Depression

Mindfulness is Associated with Lower Functional Impairment and Avoidance in Major Depressive Disorder

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Mindfulness is Associated with Lower Functional Impairment and Avoidance in Major Depressive Disorder

 

By John M. de Castro, Ph.D.

 

“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

 

Clinically diagnosed depression is the most common mental illness, affecting over 6% of the population. Major depression can be quite debilitating, impairing the ability of the patients to effectively conduct their lives. 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. Behavioral activation involves engaging with what is going on in the present moment and is thought to help with depression while avoiding symptoms and ruminating tend to exacerbate the depression. There is little data, however, of the interplay of activation and mindfulness in patients with major depression.

 

In today’s Research News article “Roles of Trait Mindfulness in Behavioral Activation Mechanism for Patients With Major Depressive Disorder.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7202344/), Takagaki and colleagues had adult patients with major depressive disorder complete questionnaires designed to measure behavioral activation for depression including subscales measuring activation, avoidance/rumination, work/school impairment, and social impairment; mindfulness including subscales measuring describe, observe, act with awareness, nonreactivity, and non-judging; depression; and disability.

 

They found that the greater the level of depression the greater the level of disability, avoidance/rumination, and mindful observing and the lower the levels of mindful describing, acting with awareness, nonreacting and non-judging. Similarly, they also found that the higher the levels of avoidance/rumination the greater the levels of depression, disability, and mindful observing and the lower the levels of mindful describing, acting with awareness, nonreacting and non-judging. Structural equation modelling revealed that mindful acting with awareness, nonreacting and non-judging was directly negatively related to avoidance/rumination which was in turn positively related to disability. In addition, mindful acting with awareness and nonreacting were directly negatively related to disability.

 

These results are correlative and caution must be taken in making causal inferences. Nevertheless, the results suggest that the degree of disability/impairment in patients with major depressive disorder is directly and indirectly associated with mindfulness with avoidance/rumination as an intermediary. That is, avoidance of a negative aversive state and engagement in rumination rather than active problem-solving to some extent mediates the association of mindfulness with lower levels of impairment in life. Hence, mindfulness is related to the patient’s ability to better conduct their life and it does so directly and indirectly by being associated with less avoidance of psychological pain and less rumination.

 

So, mindfulness is associated with lower functional impairment and avoidance in major depressive disorder.

 

“Mindfulness training can “generate positive emotions by cultivating self-compassion and self-confidence through an upward spiral process, although behavioral activation is action oriented while mindfulness emphasizes the acceptance and awareness of present moment emotions, thoughts, and bodily sensations, the two can be complementary.” _ Amanda MacMillan

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Takagaki, K., Ito, M., Takebayashi, Y., Nakajima, S., & Horikoshi, M. (2020). Roles of Trait Mindfulness in Behavioral Activation Mechanism for Patients With Major Depressive Disorder. Frontiers in psychology, 11, 845. https://doi.org/10.3389/fpsyg.2020.00845

 

Abstract

Behavioral activation and mindfulness have both been shown to engender improvement of functional impairment in patients with major depressive disorder. In behavioral activation, the practice of engaging with the direct experience of the present moment is central, especially when targeting avoidance. Consequently, mindfulness affects changes of avoidance in behavioral activation. This study was designed to assess exploratory relations among trait mindfulness, avoidance, and functional impairment in behavioral activation mechanism for depression. For 1042 participants with depression only or for depression with anxiety disorders, we used structural equation modeling to examine relations among trait mindfulness, avoidance, and functional impairment. Trait mindfulness non-reactivity, non-judging, and acting with awareness had a direct negative effect on avoidance. Trait mindfulness non-reactivity, trait non-judging, and trait acting with awareness had indirect negative effects on functional impairment. Results show that each trait mindfulness facet exhibited a distinct pattern of relations with avoidance and impairment.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7202344/

 

Reduce Depression with Infertility with Mindfulness

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Reduce Depression with Infertility with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Studies have shown that women dealing with infertility have anxiety and depression levels equals to women with cancer and HIV.” – Beth Heller

 

Infertility is primarily a medical condition due to physiological problems. It is quite common. It is estimated that in the U.S. 6.7 million women, about 10% of the population of women are infertile. Infertility can be more than just a medical issue. It can be an emotional crisis for many couples, especially for the women. Couples attending a fertility clinic reported that infertility was the most upsetting experience of their lives.

 

Women with infertility reported feeling as anxious or depressed as those diagnosed with cancer, hypertension, or recovering from a heart attack. In addition, infertility can markedly impact the couple’s relationship, straining their emotional connection and interactions and the prescribed treatments can take the spontaneity and joy from lovemaking making it strained and mechanical. The stress of infertility and engaging in infertility treatments may exacerbate the problem. Since mindfulness training has been shown to reduce depression, anxiety, and stress it is reasonable to believe that mindfulness training may be helpful in reducing the distress in women with fertility issues.

 

In today’s Research News article “Mindfulness-Based Group Counseling on Depression in Infertile Women: Randomized Clinical Trial Study.” (See summary below or view the full text of the study at:),   https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7139233/  Kalhori and colleagues recruited women aged 25 to 40 years who were diagnosed with infertility and who were undergoing in vitro fertilization. They were randomly assigned to receive treatment as usual or to receive 4 weeks, twice a week for 90 minutes of group mindfulness counseling with home exercises. They were measured before and after the 4-week training period for depression and measures of infertility.

 

They found that in comparison to baseline and the treatment as usual group, the women who received group mindfulness counseling had significant decreases in depression. It has been well established that mindfulness training reduces depression levels in a wide range of healthy and ill individuals. The present study demonstrates that it can also relieve depression in infertile women undergoing in vitro fertilization. It would be interesting in the future to determine if the improved mood increased the likelihood of successful in vitro fertilization.

 

So, reduce depression with infertility with mindfulness.

