Depression - acupuncture care in Warragul
Depression is a serious health disorder, ranked by the World Health Organization (WHO) in 2015 as the largest single contributor to global disability, with an estimated 4.4% of the population affected. The incidence of this disorder is rising at an alarming rate (18.4% increase between 2005 and 2015), with one in 15 adults (6.7%) experiencing depression in any given year, and one in six people (16.6%) at some stage in their life.
Symptoms can include feelings of guilt, worthlessness, sadness and depressed mood, changes in appetite, disturbed sleep patterns, weight changes and thoughts of suicide or death, persisting for longer than two weeks. There are many sub-classifications of depression listed in the DSM-V (Diagnostic and Statistical Manual 5) and the ICD-10 (International Statistical Classification of Diseases and Related Health Problems), both of which are used by medical professionals to diagnose psychological and patho-psychological conditions.
CLINICAL RESEARCH – ACUPUNCTURE
Acupuncture is considered to be a safe treatment for some forms of depressive disorders and recent research suggests there is moderate evidence supporting the effectiveness of acupuncture for its treatment. A systematic review conducted in 2015 reports that acupuncture, when used in conjunction with a standard pharmacological intervention was superior to the use of medication alone.
Whilst the mechanism of action (MOA) for acupuncture treatment of depression is not yet fully understood, there are recent novel research approaches that may provide insight into how acupuncture alleviates depressive behaviour. It is suggested that inflammation may play a role in the pathophysiology of depression[9,10], and research has shown that a combined treatment of acupuncture and fluoxetine significantly decreased the expression of pro-inflammatory cytokines (regulators of the body’s response to infection, inflammation, trauma and assaults on the immune system). Further research reveals that acupuncture (as a stand-alone treatment) alone may also have an antidepressant-like effect due to inhibition of inflammatory mediators released in the brain.
USUAL TREATMENT OF DEPRESSION
Mainstream medicine does not yet completely understand how depression develops, but recognizes that current treatments are ineffective for a large portion of sufferers. The usual care of this disorder primarily involves some form of pharmacotherapy which is recommended as the first-line treatment option for a major depressive episode1. There are many types of medications to choose from, including selective serotonin reuptake inhibitors (SSRI’s); serotonin-norepinephrine reuptake inhibitors (SNRI’s); tricyclic antidepressants (TCA’s); monoamine oxidase inhibitors (MAOIs); atypical antidepressants and others, which, when combined with antidepressant medication, may enhance their effects1. Adverse effects of antidepressant medication are common1, with more than 60% of patients experiencing at least one. These can range from emotional and interpersonal effects1 and weight gain (when coupled with an unhealthy lifestyle) through to increased risk of suicide (in adolescents).
There are multiple non-pharmacologic treatment options for depression, but consensus is yet to be reached regarding the strength of the evidence. Some research suggests counselling, education, exercise, problem solving, behavioural activation and guided self help programs are evidence-based options , while another suggests that the majority of non-pharmacological interventions are not evidence-based.
Research suggests that between 49%-84% sufferers of depression recognise the need for some form of treatment and prefer a non-pharmacologic approach. Therefore, as acupuncture is both effective and safe, it well-placed to rise to the top of the list of treatment options for this insidious disorder.
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American Psychiatric Association. What Is Depression? [internet].; [cited 14th July 2017]. Available from https://www.psychiatry.org/patients-families/depression/what-is-depression
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