By John M. de Castro, Ph.D.
“Mindfulness is a valuable practice for improving the cognitive symptoms of depression, such as distorted thinking and distractibility. It helps individuals recognize these more subtle symptoms, realize that thoughts are not facts and refocus their attention to the present” – Margarita Tartakovsky
Depression is epidemic. Major depressive disorder affects approximately 14.8 million American adults, or about 6.7 percent of the U.S. population age 18 and older in a given year. Depression is more prevalent in women than in men. It also affects children with one in 33 children and one in eight adolescents having clinical depression. It is so serious that it can be fatal as about 2/3 of suicides are caused by depression. It makes lives miserable, not only the patients but also associates and loved ones, interferes with the conduct of normal everyday activities, and can come back repeatedly. Even after complete remission, 42% have a reoccurrence.
The first line treatment is antidepressant drugs. But, depression can be difficult to treat. Of patients treated initially with drugs only about a third attained remission and even after repeated and varied treatments including drugs, therapy, exercise etc. only about two thirds of patients attain remission. This leaves a third of all patients treated still in deep depression. These patients are deemed to have treatment-resistant depression. Being depressed and not responding to treatment is a terribly difficult situation. The patients are suffering and nothing appears to work to relieve their intense depression. Suicide becomes a real possibility. So, it is imperative that other treatments be identified that can be applied when the typical treatments fail.
Mindfulness training has been shown to be effective for depression alone or in combination with drug therapy. Although there are a number of mindfulness treatments that are effective, Mindfulness-Based Stress Reduction (MBSR) has been found to be effective for a myriad of physical and psychological problems including depression. MBSR, like all mindfulness trainings has physical, psychological, emotional, and spiritual components and spirituality has been shown to be associated with reduced depression. But, MBSR is even more complex as it contains yoga and body scan in addition to meditation. Because of the complexity and the variety of effects of these practices it is difficult to know which components are effective in promoting well-being and which are not.
In today’s Research News article “Decreased Symptoms of Depression After Mindfulness-Based Stress Reduction: Potential Moderating Effects of Religiosity, Spirituality, Trait Mindfulness, Sex, and Age”
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4365440/
Greeson and colleagues investigate the influences of the mindfulness and spiritual aspects of Mindfulness-Based Stress Reduction (MBSR) on depression in adults. Participants completed measurement scales of anxiety, depression, mindfulness, spirituality, and religious participation both before and after 8-weeks of MBSR training. They found, as has been previously demonstrated, that following MBSR training depression was significantly reduced. They also found that the higher the level of mindfulness after treatment the lower the level of depression. This was also true for the levels of spirituality, the higher they were the lower the depression. Finally, they employed a sophisticated statistical procedure, Hierarchical multiple regression analysis, to demonstrate that mindfulness and spirituality act independently to reduce depression.
These findings are interesting and suggest that the complex and multifaceted Mindfulness-Based Stress Reduction (MBSR) program reduces depression both by increasing mindfulness and by increasing spirituality. Since there is no training in spirituality or direct effort to influence spirituality in MBSR training, it would appear to be an indirect effect of MBSR. The results suggest that it is not the result of increased mindfulness, but arises nonetheless as an added bonus of the training. MBSR is an outgrowth of ancient practices of meditation, yoga, and body scan that were initially employed for spiritual purposes. So, I guess that it should come as no surprise that even when employed in a secular practice, that they still increase spirituality. It should also come as no surprise that spirituality would be associated with reduced depression as spirituality gives meaning and purpose to life which is incompatible with depression.
So, relieve depression with mindfulness and spirituality.
“Meditation has penetrated our culture in a way that would have been inconceivable 20 years ago when I started to investigate it [as a potential treatment] for mood disorders. It resonates with people’s desires to find a way of slowing down and returning to an inner psychological reality that is not as easily perturbed.” – Zindel Segal
CMCS – Center for Mindfulness and Contemplative Studies
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