 

“Through sustained practice, mindfulness becomes a great ally, and combats the myopic thinking often caused by a diagnosis of infertility. Instead of seeing things in such bimodal terms of “all good, or “all bad,” we learn to appreciate the space in between by paying attention to whatever emerges moment to moment.” – Julie Fraga

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Kalhori, F., Masoumi, S. Z., Shamsaei, F., Mohammadi, Y., & Yavangi, M. (2020). Effect of Mindfulness-Based Group Counseling on Depression in Infertile Women: Randomized Clinical Trial Study. International journal of fertility & sterility, 14(1), 10–16. https://doi.org/10.22074/ijfs.2020.5785

 

Abstract

Background

Assisted reproductive technologies (ARTs) such as in vitro fertilization (IVF) can lead to depressive symptoms in infertile women due to their low success and high costs. Mindfulness-based group counseling can decrease depressive symptoms by increasing mental concentration. The aim of the present study was to evaluate the effect of mindfulness-based group counseling on depression in infertile women undergoing IVF.

Materials and Methods

The present clinical trial included 90 infertile women undergoing IVF treatment in an infertility center in 2016. Women were divided into two groups, intervention and control. Both groups completed a demographic questionnaire and the Beck depression inventory (BDI). Eight 90-minute sessions (two each week) of mindfulness-based group counseling were held with the intervention group, while the control group received treatment as normal. Following the intervention, the BDI was again completed by both groups. The data were analyzed and independent t tests and, paired t tests conducted at a significance level of P<0.05.

Results

No statistically significant demographic differences were observed between the two groups. Women in the control group had a somewhat lower depressive symptom score than the intervention group before the intervention. However, compared with before, the depressive symptom score among women in the intervention group decreased significantly (48%) (P<0.001) after the intervention. In contrast, the depressive symptom score in control women was higher after the intervention than before.

Conclusion

According to the findings of the present research, mindfulness-based group counseling is able to reduce depressive symptoms in infertile women under IVF treatment. Therefore, group counseling sessions are suggested for all depressed women undergoing infertility treatment (Registration number: IRCT2015082013405N14).

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7139233/

 

Improve Major Depressive Disorder with Acceptance and Commitment Therapy

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Improve Major Depressive Disorder with Acceptance and Commitment Therapy

 

By John M. de Castro, Ph.D.

 

“Insecure attachment styles are more prevalent in individuals with mood disorders and has been associated with worse clinical outcomes, whereas a secure attachment is linked to more positive health behaviors, such as greater adherence to health plans and preventive health behaviors.” – Tamara Cassis

 

Clinically diagnosed depression is the most common mental illness, affecting over 6% of the population. Major depression can be quite debilitating and difficult to treat. It is usually treated with antidepressant 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.

 

Attachment has been shown to affect the individual’s well-being. There are a variety of ways that individuals attach to others. They are secure, insecure, avoidant, ambivalent, fearful, preoccupied, and disorganized attachment styles. Secure attachment style is healthy and leads to positive development while all of the others are maladaptive and unhealthy. All of the  attachment styles, save secure attachment, are associated with depression.

 

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. Acceptance and Commitment Therapy (ACT) is a mindfulness-based psychotherapy technique that focuses on the individual’s thoughts, feelings, and behavior and how they interact to impact their psychological and physical well-being. It then works to change thinking to alter the interaction and produce greater life satisfaction. ACT employs mindfulness practices to increase awareness and develop an attitude of acceptance and compassion in the presence of painful thoughts and feelings. ACT teaches individuals to “just notice”, accept and embrace private experiences and focus on behavioral responses that produce more desirable outcomes.

 

It is possible that Acceptance and Commitment Therapy (ACT) may improve depression by affecting attachment. In today’s Research News article “Explicit and implicit attachment and the outcomes of acceptance and commitment therapy and cognitive behavioral therapy for depression.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7137238/),  A-Tjak and colleagues explore this possibility. They recruited adult patients diagnosed with major depressive disorder and randomly assigned them to receive 18 weekly 50 minute sessions of Cognitive Behavioral Therapy (CBT) or Acceptance and Commitment Therapy (ACT). They were measured before and after treatment and 6 months later for depressive symptoms, quality of life, attachment anxiety, and attachment avoidance. Implicit attachment was measured with a card sorting task.

 

They found that the two treatments were equally effective producing 75% to 80% rates of remission from depression and significant reductions in depression, attachment anxiety, and attachment avoidance and increases in quality of life. The effects were still present at the 6-month follow-up. The decreases in attachment anxiety and attachment avoidance were associated with decreases in depression and increases in quality of life while no relationships were present for implicit attachment.

 

The fact that Cognitive Behavioral Therapy (CBT) and Acceptance and Commitment Therapy (ACT) were equally effective for major depression is not surprising as ACT incorporates CBT. It is interesting that the magnitude in the changes in attachment anxiety and attachment avoidance were related to the improvements in depression and quality of life. But these results do not demonstrate causation, changes in attachment might cause changes in depression, changes in depression might cause changes in attachment, or therapy might change both independently. What is clear is that both ACT and CBT are highly effective and lasting treatments for major depressive disorder.

 

So, improve major depressive disorder with Acceptance and Commitment Therapy.

 

“Mindfulness training can “generate positive emotions by cultivating self-compassion and self-confidence through an upward spiral process.” – Amanda MacMillan

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

A-Tjak, J., Morina, N., Boendermaker, W. J., Topper, M., & Emmelkamp, P. (2020). Explicit and implicit attachment and the outcomes of acceptance and commitment therapy and cognitive behavioral therapy for depression. BMC psychiatry, 20(1), 155. https://doi.org/10.1186/s12888-020-02547-7

 

Abstract

Background

Attachment theory predicts that patients who are not securely attached may benefit less from psychological treatment. However, evidence on the predictive role of attachment in the effectiveness of treatment for depression is limited.

Methods

Explicit attachment styles, levels of attachment anxiety and attachment avoidance, as well as implicit relational self-esteem and implicit relational anxiety were assessed in 67 patients with major depressive disorder (MDD) receiving Acceptance and Commitment Therapy (ACT) or Cognitive Behavioral Therapy (CBT). ANOVA and hierarchical regression analyses were performed to investigate the predictive power of explicit and implicit attachment measures on treatment outcome.

