2019 Healthy Nurses Conference Health Focus Session A ‐ Essential Oils: A Strategy to Reduce Stress

“To reach the individual, we need an individual remedy. Each of us is a unique message. It is only the unique remedy that will suffice. We must, therefore, seek Essential Oils: A Strategy odiferous substances which present affinities to Reduce Stress with the human being we intend to treat, those which will compensate for his Debra Rodriguez, MSN, ANP-BC, PNP-BC, CCAP, CH deficiencies, and those which will make his [email protected] faculties blossom.” Marguerite Maury

Objectives What is Mental Health?

 List 1 essential oils for depression Mental Health Includes: Mental Health Affects:

 List 1 essential oil for stress  Emotional well-being  How we feel

 List 1 acupressure point for stress  How we act  Psychological well-being  How we respond to stress  How we make choices  Social well-being  How we relate to others

Areas of Focus for Mental Wellness Plan

 Stress reduction * Specific mood support -Consideration for: -Consideration for: * anxiety, mood impulse, psychotic, * Mood disorders tic disorders * stress response syndromes * Circadian rhythm support -Consideration for: * Insomnia, daytime lethargy, neuro- endocrine disruptions and imbalances

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Chronic Stress

Merriam-Webster Definitions Stress Anxiety

 A state of mental tension &  Fear or nervousness worry caused by problems in about what might your life, work, etc. happen, often marked by physiological signs –  Something that causes sweating, increased strong feelings of worry or pulse anxiety  A feeling of wanting to  Physical force or pressure do something very much

Circadian Rhythm

The Circadian Rhythm is a 24 hour clock that governs some 100+ biological processes peak and dip each Circadian Rhythm day. Function Typical Circadian Rhythm  Peak mental alertness and memory  2 daily peaks: ~9am and 9pm  Lowest body temperature  ~ 97 F around 4am  Highest body temperature  ~99 F around 4pm  Peak physical strength  2 daily peaks: ~11am and 7pm  Peak hearing, visual, taste & smell  2 daily peaks: ~3am and 6pm sensitivity  Lowest sensitivity to pain  ~4pm  Peak sensitivity to pain  ~4am  Peak degree of sleepiness  2 daily peaks: ~3am and 3pm  Peak melatonin hormone in blood  Between 1am and 3am  Peak allergic sensitivity to pollen  Between 11pm and 1am and dust

Exercise

Integrative Modalities to use in the Clinic Setting  Regular physical activity “burns off” the stress and at Home hormones and helps the body to relax

 Outdoor activities use nature to “burn off” the stress hormones

 Exercise produces “feel good” hormones

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Creating a routine SQUARE BREATHING  Breathe in for 4 seconds,  Choose a special place where you can sit (or lie down) comfortably and quietly.   Hold it in for 4 seconds. Don't try too hard. That may just cause you to tense up.  Have a focal.   Breathe out for 4 seconds, Try to practice once or twice a day, always at the same time, in order to enhance the sense of ritual and establish a habit.  Repeat this 4 times.  Try to practice at least 5 minutes each day and gradually Picture breathing around a 4 square frame, going up 1 side, increase your time to 10-20 minutes each day. holding across the top, breathing out going down the other Per http://www.health.harvard.edu/mind-and-mood/relaxation-techniques-breath-control-helps-quell-errant-stress- side and holding again across the bottom. response

What is Aromatherapy? Aromatherapy is rooted in herbal medicine.

Aromatherapy is the use of essential oils to produce therapeutic outcomes.

Essential oils are the distillates extracted from various aromatic plants.

What should I know before I use an essential oil? Determining Quality of Essential Oils

 What’s in the bottle?  Verification of the plants botanical  common name species  botanical name  Crops were not subjected to  What’s really in the bottle? agrochemicals  Family  Low pressure distillation techniques  Genus employed  Species  Visually inspecting the oil  Variety/part   How is it extracted? Odor evaluation of the oil  steam distilled  Testing the oils purity using GC or  expressed GC/MS technology

