The Dynamics of Neroli Essential Oil and Its Effects On Anxiety written by Suzanne Botsford Neroli oil, Citrus

aurantium var amara or C. bigaradia, is an exquisite oil from the flower of the bitter orange tree. Belonging to the botanical family Rutaceae, citrus trees are said to originate from oriental Asia, China, India and Southeast Asia1. This evergreen can grow up to 33ft, has glossy dark green leaves and fragrant waxy white flowers. The blossoms are gathered, usually by hand, in late April to early May. Neroli essential oil is widely produced in Egypt, Spain, Tunisia, US and France. In oils for aromatherapy purposes flowers are steam distilled verses solvent extracted; a common practice in perfuming. It is reputed to take approximately 100 lbs of blossoms to produce 1 lb of neroli essential oil and therefore the price is indicative of the art and the precious nature of the oil. The history and folklore around the oil is interesting and diverse. Some references site the oils name came from the 17th century princess of Nerola. She was alleged to have fragranced much of her belongings, and herself, with the scent. Neroli is further believed to have acquired its name from the Roman Emperor, Nero (37AD). It has also been noted that Neroli was named after a 17th century Duchess -The Duchess of Tremoille. She was known as la Nerola because she used neroli to scent her gloves (some sites indicate this being the same woman as the princess, others differentiate the two). Both the common and the official name of neroli are reported to originate from the Sanskrit word nagarana or naranj which means orange in Arabic. For hundreds of years, orange blossoms were woven into a brides bouquet and hair symbolizing chastity and to ensure good luck, happiness and fertility. The blossoms were placed on the bridal bed to calm the nerves before the couple retired. In other traditions, Madrids women of the night were said to wear neroli as a distinguishable perfume to lure clients. Orange flowers were a constituent of Hungary Water, which Queen Elizabeth of Hungary claimed to heal her crippling arthritis. In 1709, J.M. Farina (the famous Italian perfume manufacturer)

Kurt Schnaubelt, The Healing Intelligence of Essential Oils, 2011, pg114.

began selling an essential oil blend of bergamot, lavender, lemon, petitgrain, rosemary and neroli. He called this famous blend Eau de Cologne. Orange blossom water has long been used in Middle Eastern and Mediterranean cuisines to perfume sugar syrups used in sweets and pastries and to flavor beverages. In the perfume industry of today, neroli or orange blossom is used in a plethora of scents including over 150 different brands.2 The fascination with this oil and its fragrance has been pervasive throughout history and is still going strong. There is extensive empirical evidence of its effects on physiological, emotional and mental states as well as a small number of attempts at proving, in scientific standards, that this oil deserves much attention and prominence in aromatherapy practice today. In Julia Lawless book, The Illustrated Encyclopedia of Essential Oils, the principal constituents listed in Citrus aurantium are linalool, linalyl acetate, limonene, pinene, nerolidol, geraniol, nerol, methyl anthranilate, indole, citral, and jasmone.3 Schnaubelt describes the oil in its alcohol/ester synergy and lists the oils terpene hydrocarbons at 30%, terpene alcohols at 40% and esters at 10-20%.4 The therapeutic attributes of the oil, although sometimes disputed or contradictory depending on the source, are listed as antidepressant, anti-inflammatory, antiseptic, antispasmodic, antiviral, anxiolytic, aphrodisiac, astringent, bactericidal, carminative, cicatrizant, cordial, deodorant, digestive, fungicidal, mild hypnotic, hypotensive, sedative, stimulant for nervous system, cardiac and circulatory tonic, hepatic and pancreatic stimulant. However many qualities the oil is attributed, the one overwhelmingly recorded is anti-anxiety (or anxiolytic). Each and every author I have researched has given the oil recognition for assisting those experiencing the effects of anxiety. In 1994, a noted, randomised controlled trial was conducted to assess the effects of aromatherapy and massage on post-cardiac surgery patients. Foot massage given with or without the essential oil of Neroli, on day 1 postoperatively showed that a statistically significant psychological benefit was derived from
2 3

http://www.fragrantica.com/notes/Neroli-17.html-sited from web database of current perfumes on the market. Julia Lawless, The Illustrated Encyclopedia of Essential Oils, 1995, pg117. 4 Kurt Schnaubelt, Advanced Aromatherapy, 1998, pg61.