Results

Explicit attachment avoidance at pre-treatment significantly predicted reduction of depressive symptoms following treatment. Reductions in attachment anxiety and avoidance from pre- to post-treatment predicted better treatment outcomes. Neither one of the implicit measures, nor change in these measures from pre- tot post-treatment significantly predicted treatment outcome.

Conclusions

Our findings show that attachment avoidance as well as reductions in avoidant and anxious attachment predict symptom reduction after psychological treatment for depression. Future research should use larger sample sizes to further examine the role of attachment orientation as moderator and mediator of treatment outcome.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7137238/

 

Reduce Distress and Increase Pregnancy in Women with Fertility Problems with Mind-Body Practices

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Reduce Distress and Increase Pregnancy in Women with Fertility Problems with Mind-Body Practices

 

By John M. de Castro, Ph.D.

 

“mindfulness becomes the perfect antidote for the paradoxical land mines infertility presents. Mindfulness starts from the perspective that you are whole and complete already, regardless of flaws or imperfections. It is based on the concept of original goodness: your essential nature is good and pure. Proceeding from this vantage point gives you freedom from the bondage of inadequacy and insecurity.” – Janetti Marrota

 

Infertility is primarily a medical condition due to physiological problems. It is quite common. It is estimated that in the U.S. 6.7 million women, about 10% of the population of women 15-44, have an impaired ability to get pregnant or carry a baby to term and about 6% are infertile. Infertility can be more than just a medical issue. It can be an emotional crisis for many couples, especially for the women. Couples attending a fertility clinic reported that infertility was the most upsetting experience of their lives.

 

Women with infertility reported feeling as anxious or depressed as those diagnosed with cancer, hypertension, or recovering from a heart attack. In addition, infertility can markedly impact the couple’s relationship, straining their emotional connection and interactions and the prescribed treatments can take the spontaneity and joy from lovemaking making it strained and mechanical. The stress of infertility and engaging in infertility treatments may exacerbate the problem. Since mindfulness training has been shown to reduce depression, anxiety, and stress it is reasonable to believe that mind-body training may be helpful in reducing the distress in women with fertility issues.

 

In today’s Research News article “An internet-based mind/body intervention to mitigate distress in women experiencing infertility: A randomized pilot trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7080396/), Clifton and colleagues recruited childless adult women who were seeking care for infertility. They were randomly assigned to either a wait-list control condition or to receive a 10-week online program of mind/body for fertility including weekly online modules and homework assignments. “The skills and strategies taught included: (a) knowledge regarding the relationship between stress, lifestyle, and fertility; (b) relaxation techniques including diaphragmatic breathing and Hatha Yoga; (c) mindfulness; (d) cognitive restructuring; (e) stress reduction strategies; (f) listening and communication skills; (g) strategies for emotional expression and effective coping with anger; and (h) assertiveness training and goal-setting skills.” They were measured before and after training for anxiety, depression, perceived stress, and fertility problems.

 

They found that in comparison to baseline and the wait-list control group, the women who received the training had significantly lower levels of anxiety, depression, perceived stress, and infertility related stress specific to sexual and social concerns. At the end of the study the women who received the training had significantly higher self-reported pregnancy rates. 53% of the trained women reported successful pregnancy while only 20% of the wait-list control women did.

 

The study was a randomized controlled trial but the control condition, wait-list, was passive. It would be important for future research to include an active control condition, such as online health education. In addition, the program included a complex set of practices and it is impossible to tease apart what components or combination of components were necessary for the effects observed. It would be interesting in future research to examine the effectiveness of the individual components.

 

Nevertheless, these are interesting and potentially important findings. The online mind/body for fertility program produced significant reductions in the distress levels of the women and increased the likelihood of becoming pregnant. By reducing the psychological distress produced by infertility the program appeared to markedly improve the likelihood of becoming pregnant. This is very helpful in reducing the suffering produced by infertility and thereby improving pregnancy success..

 

In addition, the fact that the program was implemented online makes it scalable at low cost to large groups of women over wide geographic areas and the women can engage in the program at times and places that were most comfortable and convenient for them. This greatly expands the usefulness of the program.

 

So, reduce distress and increase pregnancy in women with fertility problems with mind-body practices.

 

“Many women fear that becoming mindful and starting to meditate will make them passive in their quest for a child.  This simply isn’t so.  The wish for a child remains vibrant and active – it’s simply that happiness doesn’t depend on the fulfillment of this wish.” – Beth Heller

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Clifton, J., Parent, J., Seehuus, M., Worrall, G., Forehand, R., & Domar, A. (2020). An internet-based mind/body intervention to mitigate distress in women experiencing infertility: A randomized pilot trial. PloS one, 15(3), e0229379. https://doi.org/10.1371/journal.pone.0229379

 

Abstract

Objective

To determine if an internet-based mind/body program would lead to participants experiencing infertility (1) being willing to be recruited and randomized and (2) accepting and being ready to engage in a fertility-specific intervention. Secondary exploratory goals were to examine reduced distress over the course of the intervention and increased likelihood to conceive.

Methods

This was a pilot randomized controlled feasibility trial with a between-groups, repeated measure design. Seventy-one women self-identified as nulliparous and meeting criteria for infertility. Participants were randomized to the internet-based version of the Mind/Body Program for Fertility or wait-list control group and asked to complete pre-, mid- and post-assessments. Primary outcomes include retention rates, number of modules completed, and satisfaction with intervention. Secondary exploratory outcomes sought to provide preliminary data on the impact of the program on distress (anxiety and depression) and self-reported pregnancy rates relative to a quasi-control group.

Results

The retention, adherence, and satisfaction rates were comparable to those reported in other internet-based RCTs. Although time between pre- and post-assessment differed between groups, using intent-to-treat analyses, women in the intervention group (relative to the wait-list group) had significant reduction in distress (anxiety, p = .003; depression, p = .007; stress, p = .041 fertility-social, p = .018; fertility-sexual, p = .006), estimated as medium-to-large effect sizes (ds = 0.45 to 0.86). The odds of becoming pregnant was 4.47 times higher for the intervention group participants as compared to the wait-list group, OR 95% CI [1.56, 12.85], p = .005 and occurred earlier. The findings suggest that the research design and program specific to this population are feasible and acceptable. Replication efforts with an active control group are needed to verify distress reduction and conception promotion findings.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7080396/

 

Reduce Anxiety and Depression with COPD with Mind-Body practices

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Reduce Anxiety and Depression with COPD with Mind-Body practices

 

By John M. de Castro, Ph.D.

