Anxiety & Depression: Holistic Support

Acupuncture may help ease symptoms of anxiety and depression by calming an overactive stress response and supporting the nervous-system balance mood depends on — research shows a moderate benefit for depression (strongest when used alongside standard care) and a promising, still-developing signal for anxiety, always as a complement to therapy and medication, never a replacement for them.

Anxiety and depression aren't character flaws or "just stress" — they're nervous-system states with measurable physiology: an overactive stress-response (HPA) axis, low vagal tone, disrupted mood-regulating brain chemistry, and, for many people, a low-grade inflammatory component that keeps the body in a kind of internal alarm state. Julie K. O'Leary, L.Ac., LMT is a Licensed Acupuncturist, Licensed Massage Therapist, and Licensed Herbalist with more than 20 years of practice in Marble Falls, and her approach treats the whole person — acupuncture, therapeutic massage, Chinese herbal medicine, cupping, gua sha, and somatic mindfulness — as pieces of one integrative plan for nervous-system support, not competing "alternative" treatments.

What Does Research Say About Acupuncture for Depression?

The most honest anchor here comes from the National Center for Complementary and Integrative Health (NCCIH): a 2018 Cochrane review of 64 studies (over 7,000 participants) found acupuncture "may result in a moderate reduction in the severity of depression when compared with treatment as usual," with the important caveat that most of the underlying trials were of low or very-low quality. A more recent 2019 meta-analysis of 29 trials refined that picture further — acupuncture showed a small-to-moderate benefit versus usual care, a moderate benefit versus sham acupuncture, and its strongest effect when used as an adjunct alongside antidepressant medication, with more sessions generally tracking greater improvement. A 2024 review in a peer-reviewed neuroscience journal reinforced this signal while noting acupuncture's favorable side-effect profile compared to medication alone.

What's actually happening physiologically is multi-layered: brain-imaging studies show acupuncture calming overactive fear- and rumination-related circuits, while other research documents shifts in serotonin and stress-hormone (cortisol) activity, and a reduction in inflammatory markers that are increasingly linked to a "hard to treat" subset of depression. None of this means acupuncture cures depression — it means there's a real, biologically plausible reason it may help as part of a broader plan that includes psychotherapy and, when appropriate, medication.

Is Acupuncture Helpful for Anxiety Too?

The evidence for anxiety is encouraging but earlier-stage than for depression. Research has found positive signals for generalized anxiety, anxiety before medical procedures, and anxiety tied to pregnancy or digestive conditions, but systematic reviews consistently call for larger, more rigorous trials before a firm recommendation. NCCIH does not currently list acupuncture as a confirmed anxiety treatment, though research into related approaches (like ear-point stimulation) is active.

What's well documented is the mechanism: anxiety tends to reflect a nervous system stuck in sympathetic "fight-or-flight" mode, with low heart-rate variability (HRV) as a measurable marker. Acupuncture and slow, rhythmic massage have both been shown to shift HRV toward a calmer, parasympathetic pattern — the physiological groundwork mood stability is built on, even where the anxiety-specific research is still catching up. The defensible, honest claim is that acupuncture may help reduce anxiety symptoms as part of a broader care plan — not that it treats or resolves an anxiety disorder on its own.

How Does Massage Support a Calmer Nervous System?

Manual therapy's calming effect is smaller than acupuncture's but well documented. In one small clinical trial of people with major depressive disorder, a single Swedish massage session measurably increased HRV and reduced anxiety scores within the same visit. Interestingly, part of that shift showed up even with light touch alone, while firmer hands-on pressure added an extra layer of positive mood benefit — suggesting the calming effect comes from both the relational, attentive quality of bodywork and its physical mechanics. Julie's dual training as an LAc and LMT means a session can draw on both: needling for a deeper systemic shift, and massage to extend and reinforce it.

Slow-tempo, rhythmic strokes, sustained holds at the neck and shoulders, and unhurried pacing all support the vagal ("rest-and-digest") shift a mood-focused session is aiming for — which is part of why Julie's signature acupuncture and massage sessions are built to be unrushed, with the last several minutes of every visit intentionally spent settling the nervous system rather than activating it.

Where Does Chinese Herbal Medicine Fit In?

As a Licensed Herbalist, Julie may incorporate classical Chinese herbal formulas as a complementary layer alongside acupuncture and massage — never as a substitute for prescribed medication. Formulas like Xiao Yao San ("Free and Easy Wanderer"), traditionally used for stress-related tension and irritability, or Gan Mai Da Zao Tang, traditionally used to ease emotional volatility and support restful sleep, are part of a centuries-old herbal tradition that many practitioners still draw on today for supportive, whole-body care.

This is one area where transparency really matters: some herbs and supplements — St. John's Wort in particular — can interact seriously with SSRIs and other antidepressants (a risk known as serotonin syndrome), and others (SAMe, 5-HTP) carry similar concerns. Julie reviews your full medication and supplement list at every visit and coordinates with your prescriber before recommending anything, and if you're pregnant, have a bleeding disorder, or take blood-thinning medication, that's essential information to share before any needling or herbal recommendation as well.

What Is the Five-Element Approach to Emotional Wellness?

