Therapeutic Touch and Acupressure on Depressive Symptoms

Overview

Therapeutic touch intervention Participants in the therapeutic touch group received eight sessions over four weeks (two sessions per week), with each session lasting approximately 20 minutes. The intervention was conducted by a researcher trained in therapeutic touch following a standardized protocol. The session began with a centering phase lasting approximately 2-3 minutes, during which the practitioner focused attention through controlled breathing and mental concentration. This was followed by an energy field assessment lasting approximately 5-7 minutes, during which the practitioner held the hands 5-10 cm above the body without direct contact and slowly moved from the head toward the feet to assess the energy field. The final phase consisted of energy balancing lasting approximately 10-12 minutes, during which slow and rhythmic hand movements were used to promote balance in the participant's energy field. Acupressure intervention Participants in the acupressure group also received eight sessions over four weeks (two sessions per week). During each session, pressure was applied to three acupressure points for two minutes each, resulting in a total active stimulation time of six minutes. Including short preparation and resting periods before and after the intervention, the total session duration was approximately ten minutes. The acupressure points used in this study were Yintang (EX-HN3), Shenmen (HT7), and Neiguan (PC6). Yintang is located on the midline between the medial ends of the eyebrows and is commonly used for calming and stress reduction. Shenmen (HT7) is located on the inner wrist crease on the radial side of the flexor carpi ulnaris tendon and is associated with emotional regulation. Neiguan (PC6) is located on the inner forearm approximately three fingerbreadths proximal to the wrist crease between the palmaris longus and flexor carpiradialis tendons and is associated with regulation of the autonomic nervous system. Pressure was applied using the thumb with mild-to-moderate intensity in rhythmic circular movements. HT7 and PC6 points were stimulated bilaterally, whereas Yintang was stimulated unilaterally. If a participant reported discomfort during the procedure, the pressure intensity was reduced.

Menopause is defined as the permanent cessation of menstrual bleeding as a natural consequence of the reproductive period and is confirmed after 12 consecutive months of amenorrhea. During this process, the decline in estrogen and progesterone levels leads not only to vasomotor and somatic symptoms but also to psychological changes. It has been reported that the prevalence of depressive symptoms increases particularly during the postmenopausal period, with biological, psychosocial, and environmental factors playing a significant role in this process. Depressive symptoms observed during the postmenopausal period are considered a public health problem because they negatively affect women's quality of life, social functioning, and overall health status. Hormonal fluctuations experienced during this period may influence the central nervous system, and alterations in serotonergic and noradrenergic neurotransmitter systems may contribute to the development of depressive symptoms. Furthermore, differences in the hypothalamic-pituitary-adrenal (HPA) axis, which plays a central role in regulating the stress response, may also contribute to the development of these symptoms. In addition to individual biological and psychosocial factors, traumatic life events such as natural disasters can profoundly affect mental health. Sudden and destructive disasters such as earthquakes may increase the risk of depression by causing multidimensional consequences including loss, displacement, economic hardship, and the weakening of social support systems. Women's experiences of disasters may vary depending on their stage of life. Menopause represents a period during which women's vulnerability during disasters may increase. Although pharmacological treatments are effective in the management of depression, interest in complementary and holistic approaches has increased due to potential side effects, the need for long-term use, and some women's reluctance to use medication. In this context, non-pharmacological interventions such as therapeutic touch and acupressure have gained attention. Therapeutic touch is a holistic nursing intervention that aims to balance an individual's energy field and enhance the relaxation response. Touch has been suggested to increase oxytocin release, reduce sympathetic nervous system activity, and support parasympathetic activation. Through these physiological mechanisms, stress levels may decrease and psychological well-being may be improved. Acupressure, on the other hand, is a method based on traditional Chinese medicine that aims to regulate energy flow through the application of pressure to specific meridian points. From a neurophysiological perspective, acupressure may increase endorphin release and produce beneficial effects on autonomic nervous system balance. These effects may play a potential role in alleviating depressive symptoms, particularly in conditions accompanied by traumatic stress. Previous studies have examined the effects of therapeutic touch and acupressure on anxiety, pain, and sleep quality, and their effects on depressive symptoms among women who have experienced earthquakes have also been investigated. However, no studies have been found examining the effects of these interventions on depressive symptoms in postmenopausal women. Evaluating safe, low-cost, and easily applicable holistic interventions in the post-disaster period is important for community-based mental health services. Therefore, this study was designed to investigate the effects of therapeutic touch and acupressure on depressive symptoms among postmenopausal women who experienced an earthquake.