 

“We found that yoga can be a simple, cost-effective method that can help improve quality of life in patients with COPD.” – Randeep Guleria

 

Chronic Obstructive Pulmonary Diseases (COPD) are progressive lung diseases that obstruct airflow. The two main types of COPD are chronic bronchitis and emphysema. COPD is very serious being the third leading cause of death in the United States, over 140,000 deaths per year and the number of people dying from COPD is growing. More than 11 million people have been diagnosed with COPD, but an estimated 24 million may have the disease without even knowing it. COPD causes serious long-term disability and early death.

 

There is no cure for COPD. Treatments include lifestyle changes, medicine, bronchodilators, steroids, pulmonary rehabilitation, oxygen therapy, and surgery. They all attempt to relieve symptoms, slow the progress of the disease, improve exercise tolerance, prevent and treat complications, and improve overall health. Gentle mind-body exercise such as Yoga, Tai Chi and Qigong practices could improve COPD symptoms. Yoga has been shown to improve exercise tolerance and overall health and includes breathing exercises. Indeed, it has been shown that yoga practice improves the mental and physical health of patients with COPD. Mindful movement practices such Tai Chi and Qigong are ancient Chinese practices involving mindfulness and gentle movements. They are easy to learn, safe, and gentle. So, it may be appropriate for patients with COPD who lack the ability to engage in strenuous exercises to engage in these gentle mind-body practices.

 

In today’s Research News article “Mind-Body Exercise for Anxiety and Depression in COPD Patients: A Systematic Review and Meta-Analysis.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6981896/), Li and colleagues review, summarize, and perform a meta-analysis of the published research studies of the effectiveness of mind-body practices on the symptoms of Chronic Obstructive Pulmonary Diseases (COPD).

 

They found 13 peer-reviewed randomized controlled trials; 7 employing Qigong, 3 Tai Chi, and 3 yoga. They report that the published research found that mind-body practices produced significant reductions in anxiety and depression in patients with Chronic Obstructive Pulmonary Diseases (COPD).

 

Mindfulness practices, in general have been found to reduce anxiety and depression. The present review extends this effectiveness to mind-body mindfulness practices with patients with COPD. The mechanisms by which these practices produce these effects are not known. But all these practices involve focusing on the present moment. Anxiety is produced by fear of the future while depression is produced by rumination about the past. While focusing on the present, anxiety and depression are eliminated. Obviously, training does not eliminate thinking about the past and future. But, it may reduce the amount of time spent outside the present moment and thereby reduce the overall levels of anxiety and depression.

 

So, Reduce Anxiety and Depression with COPD with Mind-Body practices.

 

“The challenge for meditators with a history of asthma, COPD, or other breathing problems is that the seemingly simple process of breathing is entangled with fear, anxiety, and other difficult emotions.” – Susan Haejin Lee

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Li, Z., Liu, S., Wang, L., & Smith, L. (2019). Mind-Body Exercise for Anxiety and Depression in COPD Patients: A Systematic Review and Meta-Analysis. International journal of environmental research and public health, 17(1), 22. https://doi.org/10.3390/ijerph17010022

 

Abstract

Objectives: Mind–body exercise has been generally recognized as a beneficial strategy to improve mental health in those with Chronic Obstructive Pulmonary Disease (COPD). However, to date, no attempt has been made to collate this literature. The aim of the present study was to systematically analyze the effects of mind–body exercise for COPD patients with anxiety and depression and provide scientific evidence-based exercise prescription. Methods: both Chinese and English databases (PubMed, the Cochrane Library, EMBASE, Web of Science, Google Scholar, Chinese National Knowledge Infrastructure, Wanfang, Baidu Scholar) were used as sources of data to search randomized controlled trials (RCT) relating to mind–body exercise in COPD patients with anxiety and depression that were published between January 1982 to June 2019. 13 eligible RCT studies were finally used for meta-analysis. Results: Mind–body exercise (tai chi, health qigong, yoga) had significant benefits on COPD patients with anxiety (SMD = −0.76, 95% CI −0.91 to −0.60, p = 0.04, I2 = 47.4%) and depression (SMD = −0.86, 95% CI −1.14 to −0.58, p = 0.000, I2 = 71.4%). Sub-group analysis indicated that, for anxiety, 30–60 min exercise session for 24 weeks of health qigong or yoga had a significant effect on patients with COPD who are more than 70 years and have more than a 10-year disease course. For depression, 2–3 times a week, 30–60 min each time of health qigong had a significant effect on patients with COPD patients who are more than 70 years old and have less than a 10-year disease course. Conclusions: Mind–body exercise could reduce levels of anxiety and depression in those with COPD. More robust RCT are required on this topic.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6981896/

 

Improve Major Depressive Disorder with Psilocybin and Mindfulness Meditation

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Improve Major Depressive Disorder with Psilocybin and Mindfulness Meditation

 

By John M. de Castro, Ph.D.

 

“mindfulness training enhances the positive effects of a single dose of psilocybin, and can increase empathy and permanently reduce ego-centricity. This opens up new therapeutic avenues, for example for the treatment of depression.” – Franz Vollenweider

 

Psychedelic substances have been used almost since the beginning of recorded history to alter consciousness and produce spiritually meaningful experiences. People find these experiences very pleasant and eye opening. They often report that the experiences changed them forever. Even though the effects of psychedelic substances have been experienced and reported on for centuries, only very recently have these effects come under rigorous scientific scrutiny.

 

Psilocybin is a psychedelic substance that is found naturally in a number of varieties of mushrooms. It has been used for centuries particularly by Native Americans for their spiritual practices. When studied in the laboratory under double blind conditions, Psilocybin has been shown to “reliably occasion deeply personally meaningful and often spiritually significant experiences (e.g. mystical-type experiences).” Psilocybin has also been shown to improve clinical depression. Mindfulness training has also been found to improve depression. Since the effects of meditation and psilocybin appear similar, it’s important to look at the mechanism by which mindfulness meditation and psilocybin improve depression.