One of the more distinctive threads in Julie's practice is Five-Element acupuncture, a classical Chinese medicine framework that maps specific emotions to specific organ systems — not as a diagnosis, but as a working lens for the texture of what someone is carrying. In this tradition, the Metal element (Lung) relates to grief and letting go; Wood (Liver) to anger, frustration, and feeling "stuck"; Fire (Heart) to relational wounds and joy; Earth (Spleen) to worry and overthinking; and Water (Kidney) to fear, depletion, and trauma. A client processing a loss might be treated with points that support the Metal element's capacity for release, paired with breathwork that opens the chest — while someone carrying years of unexpressed frustration might receive Wood-element points alongside grounding, movement-oriented homework.

This framework never replaces a mental-health diagnosis or treatment plan — it's a complementary, pattern-level language that sits alongside Western care, giving many clients a different, less clinical way to understand and work with what they're feeling.

What Happens in a Session Focused on Anxiety or Depression?

A typical mood-focused visit opens with a conversation — how you've been sleeping, eating, and feeling, and a brief, judgment-free check-in about safety and severity. Acupuncture needles are then placed at points associated with calming the mind (often on the wrist, forearm, scalp, and lower leg), followed by a quiet rest period where much of the physiological shift happens. Many sessions add gentle somatic tools — paced breathing, grounding, brief guided attention to the body — that clients can use again on their own between visits. If tension or fatigue is part of the picture, massage may be layered in, and every session is built to end on a settled, parasympathetic note rather than an activated one.

A reasonable expectation is a course of care — often weekly for around six weeks — rather than a single visit, since research on both acupuncture and massage for mood shows benefits building gradually with consistency. This mirrors the same nervous-system-first approach used for related concerns like poor sleep and stress-related digestive upset, both of which frequently travel alongside anxiety and low mood.

When Should You See a Doctor or Therapist Instead of — or Alongside — Bodywork?

This is the single most important section of this article. Acupuncture and massage are adjunctive nervous-system support — they are not a substitute for psychotherapy, psychiatric care, or medication, and they are never appropriate as the sole treatment for severe depression, suicidal thoughts, psychotic symptoms, or bipolar disorder. Julie's practice screens for these at intake and will always refer out — warmly and promptly — when they're present, coordinating with your existing therapist or prescriber whenever possible.

If you are having thoughts of suicide or self-harm, or are in crisis, call or text 988 (the Suicide & Crisis Lifeline) right now — it's free, confidential, and available 24/7. Never stop or change antidepressant or anti-anxiety medication without talking to your prescriber first; stopping SSRIs abruptly can cause a genuinely uncomfortable and sometimes dangerous withdrawal reaction. Bodywork works best as one supportive piece of a coordinated plan, not a stand-alone fix.

Frequently Asked Questions

Can acupuncture replace my antidepressant or anti-anxiety medication?

No. Acupuncture is best understood as adjunctive nervous-system support that may complement — but should never replace — psychotherapy or prescribed medication. Research actually shows acupuncture's strongest measured benefit for depression when it's used alongside antidepressants, not instead of them. Never stop or adjust medication without talking to your prescriber first, since some medications carry withdrawal risks if stopped abruptly.

How many sessions does it typically take to notice a difference?

Most research protocols and clinical experience point to a reasonable trial of weekly sessions for about six weeks, with meaningful shifts often beginning to show around week three or four. Some people notice calmer, more settled feelings after a single visit, but sustained change in mood typically requires a full course rather than a one-time appointment, reassessed along the way.

Is it safe to combine acupuncture with therapy and medication?

Generally, yes — many people use acupuncture and massage specifically alongside therapy and medication, and Julie's practice is glad to coordinate with your existing providers with your consent. The main safety considerations are disclosing your full medication and supplement list (certain herbs can interact with antidepressants) and letting your practitioner know about pregnancy, bleeding disorders, or blood-thinning medication before treatment.

Can Chinese herbal medicine help with anxiety or depression?

Some classical formulas have traditionally been used to support emotional balance and restful sleep, and Julie, as a Licensed Herbalist, may recommend them as a complementary layer alongside acupuncture and massage. They are never a substitute for prescribed medication, and because certain herbs (like St. John's Wort) can interact with antidepressants, full disclosure of your medication list is essential before starting any herbal support.

What if I don't have a formal diagnosis but just feel anxious, low, or "off"?

You don't need a clinical diagnosis to benefit from nervous-system-focused care. Many clients seek support for general stress, grief, burnout, or feeling emotionally "stuck" without a formal mental-health diagnosis, and the same calming, parasympathetic-supporting approach applies. If screening at intake suggests something more significant is present, Julie will always discuss a referral to a licensed mental-health professional.

A Whole-Person Approach to Emotional Wellness

Anxiety and depression rarely show up in isolation — they're woven into sleep, digestion, pain, and how the whole body carries stress, which is why Julie treats them as part of a broader whole-body wellness approach rather than an isolated symptom. If you're ready to explore whether acupuncture, massage, and herbal support could be a helpful piece of your care, book an appointment with Palomino Massage & Acupuncture and Julie will walk you through an honest, unhurried conversation about what might help.