By John M. de Castro, Ph.D.
“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. MBCT helps them to recognize that’s happening, engage with it in a different way and respond to it with equanimity and compassion.” – Willem Kuyken
Clinically diagnosed depression is the most common mental illness, affecting over 6% of the population. It is generally episodic, coming and going. Some people only have a single episode but most have multiple reoccurrences of depression. Major depression can be quite debilitating. It is distinguishable from everyday sadness or grief by the depth, intensity, and range of symptoms. These can include feelings of sadness, tearfulness, emptiness or hopelessness, angry outbursts, irritability or frustration, even over small matters, loss of interest or pleasure in most or all normal activities, such as sex, hobbies or sports, sleep disturbances, including insomnia or sleeping too much, tiredness and lack of energy, so even small tasks take extra effort, changes in appetite — often reduced appetite and weight loss, but increased cravings for food and weight gain in some people, anxiety, agitation or restlessness, slowed thinking, speaking or body movements, feelings of worthlessness or guilt, fixating on past failures or blaming yourself for things that aren’t your responsibility, trouble thinking, concentrating, making decisions and remembering things, frequent or recurrent thoughts of death, suicidal thoughts, suicide attempts or suicide, unexplained physical problems, such as back pain or headaches. Needless to say individuals with depression are miserable.
Depression appears to be the result of a change in the nervous system that can generally only be reached with drugs that alter the affected neurochemical systems. But, depression can be difficult to treat. Of patients treated initially with drugs only about a third attained remission of the depression. After repeated and varied treatments including drugs, therapy, exercise etc. only about two thirds of patients attained remission. In, addition, drugs often have troubling side effects and can lose effectiveness over time. In addition, many patients who achieve remission have relapses and recurrences of the depression. So, it is important to investigate alternative treatments for depression.
Mindful meditation training is a viable alternative treatment for depression. It has been shown to be an effective treatment for active depression and for the prevention of its recurrence. It can even be effective in cases where drugs fail. In today’s Research News article “Critical Analysis of the Efficacy of Meditation Therapies for Acute and Subacute Phase Treatment of Depressive Disorders: A Systematic Review.” See:
or below or view the full text of the study at:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4383597/
Jain and colleagues investigated the state of knowledge regarding mindful meditation effectiveness for depression. They reviewed the published research literature on the application of mindful meditation training to the relief of depression and/or the prevention of relapse. Meditation occurred in a variety of different techniques, meditation, yoga, mindful movement (i.e. Tai Chi), and mantra meditation. The most frequent technique (57% of studies) was Mindfulness Based Cognitive Therapy (MBCT). This was not a surprise as MBCT was developed specifically to treat depression.
They reported that the research results made a clear case that meditation therapies are effective for depression. They were effective in relieving depression when the patient was experiencing an active episode and also when the patient had recovered from major depression but was experiencing residual depressive symptoms. Thus, the published research is clear that mindful meditation is an effective treatment for depression. They caution, however, that more research is needed to unequivocally demonstrate its effectiveness under more highly controlled conditions.
It is not known exactly how meditation relieves depression. It can be speculated that mindful meditation by shifting attention away from the past or future to the present moment interrupts the kinds of thinking that are characteristic of and support depression. These include rumination about past events, worry about future events, and catastrophizing about potential future events. Mindfulness meditation has been shown to interrupt rumination, worry, and catastrophizing and focus the individual on what is transpiring in the present. By interrupting these forms of thinking that support depression, shifting attention to the present moment where situations are actually manageable, mindful meditation may disrupt depression.
Regardless of the speculations, it is clear that mindfulness meditation is a safe and effective treatment for depression.
“It’s been more than two years since I started that experiment. I have not missed a single day. And I’m going to tell you right now, still in half-disbelief myself: meditation worked. I don’t mean I feel a little better. I mean the Depression is gone. Completely. I still have very hard days, yes. But when issues come up, real or imagined (or a combination of both), meditation provides an awareness that helps me sort through it all, stay steady on, and understand deeply what is going on. “ – Spike Gillespie
CMCS – Center for Mindfulness and Contemplative Studies
Study Summary
Jain, F. A., Walsh, R. N., Eisendrath, S. J., Christensen, S., & Cahn, B. R. (2015). Critical Analysis of the Efficacy of Meditation Therapies for Acute and Subacute Phase Treatment of Depressive Disorders: A Systematic Review. Psychosomatics, 56(2), 140–152. http://doi.org/10.1016/j.psym.2014.10.007
Abstract
Background: Recently, the application of meditative practices to the treatment of depressive disorders has met with increasing clinical and scientific interest, due to a lower side-effect burden, potential reduction of polypharmacy, as well as theoretical considerations that such interventions may target some of the cognitive roots of depression. We aimed to determine the state of the evidence supporting this application.
Methods Randomized, controlled trials of techniques meeting the Agency for Healthcare Research and Quality (AHRQ) definition of meditation, for participants suffering from clinically diagnosed depressive disorders, not currently in remission, were selected. Meditation therapies were separated into praxis (i.e. how they were applied) components, and trial outcomes were reviewed.
Results: Eighteen studies meeting inclusionary criteria were identified, encompassing seven distinct techniques and 1173 patients, with Mindfulness-Based Cognitive Therapy comprising the largest proportion. Studies including patients suffering from acute major depressive episodes (N = 10 studies), and those with residual subacute clinical symptoms despite initial treatment (N = 8), demonstrated moderate to large reductions in depression symptoms within group, and relative to control groups. There was significant heterogeneity of techniques and trial designs.
Conclusions: A substantial body of evidence indicates that meditation therapies may have salutary effects on patients suffering from clinical depressive disorders during the acute and subacute phases of treatment. Due to methodological deficiences and trial heterogeneity, large-scale, randomized controlled trials with well-described comparator interventions and measures of expectation are needed to clarify the role of meditation in the depression treatment armamentarium.