Anxiety

Improve Mental Health with Mindfulness

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By John M. de Castro, Ph.D.

 

“Mindfulness-Based Cognitive Therapy (MBCT) is designed to help people who suffer repeated bouts of depression and chronic unhappiness. It combines the ideas of cognitive therapy with meditative practices and attitudes based on the cultivation of mindfulness. The heart of this work lies in becoming acquainted with the modes of mind that often characterize mood disorders while simultaneously learning to develop a new relationship to them.” – MBCT.com

 

About one out of every five people suffers from a mental disorder. In the U.S. that amounts to over 44 million people. For the U.S. adults about 1.1% live with schizophrenia, 2.6% with bipolar disorder.  6.9% with major depression, 18.1% with anxiety disorders, and 3% with substance use disorders. This places a tremendous burden on the individual, their families, and the health care system. Obviously there is a critical need to find safe, effective, and affordable treatments for these disorders.

 

Mindfulness training has been shown to be helpful in treating many of these disorders, including schizophrenia, depression, anxiety, and substance abuse. One form of therapy that includes mindfulness training is Mindfulness-Based Cognitive Therapy (MBCT). It was developed specifically to treat depression and has been found to reduce depression alone or in combination with antidepressive drugs. 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. It has proved so effective for depression that it has also begun to be applied to a variety of other mental disorders.

 

In today’s Research News article “Effects of mindfulness-based cognitive therapy on mental disorders: a systematic review and meta-analysis of randomised controlled trials..” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1444323605591561/?type=3&theater

or see summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5030069/

Galante and colleagues review the published research literature on the effectiveness of Mindfulness-Based Cognitive Therapy (MBCT) for a variety of mental disorders. They found 11 published randomized controlled trials 10 of which compared MBCT to treatment as usual. There were only a sufficient number of studies to perform a meta-analysis for depression, depression relapse rates, and anxiety. They found that overall the research has demonstrated significant treatment effects for MBCT for the reduction in anxiety and depression. Importantly, MBCT had long-term beneficial effects as evidenced by a significant lowering of the relapse rates from depression on average by 40%.

 

These are important findings that strongly support the application of MBCT for the treatment of depression and anxiety disorders. The effects were not only robust but lasting, still being significantly better then treatment as usual a year after the end of treatment. It is unfortunate that there were not a greater number of studies of the effectiveness of MBCT for other mental disorders. This underscores the need for more research into the application of MBCT to disorders other than anxiety and depression. It has such powerful and lasting effects on anxiety and depression that it would be predicted that it would also be effective for other disorders.

 

It is not known exactly how MBCT relieves anxiety and depression. But, it can be speculated that MBCT, by shifting attention away from the past or future to the present moment, interrupts the kinds of thinking that are characteristic of and support anxiety and depression. These include rumination about past events, worry about future events, and catastrophizing about potential future events. Mindfulness 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 anxiety and depression, shifting attention to the present moment where situations are actually manageable, mindfulness may disrupt depression. MBCT also improves the ability to see thoughts as objects of awareness and not something personal. This may be the most important change to improve anxiety and depression. This changes the relationship of the patients with their thoughts, making them less personal and thereby easier to cope with and change.

 

So, improve mental health 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

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts

 

Study Summary

Galante, J., Iribarren, S. J., & Pearce, P. F. (2013). Effects of mindfulness-based cognitive therapy on mental disorders: a systematic review and meta-analysis of randomised controlled trials. Journal of Research in Nursing : JRN, 18(2), 133–155. http://doi.org/10.1177/1744987112466087

 

Key points for policy, practice and research

  • Patients with recurrent depression (three episodes or more) treated with additive MBCT have on average 40% fewer relapses at one year of follow-up compared to patients undergoing treatment as usual.
  • Improvements in depression and anxiety with additive MBCT were significant at one year of follow-up but unstable in sensitivity analyses.
  • More studies with active control groups and long-term follow-ups are needed to better understand the specific effects of MBCT.
  • Depression is a symptom that is present in many conditions. More high quality RCTs are needed to evaluate MBCT in populations with varying depression severity as well as diagnosis with multiple co-morbidities.

Abstract

Objective: Mindfulness-based cognitive therapy (MBCT) is a programme developed to prevent depression relapse, but has been applied for other disorders. Our objective was to systematically review and meta-analyse the evidence on the effectiveness and safety of MBCT for the treatment of mental disorders.

Methods: Searches were completed in CENTRAL, MEDLINE, EMBASE, LILACS, PsychINFO, and PsycEXTRA in March 2011 using a search strategy with the terms ‘mindfulness-based cognitive therapy’, ‘mindfulness’, and ‘randomised controlled trials’ without time restrictions. Selection criteria of having a randomised controlled trial design, including patients diagnosed with mental disorders, using MBCT according to the authors who developed MBCT and providing outcomes that included changes in mental health were used to assess 608 reports. Two reviewers applied the pre-determined selection criteria and extracted the data into structured tables. Meta-analyses and sensitivity analyses were completed.

Results:Eleven studies were included. Most of them evaluated depression and compared additive MBCT against usual treatment. After 1 year of follow-up MBCT reduced the rate of relapse in patients with three or more previous episodes of depression by 40% (5 studies, relative risk [95% confidence interval]: 0.61 [0.48, 0.79]). Other meta-analysed outcomes were depression and anxiety, both with significant results but unstable in sensitivity analyses. Methodological quality of the reports was moderate.

Conclusion: Based on this review and meta-analyses, MBCT is an effective intervention for patients with three or more previous episodes of major depression.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5030069/

 

 

Reduce Anxiety and Depression in Pregnancy with Mindfulness

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By John M. de Castro, Ph.D.

 

“research is beginning to show how mindfulness decreases depression and anxiety during pregnancy and boosts positive emotions.” – Mindful

 

Depression occurring after delivery of a baby is well known, documented and discussed. Less well known but equally likely is intense depression and anxiety during pregnancy. But, between 14% and 23% of women suffer from some form of depression and between 5% to 16% of women experience an anxiety disorder during pregnancy. Intense anxiety and depression are difficult to deal with under the best of conditions but in combinations with the stresses of pregnancy can turn what could be a joyous experience of creating a human life into a horrible torment.

 

Without treatment, prenatal depression can pose a serious threat to a mother-to-be, who may stop taking care of herself or, in extreme cases, become suicidal. This can even cause a woman to want to terminate her pregnancy. There are no statistics on the matter but it has been speculated that prenatal depression can lead to abortion. Anxiety during depression is also a serious threat being associated with more health problems during pregnancy, postpartum depression and anxiety, and premature birth.

