Aromatherapy for Anxiety

By Jenni Moore, RN, BSN

Introduction
Aromatherapy dates from more
than 5000 years ago when Egyptians
used scented oils for embalming, cosmetics, and perfumes. Hippocrates
taught its health
enhancing benefits in
Greece in the late 5th
century B.C. It became a formal science
in the 1930s when
the severely burned
hand of French
chemist, Gattefosse,
was healed after he
plunged it into lavender oil, the nearest
liquid available in his
lab(Worwood, 1991).
Aromatherapy continues to be one ofthe
most commonly used
complementary and
alternative medicines (CAM) today
with concentrated oils obtained from
flowers, leaves, resins, seeds, roots,
and grasses of between 75 to 300 different plant species (Worwood, 1991).
Although the mechanism of action
is not known, the essential oils are
suspected to aftect the limbic system,
the area of the brain associated with
basic drives of hunger, thirst, breathing, sleep patterns, sex drive, mood,
memory (learning), and emotions
(Braden, Reichow, & Halm, 2009).
Oils can be administered by inhalation where they are believed to travel
directly through the olfactory bulb
to the limbic system, or topically, by
massage and bathing, with absorption
through the skin into the blood stream
within 10-30 minutes. Various aromatherapy oils are used for stings and
bites, insomnia, nausea, depression,
anxiety, infections, and pain. Supporting data for aromatherapy includes a
large proportion of anecdotal accounts
(Howard & Hughes, 2008; Lee, Wu,
Tsang, Leung, & Cheung, 2011) but it
has become quite popular as a gener-

ally safe, low-cost treatment, with few

contraindications, sensitivities, or drug
interactions.
Approximately four to six percent of
people worldwide suffer from anxiety
of some type (Lee et al, 2011). At
least ten different
essential oils are
believed to relieve
anxiety, but lavender
is the most widely
recommended oil for
this problem (Howard
& Hughes, 2008; Lee
etal, 2011). Lavender oil is believed to
retain therapeutic
properties even for
people with impaired
olfactory senses
(Braden et al, 2009).
Symptoms of
anxiety can be largely
subjective, including
complaints of fatigue, tension, irritability, restlessness, headache, and general unpleasant feelings. Objective
measurements of anxiety include high
blood pressure, elevated heart rate,
sweating, diarrhea,
and an inability to
focus (Lee e t a l , 2011;
McCaffrey, Thomas,
& Kinzelman, 2009).
Because blood pressure changes tend
to occur over time,
heart rate may reflect
reactions to short term
acute stress more accurately (McCaffrey et
al., 2009). Frequency
of requests for pain
medication has been
used as an objective measurement of
subjective feelings
in an attempt to measure effectiveness of lavender (Kim, Wajda, Cuff,
Serota, Schlame, Axelrod, & Bekker,
2006). This research article explores
evidence for lavender's physiological

effectiveness to treat anxiety.

Review of Literature
Using data bases of CINAHL and
PubMed, a literature search was made
of peer reviewed journals from 2005 to
present with key words aromatherapy
and anxiety, producing more than sixty
articles. Refining the search for adults
using lavender oil produced sixteen
articles; three were selected for this
review of effects of administration by
inhalation ofthe scented oil.
Table 1 (page 13) provides a summary ofthe reviewed articles.
Studies for this review of literature
were purposefully selected to have
similarities and differences. All three
study designs evaluated lavender oil
administered by inhalation. Two of
the studies compared healthy subjects
with situational anxiety while the other
studied surgical patients anticipating a
wide variety of procedures. Two of the
studies utilized an experimental group,
a control group, and a placebo group,
while the other used repeated measures. Two ofthe studies attempted to
measure physiological changes and two
measured reported
anecdotal results.
Only one ofthe studies was double-blind
in design.
More research is needed to
test individual oils, as
many studies focus
on aromatherapy
using multiple oils or
in combination with
massage or music.
In these studies it is
unclear to what extent
each component influences patient outcomes. The large
number of oils utilized for a wide range
of health conditions will require welldesigned studies to determine specific
effects of each. Blind and double-blind
continued on page 12

