Aromatherapy and Anxiety: A Literature Review of How Essential Oils Can Benefit Those with Anxiety/Depression

Living in a society where the more you do and have, the better off you are supposed to feel has created an environment that is cultivating a society of anxious people.  Medical doctors are taught to prescribe pharmaceutical medications to treat anxiety and the population is becoming one that is highly over-medicated.  The repercussions of this are becoming prevalent in suicide rates increasing, drug overdoses, and mass shootings around the country.  It is time to stop over-medicating with pharmaceuticals and begin treating patients with plant-based medicines that have little to no side effects.  Plant-based medicine practices, such as aromatherapy, have been on the rise because people want a change.  Using essential oils as a treatment for anxiety is an effective and safe way to treat those who struggle with this diagnosis.

     Our society has trained us to always go after the bigger and better things in life.  For some, this pressure can be too much.  This is where anxiety flourishes.  A perfect environment has been created to want fancy cars, bigger houses, and great new pharmaceutical medications. In turn, society has seen an influx in patients with anxiety diagnosis.  Being taught to trust  physicians is now a common practice, while physicians are trained to write prescriptions.  It is time for a change in our culture to one of rest and balance.  Using plant-based medicine, particularly aromatherapy, is a safe, convenient way to help those struggling with anxiety.  Whether it be children struggling in school, a new mom giving birth, or someone in the later stages of life; aromatherapy can help ease anxiety by supporting the body to find its balance.

        Dental anxiety is an issue many have experienced in their lifetime.  For some the thought of going to the dentist can be debilitating.  There are studies that have shown a simple use of aromatherapy in waiting rooms can be effective in treating patients with this type of anxiety.  A 2012 study was conducted on children between the ages of 6-9 years old who were given dental treatments of dental fissure sealants and dental prophylaxis.  The study was conducted on 30 children who had salivary cortisol levels and pulse rates checked before and after each visit (Pour, Arman & Jaafarzacher, 2012).  One group of children were exposed to orange Citrus sinensis essential oil while the other group was not exposed to any external aroma (Pour, Arman & Jaafarazacher, 2012).  The conclusion of the study showed that the group of children exposed to orange essential oil had a lower salivary cortisol level and lower heart rates than the control group did.  In another study conducted on dental patients, lavender Lavendula angustifolia was diffused in the waiting rooms of five dental clinics.  The study consisted of 597 patients that were 18 years and older (Zabirunnisa et al., 2014).  The patients were given a questionnaire and a modified dental anxiety scale test given in the waiting room.  The results of this study showed a significant reduction in the anxiety scores of the group who were in the waiting rooms with diffused lavender oil.  An interesting component of this study is that it showed a reduction in anxiety scores in patients as age increased.  Patients who were older had less effectiveness using lavender oil.  This study shows that lavender essential oil is effective in reducing anxiety levels in dental patients.  It also concluded that it is a low cost and simple intervention that can be used to treat patients with dental anxiety (Zabirunnisa, et al., 2014).  

        Women seem to be plagued with hormonal seasons in their lives.  During certain stages, anxiety can creep in and treatment options expose women to many complicated side effects.  In a growing trend of natural and alternative medicine, women seem to be interested in non-medical interventions to support their bodies during these different stages of life.  Women who struggle with Premenstrual Syndrome can struggle with anxiety and depression. This can cause many issues in jobs, relationships, and self-preservation.  A study conducted in 2017, 17 women in their 20’s who all struggle with PMS symptoms were examined during two luteal phases.  One group was given treatments of inhalation of lavender Lavendula angustifolia and the other was given yuzu Citrua junos Sieb. ex Tanaka.  The treatments consisted of inhaling the essential oils for 10 minutes.  A Profile of Mood test was conducted on each patient and heart rate variability was measured 35 minutes after inhalation.  This measurement reflected the autonomic nerve activity (Matsumoto, 2017).  The test group that inhaled yuzu had a significant decrease in heart rate and an increase in high frequency, reflecting parasympathetic nerve activity in the luteal phase (Matsumoto, 2017).  The Profile of Mood tests showed a significant decrease in three negative sub-scales associated with anxiety and depression.  The decrease was in the sub-scales of tension-anxiety, anger and hostility, and fatigue.  The test results of using yuzu were no different from the test results of patients who used lavender essential oil.  This test revealed that yuzu essential oil could alleviate PMS emotional symptoms. In another study conducted using bergamot for the female mood, it is shown that immediately after inhalation salivary samples, his frequency heart rate monitoring, and a fatigue self-test showed that simple inhalation of bergamot essential oil had both physiological and psychological effects on the women in the study.  The women were split into three sub-groups; a resting only group, a rest and water vapor group, and a rest and water vapor with bergamot oil.  The women were exposed to their treatment for 15 minutes each.  There was a complete profile taken of each woman that consisted of the evaluation of mood states, anxiety inventory, and a fatigue self-test.  The salivary samples were tested using an ELISA test.  The results of this study demonstrated that the sub-group inhaling bergamot essential oil could have a reduction in anxiety levels. 