 

Prenatal depression and anxiety are often not recognized or diagnosed. When it is, the typical treatment is drugs. But these drugs are often ineffective and frequently have troublesome side effects and may not be safe during pregnancy. So, alternative treatments are needed. Mindfulness training may be an answer. Meditation and yoga practices have been shown to help improve mental and physical health during pregnancy. This is encouraging as mindfulness training has many benefits and is completely safe, even during pregnancy. Hence, it is important to further research the potential beneficial effects of mindfulness training during pregnancy.

 

In today’s Research News article “The Effect of Mindfulness-integrated Cognitive Behavior Therapy on Depression and Anxiety among Pregnant Women: a Randomized Clinical Trial.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1417100888313833/?type=3&theater

or see summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5045953/

Yazdanimehr and colleagues investigate the effectiveness of mindfulness training for anxiety and depression during pregnancy. They recruited women who were 1 to 6 months pregnant and randomly assigned them to receive treatment as usual (control) or Mindfulness-Based Cognitive Therapy (MBCT). Treatment was delivered over 8 weeks with 1.5 hour sessions occurring once a week. Depression and anxiety were measured before and after treatment and followed up 1 month later.

 

They found that the women receiving MBCT had significant improvements in both depression (46%) and anxiety (45%) at the end of treatment and at one month follow-up while there were no significant change for the control participants. Mindfulness-Based Cognitive Therapy (MBCT) was developed specifically to treat depression. So, its effectiveness with the women is not surprising. It develops mindfulness and works to alter thought patterns to interpret experiences objectively without reference to negative or self-deprecating beliefs. This training is very effective for the relief of depression and also anxiety.

 

The fact that MBCT had such large effects with this vulnerable population is particularly encouraging. By relieving anxiety and depression in these pregnant women it should be helping to insure a better pregnancy, more full term births, and less problems postnatally. This suggests that MBCT could be a very valuable treatment and perhaps a recommended practice for pregnant women.

 

So, reduce anxiety and depression in pregnancy with mindfulness.

 

“Pregnancy and childbirth are great crash-courses for motherhood. For nine months, you are increasingly required to be in your body. Labor and childbirth may be the time when you are most in touch with your body-the most embodied any of us will ever be-though not necessarily in a very comfortable way. This doesn’t end when the baby is born. Learning how to be present and grounded in your body even in the face of discomfort is a great skill to cultivate now and for the rest of your life as a mother.” – Cassandra Vieten 

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts

 

Study Summary

Yazdanimehr, R., Omidi, A., Sadat, Z., & Akbari, H. (2016). The Effect of Mindfulness-integrated Cognitive Behavior Therapy on Depression and Anxiety among Pregnant Women: a Randomized Clinical Trial. Journal of Caring Sciences, 5(3), 195–204. http://doi.org/10.15171/jcs.2016.021

 

Abstract

Introduction: Pregnancy can be associated with different psychological problems such as depression and anxiety. These problems are often neglected and left untreated. This study aimed to examine the effect of mindfulness-integrated cognitive behavior therapy on depression and anxiety among pregnant women.

Methods: A convenient sample of 80 pregnant women were selected. Participants were randomly allocated to either the experimental or the control groups. Participants in the experimental group received mindfulness-integrated cognitive behavior therapy while women in the control group only received routine prenatal care services. A demographic questionnaire, the Edinburgh Postnatal Depression Scale, and the Beck Anxiety Inventory were used for data collection. Descriptive statistics measures such as frequency, mean, and standard deviation as well as the repeated-measures analysis of variance test were used for data analysis.

Results: After the study intervention, the mean scores of anxiety and depression in the experimental group were significantly lower than the control group.

Conclusion: Mindfulness-integrated cognitive behavior therapy can significantly alleviate pregnant women’s depression and anxiety. So implementation of this method alongside with other prenatal care services is recommended.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5045953/

 

Get Mindful On-Line and Get Feeling Better

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By John M. de Castro, Ph.D.

 

“mindfulness exercises delivered in face-to-face settings or remotely via the Internet seem to yield similar changes in symptoms. The remote delivery does not seem to lessen the efficacy of mindfulness interventions.”– Johanna Boettcher

 

Mindfulness training has been shown through extensive research to be effective in improving the physical and psychological condition of otherwise healthy people and also treating the physical and psychological issues of people with illnesses. Techniques such as Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT) as well as Yoga practice and Tai Chi or Qigong practice have been demonstrated to be particularly effective. This has led to an increasing adoption of these mindfulness techniques for the health and well-being of both healthy and ill individuals.

 

The vast majority of the mindfulness training techniques, adopted so far, require a certified trained therapist. This produces costs that many clients can’t afford. In addition, the participants must be available to attend multiple sessions at particular scheduled times that may or may not be compatible with their busy schedules. As a results, there has been attempts to develop on-line mindfulness training programs. These have tremendous advantages in decreasing costs and making training schedules much more flexible. But, the question arises as to whether these programs are as effective as their traditional counterparts. Many believe that the presence of a therapist is a crucial component to the success of the programs and the lack of an active therapist in on-line programs may greatly reduce their effectiveness.

 

In today’s Research News article “Mindfulness Interventions Delivered by Technology Without Facilitator Involvement: What Research Exists and What Are the Clinical Outcomes?” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1362554723768450/?type=3&theater

or see summary below or view the full text of the study at:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5010616/

Fish and colleagues review the published research literature on the effectiveness of technology-based mindfulness training programs that did not include an active facilitator’s participation. They found 10 studies published, 9 of which were web-based programs. They found that, in general, the mindfulness programs produced increases in mindfulness and reductions in perceived stress, depression, anxiety, and rumination and these effects were maintained at follow-ups occurring as much as 6-months later. Unfortunately, compliance was relatively low and drop-out rates were relatively high.

 

These are encouraging findings and suggest that mindfulness can be effectively trained with web-based materials and that this can produce psychologically beneficial results. But, there were no direct comparisons to traditional programs. So, it cannot be determined if the web-based programs are as effective as traditional programs. In addition, there methods need to be developed to help maintain compliance and decrease dropping out of web-based programs. Regardless, the benefits are substantial and the results are sufficiently positive to encourage further research.

 

So, get mindful on-line and get feeling better.