both the groups receiving massage, compared to controls. However, significant physiological differences were limited to respiratory rate as an immediate effect of massage with or without the essential oil. The study reported Neroli lowered clients blood pressure and heart rate. A further followup questionnaire on day 5 post surgery indicated a trend towards greater and more lasting psychological benefit from the massage with the neroli oil compared to the plain vegetable oil.5 Another study, conducted in Taiwan, tested the swimming duration and distance of three groups of gerbils: a control group, a group treated with Xanax (an anxiolytic medication), and a group that had inhaled neroli oil. The rodents that had sniffed neroli swam longer and less frantically (measured by the distance they covered) than did the control group or the Xanax-fed gerbils. The researchers involved concluded, This study provides evidence-based data on aromatherapy using neroli in the treatment of anxiety.6 In fact, this too was my experience in utilizing the oil to assist my father emotionally and physically, in his 3 month long hospital stay. Experiencing compounded medical issues- from a fractured hip that required surgical replacement, a deep foot ulcer that remained an open wound for over 8 months, intermittent dementia, both osteo and rheumatoid arthritis, circulatory issues causing significant swelling and chills, as well as other less pressing concerns- posed a problem for a medical system that treats and releases their patients in a quick, cyclical manner. The use of essential oils, principally neroli, provided benefit to the whole, complex being of my father. Within the 3 months I visited almost daily and offered hand and arm massage with neroli. On approximately 3 occasions, I used other oils for the massage (rose, ylang ylang, atlas cedarwood) as I felt directed to but returned again to the regular use of neroli for the remainder of time. I feel it is important to note that with my fathers fluctuating mood and
5

C. Stevenson, Complementary Therapies in Medicine, Volume 2, Issue 1, January 1994, Pages 27 35. See abstract here: http://www.sciencedirect.com/science/article/pii/0965229994901562 6 Journal of Complementary and Integrative Medicine. Volume 5, Issue 1, Pages , ISSN (Online) 1553-3840, DOI: 10.2202/1553-3840.1143, June 2008. Inhalation of Neroli Essential Oil and Its Anxiolytic Effects by Ying-Ju Chen, Fuchou Cheng, Ying Shih, Tsong-Min Chang, Ming-Fu Wang and Sen-Sen Lan

memory, there were many days he indicated plainly that he did not like the scent of the oil yet had the same or similar effects as previous applications where he noted the scent as pleasant. A characteristic example I will give of his response to the oil is actually taken from notes written the day after his hip surgery, one night stay in the hospital: Client stated he was very sore, experiencing lots of pain. Appeared in low spirits. Reported he was extremely cold all over body. Given hand and modified foot massage (because of ulcer) with organic neroli oil at approximately 2-5% dilution in apricot kernel oil. Hands warmed significantly through treatment. Client became quiet, closed eyes and dozed dreamily in and out. Body temperature heated to the point where one blanket was removed from the bed and the other remaining ones were pulled down. My fathers breathing often deepened (indicated by rise and fall of the chest more pronounced), agitation and worry often subsided, appearance of the skins quality improved over time (very thin, pale, and fragile to touch at first), and on a few occasions changes were noted in his stomach upset or bowl movements. I decided to conduct my own case studies on neroli oil and its effects on anxiety based on the following: my experience using neroli on my father, the noted studies above and numerous accounts from authors such as Gabriel Mojay stating An all-round regulator of the nervous system, neroli oil helps to ease mental and emotional tension, nervous depression and both chronic and acute anxiety7. I asked for ten participants in a study to use Citrus aurantium var amara, as indicated for fourteen days. I had five participants successfully complete the study in its fullness. In the initial appointment scheduled a regular health intake was conducted. In addition to this participants also filled out a (modified) quiz titled Quick Anxiety Screening Test, GAD-7, developed by Drs. Robert L. Spitzer, Janet B.W. Williams, Kurt Kroenke