 

In today’s Research News article “Depression, Mindfulness, and Psilocybin: Possible Complementary Effects of Mindfulness Meditation and Psilocybin in the Treatment of Depression. A Review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7136554/), Heuschkel and colleagues review and summarize the published research studies of the effectiveness of meditation and psilocybin for the treatment of depression. They identified 95 published articles on the effectiveness of either mindfulness or psilocybin on major depressive disorders.

 

They found that the published reports that both mindfulness meditation and psilocybin produce significant and lasting improvements in mood, cognitive function, and social skills in patients with major depressive disorders. Mindfulness training has been shown through extensive research with a variety of healthy and ill individuals to reduce depression, stress responses, and inflammatory responses, and improves cognition, and social skills. It is interesting that both have similar effects.

 

The published research also reports that both mindfulness meditation and psilocybin produce significant neuroplastic changes in the nervous system but act different where mindfulness meditation produces slow changes that accumulate over time while psilocybin produces rapid changes in the brain. They also affect different neural circuits where mindfulness meditation increases activity and connectivity in brain systems associate with interoceptive awareness, psilocybin appears to disrupt function integrity of brain systems, promoting cognitive flexibility.

 

Both mindfulness meditation and psilocybin produce changes in endocrine and immune function. Both produce significant reductions in perceived stress and reduce inflammatory responses, they appear to do so through different mechanisms. Where mindful meditation appears to lower stress responses through the lowering cortisol, psilocybin appears to work through the anti-inflammatory cytokines.

 

Hence, the published research suggests that mindfulness meditation and psilocybin produce similar effects on patients with major depressive disorders, reducing depression, altering the brain both chronically and acutely, and reducing stress and inflammatory responses. But they appear to produce these effects through different biological processes. This suggests that they may complement each other. So, combining the two in a treatment for major depressive disorder may increase overall effectiveness. It remains for future research to investigate the effectiveness of combined treatment.

 

So, improve major depressive disorder with psilocybin and mindfulness meditation.

 

“A growing body of evidence suggests that psychedelic drugs, such as psilocybin, may be effective at treating a variety of psychological disorders, including depression and anxiety, and could one day be prescribed to patients.” – Traci Pederson

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Heuschkel, K., & Kuypers, K. (2020). Depression, Mindfulness, and Psilocybin: Possible Complementary Effects of Mindfulness Meditation and Psilocybin in the Treatment of Depression. A Review. Frontiers in psychiatry, 11, 224. https://doi.org/10.3389/fpsyt.2020.00224

 

Abstract

Depression is a major public health problem that affects approximately 4.4% of the global population. Since conventional pharmacotherapies and psychotherapies are only partially effective, as demonstrated by the number of patients failing to achieve remission, alternative treatments are needed. Mindfulness meditation (MM) and psilocybin represent two promising novel treatments that might even have complementary therapeutic effects when combined. Since the current literature is limited to theoretical and empirical underpinnings of either treatment alone, the present review aimed to identify possible complementary effects that may be relevant to the treatment of depression. To that end, the individual effects of MM and psilocybin, and their underlying working mechanisms, were compared on a non-exhaustive selection of six prominent psychological and biological processes that are well known to show impairments in patients suffering from major depression disorder, that is mood, executive functioning, social skills, neuroplasticity, core neural networks, and neuroendocrine and neuroimmunological levels. Based on predefined search strings used in two online databases (PubMed and Google Scholar) 1129 articles were identified. After screening title and abstract for relevance related to the question, 82 articles were retained and 11 were added after reference list search, resulting in 93 articles included in the review. Findings show that MM and psilocybin exert similar effects on mood, social skills, and neuroplasticity; different effects were found on executive functioning, neural core networks, and neuroendocrine and neuroimmune system markers. Potential mechanisms of MM’s effects are enhanced affective self-regulation through mental strategies, optimization of stress reactivity, and structural and functional adjustments of prefrontal and limbic areas; psilocybin’s effects might be established via attenuation of cognitive associations through deep personal insights, cognitive disinhibition, and global neural network disintegration. It is suggested that, when used in combination, MM and psilocybin could exert complementary effects by potentiating or prolonging mutual positive effects, for example, MM potentially facilitating psilocybin-induced peak experiences. Future placebo-controlled double-blind randomized trials focusing on psilocybin-assisted mindfulness-based therapy will provide knowledge about whether the proposed combination of therapies maximizes their efficacy in the treatment of depression or depressive symptomatology.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7136554/

 

Improve the Psychological Health in Breast Cancer Patients with Mindfulness

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Improve the Psychological Health in Breast Cancer Patients with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness is a state of mind which we can all acquire and use to support our wellbeing physically, emotionally and mentally.  . . Having cancer, or specifically breast cancer, is no exception. Our cancer experiences take up a lot of energies, mental focus and can drain us emotionally. It is important to have a few tools to help us create ‘down’ and ‘out’ times, and to replenish and reconnect with who we are. “ – Breast Cancer Now

 

Receiving a diagnosis of cancer has a huge impact on most people. Feelings of depression, anxiety, and fear are very common and are normal responses to this life-changing and potentially life-ending experience. But cancer diagnosis is not necessarily a death sentence. Over half of the people diagnosed with cancer are still alive 10 years later and this number is rapidly increasing. But, surviving cancer carries with it a number of problems. Anxiety, depression, fatigue and insomnia are common symptoms in the aftermath of surviving breast cancer. These symptoms markedly reduce the quality of life of the patients.

 

Mindfulness training has been shown to help with cancer recovery and help to relieve chronic pain. It can also help treat the residual physical and psychological symptoms, including stress,  sleep disturbance, fear, and anxiety and depression. There has been considerable research conducted on the effectiveness of mindfulness practices in treating the psychological issues associated with cancer. So, it makes sense to step back and summarize what has been learned.

