• Dr. Becker

The use of citrus essential oils and lavender in treating anxiety, depression, and stress

Sharing my article from 2014 discussing the efficacy of lavender with citrus essential oils for stress relief.

The use of citrus essential oils and lavender in treating anxiety, depression, and stress: a scientific perspective

Shannon E. Duke Becker, PhD CA

Introduction

Although essential oils have been used as perfumes and for spiritual, emotional, and physical well being for at least 5000 years (Perry and Perry, 2006), the mainstream acceptance of essential oil therapy (aromatherapy) has been variable. Part of the reason is that there are no national regulating agencies for essential oils in the United States. In effect, companies are self-regulating, much like the vitamin and supplements market. Unlike pharmaceuticals, where there is an established method for drug discovery, clinical testing, and regulation, the FDA (Food and Drug Administration) considers essential oils to be part of the perfume industry in most cases. Despite this, many holistic-minded medical professionals are open to the use of aromatherapy in parallel with more traditional medical practices.

Citrus oils including bergamot [citrus bergamia], sweet orange [citrus sinensis], grapefruit [citrus paradisii], and neroli [citrus aurantium var. amara], along with lavender [lavandula augustifolia] essential oils have been studied extensively in in vitro cultured cells (Russo et al., 2013), in vivo animal models (Tanida et al., 2005; Tanida et al., 2006; Wu et al., 2012), and also in clinical settings with human hospice, surgical, psychiatric, maternity, and dental patients (Burns and Blamey, 1994; Burns et al., 2000a; Burns et al., 2000b; Lehrner et al., 2005; Mousley, 2005; Imura et al., 2006; Field et al., 2008; Sears et al., 2013). In each of these settings, it has been shown that citrus and lavender essential oils help with relaxation, depression, pain relief, and difficulty sleeping. This review focuses on these essential oils and their use in reducing anxiety, depression, and stress.

Chemical constituents of citrus and lavender essential oils

Citrus essential oils’ chemical constituents (as verified by gas chromatography and mass spectrometry tests) usually include d- limonene, β-pinene, γ-terpinene, linalyl acetate, and linalool in varying amounts. The first three constituents [d-limonene, β-pinene, and γ- terpinene] are monoterpenes, which generally are analgesic, anti- inflammatory, and anti-spasmodic (Butje). Linalyl acetate is considered sedative, analgesic, and anti-inflammatory (Igarashi, 2013; Russo et al., 2013). Linalool is considered anti-spasmodic, sedative, analgesic, and anti-inflammatory, and anxiolytic (Igarashi, 2013; Russo et al., 2013).

Researchers were able to introduce lavender or grapefruit essential oils or their chemical components via olfaction to rats, and then measure the affects in blood pressure and limbic system regions of the brain, including the hypothalamus (Tanida et al., 2005; Tanida et al., 2006). It was shown that lavender and linalool, the major component of lavender oil, can cause increase in appetite and decrease in blood pressure, while grapefruit oil and limonene, the major component of grapefruit oil, reduces appetite and increases blood pressure (Tanida et al., 2005; Tanida et al., 2006). This experiment shows that essential oils and their components can pass through the olfactory membrane and cause biological and behavior changes. In other rodent studies, inhalation of lavender for one hour resulted in similar behaviors in the test rats compared to rats administers diazepam (Perry and Perry, 2006), a sedative. Lavender inhalation also reversed coffee-induced agitation in mice (Perry and Perry, 2006).

Because of technical and ethical reasons, doing the pharmacokinetic work needed to prove the trans-dermal absorption rates in humans has not been done. Instead, human studies have been done exploring inhalation-based aromatherapy, using self-reporting methods with specific groups of people. Hospice patients, dental patients, labor and delivery patients have filled out surveys designed to measure levels of anxiety, pain, and stress before and after administration of aromatherapy in a stressful environment. In each experiment those patients receiving aromatherapy were compared to control groups not receiving aromatherapy, with a significant difference found in the aromatherapy group (Burns and Blamey, 1994; Burns et al., 2000a; Burns et al., 2000b; Mousley, 2005; Imura et al., 2006; Perry and Perry, 2006; Goes et al., 2012; Igarashi, 2013).

