Anxiety Disorders is a major problem that is characterized by an uncontrollable feeling of dread and fear that often interfere with daily activates. Anxiety increase the release of epinephrine and norepinephrine which stimulates the sympathetic response which then leads to an increase in heart rate, blood pressure and respiratory rate (Mirbastegan et al., 2016). There are multiple kinds of anxiety, however they all share similar characteristics. Occasional anxiety is normal, however people who suffer from anxiety disorder have frequent, intense fear about living everyday life. Often times these include panic attacks, where the individual feels like they are going to die. Anxiety disorder normally develops from many different risk factors. These may include genetics, environmental factors, traumatic life events, substance abuse, personality types and brain chemistry (“Anxiety Disorders.” 2018).
Situations that can include a simple task may turn into a nightmare for someone with anxiety making daily tasks hard to accomplish. According to Anxiety and Depression Association of America, anxiety disorders affect an estimated 44 million (18.1 %) of adults in the United States, with only one-third of those seeking help. The people who do seek medical attention are normally prescribed Benzodiazepines for a short period of time, Beta-Blockers, Buspirone for chronic anxiety, SSRIs as a front line treatment, and SNRIs (Holmes, 2018). All of these have to be prescribed by a provider and bought from a pharmacy. Unfortunately, being diagnosed with a mental illness often comes with a stigma and sometimes discrimination (Davey, 2013). When there are stigmas and/or discrimination towards an individual, they may be less likely to seek treatment due to the negative connotation towards them. They become afraid of what others will think and say about them. The purpose of this study is to investigate the effect of aromatherapy, specifically lavender, on anxiety.
According to National Association for Holistic Aromatherapy (n.d), aromatherapy is a way of using extracted parts of plants to promote health of the body and mind. The use of the aroma helps to enhance the healing process of an individual (“What is Aromatherapy?” n.d.).
Aromatherapy has been found to reduce serum cortisol in the body which is our stress hormone. When this hormone is reduced, the individual will feel more relaxed (Mirbastegan et al., 2016).
Different studies have shown that the inhalation of essential oils stimulate olfactory receptors, releasing endorphins, and serotonin which in return reduces anxiety. If lavender essential oils by the use of aromatherapy help to reduce anxiety, people diagnosed with anxiety can have another option to treat their disorder.
Research Question
Do patients with anxiety experience less anxiety by the use of aromatherapy measures such as lavender essential oil, compared to pharmacologic interventions over a three month period?
Importance to Nursing
The use of a natural way to heal anxiety is thrilling for both nurses and the patient. Referring to the stigma of mental health, a way to purchase a natural remedy over the counter to help with the anxiety can help an individual’s self-esteem (Davey, 2013). Although there are a variety of anxiety medications and many that have a generic brand, they still can cost an individual over $100 monthly to treat their anxiety (N., M., J., G., M., B. B., & M. H., R., 2016). The stress of paying for an individual’s medications can potentially raise anxiety levels.
When using an essential oil, the patient doesn’t have to be prescribed an anxiolytic, and go through the pharmacy, and the costs are significantly reduced. According to Mayo Clinic (2017), another benefit to introducing aromatherapy into medicine is the benefits it has on women in labor. Lavender, one of the essentials oils that were found helpful, reduced fear and anxiety experienced by mothers, reducing the need for pain medication. The use of lavender essential oil aromatherapy may not work in extreme cases, however it may be useful along with an anxiolytic until the anxiety is controlled.
Literature Review
The research that has been found and the studies that have been done are based on specific patients experiencing physiologic stress on their body. The research isn’t directly comparing patients diagnosed with anxiety disorder and the use of lavender essential oils, however it will support the idea that lavender has a positive influence on the stress that the human body encounters.
Patients who experience a Myocardial Infarction (MI) often times experience anxiety especially during the beginning of their recovery while they are in the intensive care unit (ICU). A study done at AL Zahra heart hospital in Shiraz in Iran wanted to see if inhaling lavender essential oil would have an effect on anxiety and vital signs on patients that have experienced an MI. The sample size was 60 individuals, ages between 30-70 and stable with no history of mental health problems, Alzheimer’s, addiction and no use of anxiolytic medications (Mirbastegan et al., 2016). They had the participants take a Spielberg State-Trait Anxiety self-evaluation to measure their anxiety the patient was currently experiencing before introducing the lavender aromatherapy and the baseline vital signs were also measured. The participants were divided into two groups, one with mild-moderate severity and moderately sever-very severe).
The lavender essential oil was then attached to a cloth that was attached to the patients clothing and the participant was asked to inhale normally for 20-30 minutes, three times a day for three days. The same process happened with the placebo group, but they had sterile water on their piece of cloth. The study found that at the beginning of the study, the control and intervention group had the following measurements, with no significant differences (56.60±10.14 vs 60.26±9.29, p=0.063) and trait anxiety (54.13±0.17 vs 55.73±10.22, p=0.526), But at the third day there was a significant reduction in state anxiety level of intervention group (From 60.26±9.29 to 41.56 ± 7.57P (Mirbastegan et al., 2016). They also found that on the third day, the intervention group had much lower blood pressure. The authors concluded that lavender essential oil was confirmed to reduce anxiety and blood pressure in patients that experienced and MI and in the intensive care unit (Mirbastegan et al., 2016). The essential oil was more effective on patients experiencing sever anxiety. Considering a high blood pressure can cause further problems, implementing lavender essential oil to patients recovering from and MI can be cost effective and beneficial to the patient’s recovery.
Another study conducted in Korea at Euliji University Hospital tested the effects of aromatherapy using lavender, chamomile and neroli oil on patients who have been diagnosed with coronary artery disease and were undergoing stent insertions during coronary angiogram and being admitted to the intensive care unit (ICU). The study tested anxiety levels, sleep and blood pressure. They had a total of 56 participants, 28 in the aromatherapy group and 28 in the control group (Cho et al., 2013). Similar to the study done in Iran, they had the participants take a Spielberg State-Trait Anxiety self-evaluation to measure anxiety levels and also took baseline vital signs. Lavender lowers heart stimulation which then lowers blood pressure, therefore helpful in patients with heart conditions. The intervention included the inhalation of the aroma that was placed on aroma stones. In the aromatherapy group, two drops of the aromatherapy blend were placed on the stones and inhaled through 10 deep breaths before and after PCI, the procedure. After the breaths were completed, the stones were placed under the patient’s pillow. The control group just received typical nursing care.
The study found that after treatment, the anxiety levels of the aromatherapy group were 0.36 and 3.11 in the control group, the lower the number the less the anxiety level (Cho et al., 2013). These statistics show a major decrease in anxiety levels in the aromatherapy group. The aromatherapy group also had an increase in sleep and a reduction in blood pressure. These results are consistent with the previous study, supporting the use of aromatherapy to help reduce anxiety.
Patients undergoing hemodialysis often experience anxiety and depression. Another study conducted in Iran tested the use of lavender essential oil aromatherapy on anxiety and depression in patients going through dialysis. In the study there was a total of 72 hemodialysis patients divided into a control group and experimental group. The experimental group were given 3 drops of 5% lavender essential oil 5% for 10 minutes every time they underwent hemodialysis for period of one month (Masoumeh, Shorofi, Nikkhah, and Espahbodi, 2017).
After the month was over there was no significant change in the patient’s anxiety levels during hemodialysis. Knowing that the percentage of lavender essential oil that was used in this study was not effective, it is important in future studies to increase the amount.
