A brief review: Complementary and alternative therapies for mental disorders
By Abimbola Farinde

In the clinical practice setting, clinicians may be more inclined to use pharmacotherapy when it comes to different types of mental disorders. And if a particular medication is FDA approved for a particular indication, a clinician may be more likely to use these agents as first-line therapies versus other medications do not have supporting evidence.

On the other hand, there is reason to believe that the use of complementary and alternative therapies or interventions can be utilized in individuals with psychiatric disorders when compared to the general population (Kessler et al., 2001). There are situations where a client may not require pharmacotherapy to alleviate some of the symptoms of their anxiety or depression, and generally these symptoms tend to be mild to moderate symptoms.

The interest in the use of complementary and alternative interventions has been increasing among healthcare professionals as a legitimate method for improving patients’ conditions. While there is an immense interest in the uses of complementary and alternative interventions there is difficulty bringing this under one umbrella as a result of the variations of practice standards across various cultures (Van de Watt, Laugharne, & Janca, 2008).

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The use of relaxation and meditation techniques has a long and observable history within many cultures. The intended purpose of meditation is to help an individual to focus all of their attention on a phrase, image and idea in hopes of reducing anxiety symptoms or other problematic symptoms. According to a meta-analysis that reviewed the use of meditation for anxiety disorder that compared the use of mediation to pharmacotherapy and psychological treatments, the intervention proved to be successful in alleviating some of the problematic symptoms that were experienced by individuals with anxiety disorder. A 2007 study published by Lee and colleagues sought to investigate the effectiveness of the meditation-based stress management – which included exercise, relaxation and hypnotic suggestion – in individuals with anxiety disorder. The study was able to identify a reduction in all of the anxiety scale scores for the group that received meditation compared to those that did not.

Acupuncture is another form of alternative intervention. The traditional Chinese treatment uses needles that are inserted in specific parts of the body to help achieve homeostasis between the yin and yan forces that circulate throughout the body. This technique is believed to achieve balance, which is considered to be an integral component to achieving good health (Van der Watt, Laugharne, & Janca, 2008). In a clinical randomized trial that was conducted by Gibson and colleagues (2007) that compared the effects of acupuncture and breath retraining in a sample of 10 individuals that were diagnosed with hyperventilation syndrome, it was determined that acupuncture produced positive effects in reducing their anxiety symptoms and hyperventilation symptoms.

In terms of depression treatment, alternative treatments that have been identified include herbal interventions, nutritional supplements, aromatherapy, cognitive-based interventions (e.g. hypnotherapy), mindfulness-based cognitive therapy or light therapy. The use of the herbal remedy such as St. John’s wort for the treatment of mild-to-moderate therapy has been examined in several clinical trials and even a meta-analysis released by Roder and colleagues found the use of St. John’s wort to be comparable to conventional antidepressants (Van der Watt, Laugharne, & Janca, 2008). St. John’s wort is recognized as an herbal medication that should be tried in those who are unable to tolerate other antidepressant therapies but caution is to be exercised when it given with other medications due to the potential for drug-drug interactions such as increasing the plasma concentration of other drugs (Hahn, Albers, & Reist, 2008).

Other complementary medications that are used for depression include 5-hydroxytroptophan, S-adenosyl methionine or folate, which have been shown to have a significant effect on improving depressive symptoms when used in combination with antidepressants (Van der Watt, Laugharne, & Janca, 2008). While aromatherapy has displayed some positive results – such as the mood improvement – there is still a lack of substantial clinical evidence to support its use for treating depression, so more trials demonstrating its efficacy are still required.

Additionally, the use of hypnosis and cognitive behavioral therapy (termed cognitive hypnotherapy) was examined in a randomized, controlled trial of 84 patients with major depression for 16 weeks, and it was found that treatment outcomes were significantly improved for individuals who were on the combination of CBT and hypnotherapy with reductions in depression, anxiety and hopelessness being observed in the cognitive hypnotherapy group compared to the CBT-only group (Alladin & Alibhai, 2007).

The interest that is currently being directed toward the use of complementary therapies for depression and anxiety will only continue to grow as more and more clinical trials are released that support the use of these therapies as either being comparable or even exceeding the efficacy of conventional therapies in certain case. Until this time more evidence will continue to mount in favor or against these approaches for anxiety and depressive disorders.

References

Alladin, A., & Alibhai, A. (2007). Cognitive hypnotherapy for depression: an empirical investigation. Int J Clin Exp Hypnosis, 55,147-166.

Gibson D, Bruton A., Lewith, G.T., et al (2007). Effects of acupuncture as a treatment for hyperventilation syndrome a pilot, randomized crossover trial. J Altern Complement Med , 13,39-46.

Kessler, R.C., Soukup, J. , Davis, R.B., Foster, D.F., Wikey, S.A., Van Rompay, M.I., et al (2001). The Use of Complementary and Alternative Therapies to Treat Anxiety and Depression in the United States. Am J Psychiatry 158,289-294

Lee SH, Ahn SC, Lee YJ, et al. Effectiveness of a meditation-based stress management program as an adjunct to pharmacotherapy in patients with anxiety disorder. J Psychosom Res 2007; 62:189-195. Van der Watt, G., Laugharne, J., & Janca, A. (2008). Complementary and Alternative Medicine in the Treatment of Anxiety and Depression. Curr Opin Psychiatry,21(1),37-42.