 

In today’s Research News article “Mindfulness-based stress reduction for women diagnosed with breast cancer.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6436161/), Schell and colleagues review, summarize, and perform a meta-analysis of the published research studies investigating the effectiveness of the Mindfulness-Based Stress Reduction (MBSR) program for the treatment of the psychological problems that occur in women who survive breast cancer. MBSR includes meditation, body scan, yoga practices, and discussion along with daily home practice. They identified 14 randomized controlled trials.

 

They report that the published research studies provide evidence that the Mindfulness-Based Stress Reduction (MBSR) program improves the quality of life and sleep and reduces anxiety, depression, and fatigue in breast cancer patients. The effect sizes are small and the effects were no longer present at long-term follow-up a year after the end of treatment. MBSR is a complex of practices and the research to date cannot differentiate which components or which combination of components are responsible for the benefits.

 

There is substantial evidence that mindfulness training improves quality of life and sleep and reduces anxiety, depression, and fatigue in a wide variety of healthy and ill individuals. The present results suggest that it also has these benefits for women suffering with breast cancer. Hence, MBSR may be recommended to improve the psychological health of breast cancer patients.

 

So, improve the psychological health in breast cancer patients with mindfulness.

 

“Studies have shown mindfulness-based stress reduction can be effective in alleviating anxiety and depression, decreasing long-term emotional and physical side effects of treatments and improving the quality of sleep in breast cancer patients.” – Breast Cancer Research Foundation

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Schell, L. K., Monsef, I., Wöckel, A., & Skoetz, N. (2019). Mindfulness-based stress reduction for women diagnosed with breast cancer. The Cochrane database of systematic reviews, 3(3), CD011518. https://doi.org/10.1002/14651858.CD011518.pub2

 

Abstract

Background

Breast cancer is the most common cancer in women. Diagnosis and treatment may drastically affect quality of life, causing symptoms such as sleep disorders, depression and anxiety. Mindfulness‐based stress reduction (MBSR) is a programme that aims to reduce stress by developing mindfulness, meaning a non‐judgmental, accepting moment‐by‐moment awareness. MBSR seems to benefit patients with mood disorders and chronic pain, and it may also benefit women with breast cancer.

Objectives

To assess the effects of mindfulness‐based stress reduction (MBSR) in women diagnosed with breast cancer.

Search methods

In April 2018, we conducted a comprehensive electronic search for studies of MBSR in women with breast cancer, in the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, and two trial registries (World Health Organization’s International Clinical Trials Registry Platform (WHO ICTRP) and ClinicalTrials.gov). We also handsearched relevant conference proceedings.

Selection criteria

Randomised clinical trials (RCTs) comparing MBSR versus no intervention in women with breast cancer.

Data collection and analysis

We used standard methodological procedures expected by Cochrane. Using a standardised data form, the review authors extracted data in duplicate on methodological quality, participants, interventions and outcomes of interest (quality of life, fatigue, depression, anxiety, quality of sleep, overall survival and adverse events). For outcomes assessed with the same instrument, we used the mean difference (MD) as a summary statistic for meta‐analysis; for those assessed with different instruments, we used the standardised mean difference (SMD). The effect of MBSR was assessed in the short term (end of intervention), medium term (up to 6 months after intervention) and long term (up to 24 months after intervention).

Main results

Fourteen RCTs fulfilled our inclusion criteria, with most studies reporting that they included women with early breast cancer. Ten RCTs involving 1571 participants were eligible for meta‐analysis, while four studies involving 185 participants did not report usable results. Queries to the authors of these four studies were unsuccessful. All studies were at high risk of performance and detection bias since participants could not be blinded, and only 3 of 14 studies were at low risk of selection bias. Eight of 10 studies included in the meta‐analysis recruited participants with early breast cancer (the remaining 2 trials did not restrict inclusion to a certain cancer type). Most trials considered only women who had completed cancer treatment.

MBSR may improve quality of life slightly at the end of the intervention (based on low‐certainty evidence from three studies with a total of 339 participants) but may result in little to no difference up to 6 months (based on low‐certainty evidence from three studies involving 428 participants). Long‐term data on quality of life (up to two years after completing MBSR) were available for one study in 97 participants (MD 0.00 on questionnaire FACT‐B, 95% CI −5.82 to 5.82; low‐certainty evidence).

In the short term, MBSR probably reduces fatigue (SMD −0.50, 95% CI −0.86 to −0.14; moderate‐certainty evidence; 5 studies; 693 participants). It also probably slightly reduces anxiety (SMD −0.29, 95% CI −0.50 to −0.08; moderate‐certainty evidence; 6 studies; 749 participants), and it reduces depression (SMD −0.54, 95% CI −0.86 to −0.22; high‐certainty evidence; 6 studies; 745 participants). It probably slightly improves quality of sleep (SMD −0.38, 95% CI −0.79 to 0.04; moderate‐certainty evidence; 4 studies; 475 participants). However, these confidence intervals (except for short‐term depression) are compatible with both an improvement and little to no difference.

In the medium term, MBSR probably results in little to no difference in medium‐term fatigue (SMD −0.31, 95% CI −0.84 to 0.23; moderate‐certainty evidence; 4 studies; 607 participants). The intervention probably slightly reduces anxiety (SMD −0.28, 95% CI −0.49 to −0.07; moderate‐certainty evidence; 7 studies; 1094 participants), depression (SMD −0.32, 95% CI −0.58 to −0.06; moderate‐certainty evidence; 7 studies; 1097 participants) and slightly improves quality of sleep (SMD −0.27, 95% CI −0.63 to 0.08; moderate‐certainty evidence; 4 studies; 654 participants). However, these confidence intervals are compatible with both an improvement and little to no difference.

In the long term, moderate‐certainty evidence shows that MBSR probably results in little to no difference in anxiety (SMD −0.09, 95% CI −0.35 to 0.16; 2 studies; 360 participants) or depression (SMD −0.17, 95% CI −0.40 to 0.05; 2 studies; 352 participants). No long‐term data were available for fatigue or quality of sleep.

No study reported data on survival or adverse events.

