Improve Depression in Overweight Adolescent Girls with Mindfulness
By John M. de Castro, Ph.D.
“By practicing meditation, you’re able to gently develop a capacity to witness pain as it happens inside you without letting the stories your mind tells you cause you to act self-destructively. Meditation teaches us to wake up from the habits of our mind so we have clear, conscious choice in our actions. By practicing sitting still in silence—especially when I didn’t want to, when I didn’t ‘have time,’ or when it was wildly uncomfortable—and developing compassion for whatever showed up inside me, all the self-judgment and self-deprecation, my neuropathways were rewired.” – Michael Hebb
Adolescence is a transitional period marked by rapid physical, behavioral, emotional, and cognitive developmental changes. Up to a quarter of adolescents suffer from depression or anxiety disorders, and an even larger proportion struggle with subclinical symptoms. Anxiety and depression during this stage can lead to impaired academic, social, and family functioning, and have long-term adverse outcomes.
Type 2 diabetes is a common and increasingly prevalent illness that is largely preventable. Although this has been called adult-onset diabetes it is increasingly being diagnosed in children and adolescents. One of the reasons for the increasing incidence of Type 2 Diabetes is its association with overweight and obesity which is becoming epidemic in the industrialized world.
Type 2 Diabetes results from a resistance of tissues, especially fat tissues, to the ability of insulin to promote the uptake of glucose from the blood. As a result, blood sugar levels rise producing hyperglycemia.
It is clear that methods need to be found to reduce the likelihood of the development of Type II diabetes and depression in adolescents. One promising avenue is mindfulness. It has been shown to be effective in treating Type II diabetes. In today’s Research News article “Pilot Randomized Controlled Trial of a Mindfulness-Based Group Intervention in Adolescent Girls at Risk for Type 2 Diabetes with Depressive Symptoms.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5705100/ ), Shomaker and colleagues recruited overweight and obese adolescent girls (aged 12-17 years) with a family history of Type II Diabetes and who also had symptoms of depression and randomly assigned them to receive either a 6-week mindfulness-based or 6-week cognitive-behavioral program.
Both treatment programs met once a week for 1 hour and there was 10 minutes of homework daily. The mindfulness program occurred in groups and included breath awareness, body scanning, mindful eating, sitting meditation, loving kindness practice, and yoga. The cognitive-behavioral program also occurred in groups and included psycho-education, cognitive restructuring, pleasant activities, self-reinforcement, and coping skills. They were measured before and after treatment and 6 months later for mindfulness, depression, anxiety, perceived stress, insulin resistance, and body composition.
They found that after treatment that both groups had significant decreases in depression, anxiety, and perceived stress that persisted to the 6-month follow-up. The decrease in depression, however, was significantly greater in the mindfulness group. After treatment, the groups also had significant decreases in insulin resistance and fasting insulin levels, but the improvements were significantly greater in the mindfulness group. It is interesting that the programs affected insulin resistance and levels as they did not include dieting or exercise components. It should be noted, however, that these improvements did not persist at the 6-month follow-up while the psychological effects did.
These results are encouraging and suggest that both mindfulness-based and cognitive-behavioral programs are acceptable, safe, and effective for the psychological and physical states of adolescent girls who are overweight or obese, are mildly or moderately depressed and who are at-risk for Type II Diabetes. Importantly, the results show that mindfulness training is superior to cognitive-based programs in relieving symptoms. Treating these girls in adolescence may help to prevent or delay the onset of Type II Diabetes and improve the quality of life in this vulnerable population. This could go a long way toward reducing health care costs and preventing and relieving their suffering.
So, improve depression in overweight adolescent girls with mindfulness.
“In the last few years mindfulness has emerged as a way of treating children and adolescents with conditions ranging from ADHD to anxiety, autism spectrum disorders, depression and stress. And the benefits are proving to be tremendous.” – Julianne Garey
CMCS – Center for Mindfulness and Contemplative Studies
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Shomaker, L. B., Bruggink, S., Pivarunas, B., Skoranski, A., Foss, J., Chaffin, E., … Bell, C. (2017). Pilot Randomized Controlled Trial of a Mindfulness-Based Group Intervention in Adolescent Girls at Risk for Type 2 Diabetes with Depressive Symptoms. Complementary Therapies in Medicine, 32, 66–74. http://doi.org/10.1016/j.ctim.2017.04.003
- A mindfulness-based group was feasible and acceptable to adolescent girls at-risk for type 2 diabetes with depressive symptoms
- Adolescents in the mindfulness-based group had greater decreases in depressive symptoms than adolescents in the cognitive-behavioral group at post-treatment and six-months
- Adolescents in the mindfulness-based group had greater decreases in insulin resistance and fasting insulin at post-treatment than adolescents in the cognitive-behavioral group
(1) Evaluate feasibility and acceptability of a mindfulness-based group in adolescent girls at-risk for type 2 diabetes (T2D) with depressive symptoms, and (2) compare efficacy of a mindfulness-based versus cognitive-behavioral group for decreasing depressive symptoms and improving insulin resistance.
Design and setting
Parallel-group, randomized controlled pilot trial conducted at a university.
Thirty-three girls 12-17y with overweight/obesity, family history of diabetes, and elevated depressive symptoms were randomized to a six-week mindfulness-based (n=17) or cognitive-behavioral program (n=16).
Both interventions included six, one-hour weekly group sessions. The mindfulness-based program included guided mindfulness awareness practices. The cognitive-behavioral program involved cognitive restructuring and behavioral activation.
Main outcome measures
Adolescents were evaluated at baseline, post-intervention, and six-months. Feasibility/acceptability were measured by attendance and program ratings. Depressive symptoms were assessed by validated survey. Insulin resistance was determined from fasting insulin and glucose, and dual energy x-ray absorptiometry was used to assess body composition.
Most adolescents attended ≥80% sessions (mindfulness:92% versus cognitive-behavioral:87%, p=1.00). Acceptability ratings were strong. At post-treatment and six-months, adolescents in the mindfulness condition had greater decreases in depressive symptoms than adolescents in the cognitive-behavioral condition (ps<.05). Compared to the cognitive-behavioral condition, adolescents in the mindfulness-based intervention also had greater decreases in insulin resistance and fasting insulin at post-treatment, adjusting for fat mass and other covariates (ps<.05).
A mindfulness-based intervention shows feasibility and acceptability in girls at-risk for T2D with depressive symptoms. Compared to a cognitive-behavioral program, after the intervention, adolescents who received mindfulness showed greater reductions in depressive symptoms and better insulin resistance.