Vol. 83 Number 3 May-June 2013 The Kansas Nurse

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11

Aromatherapy for Anxiety

By Jennifer Moore, RN, BSN
Continued from page 11

studies are needed to test for scented

oils, a challenge because many scents
are difficult to mask. Study designs
will also need to compare similar
methods of administration, standardized doses, and timing for oils (\Afett &
Janda, 2008).
Incorporation into Advanced Nursing Practice
Aromatherapy is an extremely
popular CAM despite the anecdotal
nature of much of the supporting
literature. While the overall quality
of studies leaves many unanswered
questions, there does seem to be
evidence for effectiveness in mild or
short term issues. Essential oils may
provide safe and low-cost adjuncts to
other treatments in most populations.
There is currently no professional
certification for aromatherapy, but clinical courses are available to members
ofthe National Association of Holistic
Aromatherapy (NAHA, 2012). When
oils are used, their purpose should be
clear, with targeted outcomes that are
measurable by objective as well as

subjective means. The large number

of oils and applications of aromatherapy require specialized training to
utilize them safely in patient care. The
complex physiological, psychological,
and spiritual natures of humans may
indeed benefit from aromatherapy, but
much more information is needed for
truly evidence-based usage.
References
Braden, R., Reichow, S., & Halm, M.
A. (2009, December). The Use
ofthe Essential Oil Lavandin
to Reduce Preoperative Anxiety in Surgical Patients. Journal of PeriAnesthesia Nursing,
24('6;, 348-355. doi:10.1016/
j.jopan.2009.10.002
Howard, S., & Hughes, B. M. (2008).
Expectancies, not aroma, explain impact of lavender aromatherapy on psychophysiological
indices of relaxation in young
healthy women. British Journal of
Health Psychology, 3, 603-617.
doi: 10.1348/135910707X238734
Kim, J. T, Wajda, M., Cuff, G., Serota,
D., Schlame, M., Axelrod, D. M.,...
Bekker, A. Y. (2006). Evaluation of
aromatherapy in treating post-

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operative pain: pilot study. Pain

Practice, 6(4), 273-277.
Lee, Y., Wu, Y, Tsang, H. W., Leung,
A., & Cheung, W. M. (2011). A
Systematic Review on the Anxiolytic Effects of Aromatherapy
in People with Anxiety Symptoms. The Journal of Alternative
and Complementary Medicine,
17{2), 101-108. doi: 10.1089/
acm.2009.0277
McCaffrey, R., Thomas, D. J., &
Kinzelman, A. O. (2009, March/
April). The Effects of Lavender and Rosemary Essential
Oils on Test-Taking Anxiety
Among Graduate Nursing Students. Holistic Nursing Practice,
23(2), 88-93. doi:10.1097/HNP
Ob013e3181a110aa
National Association of Holistic Aromatherapy (NAHA) (2012). Retrieved
July 2, 2012, from http://www.
naha.org
Watt, G. V, & Janda, A. (2008, August). Aromatherapy in nursing
and mental health care. Contemporary Nurse, 30(1), 69-75.
Worwood, V. A. (1991). The Complete
Book of Essential Oils & Aromatherapy. San Rafael, CA: New
World Library.
Jenni Moore, RN,
BSN, has extensive experience in
multiple areas of
nursing, including
school nursing,
community health,
and education.
She is currently seeking a Master's
Degree in Nursing at Washburn
University, Topeka. She is a KSNA
District 18 member.

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The Kansas Nurse May-June 2013 Vol. 88 Number 3

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Copyright of Kansas Nurse is the property of Kansas State Nurses Association and its content
may not be copied or emailed to multiple sites or posted to a listserv without the copyright
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individual use.

Copyright of Kansas Nurse is the property of Kansas State Nurses Association and its content
may not be copied or emailed to multiple sites or posted to a listserv without the copyright
holder's express written permission. However, users may print, download, or email articles for
individual use.