 

“Internet delivery of mindfulness training may be a viable alternative if an evidence base can be established. It can be self-paced, less costly, and more accessible while additionally allowing for participant anonymity. “ – David Messer

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts

 

Study Summary

Fish, J., Brimson, J., & Lynch, S. (2016). Mindfulness Interventions Delivered by Technology Without Facilitator Involvement: What Research Exists and What Are the Clinical Outcomes? Mindfulness, 7(5), 1011–1023. http://doi.org/10.1007/s12671-016-0548-2

 

Abstract

New cost-effective psychological interventions are needed to contribute to treatment options for psychiatric and physical health conditions. This systematic review aims to investigate the current literature on one potentially cost-effective form of mindfulness-based therapy, those delivered through technological platforms without any mindfulness facilitator input beyond the initial design of the programme. Three electronic databases (Ovid Medline, PsychINFO and Embase) were searched for relevant keywords, titles, medical subject headings (MeSH) and abstracts using search terms derived from a combination of two subjects: ‘mindfulness’ and ‘technology’. Overall, ten studies were identified. The majority of studies were web-based and similar in structure and content to face-to-face mindfulness-based stress reduction courses. Clinical outcomes of stress (n = 5), depression (n = 6) and anxiety (n = 4) were reported along with mindfulness (n = 4), the supposed mediator of effects. All eight studies that measured significance found at least some significant effects (p < .05). The highest reported effect sizes were large (stress d = 1.57, depression d = .95, both ps > .005). However, methodological issues (e.g. selection bias, lack of control group and follow-up) which reflect the early nature of the work mean these largest effects are likely to be representative of maximal rather than average effects. Whilst there are important differences in the construction, length and delivery of interventions, it is difficult to draw firm conclusions about the most effective models. Suggestions of key characteristics are made though, needing further investigation preferably in standardised interventions. Given the existing research and the speed at which technology is making new platforms and tools available, it seems important that further research explores two parallel lines: first, refinement and thorough evaluation of already established technology-based mindfulness programmes and second, exploration of novel approaches to mindfulness training that combine the latest technological advances with the knowledge and skills of experienced meditation teachers.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5010616/

 

Reduce Anxiety and Depression with Mindfulness and Yoga

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mindfulness-yoga-depression-anxiety2-falsafi

By John M. de Castro, Ph.D.

 

“But for many patients dealing with depression, anxiety, or stress, yoga may be a very appealing way to better manage symptoms. Indeed, the scientific study of yoga demonstrates that mental and physical health are not just closely allied, but are essentially equivalent. The evidence is growing that yoga practice is a relatively low-risk, high-yield approach to improving overall health.” – Harvard Mental Health Letter

 

Many people have fond memories of their college years. It is likely, however, that they forgot about the stress and angst of those years. The truth is that college is generally very stressful for most students, from the uncertainty of freshman year, to the social stresses of emerging adulthood, to the anxiety of launching into a career after senior year. Evidence for the difficulties of these years can be found in college counseling centers which are swamped with troubled students. In fact, it’s been estimated that half of all college students report significant levels of anxiety and depression.

 

In recent years, it has become apparent that contemplative practices are powerful treatment options for depression and anxiety disorders either alone or in combination with other therapies. Both mindfulness training and yoga practice have been found to be effective. But, there has not been a direct comparison. In today’s Research News article “Controlled Trial of Mindfulness Versus Yoga: Effects on Depression and/or Anxiety in College Students.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1357219097635346/?type=3&theater

or see summary below, Falsafi recruited college students, with a diagnosis of wither anxiety disorder or depression, and randomly assigned them to receive 8 weeks, 75 minutes per week, plus 20 minutes per day of home practice, of either mindfulness training or Hatha yoga practice, or to a no-treatment control condition. All groups also continued their usual treatments of drugs or psychotherapy. The students were assessed for mindfulness, depression, anxiety, stress, and self-compassion prior to treatment, mid treatment (week 4), the end of treatment (week 8) and a follow-up at week 12.

 

They found that in comparison to the no-treatment control condition both the mindfulness training and yoga practice groups had significant decreases in anxiety, depression, and stress, and increases in mindfulness and these improvements were maintained at the 12-week follow-up. There were no significant differences found between the effects of mindfulness training or yoga practice, except that only the mindfulness training groups showed a significant increase in self-compassion. This latter difference was probably due to the fact that the mindfulness training included specific exercises to improve self-compassion including loving-kindness meditation practice.

 

These findings confirm previous findings that both mindfulness training and yoga practice produce clinically significant improvements in mindfulness, anxiety, depression, and stress, and that mindfulness improves self-compassion. The interesting aspect of this study is that comparable amounts of mindfulness and yoga practice did not differ in effectiveness. This is useful as different people prefer mindfulness training or yoga practice. So, individuals with anxiety and depression can choose which practice they are most comfortable with. This should increase participation and compliance and as a result effectiveness.

 

So, reduce anxiety and depression with mindfulness and yoga.

 

 

“People with anxiety have a problem dealing with distracting thoughts that have too much power. They can’t distinguish between a problem-solving thought and a nagging worry that has no benefit. If you have unproductive worries, you can train yourself to experience those thoughts completely differently. You might think ‘I’m late, I might lose my job if I don’t get there on time, and it will be a disaster!’ Mindfulness teaches you to recognize, ‘Oh, there’s that thought again. I’ve been here before. But it’s just that—a thought, and not a part of my core self,’” – Elizabeth Hoge

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts

 

Study Summary

Falsafi N. A Randomized Controlled Trial of Mindfulness Versus Yoga: Effects on Depression and/or Anxiety in College Students. J Am Psychiatr Nurses Assoc. 2016 Aug 26. pii: 1078390316663307. [Epub ahead of print]

 

Abstract

BACKGROUND: Depression and anxiety disorders are two of the most common mental disorders in the United States. These disorders are prevalent among college students.

OBJECTIVE: The main objective of this study is to compare the effectiveness of two different types of intervention practices (mindfulness vs. yoga) and a noninterventional control group in mitigating the effects of depression and/or anxiety in college students.

METHOD: A sample of 90 students (both genders) over age 18 who had a diagnosis of anxiety and/or depression was recruited from 11,500 undergraduate college students in a mid-size university. The study’s design included stratified-randomized controlled repeated measures with three groups: a mindfulness intervention group, a yoga-only intervention group, and a noninterventional group. Participants were randomly assigned to the aforementioned three groups. Participants in the intervention groups received an 8-week training either in mindfulness or yoga. Depressive, anxiety, stress symptoms, self-compassion, and mindfulness were measured at baseline, Week 4, Week 8, and Week 12.