        The struggle with anxiety during labor and the postpartum phase of pregnancy can be a daunting, anxiety-filled time in a woman’s life.  There are fear and trepidation of the unknown, or memories of a birth that wasn’t conducted as planned.  Certain studies are showing aromatherapy to be a promising treatment during these stages of a women’s life.  In a study using two groups of women consisting of 63 patients.  The groups were given either 4 ml of neroli essential oil or a saline solution to inhale that was attached to their collar during labor.  Each woman filled out a questionnaire before and after the treatments.  The anxiety levels of each woman were measured at baseline and after treatments that were given at 3-4cm dilation and 6-8cm dilation.  The women were followed and re-evaluated at the first and fifth minute Apgar scores that were taken on the infant.  The study showed a significant decrease in the anxiety levels during all stages of labor (Namazi, et al., 2014).  The researchers concluded also that neroli essential oil is a simple and inexpensive way to treat women experiencing anxiety during labor (Namazi, et al. 2014).  Researchers are also looking for alternative treatments for women who experience postpartum anxiety/depression after the birth of their baby.  In the study conducted in 2012, researchers have found some concrete solutions to use.  This study included 28 women who were 0-18 months postpartum.  Each had inhalation sessions of Rose Rose otto and lavender Lavendula angustifolia essential oil in a 2% dilution twice a week for four weeks.  A control group was to avoid all aromatherapy for the four-week study.  Each of the women who were currently on an allopathic treatment for their postpartum anxiety/depression continued that treatment also.  Each woman completed an Edinburg Postnatal Depression Scales test and a Generalized Anxiety Disorder Scale test at the beginning of the study. These tests were repeated after two and four weeks of treatment to measure the differences.  At the beginning of treatment, the women had no differences in the scores of the tests.  At weeks two and four there showed to be a significant improvement in the test scores (Conrad, 2012).  The best thing about this study was that there were no adverse effects for the woman and no complications with those who were being treated with allopathic treatments.  

        Through all stages of life experiencing anxiety is a normal thing.  Research is being conducted regularly to help in all stages of life; from children in school to those struggling with major illnesses, aromatherapy can play a role in the treatment.  Fifty-four students in the 7th grade were studied to try and eliminate test anxiety.  They sniffed handkerchiefs with tuberose essential oil for 15-20 minutes during exams and a placebo group sniffed a plain handkerchief.  The students were given test anxiety questionnaires before and after the essential oil treatment.  The tuberose group showed a significant difference in the children’s anxiety levels and there was also a big difference in the test scores between the two groups.  So not only did the test groups anxiety levels go down, but there was a correlation between lowered anxiety and improved test scores. 

         An all-male study of forty men, who were split into five groups, were given water vapor with essential oils of either sweet orange, tea tree, or just water in dilutions of 2.5 drops, 5 drops, and 10 drops (Goes, TC, 2017).  Anxiety levels were checked by using a Model of Anxiety and a video version of the Stoop Color-Word test.  These tests checked for the state of anxiety, subjective tension, tranquilization and sedation, and physiological symptoms of heart rate and gastrocnemius electromagrum.  There were no physiological symptom changes during the treatment but the groups who inhaled water vapor with 2.5 drops and 10 drops of sweet orange essential oil revealed anxiolytic activity which supports other theories that sweet orange oil can be used to have a tranquilizing effect on the body (Goes, TC, 2017).  

        Those who suffer from major depression are not left out of using aromatherapy as a treatment option.  A very interesting study was done using oral lavender Lavendula angustifolia in a capsule (Lasea).  The belief was that it could have comparable effects as a medication called Lorazepam.  The main outcome and effectiveness were measured using the Hamilton rating scale for depression.  Eight studies were analyzed and out those, six studies showed that using an antidepressant and Lasea together resulted in a decrease of Major Depressive Disorder (Fibler, M., et al. 2014).  In six of the studies, the oral lavender also reduced agitation in the patients.  Psychological anxiety was decreased in 5 cases, and somatic anxiety decreased in four of the eight cases studied (Fibler, M., et al. 2014).  Those that struggled with falling asleep and staying asleep had better sleep quality in three cases.  In those same cases, there was some decrease in anxiety levels related to sleep disturbances in those with Major Depressive Disorder (Fibler, M., et al. 2014).  The best results were with patients who used anti-depressants and Lasea together.  This study evaluation opens the doors for those who suffer from medication not being sufficient for their treatment of Major Depressive Disorder.  