Aromas and olfactory receptors

Inhalation and dermal application are the two most effective methods to use essential oils in aromatherapy (Perry and Perry, 2006). Dermal application, where the essential oil is diluted in a carrier oil/cream/balm and applied to the skin, enables the essential oil to penetrate slowly over time through the skin, while also entering the body through inhalation. It could be argued that inhalation is the fastest and most efficient way to apply essential oils that are meant to treat mood disorders and generalized pain. Aromas enter the body through the nose and stimulate olfactory receptors that are part of the olfactory membrane, which is located in the nasal passages. These receptors send information to the olfactory bulb, which is part of the limbic system of the brain. The limbic system is responsible for processing emotions, olfactory signals, automatic emotional responses, and associative learning (Lehrner et al., 2005). This is the “not under conscious control” part of our brains and it is this part of the brain that receives scent information. This is also the part of the brain that retains control when someone is having a panic attack (Demenescu et al., 2013).

Chronic and generalized anxiety

Chronic anxiety and panic disorders are characterized by overreactive “fright, flight, freeze” responses, both when exposed to dangerous stimuli or seemingly innocuous stimuli. Termed panic disorder in some circles, it is “characterized by recurrent, spontaneous panic attacks which are acute episodes of intense fear accompanied by physical as well as cognitive symptoms” (Demenescu et al., 2013). The processing of threat stimuli takes place in the amygdala, a structure that is part of the limbic system. In people with panic attacks, the amygdala appears to be hyperactive during spontaneous panic attacks but hypoactive during anticipatory anxiety, compared to healthy volunteers (Demenescu et al., 2013). Amygdala hypoactivation was seen in response to fear, anger, happiness, and neutral emotions compared to healthy volunteers. In addition to changes in activation of the amygdala, there is a disruption between the amygdala and other portions of the brain, and this corresponds with hyper-vigilance to external stimuli (Demenescu et al., 2013). Unfortunately, there has been little research into aromatherapy treatment for chronic panic disorders. Although not published, essential oil blends containing bergamot, sweet orange, grapefruit, lavender, and a related oil called lavandin [lavandula augustifolia, lavandula latifolia hybrid] have been extremely effective in mood stabilization, decreasing anxiety, improving depression, and encouraging optimistic outlooks in many patients (Duke Becker, 2014). These patients report diagnoses of generalized anxiety disorder, panic disorder, depression, post-traumatic stress disorder, and self-diagnosed extreme stress. All report improvement in these conditions after using essential oil blends containing lavender and/or citrus oils. In the case of patients with panic disorder, the essential oil blends have been effective in stopping and recovering from acute panic attacks. These patients would normally have pharmaceuticals to choose from, along with learned behavior such as deep breathing and Cognitive Behavioral Therapy (CBT) reframing techniques. Used together, the CBT and aromatherapy techniques have greatly reduced the need for pharmaceuticals (Duke Becker, 2014) such as benzodiazepine, an addictive drug commonly used for panic disorders.

Situational anxiety, including labor and delivery, surgery, and dental appointments

There has been much more research into situational anxiety and aromatherapy treatments. Dental patients have been successfully calmed using sweet orange and lavender essential oils (Lehrner et al., 2005). Surgical patients have reduced pain and anxiety when they use lavender essential oil alongside massage and guided imagery (Sears et al., 2013). Pregnant women and laboring women have had success with aromatherapy reducing their fear and general outlook on their birth and antenatal experience. These studies used up to ten essential oils, but found the most success with citrus and lavender oils (Burns et al., 2000a; Burns et al., 2000b).

Depression

There are many anecdotal stories of depression improving when smelling something that reminded the person of happier times, which supports the idea of olfactory input being processed and attached to memories (Perry and Perry, 2006). Unfortunately, there are no current studies exploring depression and essential oil usage. Anecdotally, I have found that essential oil usage does seem to supplement the pharmaceuticals for anxiety and depression. Based on the essential oil properties, it should not be a surprise that citrus oils and lavender oil improve depression as well as anxiety. The chemical components of the citrus and lavender oils offer analgesic, anti-inflammatory, anti-spasmodic, sedative, and anxiolytic properties (Butje; Igarashi, 2013; Russo et al., 2013).

