Do you find it difficult to switch off?

Does an underlying level of stress, worry, or apprehension accompany your daily life?

Does your heart race, your body tense, or your energy feel depleted?

Are you curious whether it's possible to find relief for these and the other symptoms of stress and anxiety, naturally??

The short answer is yes; relief is achievable.

The long answer is infinitely more interesting and empowering. Because understanding your biology — what’s happening in your body and brain — puts you in the driver's seat.

So, let’s take a deeper look: at stress, anxiety, their signs and symptoms, the similarities and differences, and how acupuncture may safely support recovery.

[10 minute read]

What is stress?

For most people, the word stress is used interchangeably with psychological strain, tension, or worry.

It’s literal definition is the measure of an external force acting on an object. After the industrial revolution, many scientists borrowed the language of engineering, to explain concepts in the health sciences.

Before then, ‘stress’ had little to do with our psychological state, except by implication, as it was used to describe a person facing adversity or hardship.

By the 20th century, ‘stress’ was in common usage in both biology and psychology. As a result ‘stress’ has accumulated a richness of meaning that can, at times, be a little confusing.

Today, the term ‘stress’ is colloquially used to describe three things:

  1. The source of a threat. This is the cause of a ‘stressful’ situation. For example, not finishing your work, being involved in a conflict, or experiencing the loss of a loved one.

  2. The physiological response. This is the way the body feels. For example, ‘stress’ in your body might be felt as a knotted tummy, a tense muscle, or a stress-induced headache.

  3. The psychological response. This is related to our feelings. For example, being swamped, scared, irritated, ‘stressed.’

In the health sciences, ‘stress’ is a concept. So, lets get specific about what this concept is — because when we are specific — when we pinpoint exactly what we’re talking about — we can use knowledge as a starting point to find a pathway to recovery.

From here on, lets think about ‘stress’ as:

1.) An adaptive response of human beings.

2.) Associated with emotional reactions and arousal.

3.) Characterized by feelings of unease or overwhelm.

4.) Used to meet adverse or demanding external circumstances,

5.) Especially in situations that are unpredictable and uncontrollable.

In short, we experience stress when an unplanned or uncontrollable demand overwhelms us. It’s a situation that requires us to step up; to change the way our biology works in order to respond.

In the short-term this can be positive, providing the energy we need to meet a challenge. Like planting your foot on the gas pedal so you can overtake a car on a country highway.

If used long term, without restraint, these changes take their toll. We maintain responses that are meant to be short term and that chew through energy quickly. Like a car driven recklessly, accumulating wear and tear and left to run on the smell of an oily rag.

Sounds simple enough, right?

The short story on the biology of stress

The biology of stress — at least the physical aspect — is essentially the biology of arousal. There are a range of factors that activate our stress biology; some normal, some abnormal. These include:

  • A threat, particularly one that’s associated with an in-built need: for example, food, reproduction, parental/ social attachments and future plans/ ambitions.

  • Behaviours that rely on arousal. Yes, this includes positive experiences. Say, the increased heart rate and positive emotion involved in sex.

  • The general arousal triggered by the circadian rhythm; the ebb and flow of the day-night rhythm that is required to maintain wakefulness and meet the challenge of daily life

There are three key systems that promote arousal and respond to stress. These include:

  1. The sympathetic division of the Autonomic Nervous System (ANS)

    This part of your nervous system reacts automatically; in an instant. It's like a sprint: fast and short lasting. That’s why when you hear an unexpected loud noise you might startle or jump.

  2. The Hypothalamic-Pituitary-Adrenal axis (HPA axis)

    The HPA involves the interplay of nervous and hormonal systems. Because hormones need to be delivered by the bloodstream to potentially far off destinations, its effects are slower and longer lasting.

    This system is important in regulating the “maintenance of homeostasis and allostasis during stress.” That is, the body’s balance and ability to handle stress.

  3. The inflammatory response

    When we face a threat our inflammatory response swings into action. Think back to when dangers included a spear from an enemy tribe or a bite from a predator. The inflammatory response prepped us to eliminate a deadly germ and ready us for healing. 

Our arousal biology is available at our beck and call, but it isn’t free of consequence. To maintain balance, this biology should follow rhythmic rise and fall or be used for short periods. When nerve, hormonal, and inflammatory responses are activated in the longer term, we chew through our reserves, wear ourselves out, and may experience physical and mental illness — including anxiety — as a result.