Authors’ conclusions

MBSR may improve quality of life slightly at the end of the intervention but may result in little to no difference later on. MBSR probably slightly reduces anxiety, depression and slightly improves quality of sleep at both the end of the intervention and up to six months later. A beneficial effect on fatigue was apparent at the end of the intervention but not up to six months later. Up to two years after the intervention, MBSR probably results in little to no difference in anxiety and depression; there were no data available for fatigue or quality of sleep.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6436161/

 

Improve Mental Health with Yoga

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Improve Mental Health with Yoga

 

By John M. de Castro, Ph.D.

 

“for many patients dealing with depression, anxiety, or stress, yoga may be a very appealing way to better manage symptoms. . . The evidence is growing that yoga practice is a relatively low-risk, high-yield approach to improving overall health.” – Harvard Health

 

Mindfulness practice has been shown to improve emotions and their regulation. Practitioners demonstrate more positive and less negative emotions and the ability to fully sense and experience emotions, while responding to them in appropriate and adaptive ways. The ability of mindfulness training to improve emotion regulation is thought to be the basis for a wide variety of benefits that mindfulness provides to mental health and the treatment of mental illness especially depression and anxiety disorders.

 

Exercise has also been shown to improve mental health. Yoga is both a mindfulness practice and an exercise. It has been shown to have a myriad of benefits for psychological and physical health, social, and spiritual well-being. There has accumulated a wealth of research studies of the effects of yoga practice on mental health. It makes sense to take a look at what has been learned. In today’s Research News article “Applications of Yoga in Psychiatry: What We Know.” (See summary below or view the full text of the study at:), Nyer and colleagues review and summarize the published research studies of the effectiveness of yoga practice and exercise for the treatment of psychological problems.

 

They report that the published research studies found that there was a powerful effect of yoga practice on depression, including major depressive disorders, even in patients who did not respond to antidepressant drugs. They also report that yoga practice is a safe and effective treatment for anxiety disorders, including generalized anxiety disorder, obsessive-compulsive disorder, and post-traumatic stress disorder, PTSD.

 

They report that the research postulates a number of potential mechanisms for yoga’s ability to improve depressive and anxiety disorders. These disorders are associated with an imbalance in the autonomic nervous system such that sympathetic activity, activation, predominates over parasympathetic activity, relaxation. Yoga practice has been shown to rebalance these systems, strengthening parasympathetic activity. Also, high levels of perceived stress have also been found to be associated with depressive and anxiety disorders and yoga practice has been shown to reduce perceived stress levels. In addition, depressive and anxiety disorders are characterized by excessive emotions and yoga practice has been found to improve the individual’s ability to regulate their emotions. These are thought to be a potential explanations for yoga’s effectiveness.

 

So, improve mental health with yoga.

 

“In Sanskrit, yoga means to unite. As you grow in your ability to sense the relationship between your mind and body, you become more aware of dualities that exist in experience. The practice of yoga brings you to the awareness that there is a relationship between two ends of one phenomenon. You are body and mind.” – Deborah Khoshaba

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Nyer, M., Nauphal, M., Roberg, R., & Streeter, C. (2018). Applications of Yoga in Psychiatry: What We Know. Focus (American Psychiatric Publishing), 16(1), 12–18. https://doi.org/10.1176/appi.focus.20170055

 

Abstract

Yoga has been in use for thousands of years in the East as a healing modality. Western practitioners are now starting to recognize the potential of yoga-based treatments. The purpose of this article is to explore the evidence-base of yoga-based treatments for depression and anxiety with the purpose of furthering the integration of yoga into conventional Western mental health treatment plans.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6519580/

 

Improve Generalized Anxiety Disorder with Acceptance and Commitment Therapy (ACT)

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Improve Generalized Anxiety Disorder with Acceptance and Commitment Therapy (ACT)

 

By John M. de Castro, Ph.D.

 

“Acceptance and commitment therapy (ACT) is a type of psychotherapy gaining popularity in the treatment of anxiety disorders like generalized anxiety disorder (GAD). It is also used to treat other conditions including depression, eating disorders, chronic pain, and substance use disorders.” – Deborah Glasofer

 

Anxiety disorders are the most common mental illness in the United States, affecting 40 million adults, or 18% of the population. 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. Anxiety disorders have generally been treated with drugs. But there are considerable side effects and these drugs are often abused. There are a number of psychological therapies for anxiety. But, about 45% of the patients treated do not respond to the therapy. So, there is a need to develop alternative treatments. Recently, it has been found that mindfulness training can be effective for anxiety disorders.

 

A therapeutic technique that contains mindfulness training is Acceptance and Commitment Therapy (ACT). It is a mindfulness-based psychotherapy technique that is employs many of the techniques of Cognitive Behavioral Therapy (CBT) and has also been shown to relieve anxiety. ACT focuses on the individual’s thoughts, feelings, and behavior and how they interact to impact their psychological and physical well-being. It then works to change thinking to alter the interaction and produce greater life satisfaction. ACT employs mindfulness practices to increase awareness and develop an attitude of acceptance and compassion in the presence of painful thoughts and feelings. ACT teaches individuals to “just notice”, accept and embrace private experiences and focus on behavioral responses that produce more desirable outcomes.

 

In today’s Research News article “A Multiple-Baseline Evaluation of Acceptance and Commitment Therapy Focused on Repetitive Negative Thinking for Comorbid Generalized Anxiety Disorder and Depression.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7082425/), Ruiz and colleagues recruited 6 adults with Generalized Anxiety Disorder (GAD) and also depression. They received a 3 session Acceptance and Commitment Therapy (ACT) protocol of 90, 60, and 60 minutes focused on repetitive negative thinking implemented at different times on a multiple baseline. They were measured weekly over the internet for emotional symptoms (a combination of anxiety, depression and perceived stress), worry, experiential avoidance, cognitive fusion, perseverative thinking, and valuing.

 

They found that all participants demonstrated no significant changes during the 5 or more weeks of the baseline period in emotional symptoms or worry. But once Acceptance and Commitment Therapy (ACT) was provided all participants immediately demonstrated a precipitous decline in emotional symptoms, worry, experiential avoidance, cognitive fusion, and perseverative thinking that was maintained for 3 months. Effect sizes were very large and 5 of the 6 participants had clinically significant changes in emotional symptoms and worry.