RESULTS: Depressive, anxiety, and stress symptoms decreased significantly (p < .01) from baseline to follow-up conditions in both the mindfulness and yoga intervention groups. The changes in mindfulness scores were also significant in both groups. However, the changes in self-compassion scores were significant only in the mindfulness intervention group. No significant changes in the control group were demonstrated.

CONCLUSIONS: The findings from this study can provide useful information to nurses and other health care providers. This study may have implications for a cost-effective treatment for depression and anxiety.

 

Relieve Generalized Anxiety with Mindfulness

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By John M. de Castro, Ph.D.

 

“People with anxiety have a problem dealing with distracting thoughts that have too much power. They can’t distinguish between a problem-solving thought and a nagging worry that has no benefit. If you have unproductive worries, you can train yourself to experience those thoughts completely differently. You might think ‘I’m late, I might lose my job if I don’t get there on time, and it will be a disaster!’ Mindfulness teaches you to recognize, ‘Oh, there’s that thought again. I’ve been here before. But it’s just that—a thought, and not a part of my core self.’” – Elizabeth Hoge

 

Anxiety disorders are the most common mental illness in the United States, affecting 40 million adults, or 18% of the population. Generalized Anxiety Disorder (GAD) affects about 3.1% of the U.S. population. GAD involves excessive worry about everyday problems. People with GAD become anxious in anticipation of problems with their finances, health, employment, and relationships. They typically have difficulty calming their concerns, even though they realize that their anxiety is more intense than the situation warrants. Physically, GAD sufferers will often show excessive fatigue, irritability, muscle tension or muscle aches, trembling, feeling twitchy, being easily startled, trouble sleeping, sweating, nausea, diarrhea or irritable bowel syndrome, and headaches.

 

Anxiety disorders have generally been treated with drugs. It has been estimated that 11% of women in the U.S. are taking anti-anxiety medications. But, there are considerable side effects and these drugs are often abused. Although, psychological therapy can be effective it is costly and only available to a small numbers of sufferers. So, there is a need to develop alternative treatments. A characterizing feature of anxiety disorders is that the suffer overly identifies with and personalizes their thoughts. The sufferer has recurring thoughts, such as impending disaster, that they may realize are unreasonable, but are unable to shake. This may indicate that treating the cognitive processes that underlie the anxiety may be an effective treatment.

 

Cognitive Behavioral Therapy (CBT) is targeted at changing unproductive and unreasonable thought patterns and has been shown to be effective for anxiety disorders. Recently, it has been found that mindfulness training can be effective for anxiety disorders. Acceptance and Commitment Therapy (ACT) combines elements from CBT and mindfulness training and has also been shown to be effective. These therapies have in common the attempt to decenter thought processes; that is to learn to observe thoughts and feelings as objective events in the mind rather than personally identifying with the thoughts or feelings which is so characteristic of Generalized Anxiety Disorder (GAD).

 

In today’s Research News article “Decentering as a Potential Common Mechanism across Two Therapies for Generalized Anxiety Disorder.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1336030083087581/?type=3&theater

or see summary below or view the full text of the study at:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4380615/

Hayes-Skelton and colleagues recruited adults who had been diagnosed with Generalized Anxiety Disorder (GAD) and randomly assigned them to receive 16-weeks of either an applied relaxation therapy or an acceptance-based behavioral therapy (ABBT). ABBT is very similar to ACT and contains mindfulness training. They measured anxiety, worry, and decentering before and after treatment and in order to look at the changes occurring during therapy, they also measured anxiety and decentering at weeks 4, 8, and 12 during treatment.

 

They found that over the 16-weeks of treatment the decentering scores increased significantly by 22% improving approximately 5% every 4 weeks and these increases were significantly related to decreased worry scores. At the same time, the anxiety levels decreased significantly by 89% improving approximately 12% every 4 weeks. In addition, they found that decentering was a leading indicator for changes in anxiety; that is that improvements in decentering preceded improvements in anxiety levels. This is an important indicator of a causal connection. There were no significant differences found between applied relaxation therapy or acceptance-based behavioral therapy (ABBT) in effectiveness for increasing decentering or decreasing anxiety.

 

These findings are important as they add to the accumulating evidence that treatments that include mindfulness training are effective in treating anxiety disorders. They are especially important as they suggest that the most important effect of treatment is to increase decentering and this, in turn, reduces anxiety. So, the ability to see thoughts as objects of awareness and not something personal may be the most important change to accomplish to improve Generalized Anxiety Disorder. This suggests why Cognitive Behavioral Therapy and mindfulness training are effective as each changes the relationship of the patients with their thoughts, making them less personal.

 

So, relieve generalized anxiety with mindfulness.

 

“instead of changing thoughts, mindfulness-based therapies (MBTs) seek to change the relationship between the anxious person and his or her thoughts. In mindfulness-based therapy, the person focuses on the bodily sensations that arise when he or she is anxious. Instead of avoiding or withdrawing from these feelings, he or she remains present and fully experiences the symptoms of anxiety. Instead of avoiding distressing thoughts, he or she opens up to them in an effort to realize and acknowledge that they are not literally true.” – George Hofmann

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts

 

Study Summary

Hayes-Skelton, S. A., Calloway, A., Roemer, L., & Orsillo, S. M. (2015). Decentering as a Potential Common Mechanism across Two Therapies for Generalized Anxiety Disorder. Journal of Consulting and Clinical Psychology,83(2), 395–404. http://doi.org/10.1037/a0038305

 

Abstract

Objective:

To examine decentering as a potential mechanism of action across two treatments for generalized anxiety disorder: an acceptance based behavioral therapy (ABBT) and applied relaxation (AR).

Method: Sixty-four individuals who completed at least half of the 16 total sessions of either ABBT or AR (65.6% female, 79.7% identified as White, average age 34.41) completed measures of decentering (Experiences Questionnaire) and of symptoms of anxiety (Depression Anxiety Stress Scale-Stress subscale) at five time points over the course of therapy and a measure of worry (Penn State Worry Questionnaire) at pre and post-treatment.

Results: Initial growth curve models showed that decentering increased significantly over therapy (z = 7.09) and this increase was associated with a decrease in worry symptoms (PSWQ) at post-treatment (z = −8.51). The rate of change did not significantly vary across treatments (Δχ2/Δdf = 0.16/1, p = 0.69). Further, a series of bivariate latent difference score models indicated that the best fitting model was one in which decentering was a leading indicator of change in symptoms (DASS-Stress). Allowing this coupling to vary across treatments did not significantly improve the fit of the model (Δχ2/Δdf = 0.71/1, p = 0.40).

