evidence-based research demonstrates improved sleep patterns where acupuncture influences nervous system activity by decreasing cardiac sympathetic (flight or fight) and increasing parasympathetic (relaxation) activity. This translates into calming, relaxing effects on the body. In particular, the acupuncture points HT-7 and PC-6 have shown to have the most significant response to insomnia relief, you might have experienced your acupuncturist needling these points on you before as they are very effective and common.

GABA is a calming neurotransmitter. It’s increased levels and activity in the brain is associated with sedative effects and the relief of insomnia. Some sleep medications are based on their ability to increase the effectiveness of GABA in the brain for this reason. Acupuncture significantly increases GABA levels as well as increasing availability of its cellular receptors. This in turn improves the body’s ability to utilize GABA, decrease the severity of insomnia related sleep disorders and best of all – it’s achieved naturally!

Melatonin is a more widely known, naturally occurring hormone produced in the pineal gland and released into the blood, which helps regulate sleep and wake cycles. Melatonin levels rise sharply in the blood around 9pm where you begin to feel less alert and sleep becomes more inviting. Daytime levels are barely detectable & even artificial light can inhibit it’s release which is why our body’s are so affected by jetlag or shift work disorder. Acupuncture has been clinically shown to increase the secretion of melatonin, in a particular study showed a significant cumulative increase after five weeks of treatment. This was also associated with improved sleep and reduced anxiety.

Various acupuncture points may be use in the treatment of insomnia. Even with a single acupoint such as HT-7, a wide range of neurochemical changes associated with insomnia relief can be measured clinically.

DEPRESSION

Clinical research shows that acupuncture can measurably influence non-opiod neurotransmitters such as serotonin and gamma-aminobutyric acid (GABA) – both of which have known functions for mood and energy regulation in the brain and body.

Acupuncture has the ability to affect these neurotransmitters by causing an increase of serotonin receptors in the cerebral cortex. This enhances the availability of serotonin as part of its mechanism in relieving depression. With the addition of electro acupuncture in depressed patients, acupuncture lowers abnormally elevated cortisol levels – a stress related hormone with complex effects on the body, creating a relaxing effect.

The effects of acupuncture have also been tested by using a known brain peptide called glial cell-derived neurotropic factor (GDNF) which is associated with depression. Acupuncture was shown to provide a faster onset of action for relief of, better response rate and a better improvement rate then SSRI selective serotonin reuptake inhibitors (SSRI anti-depressant pharmaceutical medications).

Just a side note here:- SSRI’s are still found to be effective for the treatment of depression at some level. As a professional, I personally never recommend taking or discontinuing any medications or in anyway discounting another medical doctors advice and treatment plan. Evidence based research shows that Acupuncture & Chinese Medicine has fantastic results working standalone or alongside other medical doctors and allied health practitioner treatments.

ANXIETY

Anxiety is closely associated with depression and many people suffer from both alternately or simultaneously. Physiological changes in these two conditions seem to be related, including levels of serotonin, GABA and HPA axis hormones. Acupuncture demonstrates measurable changes in levels of these neurotransmitters, just as it has in depression studies.

It improves levels of multiple anxiety- related chemicals in the body, including cortisol and the limbic-paralimbic-neocortical network of the brain in imaging studies, confirming its anti-anxiety effects.

Related references and research:
Acupuncture Revolution: The Science and Healing Power of Acupuncture. Janet Humphrey (2015).

Acupuncture for Treating Anxiety and Depression in Women: A Clinical Systematic Review.
Med Acupunct. 2013 Jun; 25(3): 164–172. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3689180/

Acupuncture for Treatment of Insomnia: A Systematic Review of Randomised Controlled Trials. J Altern Complement Med. 2009 Nov; 15(11): 1171–1186.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3156618/

Liang XM. Clinical Observations on the Therapeutic Effect of Ear Acupoint Thumbtack Needle Embedding on Senile Primary Insomnia [J]. Shanghai Journal of Acupuncture and Moxibustion, 2017, 36 (6).

Ye GC & Yan H. (2014). Therapeutic Observation of Acupuncture for Depressive Insomnia. Shanghai Journal of Acupuncture and Moxibustion. 55(6).

Lin-Peng Wang, Guo, Jing, Cun-Zhi Liu, Jie Zhang, Gui-Ling Wang, Jing-Hong Yi, Jin-Lian Cheng, and R. Musil. “Efficacy of acupuncture for primary insomnia: a randomized controlled clinical trial.” Deutsche Zeitschrift für Akupunktur 57, no. 4 (2014): 31-32.

Sheng, G. B., Li, H. & Tang, Y. (2015). Clinical Observation on the Treatment of Electroacupuncture JiaJi Acupoint Therapy Combined with Scalp Acupuncture for Generalized Anxiety Disorder. Journal of Clinical Acupuncture and Moxibustion. 31 (5).

Wang, W., Zhou, G. B. & Yu, Z. S. (2003). Dr. Yu Zhi Shun scalp acupuncture treatment clinical experiences. China TCM Modern Remote Education. (6): 28-31.

Tian, W., Yang, N., He, Q. R., Yang, T., Cui, J. M. & Wang, H. B. (2015). Efficacy of Wrist-ankle Acupuncture plus Auricular Point Sticking for Pre-exam Anxiety Syndrome.
Shanghai Journal of Acupuncture and Moxibustion. 34 (4).

Bo, Y. & Chen, X. W. (2004). Effectiveness of Auricular Seed-pressing Therapy in Treating Secondary Pupils Pre-exam Anxiety Syndrome. Chinese Doctors. 18 (6): 541.

Tian, W., Yang, N., He, Q. R., Yang, T., Cui, J. M. & Wang, H. B. (2015). Efficacy of Wrist-ankle Acupuncture plus Auricular Point Sticking for Pre-exam Anxiety Syndrome.
Shanghai Journal of Acupuncture and Moxibustion. 34 (4).

Bo, Y. & Chen, X. W. (2004). Effectiveness of Auricular Seed-pressing Therapy in Treating Secondary Pupils Pre-exam Anxiety Syndrome. Chinese Doctors. 18 (6): 541.

Eshkevari, Ladan, Susan E. Mulroney, Rupert Egan, and Lixing Lao. “Effects of Acupuncture, RU-486 on the Hypothalamic-Pituitary-Adrenal Axis in Chronically Stressed Adult Male Rats.” Endocrinology (2015): EN-2015. School of Nursing and Health Studies (L.E.), Department of Pharmacology and Physiology (L.E., S.E.M., R.E.), Georgetown University Medical Center, Washington, DC 20007; and School of Chinese Medicine (L.L.), The University of Hong Kong, Pokfulam, Hong Kong.