Also, in Okamoto, et al. (2005) massage without the aromatherapy oils might have accounted for the results, as in Wilkinson’s pre-post findings of statistically significant pre-post reductions in anxiety in both groups receiving only massage and aromatherapy massage (1999, cited in Buckley, 2002) and in Corner, Cawley, and Hildebrand’s findings, where reductions in anxiety were statistically significant in both massage and aromatherapy massage groups, but not in a group receiving no treatment (1995, cited in Buckley, 2002).
Buckley (2002) nonetheless argued that based on qualitative (interview) differences favoring those receiving aromatherapy massage, relative to those receiving only massage, aromatherapy reduced anxiety. This interpretation is an example of the failure to use the rigorous standards described above (Angell & Kassirer, 1999; Breen, 2003). The studies that have been reported lacked credibility because there were competing explanations for all findings that the researchers attributed to aromatherapy.
In contrast, a well-designed study (Diego, et al. , 1998) provided evidence that lavender, but not rosemary, reduced depression and anxiety, assessed both by self ratings using reliable scales and by EEG differences in the groups receiving lavender and rosemary. Based on the scientific method, one cannot conclude that aromatherapy generally is not effective, but can only conclude that there is insufficient evidence that it is effective.
Thus, in the absence of the contraindications noted above, those who rejected or, less likely, were not helped by the traditional medications discussed above might choose aromatherapy as a treatment for depression or anxiety. Also, since there is evidence, based on both the psychological and social anthropological literature, that human touch is essential (e. g. , Montagu, 1986), aromatherapy massage might be therapeutic for patients in long-term care facilities who, unfortunately, receive mainly the touch of latex gloves.
There seems to be a basic split between scientists and practitioners who accept what might be described as a humanistic orientation. In other words, there is disagreement about what constitutes “evidence. ” Thus, sources such as the medical giant, The New England Journal of Medicine (e. g. , Angell & Kassirer, 1999), and other scientifically oriented journals, such as The International Journal of Neuroscience (e. g. , Diego, et al. , 1998), have more rigorous standards than the nursing journals, the sources of most of the actual studies on aromatherapy (the studies described above).
If the scientific sources that have criticized the existing studies encouraged publication of well-designed studies on complementary alternative medicine, we might be able to answer the basic question: Can aromatherapy reduce depression and anxiety? It is difficult to predict one’s own behavior in a novel situation, but if I were suffering from acute depression or anxiety that was not responsive to any of the conventional excellent and well-tested medications available, I might try aromatherapy, especially since the effectiveness of so-called traditional forms of psychotherapy also is questionable (Castonguay, 2002).
As a registered nurse, if a patient asked what I thought he or she might do to receive help for depression or anxiety, in the absence of the contraindications noted above, I’d suggest consulting a reputable psychiatrist who could prescribe medication. If asked specifically about aromatherapy, I’d say there was controversy and that I shared concerns about its effectiveness, but recommended the patient discuss the therapy with other professionals before making a decision.
In summary, using and evaluating all sources I could find in a search using multiple data bases, the most reasonable conclusion, based on respect for the scientific method, would seem to be that well-designed and controlled studies are needed in order to evaluate the effectiveness of aromatherapy.
References
Angell, M. , & Kassirer, J. P. (1999). Alternative medicine – the risks of untested and unregulated remedies. The New England Journal of Medicine, 339, 839-841. Breen, K. J. (2003). Ethical issues in the use of complementary medicines. Climacteric, 6, 268-272.