Posted on June 2, 2016 in Mental Health

Mindfulness Therapy May Be as Good as Pills for Depression

You’re doing all the right things to combat your depression.

Or at least you think you are.

You meet every week with your (awesome) therapist, take the medication that’s been prescribed for you and get a fair amount of exercise. This regimen gets you feeling good, even to the point that you dare to think you’ve beaten this debilitating disease. Then a new stressor enters your life and the feelings of helplessness and hopelessness come roaring back. If you’re one of the millions who battles recurring depression, there’s another potent therapy that may have escaped your radar.

In the largest-ever analysis of its kind, researchers from Oxford University in the U.K. have discovered that a type of mindfulness therapy that helps people become more in touch with their emotions works just as well as some commonly prescribed antidepressant drugs for people battling repeat depression.

Individuals who received this type of therapy, called mindfulness-based cognitive therapy (MBCT), were 23% less likely to suffer a depressive relapse even if they stopped taking their medication compared with those who did not receive the therapy and continued the pills, according to the findings published April 27, 2016, in JAMA Psychiatry.

“When mindfulness is combined with cognitive therapy, one of the things we see is people being trained to regard their thoughts as just thoughts and not to get ensnared by them,” said neuroscientist Richard Davidson, PhD, of the University of Wisconsin-Madison, in an editorial accompanying the study review.

Depression is the leading cause of disability worldwide. Symptoms like distorted thinking, difficulty concentrating and forgetfulness can impact all areas of an individual’s life. While most people do respond to traditional treatment — talk therapy plus medication — MBCT gives those who have frequent repeat depressive episodes a powerful way to help themselves.

For the Oxford University study, researchers looked at nine clinical trials conducted in the U.K., Belgium, Canada, the Netherlands and Switzerland involving nearly 1,300 patients. Overall, they found that individuals who received MBCT were about a third less likely to experience a depressive relapse during the next 60 weeks than those who did not.

“While MBCT is not a panacea, it does clearly offer those with a substantial history of depression a new approach to learning skills to stay well in the long term,” study author William Kuyken, PhD, an Oxford University professor and director of the Oxford Mindfulness Center, said in a statement.

Mindfulness-based cognitive therapy was developed in the 1990s by three clinical scientists, Zindel Segal, Mark Williams and John Teasdale, who joined up to develop a maintenance form of cognitive behavioral therapy — the mainstay of depression treatment — that would help people remain well after they had suffered from depression.

Inspired in part by Buddhist philosophy, MBCT is designed to train the brain to allow difficult emotions, thoughts and sensations to come and go without the individual having to battle them. It is a particular type of awareness that focuses attention on purpose, the present moment and the adoption of a non-judgmental attitude to things as they are. This contrasts with mindfulness in the Indo-Tibetan tradition, which focuses more on concentration, removing distractions, and discriminating between healthy and unhealthy mental states.

“People at risk for depression are dealing with a lot of negative thoughts, feelings and beliefs about themselves, and this can easily slide into a depressive relapse,” Kuyken said. “MBCT helps them to recognize that’s happening, engage with it in a different way and respond to it with equanimity and compassion.”

The new research isn’t the first to suggest that meditation may help mental health, and especially depression. The Oxford Mindfulness Center also released research in 2015 that found MBCT reduced the risk of relapse into depression by 44%. In 2014, a meta-analysis from Johns Hopkins University found that mindfulness meditation worked as well as antidepressants for anxiety and depression.

Other studies have shown that meditation changes the structure and function of the brain in profound ways.

In 2011, Sara Lazar, PhD, a neuroscientist at Massachusetts General Hospital and Harvard Medical School, and her team found that people who practiced eight weeks of mindfulness-based stress reduction experienced thickening in these four regions of the brain, according to an interview with Lazar in the Washington Post:

  • The posterior cingulate, which is involved in mind wandering and self-relevance.
  • The left hippocampus, which assists in learning, cognition, memory and emotional regulation.
  • The temporo parietal junction, or TPJ, which is associated with perspective taking, empathy and compassion.
  • An area of the brain stem called the pons, where a lot of regulatory neurotransmitters are produced.

Importantly, the amygdala, the fight-or-flight part of the brain that controls anxiety and fear, shrank in the group that went through the mindfulness-based stress reduction program.

Mindfulness meditation is also being used to help people addicted to alcohol and other drugs resist the urge to use. University of Washington researcher Sarah Bowen, PhD, and her colleagues have developed a program called mindfulness-based relapse prevention (MBRP) for people in recovery. The program combines meditation with standard relapse prevention tools, such as identifying the people, places or things that trigger relapse. Rather than fighting or avoiding the thoughts and feelings that arise when withdrawing from substances, this combination helps people to name and tolerate craving and negative emotion.

For example, if a recovering alcoholic slips and has a drink, he or she might feel that the damage is done and go ahead and finish off the bottle. MBRP can interrupt that way of thinking.

Mindfulness has also been shown to be effective in treating physical ailments.

 

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