Remove Mental Sets to Improve Depression with Mindfulness
By John M. de Castro, Ph.D.
“This new evidence for mindfulness-based cognitive therapy … is very heartening. 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.” – Willem Kuyken
Depression is the most common mental illness, affecting over 6% of the population. Major depression can be quite debilitating. It is also generally episodic, coming and going. Some people only have a single episode but most have multiple reoccurrences of depression. Depression can be difficult to treat and it’s usually treated with anti-depressive medication. But, 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. Additionally, drugs often have troubling side effects and can lose effectiveness over time. So, it is imperative that safe and effective treatments be identified that can be applied as stand-alone treatments or applied when the typical treatments fail and/or when side effects are unacceptable.
One of the characterizing features of depression is aberrant thought processes. The thinking of individuals with depression is often fraught with rumination, repeated reflection on troubling past events, and inability to suppress irrelevant thoughts or expectancies. These ruminative and irrelevant thoughts can produce an inaccurate and dark interpretation of reality. That these thought processes may be at the core of depression is evidenced by the fact that altering them with cognitive behavioral therapy is quite effective in relieving depression.
Mindfulness training is an alternative treatment for depression. It has been shown to be an effective treatment for depression and is also effective for the prevention of its recurrence. The combination of mindfulness training with cognitive behavioral therapy is a technique called Mindfulness-Based Cognitive Therapy (MBCT). It was specifically developed to treat depression. MBCT involves mindfulness training, containing sitting and walking meditation and body scan, and cognitive therapy to alter how the patient relates to the thought processes that often underlie and exacerbate depression. MBCT has been found to reduce depression alone or in combination with anti-depressive drugs and can even be effective even in the cases where drugs fail,.
In today’s Research News article “Mindfulness-based cognitive therapy for depressed individuals improves suppression of irrelevant mental-sets,” see summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5357295/
Greenberg and colleagues investigate the thought processes of depressed individuals, the effects of Mindfulness-Based Cognitive Therapy (MBCT) on these thought processes and the relationship of the altered thought processes to the relief of depression. They recruited mildly to moderately depressed adults and randomly assigned them to either receive treatment as usual or 8-weeks of MBCT. They were measured before and after treatment for depression, rumination, and suppression of mental set. This latter measure involved measuring the ability of the participants to move from a rule used repeatedly to solve a simple comparison problem (mental set) to a new one. For example, they were asked to indicate if one to three objects varied in a characteristic, e.g. amount. After repeated trials in which amount was the relevant characteristic, without knowledge of the participants, it was changed to another characteristic smoothness. How long it took the participant to recognize the change to the new rule and begin responding to it was measured.
They found, as many previous studies, that Mindfulness-Based Cognitive Therapy (MBCT) produced large and significant relief of depression. Importantly, they also found that MBCT resulted in faster recognition of and response to the changed rule. In other words the MBCT treated participants had improved suppression of mental set. In addition, they found that the greater the improvement in suppressing mental sets the greater the relief of depression. These results strongly suggest that altering thought processes produced by MBCT are at the root of its ability to relieve depression.
It has been long suspected that changes in thinking were important for treating depression. The results of the present study provide strong evidence that this is true. They also suggest that being able to move from a single method of thinking to more flexible thinking may be a key. Depressed individuals interpret events in a way that reinforces their depression. By improving their ability to interpret events in different, more realistic, ways, MBCT interrupts the cycle of thinking that maintains the depression and thereby relives the depression.
So, remove mental sets to improve depression with mindfulness.
“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
CMCS – Center for Mindfulness and Contemplative Studies
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Study Summary
Greenberg, J., Shapero, B. G., Mischoulon, D., & Lazar, S. W. (2017). Mindfulness-based cognitive therapy for depressed individuals improves suppression of irrelevant mental-sets. European Archives of Psychiatry and Clinical Neuroscience, 267(3), 277–282. http://doi.org/10.1007/s00406-016-0746-x
Abstract
An impaired ability to suppress currently irrelevant mental-sets is a key cognitive deficit in depression. Mindfulness-based cognitive therapy (MBCT) was specifically designed to help depressed individuals avoid getting caught in such irrelevant mental-sets. In the current study, a group assigned to MBCT plus treatment-as-usual (n = 22) exhibited significantly lower depression scores and greater improvements in irrelevant mental-set suppression compared to a wait-list plus treatment-as-usual (n = 18) group. Improvements in mental-set-suppression were associated with improvements in depression scores. Results provide the first evidence that MBCT can improve suppression of irrelevant mental-sets and that such improvements are associated with depressive alleviation.