Aromatherapy for Healing the Spirit, Gabriel Mojay, 1997, pg 101.

and colleagues 8 as well as a modified Anxiety screening quiz based upon Diagnostic and Statistical Manual of Mental Disorders9 criteria for panic and anxiety disorders. Participants were asked to fill out the initial forms in reflection of their previous month to give us an indication of specific areas they tend to experience anxiety and to have a baseline to indicate any perceived or experienced change. All members directions were the same Each morning upon waking, place 2 drops of Neroli oil (in a base of organic jojoba and almond oil) on your hand. Rub into your solar plexus (just above your belly button) and onto your chest area. Close your eyes and inhale the scent on your hands deeply for 3 breaths. Repeat inhaling the scent on your hands for 2 more repetitions of 3. In total you will have spent 9 relaxing breaths with your eyes closed. At the end of each day please fill out the forms provided to you as honestly and accurately as possible. After the 14 days participants were told to discontinue use. Then after a period of one week or more, a final assessment was booked to record any changes over the time of not using the oil and to make any concluding comments or observations. All of the participants in the study indicated they would use the oil again for anxiety relief. Three people specified they had experienced a reduction of symptoms and frequency of anxiety by approximately 50%. One participant indicated a reduced level and frequency of anxiety to almost zero and another recorded only slight improvement (2 out of 10) in the anxiety frequency. The low mark was a result of the participant recognizing a far greater amount of daily anxiety than she was originally conscious of. This statement was echoed in another client, specifying over the course of the study she became aware

http://psychcentral.com/quizzes/anxiety_test.htm Psych Central is overseen by Dr. Grohol and a staff of contributing editors, providing mental health information as well as annotated guides to the most useful online resources today in mental health, psychology, social work, and psychiatry. 9 http://psychcentral.com/quizzes/anxiety.htm From the American Psychiatric Association, 4th Ed., 2004. (See more details about website in previous footnote).

that she wakes daily with a low level anxiety. It is postulated that using the oil at night may provide some relief of this experience. In the concluding data, 60% of participants revealed most improvements were perceived in two areas: the general sense of relaxation and fewer experiences of anxiety, worry, nervousness or apprehension. Two of the five remarked most improvement in their physical symptoms of anxiety such as heart racing or palpitations, stomach upset, and nausea. Another of the participants acknowledged heart palpitations from diagnosed Angina stopped completely while using the oil and nausea that was indicated in the pre-study appointment discontinued also. This participant did not acknowledge these experiences to be symptoms of her anxiety and therefore responded to the question accordingly. It is interesting to note here that even though only two people felt the most improvement was in physical symptoms experienced, every person in their final quiz recorded significant changes in this area. In the Anxiety Screening Quiz there was an average of 62% improvement in symptoms experienced (some eminent improvement, others only slight). Only one person had revealed an increase in frequency in 3 symptoms from the pre-study scores (the reasons previously stated). The balance of the scores remained at the same level indicated in pretesting. Two members of the study experienced better sleep (stayed asleep more often, felt sleep was more restorative and fell asleep faster) and another felt a great improvement was made in stabilizing her overall mood. Two people specified in our appointment, they experienced fewer headaches over the course of the 14 days. Interestingly, both participants were having on average 2 headaches a week attributed to their anxiety, worry and subsequent tension. Other areas were also reported to have improved over the course of utilizing Neroli oil daily. Better condition of the skin (specifically a decrease in acne), improved bowel movements (specifically ease of movement), less nightly mind chatter (noted mind not as busy as usual), overall digestion (indicated