Conclusions: In this sample, results suggest that increased decentering was associated with decreases in anxiety and that changes in decentering appear to precede changes in symptoms within both ABBT and AR, indicating that decentering may be an important common mechanism of action.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4380615/

Improve Anxiety and Depression in Primary Care with Mindfulness

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By John M. de Castro, Ph.D.

 

“Group mindfulness treatment should be considered as an alternative to individual psychotherapy, especially at primary health care centers that can’t offer everyone individual therapy,” – Jan Sundquist

 

“Primary care is at the front line of the health delivery system” (Craner et al., 2016). Most patients enter the health system either though primary care physicians who are responsible for wellness and for the diagnosis and treatment of mental and physical diseases. If the disease is common or simple, they’ll treat it themselves or if it’s more complex or dangerous they’ll refer it to specialists. Either way, they’re the first step in treatment.

 

Mood and anxiety disorders, including depression are the most common mental illnesses and affect almost 30% of the US population. Depression is the most common mental disorders seen in primary care patients, constituting nearly a third of all patients. People with an anxiety disorder are 3 to 5 times more likely than those without to visit their doctor and constitute around 6% of primary care patients. Hence these mood disorders are an important challenge for primary care. Yet, primary care physicians have little training in psychological therapy techniques and generally treat these disorders by prescribing drugs.

 

In recent years, it has become apparent that mindfulness training is a powerful treatment option for depression and anxiety disorders either alone or in combination with other therapies. It is rare, however, for mindfulness training to be implemented in the course of primary care. In today’s Research News article “Outcomes of a 6-Week Cognitive– Behavioral and Mindfulness Group Intervention in Primary Care.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1300205500003373/?type=3&theater

or see summary below.

Craner and colleagues recruited patients who came into primary care with a diagnosis of either depression or anxiety disorders. They were provided 6-weeks of therapy that was a combination of mindfulness training and Cognitive Behavioral Therapy (CBT). Instruction was provided in weekly 1-hour group sessions and patients were encouraged to practice at home. They were measured for depression and anxiety disorder intensity before and after the conclusion of treatment.

 

They found that after the therapy the patients had a large and significant reduction in both their depression and anxiety. This was particularly significant in that these impressive results were obtained from a relatively brief group treatment delivered in the primary care facility itself. To our knowledge this is the first demonstration of successful mindfulness-based treatment for mood disorders conducted in a primary care facility. This is an ideal point for delivery of services to treat a major mental health problem in a safe and effective way without expensive specialist involvement and without employing drugs. Because the services were delivered at the point of entry into the health care system, it allows the delivery of services quickly, immediately upon diagnosis, maximizing effectiveness.

 

But, the results must be interpreted cautiously as there was no comparison or control condition. A randomized controlled clinical trial is needed to insure that the positive results were due the mindfulness-based therapy and not due to a placebo effect, experimenter bias, spontaneous remissions, or some other confounding factor. But, these are exciting preliminary findings which clearly support conducting further research.

 

CMCS – Center for Mindfulness and Contemplative Studies

 

“Once I stopped battling anxiety, it lost its power over me. The negative thoughts do still pop up, but what has changed is how I react to them now that they no longer frighten me. On the few occasions that I have had panic attacks since practicing mindfulness, I have consciously switched to mindful breathing and the panic has subsided. The vicious circle has gone, and has been replaced with positive thoughts about everything I have achieved and may yet achieve. I will always have anxious thoughts, I’m only human, but I know they are just that, just thoughts.” – Amy Straker

 

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Study Summary

Craner, J. R., Sawchuk, C. N., & Smyth, K. T. (2016, July 14). Outcomes of a 6-Week Cognitive– Behavioral and Mindfulness Group Intervention in Primary Care. Families, Systems, & Health. Advance online publication. http://dx.doi.org/10.1037/fsh0000202

 

Abstract:

Introduction: Cognitive–behavioral and mindfulness-based interventions are established treatments for depressive and anxiety disorders; however, there is a lack of research for these interventions in primary care settings. The current study evaluates an evidence-based group intervention provided to primary care patients with a variety of mood and anxiety concerns. Method: Participants included 54 adult primary care patients who attended at least four sessions of a six-session cognitive–behavioral and mindfulness group. A total of nine separate groups were conducted, all of which were colocated within the primary care setting. Major depressive disorder and generalized anxiety disorder were the most common psychiatric conditions, with approximately 56% of the sample having one or more chronic medical conditions. Self-report measures of depression (Patient Health Questionnaire–9) and anxiety (Generalized Anxiety Disorder Questionnaire–7) were completed at each session. Results: Significant improvements were noted on self-reported measures of depression and anxiety when comparing pre- and posttreatment assessment measures with large effect sizes. Discussion: A brief, principle-based cognitive–behavioral and mindfulness group intervention delivered in primary care was associated with improved symptoms across a range of patient presentations. Evidence-based group interventions in primary care settings have the benefits of increased access and cost-effectiveness.

 

Reduce Anxiety and Depression Among Patients with Cancer with Mindfulness

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Mindfulness cancer2 Zhang

 

By John M. de Castro, Ph.D.

 

“Mindfulness meditation is known to have a positive emotional and psychological impact on cancer survivors. But some groundbreaking new research has found that meditation is also doing its work on the physical bodies of cancer survivors, with positive impacts extending down to the cellular level.” – Carolyn Gregoire

 

Receiving a diagnosis of cancer can have a huge impact on most people. Feelings of depression, anxiety, and fear are very common and are normal responses to this life-changing experience. These feeling can result from changes in body image, changes to family and work roles, feelings of grief at these losses, and physical symptoms such as pain, nausea, or fatigue. People might also fear death, suffering, pain, or all the unknown things that lie ahead. But, cancer diagnosis is not a death sentence. Over half of the people diagnosed with cancer are still alive 10 years later and this number is rapidly improving. It is estimated that 14,483,830 adults and children with a history of cancer alive in the United States today. So, there are a vast number of cancer survivors.

 

Surviving cancer carries with it a number of problems. “Physical, emotional, and financial hardships often persist for years after diagnosis and treatment. Cancer survivors are also at greater risk for developing second cancers and other health conditions.” National Cancer Survivors Day. Unfortunately, most of these residual problems go untreated. Psychologically, cancer survivors frequently suffer from anxiety, depression, mood disturbance, Post-Traumatic Stress Disorder (PTSD), sleep disturbance, fatigue, sexual dysfunction, loss of personal control, impaired quality of life, and psychiatric symptoms which have been found to persist even ten years after remission.

