Can Massage Therapy Help Treat Anxiety & Depression?

Depression is making its way into the news again, recently highlighted by female athletes: American gymnast, Simone Biles and earlier this summer with tennis pro, Naomi Osaka.
People are also discussing the long term effects from the social isolation of Covid19.
Overall, it doesn't feel to me like we've really come a long way when it comes to dealing with issues of mental health.
I don't get asked a lot if massage can help people cope with anxiety or depression.
When I suggest it to people they are often surprised.
Put it this way: how do you feel after a massage?
Many feel lighter, less pain, sleepy, relaxed.
In all fairness, some of you feel sore.
All valid observations.
I'm an RMT or a Registered Massage Therapist, practising out of Gastown, in Vancouver, BC.
Can a massage help with these emotions or moods?
The short answer is yes.
What is Anxiety or Depression?

This seems a daunting task to explain.
I think it's different things to different people but they do have professional definitions.
In the most simplistic terms:
Depression is defined as a mood and anxiety is defined as an emotion.
We don't always know what emotions we are experiencing or able to translate into words how we are feeling.
Or why.
I want to stress that at times, it is perfectly normal to feel depressed or have anxiety.
When symptoms linger or affect your daily living, there are things you can do to ease a depressive mood and reduce anxiety.
How Does a Massage Help?

As I mentioned above, most of us just plain feel better after massage therapy (MT).
It can go deeper than that though, to a physiological or a biochemistry level.
How do we response to stress?
You may have heard about the following neurotransmitters: serotonin, dopamine, norepinephrine and the hormone cortisol.
Nutshell version is that these chemicals in the body affect our moods: how we feel about the good stuff, whether we are up for a challenge, want to hide in our beds or pull a deer in the headlights.
Fight, flight or freeze = F3. (Further research includes faint or fawn, if you're interested in reading more about this, will link below).(1)
It's been suggested that massage reduces cortisol levels which in turn increases serotonin, which may elevate our mood.
Dopamine levels, associated with feeling good, are also reportedly increased after a massage.
Norepinephrine or adrenalin, responsible for that above fight or flight is also supposedly decreased.
I can find studies or online articles that will support or deny all of these ideas.
Massage Therapy is still considered an alternative therapy that continues to require a substantial amount of study to back up any claims of effectiveness on mood.
From a paper published 2011:
MT’s effect on cortisol is generally very small and, in most cases, not statistically distinguishable from zero. As such, it cannot be the cause of MT’s well-established and statistically larger beneficial effects on anxiety, depression, and pain. We conclude that other causal mechanisms, which are still to be identified, must be responsible for MT’s clinical benefits. (2)
This doesn't discount that massage is effective in treating depression or anxiety, it's just that we can't explain why.
Seems like a long way to go for an 'I don't know how it works' but it just does.
Or it just can.
I see people who come for regular massage for physical ailments also reaping the benefits from their treatment emotionally but would likely not book an appointment specifically for that reason.
For clarity, I'm not discussing what one would think simply as a relaxation massage.
It's important to establish trust in the form of a therapeutic relationship in order for you, the patient, to address or work through depression or anxiety during your treatments.
We call this 'holding space'.
I simply witness or acknowledge what you need to experience without judgement.
Cushna is a safe space with any of our practitioners.
Massage as an Aid to Manage Emotions and Moods

I talk about Cushna's vibes to whoever will listen.
The space is incredibly welcoming and light and relaxing.
Cushna is providing the framework for me to freely explore how I want to massage and who I feel I can help best.
An experience I want to share:
I saw a patient who had very recently witnessed a violent trauma.
During their treatment, I gently inquired if they felt a 'disconnect' with their body.
The answer was a resounding yes.
"How do I help this patient?" I thought.
Of course, involve them!
This is something you can do from home: start at the top of your head and focus on each body part for a moment as you make your way down to your feet. Touch what is in reach and make the physical contact. Slowly breath in and out.
They felt more grounded at the end of their treatment and more connected to their body.
Overall this experience reminded me to revisit my ideas surrounding trauma.
Trauma can be a physical injury that happens to you but in the context of mind and body; trauma is what happens on the inside as a result of what happens to you.
Mind and body links have to be seen not only for our understanding of illness but also for our understanding of health
-Gabor Mate, When the Body Says No: The Cost of Hidden Stress
Reduced anxiety. Decrease in headaches. Decrease in pain. Improved sleep quality.
This is some of the feedback that patients report regarding emotions, mood or pain from regular massage visits.
I'm now in my tenth year of practice and while I didn't discount emotions in the past, I pay way more attention to them now.
Emotional reasons for pain are just as valid as physical ones.
I think part of healing is being present in your skin.
You can't heal your body if you aren't in it.
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Jennifer Halisky RMT, is a registered massage therapist working out of Cushna Wellness, in the lovely neighbourhood of Gastown, situated in Vancouver, British Columbia.
Reference
https://en.wikipedia.org/wiki/Fight-or-flight_response
(2) Moyer, C. A., Seefeldt, L., Mann, E. S., & Jackley, L. M. (2011). Does massage therapy reduce cortisol? A comprehensive quantitative review. Journal of Bodywork and Movement Therapies, 15(1), 3–14. https://doi.org/10.1016/J.JBMT.2010.06.001