Mindfulness Improves Depression in Real-World Healthcare Applications
By John M. de Castro, Ph.D.
“Rather than try to avoid or eliminate sadness or other negative emotions, one learns to change their relationship with these emotions by practicing meditation and other mindfulness exercises.” – Psychology Today
Clinically diagnosed depression is the most common mental illness, affecting over 6% of the population. Major depression can be quite debilitating. Depression can be difficult to treat and is 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. But 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. Even after remission some symptoms of depression may still be present (residual symptoms).
Being depressed and not responding to treatment or relapsing 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 relieve the suffering. Mindfulness training is an alternative treatment for depression. It has been shown to be an effective treatment for depression and its recurrence and even in the cases where drugs fail. Mindfulness-Based Cognitive Therapy (MBCT) was specifically developed to treat depression. MBCT involves mindfulness training, containing sitting, walking and body scan meditations, and cognitive therapy that attempts to teach patients to distinguish between thoughts, emotions, physical sensations, and behaviors, and to recognize irrational thinking styles and how they affect behavior.
There has been considerable research demonstrating that Mindfulness-Based Cognitive Therapy (MBCT) is effective in treating depression. Most of the work has been done in controlled research situations. At this point an examination is needed of how effective MBCT is when employed routinely in healthcare settings.
In today’s Research News article “The Effectiveness of Mindfulness-Based Cognitive Therapy (MBCT) in Real-World Healthcare Services.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6995449/), Tickell and colleagues extracted the data from 1554 participants in group Mindfulness-Based Cognitive Therapy (MBCT) programs. They obtained data on the patients sociodemographic status, depression levels and attendance at MBCT sessions.
On average the patients attended 6.37 of the 8 MBCT sessions. They report that after the Mindfulness-Based Cognitive Therapy (MBCT) program there was significant reductions in depression with small to medium effect sizes. Of those participants who were clinically depressed 45% were recovered and 34% were reliably recovered after MBCT. There were no differences in improvement in depression for different ages or genders.
These results were not from highly controlled randomized clinical trials. Rather they were from real-world clinical applications of Mindfulness-Based Cognitive Therapy (MBCT) for the treatment of depression. There is ample evidence from controlled trials that mindfulness training and MBCT in particular are effective in reducing depression. The strength of the current study is that it demonstrates that when MBCT is implemented by clinicians in typical treatment settings it is also effective in reducing depression.
So, mindfulness improves depression in real-world healthcare applications.
“Mindfulness and other meditations, particularly combined with cognitive therapy, work just as well for anxiety or depression as the medications do, but they don’t have those side effects,” – Daniel Goleman
CMCS – Center for Mindfulness and Contemplative Studies
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Study Summary
Tickell, A., Ball, S., Bernard, P., Kuyken, W., Marx, R., Pack, S., Strauss, C., Sweeney, T., & Crane, C. (2020). The Effectiveness of Mindfulness-Based Cognitive Therapy (MBCT) in Real-World Healthcare Services. Mindfulness, 11(2), 279–290. https://doi.org/10.1007/s12671-018-1087-9
Abstract
Depression is common with a high risk of relapse/recurrence. There is evidence from multiple randomised controlled trials (RCTs) demonstrating the efficacy of mindfulness-based cognitive therapy (MBCT) for the prevention of depressive relapse/recurrence, and it is included in several national clinical guidelines for this purpose. However, little is known about whether MBCT is being delivered safely and effectively in real-world healthcare settings. In the present study, five mental health services from a range of regions in the UK contributed data (n = 1554) to examine the impact of MBCT on depression outcomes. Less than half the sample (n = 726, 47%) entered with Patient Health Questionnaire (PHQ-9) scores in the non-depressed range, the group for whom MBCT was originally intended. Of this group, 96% sustained their recovery (remained in the non-depressed range) across the treatment period. There was also a significant reduction in residual symptoms, consistent with a reduced risk of depressive relapse. The rest of the sample (n = 828, 53%) entered treatment with PHQ-9 scores in the depressed range. For this group, 45% recovered (PHQ-9 score entered the non-depressed range), and overall, there was a significant reduction in depression severity from pre-treatment to post-treatment. For both subgroups, the rate of reliable deterioration (3%) was comparable to other psychotherapeutic interventions delivered in similar settings. We conclude that MBCT is being delivered effectively and safely in routine clinical settings, although its use has broadened from its original target population to include people experiencing current depression. Implications for implementation are discussed.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6995449/