 

Mindfulness training may be helpful for dealing with these psychological residual symptoms of cancer. It has been shown to improve recovery from cancer and to reduce anxiety and depression in people with a wide variety of conditions.  In today’s Research News article “Effectiveness of Mindfulness-based Therapy for Reducing Anxiety and Depression in Patients with Cancer: A Meta-analysis.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1290482744308982/?type=3&theater

or below or view the full text of the study at:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4912240/

Zhang and colleagues examine the published research literature investigating the effectiveness of mindfulness training for anxiety and depression in cancer patients. They report that the most common form of mindfulness training used in the published research for cancer were 8-week Mindfulness-Based Stress Reduction (MBSR) programs involving meditation, body scan and yoga practices. All studies examined contained a control condition, most commonly a treatment as usual wait-list group.

 

They found that the literature made a clear case that mindfulness based therapies produce significant improvements in both anxiety and depression in the cancer patients. Since mindfulness training involves training to focus on the present moment, it is easy to see how it could be effective against anxiety and depression. Anxiety involves fear of potential future problems while depression involves rumination about the past. The focus on what’s happening now, produced by mindfulness training, prevents thinking about the past producing depression and thinking about the future producing anxiety.

 

The findings in the research literature are important as depression causes great distress, impairs functioning, and might even make the person with cancer less able to follow their cancer treatment plan. In addition, high levels of anxiety are stressful, depleting the patient’s energy and reducing their ability to fight the cancer or other potential infections. Hence the ability of mindfulness training to reduce the depression and anxiety is important for not only the patients’ mental health but also for their physical ability to fight the cancer.

 

So, reduce anxiety and depression among patients with cancer with mindfulness.

 

“Cancer is not something that any of us would ever want to have happen to us, but it can be a tremendous opportunity to look at some of our conditioning. It can also be an opportunity to look deeply and make amends for some things we don’t like. We can come into a greater sense of peace with ourselves and with others.”  – Elana Rosenbaum

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts

 

Study Summary

Zhang, M.-F., Wen, Y.-S., Liu, W.-Y., Peng, L.-F., Wu, X.-D., & Liu, Q.-W. (2015). Effectiveness of Mindfulness-based Therapy for Reducing Anxiety and Depression in Patients with Cancer: A Meta-analysis. Medicine, 94(45), e0897. http://doi.org/10.1097/MD.0000000000000897

 

Abstract

Anxiety and depression are common among patients with cancer, and are often treated with psychological interventions including mindfulness-based therapy.

The aim of the study was to perform a meta-analysis of the effectiveness of mindfulness-based interventions for improving anxiety and depression in patients with cancer.

Medline, the Cochrane Library, EMBASE, and Google Scholar were searched. The randomized controlled trials designed for patients diagnosed with cancer were included. Mindfulness-based interventions were provided.

The outcomes assessed were the changes in anxiety and depression scores from before to after the intervention. The treatment response was determined by calculating the standardized mean difference (SMD) for individual studies and for pooled study results. Subgroup analyses by cancer type, type of therapy, and length of follow-up were performed.

Seven studies, involving 469 participants who received mindfulness-based interventions and 419 participants in a control group, were included in the meta-analysis. Mindfulness-based stress reduction and art therapy were the most common interventions (5/7 studies). All studies reported anxiety and depression scores. The pooled SMD of the change in anxiety significantly favored mindfulness-based therapy over control treatment (−0.75, 95% confidence interval −1.28, −0.22, P = 0.005). Likewise, the pooled SMD of the change in depression also significantly favored mindfulness-based therapy over control (−0.90, 95% confidence interval −1.53, −0.26, P = 0.006). During the length of follow-ups less than 12 weeks, mindfulness-based therapy significantly improved anxiety for follow-up ≤12 weeks after the start of therapy, but not >12 weeks after the start of therapy.

There was a lack of consistency between the studies in the type of mindfulness-based/control intervention implemented. Patients had different forms of cancer. Subgroup analyses included a relatively small number of studies and did not account for factors such as the severity of anxiety and/or depression, the time since diagnosis, and cancer stage.

Mindfulness-based interventions effectively relieved anxiety and depression among patients with cancer. However, additional research is still warranted to determine how long the beneficial effects of mindfulness-based therapy persist.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4912240/

ACT and CBT for Social Anxiety

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jealousy or lovesickness: woman and man with girls in background

 

By John M. de Castro, Ph.D.

 

“The power of a mindfulness practice, however, may come in the realization that one can live a meaningful life even with social anxiety. [A participant], says that he still feels nervous in social situations but now feels compassion — not judgment — for himself, and sees that “I can be more the person I want to be.” – Jason Drwal

 

Everyone experiences occasional anxiety and that is normal. But, frequent or very high levels of anxiety can be quite debilitating. These are termed anxiety disorders and they are the most common psychological problem. In the U.S., they affect over 40 million adults, 18% of the population, with women accounting for 60% of sufferers One out of every three absences from work are caused by high levels of anxiety and it is the most common reason for chronic school absenteeism. In addition, people with an anxiety disorder are three-to-five times more likely to go to the doctor and six times more likely to be hospitalized for psychiatric disorders than non-sufferers, making it a major burden on the healthcare system.

 

It is almost a common human phenomenon that being in a social situation can be stressful and anxiety producing. This is particularly true when asked to perform in a social context such as giving a speech. Most people can deal with the anxiety and can become quite comfortable. But many do not cope well with the anxiety or the level of anxiety is overwhelming, causing the individual to withdraw. Social Anxiety Disorder (SAD) is characterized by a persistent, intense, and chronic fear of being watched and judged by others and feeling embarrassed or humiliated by their actions. This fear may be so severe that it interferes with work, school, and other activities and may negatively affect the person’s ability to form relationships. SAD is the most common form of anxiety disorder occurring in about 7% of the U.S. population.

 

Anxiety disorders have generally been treated with drugs. It has been estimated that 11% of women in the U.S. are taking anti-anxiety medications. But, there are considerable side effects and these drugs are often abused. Although, psychological therapy can be effective it is costly and only available to a small numbers of sufferers. So, there is a need to develop alternative treatments. Recently, it has been found that mindfulness training can be effective for anxiety disorders including Social Anxiety Disorder (SAD). There is a need, however, to investigate the effectiveness of different therapeutic techniques for anxiety disorders.