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Essential Oil Safety Skin Reactions  DO NOT take EO internally  Check medical history  Use proper dilutions esp. for  KEEP OUT OF REACH of the very young and the very CHILDREN  Irritation old.  Ensure EO is from reputable  NEVER use EO undiluted. supplier and all bottles are  Sensitization  KEEP OUT OF EYES: if enters labeled correctly. eye rinse with carrier oil  Do not store in plastic, use then water for 30 minutes dark colored glass bottles  Cross-sensitization  Check allergies and keep in cool dark place  DO a patch test for skin  Citrus oils are photosensitive  Phototoxicity sensitivity or irritation so stay out of sun or tanning beds

Doses, Conversions & Equivalents Doses, Conversions, & Equivalents

 1 drop EO in 20ml (4 tsp) of carrier oil = 0.25%  There are:  1 drop of EO in 10ml (2 tsp) carrier oil = 0.5% - Approximately 20 drops in 1ml of essential oil  1 drop of EO in 5ml (1 tsp) carrier oil = 1% - Approximately 100 drops in 5ml of essential oil  5 drops of EO in 5ml carrier oil = 5%  10 drops of EO 5ml carrier oil = 10% Therefore, use 5ml (1 tsp) as 100%. So, 1 drop of essential oil in 5ml carrier oil is 1%

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Dilution Guideline General dilution rate guidelines

 0.5 % = 4 drops per ounce (sensitive skin, emotional and  CHILDREN spiritual purposes) Newborn-2 years  1% = 9 drops per ounce (recommended for children, – 0.25%-0.5% 1 drop in 20ml (4 tsp) to 1 drop in 10ml (2 tsp) expectant mothers, skin care) in a carrier oil  2% = 18 drops per ounce (massage, body lotion) 2-5 years – 0.5% - 1% 1 drop in 10ml (2 tsp) to 1 drop in  3% = 27 drops per ounce (massage, body lotion) 5mls (1 tsp) carrier oil.  10% = 3 ml (sixty drops) (pain, infection, usually on small 5-12 years – 1 – 5% body area) 12 – Adult - 1 - 5%

Amount of essential oil absorbed depends on: What are Carrier Oils?

 Should be of vegetable origin  Dilution  Skin temperature  Obtained from seeds or nuts  Cold-pressed  Amount  Age  Non-hydrogenated  Fixed because they can’t be steam distilled  Amount of skin surface  Carrier oil  Used as a base oil for topical applications covered  Properties have much to do with the desired therapeutic effect.

Which Carrier Oil to Use? Carrier Oils

 Aloe Vera Gel  Grapeseed  Choose one that meets the need of the  Sweet Almond treatment  Jojoba  Arnica  Mineral/Baby oil or Vaseline are NOT used in aromatherapy because these products  Tamanu are not natural and can prevent essential  Castile soap oil absorption into the skin

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Essential Oils in Plants

Chemical Groups in Essential Oils

Eight predominant chemical groups are involved in the composition of essential oils and each group contributes a particular therapeutic quality. Chemical analysis using the method of Gas Liquid Chromatography (GLC) means the purity of the oil can be assessed, and the presence of any foreign ingredients can Chemistry of Essential Oils be spotted – for example, artificial fertilizers or pesticides – in oils claimed to have been organically grown. To fully understand why it is so important to have as pure essential oils as possible, it is necessary to understand the chemical make-up of each essential oil, and the therapeutic effect of each chemical group. It is the chemistry of the essential oil which determines The eight main chemical groups found in essential oils are Aldehydes, Esters, Ketones, Phenyl Methyl Ethers, Oxides, Phenols, Alcohols and Mono Terpenes. CHEMICAL NAME THERAPEUTIC QUALITIES EXAMPLES

it’s therapeutic properties. Aldehydes anti-infectious, analgesic, anti-inflammatory; they also help geraniol, found in e.g. Rose Geranium (pelagoniun regulate the central nervous system graveolens)

Esters calming, sedative, and they help regulate the central nervous linalyl, found in e.g. Lavender (lavandula angustifolia), system they are also anti-spasmodic, and mucolytic (breaks 40% down mucous)

Ketones anti-infectious, skin healing, mucolytic, lipolytic (breaks down verbenone, found in e.g. Rosemary (rosmarinus official) Complex mixtures of chemical functional groups make fats), aides respiratory tract infections

Phenyl Methyl Ethers anti-infectious, anti-spasmodic, oestrogen-like and therefore can chavicol, found in e.g. Basil (ocimum basilicum) up the chemical profile. help regulate hormonal system as well as help regulate central nervous system

Oxides expectorant, some are anti-infectious cineole or eucalyptole, found in e.g. Eucalyptus (globulus) 70%.