Conclusions

Essential oils are useful for stress reduction and helping increase sleep quality in infants, adults, and the elderly. Citrus oils including bergamot [citrus bergamia], sweet orange [citrus sinensis], grapefruit [citrus paradisii] and neroli [citrus aurantium var. amara], along with lavender [lavandula augustifolia] essential oils are particularly effective for stress reduction, reducing anxiety, and controlling pain in many settings. These and other essential oils should be further explored as supplemental psychiatric treatments to augment pharmaceuticals and in some cases, replace them. In addition, they are great options to reduce situational anxiety, such as labor, surgery, and dentistry.

Works Cited

Aromatics International I. "GC/MS Reports." from http://www.aromaticsinternational.com/gcms_reporting.

Burns E and Blamey C (1994). Complementary medicine. Using aromatherapy in childbirth. Nurs Times 90(9): 54-60.

Burns E, Blamey C, Ersser SJ, Lloyd AJ and Barnetson L (2000a). The use of aromatherapy in intrapartum midwifery practice an observational study. Complement Ther Nurs Midwifery 6(1): 33-4.

Burns EE, Blamey C, Ersser SJ, Barnetson L and Lloyd AJ (2000b). An investigation into the use of aromatherapy in intrapartum midwifery practice. J Altern Complement Med 6(2): 141-7.

Butje A. "Therapeutic Components List." from http://www.aromahead.com/online- course/aromatherapy-certification-program/reference/general- reference/therapeutic-component-list.

Demenescu LR, Kortekaas R, Cremers HR, et al. (2013). Amygdala activation and its functional connectivity during perception of emotional faces in social phobia and panic disorder. J Psychiatr Res 47(8): 1024-31.

Duke Becker SE (2014). Petrichor Apothecary blends Brave, FYG, Take a Deep Breath, and You Go Gurl! help with mood stabilization, decreasing anxiety, improving depression, and encouraging optimistic outlooks.

Field T, Field T, Cullen C, et al. (2008). Lavender bath oil reduces stress and crying and enhances sleep in very young infants. Early Hum Dev 84(6): 399-401.

Goes TC, Antunes FD, Alves PB and Teixeira-Silva F (2012). Effect of sweet orange aroma on experimental anxiety in humans. J Altern Complement Med 18(8): 798- 804.

Igarashi T (2013). Physical and psychologic effects of aromatherapy inhalation on pregnant women: a randomized controlled trial. J Altern Complement Med 19(10): 805-10.

Imura M, Misao H and Ushijima H (2006). The psychological effects of aromatherapy- massage in healthy postpartum mothers. J Midwifery Womens Health 51(2): e21- 7.

Lehrner J, Marwinski G, Lehr S, Johren P and Deecke L (2005). Ambient odors of orange and lavender reduce anxiety and improve mood in a dental office. Physiol Behav 86(1-2): 92-5.

Mousley S (2005). Audit of an aromatherapy service in a maternity unit. Complement Ther Clin Pract 11(3): 205-10.

Perry N and Perry E (2006). Aromatherapy in the management of psychiatric disorders: clinical and neuropharmacological perspectives. CNS Drugs 20(4): 257-80.

Russo R, Ciociaro A, Berliocchi L, et al. (2013). Implication of limonene and linalyl acetate in cytotoxicity induced by bergamot essential oil in human neuroblastoma cells. Fitoterapia 89: 48-57.

Sears SR, Bolton S and Bell KL (2013). Evaluation of "Steps to Surgical Success" (STEPS): a holistic perioperative medicine program to manage pain and anxiety related to surgery. Holist Nurs Pract 27(6): 349-57.

Tanida M, Niijima A, Shen J, Nakamura T and Nagai K (2005). Olfactory stimulation with scent of essential oil of grapefruit affects autonomic neurotransmission and blood pressure. Brain Res 1058(1-2): 44-55.

Tanida M, Niijima A, Shen J, Nakamura T and Nagai K (2006). Olfactory stimulation with scent of lavender oil affects autonomic neurotransmission and blood pressure in rats. Neurosci Lett 398(1-2): 155-60.

Wu Y, Zhang Y, Xie G, et al. (2012). The metabolic responses to aerial diffusion of essential oils. PLoS One 7(9): e44830.

#science #research #monoterpenes #aromatherapy

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