 

In today’s Research News article “Cognitive Mediators of Treatment for Social Anxiety Disorder: Comparing Acceptance and Commitment Therapy and Cognitive-Behavioral Therapy.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1286451728045417/?type=3&theater

or below or view the full text of the study at:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4842179/

Niles and colleagues compare the ability of two common and popular therapies for social anxiety disorder, one mindfulness based, Acceptance and Commitment Therapy (ACT), and one not, Cognitive-Behavioral Therapy (CBT). Individuals with SAD were randomly assigned to receive ACT, CBT, or as a wait-list control. They were assessed for levels of social anxiety, anxiety during public speaking, experiential avoidance, depression, and quality of life before and after treatment and again 6 and 12 months later.

 

They found that both ACT and CBT were effective, significantly reducing the symptoms of social anxiety and that these reductions were still present 6 and 12 months later. They then compared the two treatments for the development of their effectiveness over the course of treatment. Both treatments significantly decreased both experiential avoidance and anxiety during public speaking, but ACT produced a more rapid decrease in both symptoms in the early stages of treatment whereas CBT produced a more rapid decrease in the later stages of treatment.

 

These are exciting findings. Both a therapy containing mindfulness training, ACT, and one that did not, CBT, were very effective for the treatment of Social Anxiety Disorder (SAD), although having different profiles of improvement during the course of treatment. This suggests that there are two new viable treatments for this very prevalent disorder. Future research should investigate which treatment works best for different kinds of patients. Regardless, the results suggest that either ACT or CBT should be used to reduce social anxiety in highly anxious patients.

 

“instead of thinking, “I am so anxious. I will never get through this speech,” mindfulness would have you notice your anxiety with the thought, “Sometimes I have anxious feelings, but they are temporary. I know they will soon pass.” – Arlin Cuncic

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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Study Summary

Niles, A. N., Burklund, L. J., Arch, J. J., Lieberman, M. D., Saxbe, D., & Craske, M. G. (2014). Cognitive Mediators of Treatment for Social Anxiety Disorder: Comparing Acceptance and Commitment Therapy and Cognitive-Behavioral Therapy. Behavior Therapy, 45(5), 664–677. http://doi.org/10.1016/j.beth.2014.04.006

 

Abstract

Objective: To assess the relationship between session-by-session mediators and treatment outcomes in traditional cognitive-behavioral therapy (CBT) and acceptance and commitment therapy (ACT) for social anxiety disorder.

Method: Session-by-session changes in negative cognitions (a theorized mediator of CBT) and experiential avoidance (a theorized mediator of ACT) were assessed in 50 adult outpatients randomized to CBT (n = 25) or ACT (n= 25) for DSM-IV social anxiety disorder.

Results: Multilevel modeling analyses revealed significant nonlinear decreases in the proposed mediators in both treatments, with ACT showing steeper decline than CBT at the beginning of treatment and CBT showing steeper decline than ACT at the end of treatment. Curvature (or the nonlinear effect) of experiential avoidance during treatment significantly mediated posttreatment social anxiety symptoms and anhedonic depression in ACT, but not in CBT, with steeper decline of the Acceptance and Action Questionnaire at the beginning of treatment predicting fewer symptoms in ACT only. Curvature of negative cognitions during both treatments predicted outcome, with steeper decline of negative cognitions at the beginning of treatment predicting lower posttreatment social anxiety and depressive symptoms.

Conclusions: Rate of change in negative cognitions at the beginning of treatment is an important predictor of change across both ACT and CBT, whereas rate of change in experiential avoidance at the beginning of treatment is a mechanism specific to ACT.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4842179/

 

Relieve Test Anxiety with Mindfulness

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By John M. de Castro, Ph.D.

 

“In mindfulness-based therapy, the person focuses on the bodily sensations that arise when he or she is anxious. Instead of avoiding or withdrawing from these feelings, he or she remains present and fully experiences the symptoms of anxiety. Instead of avoiding distressing thoughts, he or she opens up to them in an effort to realize and acknowledge that they are not literally true. Although it may seem counter-intuitive, fully realizing the experience of anxiety enables anxious people to release their over identification with negative thoughts. The person practices responding to disruptive thoughts, and letting these thoughts go.” – George Hofmann

 

It’s a normal human response to become anxious while being evaluated by others. In fact, the vast majority of students report that the stress and anxiety associated with being evaluated is greater than that produced by anything else in their lives. The majority of students are able to cope with the anxiety and perform on tests in spite of it. But, for a minority of students, somewhere around 16%-20%, the anxiety level is so high that it causes them to “freeze” on tests and markedly impair their performance. It is estimated that they perform 12 points lower, more than one letter grade, on average than students lower in anxiety. Counselling centers in colleges and universities report that evaluation anxiety is the most common complaint that they treat among students.

 

It has been demonstrated repeatedly that mindfulness counteracts anxiety and mindfulness training is an effective treatment for a variety of forms of anxiety. In today’s Research News article “Mindfulness Based Stress Reduction for Academic Evaluation Anxiety: A Naturalistic Longitudinal Study.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1267815219909068/?type=3&theater

or below or view the full text of the study at:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4867855/

Dundas and colleagues examine the effectiveness of an 8-week Mindfulness Based Stress Reduction (MBSR) program for the treatment of test anxiety in college students. MBSR involves training in three mindfulness practices; meditation, body scan, and yoga. Students were tested for anxiety levels, self-esteem, and self-efficacy before, during, and after MBSR training and before their first test after training and later follow-up. The students’ anxiety levels were compared to a group of untreated students.

 

They found significant improvements with moderate effect sizes in evaluation, state, and trait anxiety levels, self-esteem, and self-efficacy following MBSR treatment. The students showed improvements in both the cognitive and emotional components of evaluation anxiety. The improvement in anxiety levels continued following the end of treatment such that at the long-term follow-up point, as much as two years later, evaluation anxiety levels were significantly lower than they were after the completion of treatment. Hence, MBSR treatment significantly reduced evaluation anxiety and improved self-esteem and self-efficacy in college students and the students continued improving afterwards.

 

These are impressive results. But, given the demonstrated efficacy of MBSR for the treatment of anxiety and the reduction of stress, they are not surprising. Mindfulness training and MBSR in particular have been shown to significantly reduce the psychological and physiological responses to stress. A reduction in the students’ responses to the stress of evaluation should reduce anxiety. Since this would be expected, in turn, to improve performance, this may result in further improvement as confidence levels rise. The fact that the students reported improved self-efficacy after MBSR supports the idea that they also improved in confidence. So, mindfulness treatment might well produce an upward spiral of improved anxiety levels and performance.

 

So, relieve test anxiety with mindfulness.