Remember, you can’t sprint a marathon. Ongoing stress is bad for you.

The short story on the brain’s role in stress

The brain is an incredibly powerful tool that allows us to sense the environment, analyse incoming information, and respond; that is, take helpful physical action.

If you’ve read about stress, you might have noticed that much of the research focuses on the deep area of the brain — called the Limbic System. This area is involved in directing nerve and hormonal responses that alter our body and behaviour; the neuroendocrine system's stress responses.

 
Diagram of the Limbic System

Pictured is the Limbic System - comprised of the Thalamus, Hypothalamus, Amygdala & Hippocampus. Notice these areas are under the Cortex (the wrinkly pink outer area).

 

But, the Limbic System doesn’t reason. It doesn’t appraise the situation. This requires the cortex (the wrinkly outer area); the portion that enables us to understand and remember, to think and reason, to feel and respond. Yes, the Limbic System feeds information to the cortex. But the cortex decides how to interpret this data.

That’s why there are two main aspects to stress: the physiological and the psychological components. Together, these determine the way we experience and respond to stress. As this is important in the perception of stress and the development of anxiety, let’s look at each.

The physiological aspects of stress

Your brain is made of various parts. Two parts are particularly involved in stress: the newer, outer cortex and the older, deeper Limbic System.

The cortex is the outermost layer; the wrinkly part that springs to mind when we imagine this organ. It comprises the frontal, occipital, parietal, and temporal lobes. These lobes process different kinds of information. They’re what enables us to understand and use language, memory, and our muscles; to think, learn, reason, and make decisions; to have feelings, to possess intelligence, and to have a personality.

The Limbic System portion of the brain is responsible for physiological responses to stress. It directs the physical and behavioural changes that enable us to fight or flee. This includes “setting off” the powerful sympathetic division of the Autonomic Nervous System (ANS) and Hypothalamic-Pituitary-Adrenal (HPA) axis, which together — through hormone and nerve system effects —  increases heart rate and blood pressure, elevates breathing rate, increases the availability of glucose, alters gut function, and more.

The experience of these physical and behavioural changes are called emotion. Many people think emotions and feelings are the same. However, scientists understand emotions as sensations and feelings as perceptions. More on this interesting fact shortly.

In the table below, I’ve listed the symptoms of stress and anxiety, notice how some are connected to the Limbic system and it’s nerve and hormonal responses, and others to the cortex.

Limbic SystemCortex
Increased arousal, agitation, insomniaMemory impairment (recall of names, dates, places & words)
Palpitations (increased heart rate/ increased strength of contraction)Concentration difficulties
Rapid breathing, breathlessnessLearning difficulties
Spontaneous sweatingFeeling tense, overwhelmed, vigilant, worried, fearful
High blood pressureIncreased likelihood of pain
Muscle tension
Reduced appetite, reduced intake of food & fluid
Nausea/ vomiting
Bloating
Diarrhoea

You can also watch this fantastic video if you would like more detail on how the sympathetic division of the ANS and the HPA axis contribute to stress. [This is optional — for those who love detail]

 
 
 

The psychological aspects of stress

You’ve probably noticed that what is stressful for some people is invigorating, exciting, or enjoyable for others. Why does this difference exist?

Feeling stressed results from overwhelm; from mental strain relating to circumstances that are too intense, uncontrollable, or unpredictable. So, the psychological experience of stress depends on an individual’s perception, level of resilience, and ownership of effective coping strategies.

The cortex (again the wrinkly outer area of the brain) is responsible for the ‘feelings’ of stress. Yes, the cortex absolutely takes cues from the Limbic System. But we interpret the meaning of these signals based on the three factors just mentioned: perception, resilience, coping strategies.

Think of a skydiver. For an expert adrenalin-loving skydiver, the racing heart, honed focus, burst of energy, and complete in-the-moment immersion is exhilarating! For a person with a fear of heights, the same physical sensations are understood as absolute terror!


When does stress shift from good to bad?

Excessive activation of our stress system, of our arousal biology, throws off homeostasis — our biological balance. This balance of vital physiological variables (like blood pressure, blood sugar, etc.) are essential for long term well-being.

When our neural and hormonal biology cannot return to it’s normal balance-point, we increase the risk of disease in our body. Unsurprisingly, this is when stress shifts from good to bad and can lead to physical and mental illness.