some issue in pre-study appointment), and stress related TMJ was reported to have some improvement over the course of the study. No contraindications were experienced by any of the persons on medications. When framing the course of this study, I wanted to observe what improvements, if any, could be made on the experience or frequency of anxiety by incorporating this oil into daily life. I also wanted to observe upon discontinuing use, if any symptoms of anxiety lessoned would return. Various verbal feedback from participants suggested that symptoms or frequencies returned, sometimes not all symptoms, however this varied from person to person. A noted difference for one participant, when no longer using the oil, was when her anxiety and worry regarding finances were again greatly affecting daily functioning. Another person, when asked, recounted she had not had any psoriasis flare-ups in the two weeks with Neroli but subsequently had a breakout approximately 10 days after suspending daily use of the oil. There were distinguished improvements in the levels and the frequency of anxiety in each participant from pre to post testing. The members were asked to rate their average level of anxiety experienced over the previous month. A scale was provided with the rating of 1 through 10. 1 represented having no anxiety, 10 indicated high anxiety. The second scale of 1-10 was to rate the approximate frequency of anxiety experienced over the previous month. S, went from a level 7 anxiety (between moderate to high), to an average 4.5. The approximate frequency of anxiety experienced for S, went from a 9 to an average 6.5. D recorded a change from a level 7 to a level 5 and a frequency change from a 5 to an 8. As stated earlier, D she became more self-aware during the course of the study and recognized she had much higher occurrences of anxiety than originally indicated. K went from a level 4 to a 3, and an average frequency of 3 to a 2. Ms level dropped to a 5 from 7 and frequency plunged to half from a

10 to a 5. J experienced a significant decrease in the level of experienced anxiety from 6 to a 3.5. Js frequency slid from a 4 to a 3.5. Comments from the participants were varied and enthusiastic. After the study was completed, one participant continued use of the oil now applying it at night. I received their jubilant reaction in my email, I used the oil last night and instead of 2 hours to get to sleep after taking my sleeping pill I had to put my book down in 45 minutes. Yahoooo!! And I feel more rested this morning.. I LOVE the Neroli oil! Another person identified, I wasnt holding myself the same anymore. I didnt feel the weight of anxiety I normally felt. One person commented it was clear that neroli oil was very useful for general anxiety. In reviewing the material the case study participants filled out, I feel it is indisputable that there were significant improvements made to each persons experience of anxiety. In our final meeting, I reviewed the initial information each person provided on intake and highlighted questions around specific areas they noted to be of pressing issue. Many participants were very conscious of the shifts and progresses made in general from using the oil. There were however a number of instances where my questions highlighted an area they had not noticed improvements were made. I believe it is the job and the pleasure of a good Aromatherapist to recognize when subtle changes- perhaps unexpected changes, happen for their clients. Essential oils have multiple and varied benefits from use, in contrast to the medications most prescribed to assist people with pending ailments and illnesses. Neroli oil, in each of the cases outlined above, had benefits to several areas of the persons wellbeing and health. It has been clearly demonstrated in my experience that this oil is of considerable value in practice. Many people, especially those engaged in todays fast paced lifestyle and culture, will experience or have experienced some degree of anxiety. Fear, worry and anxiety take us out the the moment and into a spiral of emotional upset and physiological responses. The most commonly talked about holistic

way of dealing with this experience is to find our way back into mindfulness of the moment, usually through breath work. I propose essential oils intrinsically do this by bringing awareness to the breath through inhaling the aroma of the plant, and carrying the therapeutic benefit of stimulating our limbic brain through our olfactory nerves. Having our primal and associative mind conjure images, feelings or memories from the moment of smell, distracts our current fret, worry or distress. At its most basic root, one is simply disrupting the program of anxietys discord. From a more scientific standpoint, one is triggering a chemical response in the body due to the unique biochemical makeup of the plant oil used. I advise essential oils are an important tool in minimizing the effects of and the frequency of anxiety; most specifically Citrus aurantium var amara (Neroli) based on current research and experiential evidence.

Like the gentle healing of a sunshine-filled day, Optimism takes hold and I am reassured, strengthened, brightened. ~excerpt from my reflective experience of Citrus aurantium var. amara

2013. Property of Suzanne Botsford. No part of this paper may be used or reproduced in any manner without expressed permission from the author except in the case of brief quotation where both author and paper cited.