Meditation and mindfulness have garnered in popularity in recent times - Amidst our busy and stressful lives, individuals are plagued with societal expectations and stresses, the ability to find some quiet and some space has become a valuable tool in the 21st century. The simplicity and effectiveness of medication is part of the appeal, in addition, the non-invasive administration compared to other medications and traditional therapies. The application of meditation as a tool for the treatment of depression has gained popularity amongst practitioners and professionals who deal with patients suffering from psychiatric alignments. Two research papers that look at the efficacy of meditation techniques are examined below.
The first research paper titled “Mindfulness Based Interventions in psychiatry” [1] investigates the effectiveness of Mindfulness Based Interventions (MBI) for the treatment of psychiatric disorders.
The research primarily looks at Mindfulness Based Interventions, or MBI in the form of Mindfulness-based Cognitive Therapy (MBCT). MBCT programs are designed to be 120-150 minutes per week, for the duration of 8 weeks. MBCT focuses on two main components: (i) formal meditation practices which includes seated meditation sessions, mindful movement (example: walking, yoga) and the body scan method, a technique used to bring attention to bodily sensations starting at the feet and progressively moving up towards the head and neck. (ii) informal meditation practices whose objective is to incorporate mindful awareness in everyday activities such as mindful eating, or mindful brushing of the teeth.
The application of MBCT has been shown to reduce the risk of depression relapse via cognitive, psychological, and neural mechanisms. Stressful life events or other triggers in everyday life can lead to recurrent negative thought patterns such as depressive rumination, judgment and anxiety which may lead to depressive relapse or other psychiatric symptoms. Mindfulness places emphasis on identifying these thinking patterns as they arise and viewing as temporary thoughts that are not facts or realities to be identified with or reacted to. The ability to accept without judgment and adopt a non-reactive attitude is one of the key mechanisms for the reduction of negative thinking patterns.
The paper provides evidence supporting the use of MBCT for the reduction of depressive relapse and includes a meta-analysis that cites four randomized controlled trials of patients with at least three depressive episodes. The evidence found that MBCT reduces the risk of relapse compared with ‘Treatment as usual’ (TAU) or placebo control groups. The MBCT+TAU patient group showed a 32% relapse rate, compared to the TAU, control group of 60%. There is strong evidence to suggest that MBCT is effective as a maintenance antidepressant medication in prevention of major depressive relapse. One caveat of the research shows that MBCT studies that include active-control groups result in mixed findings, as MBCT may not be the most effective tool for preventing relapse, especially compared to other active psychosocial interventions.
Following MBCT treatment, participants self-reported improvements in mindfulness, reduced rumination, reduced worry, improved meta-awareness, increased self-compassion and reduced emotional reactivity. MBI also helps train the individual to develop a different relationship with their thoughts by developing the skills to notice one’s thoughts, separating the perspective of the self, and creating self-awareness.
Finally, the mechanism for enhancing emotion regulation strategies, through repeated meditation, allows participants to develop body awareness through self-regulation and emotion regulation. In addition, cultivating the nonjudgmental state increases the participants ability to respond and manage stressful events.
In summary: “Despite this relative short history, MBIs have garnered considerable support for their efficacy to treat psychiatric disorders. Numerous research investigations have shown that MBIs are efficacious for reducing depression relapse and treating depression symptoms.
In addition, these interventions reduce symptoms across psychiatric disorders with mounting support for anxiety disorders, bipolar disorder, eating disorders, and substance use disorders.” [1]
The second research paper titled “Meditation Programs for Psychological Stress and Well-being: A Systematic review and Meta-analysis” [2] investigates the effectiveness of meditation programs for improving stress-related outcomes. This piece of research aggregates the results from studies dating up until June 2013 with Meditation as the primary tool.
The research looks at studies with the following criteria: Adult population (18
years or older) exhibiting medical (heart disease, cancer, diabetes, hypertension and HIV) or psychiatric (anxiety, depression, stress and insomnia) condition, ignoring healthy individuals.
Various types of meditation techniques are cited, including: (i) Mindfulness-based (MBSR, MBCT, Vipassana, Zen, other), (ii) Mantra-based (eg: Transcendental Meditation, other) and (ii) other forms of meditation. A total of 18,753 unique citations including 47 trails with 3,320 participants met the above criteria.
In addition to Mindfulness-Based Cognitive Therapy (MBCT) the other techniques mentioned include Mindfulness-Based Stress Reduction (MBSR) an eight-week course developed 40 years ago is similar to MBCT but instead of addressing a specific conditions or vulnerabilities provides techniques for “managing negative thoughts”. MBSR can be perceived as a generic technique for combating stress arising from a variety of life events, or a more generalist approach.
Vipassana, the oldest Buddhist meditation practice, is a slightly different form of meditation that focuses the command of non-reaction and freedom from the ego. The practice of Vipassana is used to develop the awareness of the interconnection between what happens in our minds in reaction to what happens to our bodies. Whether an individual experiences boredom, anger, pain or anxiety, training the mind to disconnect and be more patient is at the essence of Vipassana.
Zen meditation, sometimes known as Zazen, is a deliberate effort to focus on the ‘now’. The focus of the mediation can be on the breath, or on the sensations of sitting, or external sensory input (eg: sounds, tastes, touches, smells) – Zen meditation is to acknowledge the experience without judgement. Example “the purpose of eating dinner, is to eat dinner”.
Another form of meditation discussed is Transcendental Meditation (TM), or mantra-based meditations. TM is a silent, mantra-based form of meditation, where practitioners repeat a manta in the mind and come back to the mantra when thoughts arise. The idea is to force the mantra to transcend the process of thought.
The findings of this research paper are measured by effects on the following categories: Anxiety, depression, stress, overall affect, quality of life, attention, sleep, substance use, pain and weight. Overall, it was shown that the adoption of a mindfulness meditation program demonstrated moderate evidence to improve depression, with an Effect Size (ES) of 0.3 with 95 percent confidence intervals.
In summary: “Mindfulness meditation programs, in particular, show small improvements in anxiety, depression, and pain with moderate evidence, and small improvements in stress/distress and the mental health component of health-related quality of life with low evidence when compared to nonspecific active controls. Mantra meditation programs did not improve any of the outcomes examined, but the strength of this evidence varied from low to insufficient.” [2]
Both studies illustrate the efficacy of a Mindfulness and Meditation practice for the treatment of depression. The ability to disconnect from one’s thoughts and be less reactive to external and internal stimulus can have a positive impact. Due to the wide-ranging benefits and the variety of meditation methods, studies suggest that meditation and mindfulness is a non-invasive and easily administered tool for the improvement of general
well-being and mental health.
References
[1] B. Shapero, J. Greenberg, P. Pedrelli, M. de Jong and G. Desbordes (2018)
Mindfulness-Based Interventions in Psychiatry
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5870875/
[2] JAMA Intern Medical - M. Goyal, S Singh, E Subinga, N Gould, et al (2014)
Meditation Programs for Psychological Stress and Well-being: A Systematic Review and Meta-analysis
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