WHAT IS ANXIETY?

Anxiety shares many similarities with stress. Especially the protective way the whole organism reacts to an adverse situation; the stress responses that promote arousal to deal with a problem and aid survival.

But, when stress shifts from being an appropriate adaptive response to an inappropriate maladaptive response, its likely stress has become an anxiety disorder.

Maladaptation, in this instance, is characterized by conditioning of unhealthy behavioural and emotional adjustments.

If you experience an anxiety disorder, you’re not alone. According to the Australian Institute of Health and Welfare, anxiety is the most prevalent form of mental illness. A staggering one in seven Aussies live with this condition.

For those who would like a detailed overview on anxiety disorders, watch the video below.

 
 


The difference between stress and anxiety

While there are similarities between stress and anxiety, there are also important differences. For example:

Stress —

1.) An adaptive response of human beings.

2.) Associated with emotional reactions and arousal.

3.) Characterised by feelings of unease or overwhelm.

4.) Used to meet adverse or demanding external circumstances.

5.) Especially in situations that are unpredictable or uncontrollable.

Anxiety —

1.) A maladaptive response of human beings.

2.) Associated with persistent & excessive emotions, and intense arousal.

3.) Characterised by intrusive thoughts and negative beliefs.

4.) Often used to meet anticipated or uncertain circumstances.

5.) Especially in situations that may not be actually threatening.

In other words, anxiety is the over-protective firing of our stress system, along with the intrusive thoughts and negative beliefs attached to it.

Many mental health professionals see stress and anxiety as complimentary aspects of a stress/ anxiety continuum — that is a progression from healthy adaptation to unhealthy maladaptation.

When symptoms become truly distressing you should always consult a mental health professional — like a psychologist or psychiatrist for specialised support.

Remember, the differences between stress and anxiety are not absolute. The table below details some helpful characteristics:

StressAnxiety
Adaptive responseMaladaptive response
Normal arousal symptomsIntense arousal symptoms
Triggered by external circumstancesTriggered by internal perceptions
Identifiable threatUnidentifiable threat
Threat is in the present or pastThreat is anticipated or uncertain
Symptoms are episodicSymptoms are persistent
Response proportional to threatResponse out of proportion to threat
Feeling overwhelmDysregulated feelings, including panic
Thoughts are less prominent and appraisedThoughts are prominent and intrusive
Beliefs are difficult to elicitBeliefs are negative and often relate to possible catastrophic outcomes

                                                        

Can acupuncture soothe stress?

There is good evidence that the answer is yes. How is it possible for this ancient therapy to calm physiological arousal and quiet psychological tension?

As discussed earlier, key players of the stress response are the Limbic System, the sympathetic nervous system (SNS) and the HPA axis.

Acupuncture has shown an ability to regulate activity of the Limbic System, specifically decreasing signals in these brain areas on Functional Magnetic Resonance Imaging (fMRI). It has been theorized that this may represent some of the initial steps through which acupuncture exerts its complex multisystem effects.

These brain changes precede other positive effects on the autonomic nervous system. Specifically, regulating the balance between the SNS and parasympathetic nervous system (PNS). The PNS’s role is to return the body to rest after a stressful situation. Its activation allows rest and recovery. In our car analogy, the PNS allows the tank to be refuelled and the vehicle to be serviced.

As the journal article, Acupuncture Effect and Central Autonomic Regulation, said: Acupuncture stimulation might decrease sympathetic activity and increase parasympathetic activity… This might be beneficial to treat… hyperactivity of the sympathetic nervous system.

This perspective has gained momentum through studies showing acupuncture’s effect on heart rate and blood pressure.

As well as calming the SNS to balance the autonomic nervous system, acupuncture appears to coax the HPA axis back to equilibrium.

All these changes may significantly soothe stress by promoting the relaxation response.

This state, also achieved through meditation, tai chi and yoga, is otherwise engaged when you perform a repetitive physical or mental activity, while ignoring distracting thoughts. Considered the antagonist of the fight or flight response, the relaxation response may also protect us from the wear and tear perpetuated by persistent stress.

Common questions about acupuncture for stress relief

With the potential benefits of acupuncture for stress established, let’s look at the common questions I receive.

Does acupuncture calm the nervous system?

Yes, there is good evidence that acupuncture regulates the Limbic System, increases parasympathetic activity of the ANS and quiets overactivity of the HPA axis.

