Advances in the clinical efficacy and mechanisms of acupressure for depression treatment: A comprehensive review

Background Depression is a prevalent and debilitating mental disorder with significant global health and socioeconomic impacts. Conventional treatments, including pharmacotherapy and psychotherapy, are often limited by side effects, accessibility and incomplete efficacy. This therapeutic gap has fueled the search for complementary and integrative approaches. Acupressure, a non-invasive intervention rooted in traditional Chinese medicine (TCM), has emerged as a promising complementary therapy for depression, yet its clinical efficacy and underlying mechanisms remain to be fully elucidated. Objectives This comprehensive review synthesizes and critically evaluates the latest evidence on the clinical efficacy and underlying mechanisms of acupressure for depression. We seek to bridge the ancient wisdom of TCM with modern biomedical science, providing a nuanced understanding of how acupressure can be integrated as a viable standalone or adjunct therapy within contemporary mental healthcare frameworks. Main findings Recent studies demonstrate that acupressure significantly alleviates depressive symptoms, improves comorbid insomnia and pain, and enhances quality of life with a favorable safety profile. Efficacy appears influenced by acupoint selection and individualized protocols, such as GV20+HT7+LR3, and can be synergistic with conventional treatments like medication and psychotherapy. Mechanistically, acupressure modulates key neurobiological pathways implicated in depression. It regulates of monoamine neurotransmitters (5-HT, DA, NE), enhances of neurotrophic factors (BDNF) and promotes of neural synaptic plasticity. It also exerts significant immunomodulatory effects and regulates neuroendocrine function by attenuating hyperactivity of the hypothalamic-pituitary-adrenal (HPA) axis and normalizing cortisol levels. These integrated, multi-system effects are thought to collectively underlie its antidepressant efficacy. Conclusion Acupressure represents a scientifically plausible and clinically valuable multi-system therapeutic strategy for depression. Its ability to target core pathophysiological pathways—neurotransmission, neuroinflammation, and neuroendocrine dysfunction—while maintaining an excellent safety profile, positions it as a reasonable tool for personalized medicine. Despite these promising findings, challenges remain, including the need for standardized protocols and a deeper comprehensive understanding of its mechanisms. Future research may prioritize large-scale, multi-center randomized controlled trials and interdisciplinary studies to explore novel frontiers such as the gut-brain axis. By doing so, we can fully elucidate its therapeutic potential and integrate acupressure into clinical practice, thereby addressing unmet needs in the management of people with depression.