Alcohols anti-pathogenic, immune-stimulants linalol, found in e.g. Lavender (lavandula angustifolia).

Where the plant is grown determines the chemical Phenols strongly anti-pathogenic, stimulating. (NB, some are thymol, found in e.g. Thymes CT thymol 30% dermocaustic)

makeup of the essential oil. Mono Terpenes antiseptic, fortifying and strengthening anti-viral, cortisone-like limonene, found in e.g. lemon (citrus limone)70%

This list of natural chemical ingredients and their therapeutic effects illustrates just how important all the natural ingredients are in essential oils. The loss of any of these ingredients, through lack of purity results in essential oils with little or no therapeutic effect, in other words as we said in the beginning, they simply do not work.

Aldehyde Properties Ester Properties

 Anti-inflammatory  Calming

 Sedative  Sedative

 Antispasmodic  Antiviral

 Possibly antifungal  Analgesic

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Phenol Properties Effects of Essential Oils on the Body

 Antibacterial  PSYCHOLOGICAL - the reaction and response that takes place when the essential oil is breathed in.

 Stimulant  PHYSIOLOGICAL - the changes which occur within the body’s systems as a result of the essential oil.  Immunostimulant  PHARMACOLOGICAL - chemical changes which take place when the essential oil is carried in the blood and inter-reacts with the  Possible skin irritant body’s chemistry-neurotransmitters, hormones, enzymes.

How are essential oils used? Where Does Smell Go? Olfaction direct inhalation  Breathe in through the nose indirect inhalation  Top of nose is the olfactory Transcutaneous system topically with “M” technique  Chemicals move up into the compresses olfactory bulb baths  Stimulates olfactory center in the Ingestion brain done by a licensed professional who can prescribe

The Sense of Smell Topical Application

 Smell is instantaneous  Penetration into the skin  Smell is a chemical reaction  Smell is important  Permeation trans-dermal to  Smell affects us without us even knowing it capillaries  Smell effects how we communicate  Smell linked to our memories  Blood & lymphatic circulation

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Ways to Use Essential Oils in Mental Wellness

Direct Inhalation Indirect Inhalation  Personal inhaler  Spritzer  Aroma tab/patch  Diffusers  Tissue  Cotton ball in zip lock baggie  Pillow case  Bath  Foot soaks

Inhalation Aromatherapy Research

Direct Indirect

Aromatherapy Research Aromatherapy Research cont.

Chen, M.C., Fang, S.H., & Fang, L.(2013). The effects of Jafarzadeh, M., Arman, S., & Farahbakhsh, P.F.(2013). Effect of aromatherapy in relieving symptoms related to job stress among aromatherapy with orange essential oil on salivary cortisol & pulse rate nurses. International Journal of Nursing Practice. in children during dental treatment: a randomized controlled clinical doi:10.1111/ijn.12229. trial. Adv. Biomed Res. 2:10. Cheng-Hua Ni, Wen-Hsuan Hou, et al.(2013). The anxiolytic effect of Rhind, J.(2016). Neroli- a fresh perspective on an aromactic icon. The aromatherapy on patients awaiting ambulatory surgery: A randomized International Journal of Professional Holistic Aromatherapy 4(4), 23-32. controlled trial. Evidenced Based Complementary and Alternative Setzer, W.N.(2009). Essential oils & anxiolytic aromatherapy. Natural Medicine. Product Communications; 4(9): 1305-1316. http://dx.doi.org/10.1155/2013/927419 Emerald Dr., Mila(2016). Potential use of essential oils in prevention & management of PTSD. International Journal of Professional Holistic Aromatherapy; 4(4) 13-21.