        Terminal illness can cause major anxiety in patients, especially those in the Intensive Care Units of hospitals.  Patients who were in ICUs with Percutaneous Coronary Interuntum were studied to see if aromatherapy intervention would be helpful in treating the anxiety levels of patients.  The study followed 56 individuals in this scenario.  They were broken into two groups.  One was treated with conventional nursing and the other with lavender, Roman chamomile, and neroli essential oils.  The essential oil treatment was used by inhaling the mixture 10 times prior to and after the PCI procedure.  The conclusion showed that those in the essential oil treatment group had decreased anxiety levels and increase sleep quality (Cho, Min, Hur,& Lee, 2013). 

        I found it exciting to find the amount of research I did on aromatherapy and anxiety.  It supports the treatments I put into practice with my own patients and gives me the courage and backing needed to support my treatment plans.  Using aromatherapy can be such a controversial topic in today’s society.  I see now, that the proper research is being done to take the myths that are written and show some real scientific data on how essential oils can be used in many different treatment plans.  

    The research that was found fully supports the theory that aromatherapy can be an effective treatment for those struggling with anxiety.  It does not matter the situation the patient is in, essential oils showed to aid in the reduction of symptoms carried out by anxiety disorders.  It is a fascinating line of studies that includes all seasons of life, gender, and ages.  Knowing that there are treatment options that can work on their own or with current medications without harmful side effects is an encouragement. Having cost-effective, plant-based options is also very promising to those who are looking for a better treatment option. Using essential oils as a treatment for anxiety is an effective and safe way to treat those who struggle with this diagnosis.

 

References

A, F. (2014). A case series on the use of lavendula oil capsules in patients suffering from major     depressive disorder and symptoms of psychomotor agitation, insomnia. PubMed - NCBI.         Ncbi.nlm.nih.gov. Retrieved 9 December 2017, 

from https://www.ncbi.nlm.nih.gov/m/pubmed/24559818/?i=62&from=essential%20oils%20for%20anxiety        

C, C. (2017). The effects of clinical aromatherapy for anxiety and depression in the high risk     postpartum woman - a pilot study. - PubMed - NCBI. Ncbi.nlm.nih.gov. Retrieved 9         December 2017, from https://www.ncbi.nlm.nih.gov/m/pubmed/22789792/?i=93&from=essential%20oils%20for%20anxiety#fft

Cho, M., Min, E., Hur, M., & Lee, M. (2013). Effects of Aromatherapy on the Anxiety, Vital     Signs, and Sleep Quality of Percutaneous Coronary Intervention Patients in Intensive         Care Units. Retrieved 9 December 2017.

Goes TC, e. (2012). Effect of sweet orange aroma on experimental anxiety in humans. - PubMed - NCBI. Ncbi.nlm.nih.gov. Retrieved 9 December 2017.

Fereshteh Ghorat, M. (2016). The Effect of Inhalation of Essential Oils of Polianthes Tuberosa     on Test Anxiety in Students: A Clinical Trial. PubMed Central (PMC). Retrieved 9         December 2017, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5103518/

Matsumoto T, e. (2017). Does Japanese Citrus Fruit Yuzu (Citrus junos Sieb. ex Tanaka)         Fragrance Have Lavender-Like Therapeutic Effects That Alleviate Premenstrual             Emotional... - PubMed - NCBI. Ncbi.nlm.nih.gov. Retrieved 9 December 2017,             from https://www.ncbi.nlm.nih.gov/m/pubmed/28481623/?i=5&from=essential%20oils%20for%20anxiety

Namazi, M., Amir Ali Akbari, S., Mojab, F., Talebi, A., Alavi Majd, H., & Jannesari, S. (2014).     Aromatherapy With Citrus Aurantium Oil and Anxiety During the First Stage of Labor.         Retrieved 9 December 2017.

Watanabe E, e. (2015). Effects of bergamot ( Citrus bergamia (Risso) Wright & Arn.) essential     oil aromatherapy on mood states, parasympathetic nervous system activity, and ... -         PubMed - NCBI. Ncbi.nlm.nih.gov. Retrieved 9 December 2017, from https://www.ncbi.nlm.nih.gov/m/pubmed/25824404/?i=43&from=essential%20oils%20for%20anxiety

Zabirunnisa, M., Gadagi, J., Gadde, P., Koneru, J., Myla, N., & Thatimatla, C. (2014). Dental     patient anxiety: Possible deal with Lavender fragrance. Retrieved 9 December 2017.

 

 

 

 

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