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
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).
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).
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.
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