 

“”Mindfulness also allows us to become more aware of the stream of thoughts and feelings that we experience and to see how we can become entangled in that stream in ways that are not helpful. Most of us have issues that we find hard to let go and mindfulness can help us deal with them more productively. We can ask: ‘Is trying to solve this by brooding about it helpful, or am I just getting caught up in my thoughts?’” – Marc Williams

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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Study Summary

Dundas, I., Thorsheim, T., Hjeltnes, A., & Binder, P. E. (2016). Mindfulness Based Stress Reduction for Academic Evaluation Anxiety: A Naturalistic Longitudinal Study. Journal of College Student Psychotherapy, 30(2), 114–131. http://doi.org/10.1080/87568225.2016.1140988

 

ABSTRACT

Mindfulness based stress reduction (MBSR) for academic evaluation anxiety and self-confidence in 70 help-seeking bachelor’s and master’s students was examined. A repeated measures analysis of covariance on the 46 students who completed pretreatment and posttreatment measures (median age = 24 years, 83% women) showed that evaluation anxiety and self-confidence improved. A growth curve analysis with all 70 original participants showed reductions in both cognitive and emotional components of evaluation anxiety, and that reduction continued postintervention. Although more research is needed, this study indicates that MBSR may reduce evaluation anxiety.

 

Improve Well-Being with Menstrual Disorder with Yoga Nidra

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By John M. de Castro, Ph.D.

 

“The ancient practice of yoga nidra, also known as yogic sleep, is a meditative practice that results in conscious deep sleep. Current research suggests that yoga nidra can help relieve menstrual problems, diabetes symptoms and post-traumatic stress disorder (PTSD).” – Elaine Gavalas

 

Menstrual disorders are associated with disruptive physical and/or emotional symptoms just before and during menstruation, including heavy bleeding, missed periods and unmanageable mood swings. Symptoms can include abnormal uterine bleeding, which may be abnormally heavy or absent or occurs between periods, painful menstrual periods, premenstrual syndrome, or premenstrual dysphonic disorder (depression). These disorders are all very common and most women experience some of these symptoms sometime during their premenopausal years, while around 20% experience them throughout their fertile years.

 

Yoga has documented benefits for the individual’s psychological and physical health and well-being. It has also been shown to improve menstrual problems. Yoga, however, consists of a number of components including, poses, breathing exercises, yoga nidra (meditation), concentration, and philosophy/ethics.  So, it is difficult to determine which facet or combination of facets of yoga are responsible for which benefit. Hence, it is important to begin to test each component in isolation to determine its effects.

 

In today’s Research News article “Psycho-Biological Changes with Add on Yoga Nidra in Patients with Menstrual Disorders: a Randomized Clinical Trial.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1255064667850790/?type=3&theater

or below or view the full text of the study at:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4794540/

Rani and colleagues randomly assigned women who displayed menstrual disorders for more than 6-months to either a yoga Nidra or treatment as usual group. Yoga nidra is generally practiced while lying on the back on a mat on the floor with the arms out at the sides and the palm facing up. This is the what’s known as the corpse pose in yoga. It is generally a deep guided meditation practice. It usually begins with a systematic body scan meditation and then moves into a deep meditative state. The most easily observable effect of the yoga nidra practice is the extremely deep relaxation of the nervous system and healing of the body by allowing it the rest and recharge it usually lacks in our all too busy lifestyles. Yoga nidra produces a state of deep relaxation and sedation without the individual actually going to sleep.

 

At baseline Rani and colleagues measured psychological general well-being, and a variety of hormone levels. The yoga nidra group then received 30-35-minute yoga nidra, 5 days per week for 3 months and practiced at home for the subsequent 3 months. Measurements were then repeated at the end of the 6-month program. Control participants received their normal medical treatments during the 6-month period. They found that the yoga Nidra group showed significant improvements in anxiety, depression, positive well-being, general health, and vitality while the control group did not. Similarly, they found that the yoga Nidra group had significant decreases in 4 hormone levels; thyroid-stimulating hormone, follicle-stimulating hormone, luteinizing hormone, and prolactin. Hence, yoga Nidra produced positive benefits for psychological well-being and also for endocrine (hormonal) function.

 

These are exciting findings. Yoga Nidra practice improved psychological well-being in women with menstrual disorder. Yoga practice and meditation practice have these same benefits for practitioners. But, it’s interesting that these psychological benefits can be produced by yoga nidra practice alone. The findings of decreased hormone levels are significant. Pituitary hormones, follicle stimulating hormone, luteinizing hormones, prolactin and thyroid hormones are very much involved in the menstrual cycle and are required for normal development of ova. Yoga Nidra practice may be helping with menstrual disorder by producing better regulation of these crucial hormones. Future research will be required to investigate this idea.

 

It is important to note that the control group did not receive any new active treatment. It is possible that the effects observed were not due to yoga Nidra, but to the expectations of the participants that the yoga nidra would improve their disorder. It will be important for future research to include and active or placebo control condition.

 

Regardless, the results suggest that well-being can be improved in women with menstrual disorder with yoga nidra.

 

“Yoga nidra for me is like a ‘super nap’ that recharges me in no time. It is a complete rejuvenation package – a must to relieve ourselves of daily stress in today’s busy world.” – Pritika Nair

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts

 

Study Summary

Rani, K., Tiwari, S. C., Kumar, S., Singh, U., Prakash, J., & Srivastava, N. (2016). Psycho-Biological Changes with Add on Yoga Nidra in Patients with Menstrual Disorders: a Randomized Clinical Trial. Journal of Caring Sciences,5(1), 1–9. http://doi.org/10.15171/jcs.2016.001

 

Abstract

Introduction: Menstrual disorders are common problems among women in the reproductive age group. Yuga interventions may decrease the physical and psychological problems related to menstrual disorders. The present study was aimed to assess the effect of Yoga Nidra on psychological problems in patients with menstrual disorders.

Methods: A total number of 100 women recruited from the department of obstetrics and gynecology and were then randomly allocated into two groups: a) intervention received yogic intervention and medication for 6 month, and b) control group received no yogic intervention and they only received prescribed medication). Psychological General Well-Being Index (PGWBI) and hormonal profile were assessed at the time of before and after six months on both groups.

Results: The mean score of anxiety, depression, positive well-being, general health, and vitality scores, as well as hormonal levels, in posttest were significantly different in intervention group as compared with pretest. But there was no significant difference in control group.

Conclusion: Yoga Nidra can be a successful therapy to overcome the psychiatric morbidity associated with menstrual irregularities. Therefore, Yogic relaxation training (Yoga Nidra) could be prescribed as an adjunct to conventional drug therapy for menstrual dysfunction.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4794540/