How does acupuncture help relieve stress?

Acupuncture balances the neuroendocrine systems by reducing stress responses and promoting relaxation responses. This relieves arousal and the physical symptoms of stress. It may also alter feelings of tension and overwhelm in some individuals. Feelings and stress responses are co-ordinated from different neurological networks in the brain. Our feelings are dependent on individual perception of all brain and neuroendocrine activity.

How long does it take for acupuncture to work for stress?

As with any therapy, it’s impossible to know exactly how long it will take. We are all different, as are any underlying conditions.

Saying that many of my patients report benefits after one treatment. A single session may help to reduce the stress response and encourage feelings of relaxation and calm. For some, acupuncture has an accumulative effect. Repeated treatments can help achieve therapeutic goals.

Acupuncture is wonderful as part of a stress management strategy.

How long do the effects of acupuncture last?

This is a difficult question because we are all so very different. But in practice, I find that one session often provides patients with relief in the short to medium term; that’s days to weeks.

How often should you receive acupuncture for stress?

Like going to the gym, regular attendance helps transform the body and brain. Regular acupuncture — within your financial and time limitations — is an effective piece in the management puzzle. For circumstances and symptoms that are intense, sessions closer together are recommended. For mild stresses, sessions further apart are appropriate.

Does acupuncture help with anxiety?

Yes, research indicates that acupuncture could be effective for several types of anxiety, including PTSD and generalised anxiety.

As one study noted, “There is good scientific evidence encouraging acupuncture therapy to treat anxiety disorders as it yields effective outcomes, with fewer side effects than conventional treatment.”

Acupuncture also appears to enhance the benefits of medications like selective serotonin reuptake inhibitors (SSRIs). As a recent study published in the journal, Complementary Therapies in Clinical Practice, found, “Acupuncture combined with SSRIs can significantly improve anxiety state compared to anti-anxiety therapy using SSRIs alone.”

As mentioned above, acupuncture promotes the relaxation response by calming the Limbic system, boosting parasympathetic nervous system function and turning down the dial on the HPA axis.

Common questions about acupuncture for anxiety

If you suffer from anxiety, finding respite will likely be at the top of your to-do list. So, here are some common questions I receive?

Could acupuncture make anxiety worse?

Acupuncture is a gentle, relaxing experience for most. But, as with any therapy, a negative experience is possible. For example, if you have a needle phobia receiving acupuncture may be difficult. Though most people with a nervousness about needles often leave surprised by how pleasant their acupuncture experience was.

Any adverse anxiousness should last only in the short to medium term; not permanently.

How long does the effect of acupuncture for anxiety last?

As with stress, this is a difficult question to answer because we are all different. In practice, I often see that one session can provide a patient with relief for days to weeks.

Again, acupuncture works best as a supportive treatment in a greater management strategy.

How many sessions of acupuncture for anxiety are needed?

Some patients feel improvement after one session. However, regular treatment, applied within time and cost constraints, appears to enhance the benefits. Acupuncture performs best when utilized as part of a broader management strategy.

Is acupuncture good for mental health?

Yes, it can be.

Research indicates that acupuncture may quiet stress and ease anxiety. This makes it an important supportive treatment for some mental health disorders.

Does acupuncture work for overthinking?

An overthinking, ruminating mind is common in stress and anxiety. Acupuncture calms the Limbic System (deep area of the brain) and its subsequent stress responses. However, our emotions and cognition are co-ordinated by the Cortex (the outer wrinkly area of the brain). Activity of both the Cortex and Limbic System likely contributes to ruminating states. It would be remarkable if acupuncture could positively affect both these areas, but so far unproven. This could be a great question for future research to solve.

The takeaway

Stress and anxiety are common and their effects can be profound. But by understanding why they occur, you can find a pathway to relief. For many people, acupuncture can play an important, safe role in relief and recovery.

As a qualified Acupuncturist and the owner of the Traditional Acupuncture clinic on the Gold Coast, I’ve helped many patients to experience relief.

Ready to make an appointment? Great! I look forward to supporting your journey to recovery, too!

Author

Adam Hjort is a Registered Acupuncturist and member of Australian Acupuncture & Chinese Medicine Association (AACMA). He has been practicing since 2010 and maintains a clinic dedicated to the treatment of pain located in Ashmore, Gold Coast. This article was last updated 17th February 2022.