8 2019 Healthy Nurses Conference Health Focus Session A ‐ Essential Oils: A Strategy to Reduce Stress

Stress & Anxiety Reduction with Aromatherapy Essential Oils for Mental Wellness  Promote relaxation  Soothe nerves Build use of essential oils into routines: * Lavender * Geranium * Lavandin * Jasmine Meditation * Sweet Marjoram * Mandarin * Neroli Group therapy  Sink energy downwards, away  Restore energy Individual therapy from ‘busy’ brain * Black spruce Bedtime * Spikenard * Cypress * Vetiver * Sweet Marjoram

Essential Oils for Mental Wellness Circadian Daytime Support

 Depression  PTSD  Bergamot  Black spruce Lavender Lavender  Blue tansy  Peppermint Bergamot Geranium  Scot’s pine  Rosemary-caution-avoid with seizures Sweet orange and hypertension

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Circadian Bedtime Support Essential Oils & Massage

 Cedarwood-Hymalayan  Raised energy levels  Reduced muscle tension  Roman chamomile  Improved circulation  Lavender  Stimulation of the immune system  Patchouli  Promotes relaxation  Sweet marjoram  Reduction of stress and anxiety  Spikenard  More restful sleep  Vetiver  Promotion of a sense of well being

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Into the tub Lavender (Lavandula angustifolia)

 Baths-since most EO are not water soluble place them in an emulsifier (milk) before adding to the bath. 5-8gtts and disperse into bathwater. Soak 20-30minutes  Antimicrobial  Bath Gel – add 10 drops of essential oil to 2  Sedative ounces of neutral bath gel or castile soap  Analgesic  Scrub recipe - This is a very popular spa treatment. The objective of this treatment is to  Anti-inflammatory eliminate dead cells and make your skin soft and radiant.  Antiviral 1 cup of sugar/sea salt  Antispasmodic 1/2 cup of almond or grape-seed oil 15 drops of grapefruit essential oil. You may use any other essential oil.

Lavandin(Lavandula x intermedia: super) Roman Chamomile(Chamaemelum nobile)

Anti-inflammatory

Analgesic  Relaxant Sedative  Antispasmodic Calming

Anti-infectious

Frankincense(Boswellia cateri) Mandarin red (Citrus reticulata)

 Antiemetic  Anti-inflammatory  Digestive

 Analgesic  Sedative/Relaxant  Analgesic

 Sedative  Astringent

 Diuretic  Antibacterial

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Sweet Marjoram(Origanum majorana) Spikenard(Nardostachys jatamansi)

 Tranquilizing  Sedative

 Antidepressant  Anti-inflammatory  Analgesic

 Antispasmodic  Bactericidal  Antibacterial

 Antifungal  Fungicidal

Geranium(Pelargonium graveolens) Sweet Orange(Cistrus sinensis)

 Uplifting  Antidepressant

 Adrenal cortex regulator  Sedative  Antispasmodic

 Anti-inflammatory  Immune stimulant

 Antibacterial

 Diuretic

Vetiver(Vetvera zizanoides) Relaxation Blends Stress/Anxiety Insomnia  Sedative 1-2 ml of fractionated coconut oil Lavender/Red mandarin Several drops of: Vetiver  Calming Lavender/Red mandarin Spikenard Sweet orange Lavandin  Antiseptic Geranium/Ylang ylang May use independently or blend. Apply a few drops on pillow case or on a cotton ball next to the  Mild rubefacient head of the bed.

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Acupressure Stress Acupressure Points

GB 21 GB 20 CV 17 Shoulder Well Gates of Consciousness Sea of Tranquility

Relax Inhaler References

Battaglia, S. The Complete Guide to Aromatherapy, 2nd ed. Brisbane QLD, Australia,  Fractionated coconut oil base The International Centre of Holistic Aromatherapy, 2003. Buckle, J. Clinical Aromatherapy. Essential Oils in Practice. 2nd ed. New York, NY: Churchill, Livingstone, Elsevier; 2003.  Lavandin Buckle, J. Clinical Aromatherapy. Essential Oils in Healthcare. 3rd ed. St. Louise,  Sweet marjoram MO: Churchill, Livingstone, Elsevier; 2015  Sweet orange Butje, A. The Heart of Aromatherapy. An Easy-to-Use Guide for Essential Oils. Carlsbad, CA: Hay House Inc. 2017  Vetiver Purchon, N & Cantele, L. The Complete Aromatherapy & Essential Oils Handbook for Everyday Wellness. Toronto, Ontario: Robert Rose Inc. 2014 Tisserand, R. & Young, R. Essential Oil Safety: A guide for Health Care Professionals.  Use as needed 2nd ed. New York, NY: Churchill Livingstone; 2014  Enjoy

Thank you!

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