As many of us transition back into private practice, I have received numerous comments from practitioners regarding the noted mental health impact of the coronavirus on today's patients. The uncertainty and nagging anxieties caused by fear of the pandemic and its second-round effects (on employment, income, social and political stability, etc.) have not gone away, and the psychological impact of the pandemic has become even more apparent.1
According to a recent poll, more than 50 percent of American adults say COVID-19 has taken a toll on their mental health and psychological well-being.2 Even Michelle Obama revealed she was experiencing "low-grade depression" caused by the effects of the confinement and the deteriorating political climate exacerbated by the pandemic.2
Neuropsychiatric disorders, including trauma-related depression and anxiety, have long been treated by acupuncture and Chinese medicine. According to TCM principles, there is no dualism between the body and mind and therefore, no hierarchy of somatic and psychological symptoms. In essence, TCM views the body, mind, emotions and spirit as one. Numerous clinical reports from various sources attest to the efficacy of acupuncture for depression, anxiety disorders, schizophrenia and Alzheimer's disease.3
Relevant Organs / Meridians
We are trained to treat the root cause of trauma related to life's turmoil, as it is imbedded in the pattern recognition, diagnosis and treatment of qi, blood and fluids as they influence and are influenced by the elements, organs and meridians. In TCM, the heart and kidneys are commonly associated with emotional well-being. According to classic texts, when the heart is strong and healthy, the mind is calm, focused and relaxed. When out of balance, restlessness and agitation cause nervousness, anxiety and/ or panic.
The mind (shen) is also housed in the heart and is dependent upon its proper functioning. Inability to concentrate, mental fogginess or confusion is an indication of a deficiency of heart qi or blood. In concert with the heart, TCM relates anxiety to a loss of balance between the heart and kidney. When there is too much heat in the heart, it will affect the water aspect of kidney. When kidney water is unable to contain heart fire, heat rises to the mind and anxiety ensues.
Additionally, confusion, worry and lack of stability can be addressed by treating the spleen. If there are signs of desolation, sadness and grief, treating the lungs is beneficial. Anger and frustration turned inward (self-loathing) or outward (jealously, resentment) can be addressed by harmonizing the liver.
In a 2019 observational study, Moiraghi, et al., observed adult patients with earthquake-related post-traumatic stress. According to study findings:4 "Of the patients, 68.3% reported had both pain and psychological symptoms. The most frequently used meridian points were Kidney (13.17%), followed by Large Intestine (12.46%), Spleen (12.04%) and Gall Bladder (10.34%). After 3 treatments performed in daily sessions, 54.05% and 60.6% of patients reported marked improvements in psychological and pain symptoms, respectively."
Auricular Acupuncture
When treating trauma, adding ear acupuncture points can be extremely beneficial.5 The practice of auricular acupuncture is referenced in one of the oldest Chinese medical texts, Yellow Emperor's Classics of Internal Medicine. In the 1950s, French physician Paul Nogier spread the benefits of auriculotherapy throughout Europe.
Ear acupuncture points are divided into three categories: master, functional and body. Master points can be used to complement other auricular acupuncture points or can be used as a sole treatment. Master points have been described as the most active and useful points on the ear.6 Adding the two master points, shen men and the cerebral point, into clinical treatment facilitates both immediate and long-term results.7
Shen men: Tranquilizes the mind and to allow a harmonious connection to one's spirit. This master point alleviates stress, pain, tension, anxiety, depression, insomnia, restlessness, and excessive sensitivity. Utilized as one of the first points emphasized for the detoxification from drugs and the treatment of alcoholism and substance abuse, it is generally added into most treatment plans, including auricular acupuncture analgesia for surgery.
Master cerebral: The part of the cerebral cortex that makes decisions and initiates conscious action. Stimulation of this auricular point diminishes nervous anxiety, fear, worry, lassitude, dream-disturbed sleep, poor memory, obsessive-compulsive disorders, psychosomatic disorders, and negative, pessimistic thinking.
Practice Pearls
As emotional well-being (feeling good internally) and medical well-being (being free from illness) take center stage, TCM has the potential to play a significant role in today's health care climate. Studies show that acupuncture therapy is effective improving emotional and mental well-being and ease symptoms associated with specific mental health disorders, such as anxiety and depression. TCM principles integrate well with other systems, including Western medicine, and are often included among integrative medicine. TCM modalities offer an effective theoretical basis for assessing and clinically managing patients presenting with mental health issues.
Editor's Note: Ask the Expert! If you would like your questions or comments addressed this column, please send them to: info@hamptonsacupuncture.com (put "Ask the Expert" in the subject line).
References
Chronic pain afflicts over 20% of the adult population. Sadly, most MDs have essentially no education in treating pain, beyond offering a few toxic medications. Then they tend to steer people with pain away from those health practitioners who are trained. This puts the acupuncture community on the front lines for addressing this epidemic.
When the body is going through a stressful event, the sympathetic system is activated. This activation will help the body with a life-threatening situation. If this state is activated for prolonged periods of time, it starts to consume energy. These traumatic events that generate stressors in the autonomic nervous system (ANS) will eventually become internalized.
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One of the things that makes acupuncture so difficult to measure is that the medicine actually does contain some esoteric aspects. There have been numerous studies that demonstrate the neurochemical reasoning behind why acupuncture points stimulate the autonomic nervous system to enact change However, not all the benefits of TCM can easily be measured by randomized, controlled trials. But does that make them fundamentally and definitively untrue?
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