 

It is well established that mindfulness training reduces anxiety, depression, perceived, stress, and worry. Nevertheless, the results of the present study are striking. Administration of a brief Acceptance and Commitment Therapy (ACT)  focused on repetitive negative thinking produced dramatic clinically significant improvements in the core symptoms of Generalized Anxiety Disorder (GAD) and depression. The fact that this was accomplished in 3-sessions is important as it reduces the investment of therapists in treatment, reducing costs and improving the numbers of people being able to be treated. These findings suggest that this brief form of mindfulness-based therapy be implemented for anxiety and deprressive disorders.

 

So, improve Generalized Anxiety Disorder with Acceptance and Commitment Therapy (ACT).

 

“ACT helps you take action on your values, instead of letting your anxiety dictate your decisions and your days.” –  Margarita Tartakovsky

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Ruiz, F. J., Luciano, C., Flórez, C. L., Suárez-Falcón, J. C., & Cardona-Betancourt, V. (2020). A Multiple-Baseline Evaluation of Acceptance and Commitment Therapy Focused on Repetitive Negative Thinking for Comorbid Generalized Anxiety Disorder and Depression. Frontiers in psychology, 11, 356. https://doi.org/10.3389/fpsyg.2020.00356

 

Abstract

Repetitive negative thinking (RNT) is a core feature of generalized anxiety disorder (GAD) and depression. Recently, some studies have shown promising results with brief protocols of acceptance and commitment therapy (ACT) focused on RNT in the treatment of emotional disorders in adults. The current study analyzes the effect of an individual, 3-session, RNT-focused ACT protocol in the treatment of severe and comorbid GAD and depression. Six adults meeting criteria for both disorders and showing severe symptoms of at least one of them participated in the study. A delayed multiple-baseline design was implemented. All participants completed a 5-week baseline without showing improvement trends in emotional symptoms (Depression Anxiety and Stress Scale – 21; DASS-21) and pathological worry (Penn State Worry Questionnaire; PSWQ). The ACT protocol was then implemented, and a 3-month follow-up was conducted. Five of the six participants showed clinically significant changes in the DASS-21 and the PSWQ. The standardized mean difference effect sizes for single-case experimental design were very large for emotional symptoms (d = 3.34), pathological worry (d = 4.52), experiential avoidance (d = 3.46), cognitive fusion (d = 3.90), repetitive thinking (d = 4.52), and valued living (d = 0.92 and d = 1.98). No adverse events were observed. Brief, RNT-focused ACT protocols for treating comorbid GAD and depression deserve further empirical tests.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7082425/

 

Reduce Anxiety and Depression in Coronary Heart Disease Patients with Tai Chi

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Reduce Anxiety and Depression in Coronary Heart Disease Patients with Tai Chi

 

By John M. de Castro, Ph.D.

 

“Tai chi is an interesting, promising exercise option. I think based on what we found, it’s a reasonable and safe step to offer tai chi within cardiac rehab.” – Elena Salmoriago-Blotcher

 

Cardiovascular disease is the number one killer, claiming more lives than all forms of cancer combined. There are myriads of treatments that have been developed to treat cardiovascular disease including a variety of surgical procedures and medications. Importantly, lifestyle changes have proved to be quite effective. These include quitting smoking, weight reduction, improved diet, physical activity, and reducing stresses. Contemplative practices, such as meditation, tai chi, and yoga, have also been shown to be helpful for heart health. These practices have also been shown to be helpful for producing the kinds of other lifestyle changes needed such as smoking cessation, weight reduction and stress reduction.

 

Cardiac rehabilitation programs for patients recovering from implantation of a stent for coronary heart disease, emphasize lifestyle changes. Unfortunately, for a variety of reasons, 60% of coronary heart disease patients decline participation, making these patients at high risk for a heart attack.  Tai Chi and Qigong are ancient mindfulness practices involving slow prescribed movements. They are gentle and completely safe, can be used with the elderly and sickly, are inexpensive to administer, can be performed in groups or alone, at home or in a facility or even public park, and can be quickly learned. In addition, they can also be practiced in social groups without professional supervision. This can make it fun, improving the likelihood of long-term engagement in the practice. Since Tai Chi is both a mindfulness practice and a gentle exercise, it may be an acceptable, safe, and effective treatment for coronary heart disease patients.

 

In today’s Research News article “The 24-Form Tai Chi Improves Anxiety and Depression and Upregulates miR-17-92 in Coronary Heart Disease Patients After Percutaneous Coronary Intervention.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7078346/), Liu and colleagues recruited coronary heart disease patients who had a myocardial infarction and a stent implanted less than 4 days prior. The patients received usual care and were randomly assigned to receive either no further treatment or Tai Chi practice twice a day for 60 minutes for 10 months. They were measured before and after the 10-month practice period for anxiety, depression, perceived stress, and quality of life. In addition, blood was drawn and measured for miR-17-92.

 

They found that in comparison to baseline and the control group, the group that received Tai Chi training had significantly lower levels of anxiety, depression, and perceived stress and significantly higher levels of quality of life and miR-17-92. In addition, they found that the higher the levels of miR-17-92 the lower the levels of anxiety, depression, and perceived stress.

 

It should be noted that the control condition was not active. Future research should have an active control that performed some other activity of comparable duration, perhaps another type of exercise or health education. Nevertheless, the results show that Tai Chi practice can significantly improve the psychological well-being of coronary heart disease patients after surgery to insert a stent.

 

Prior research has demonstrated the RNA segments are associated with anxiety and depression. The current research also detected this relationship. But the study also demonstrated that the improvements in anxiety, depression, and perceived stress were associated with increased levels of miR-17-92. This may indicate a mechanism of action by which Tai Chi practice improves psychological well-being. It remains for future research to further explore this interesting possibility.

 

So, reduce anxiety and depression in coronary heart disease patients with Tai Chi.

 

“Tai chi shows promise for patients with existing heart disease. Participants in the intensive tai chi program were significantly more active, lost more weight and reported a higher quality of life.” – CardioSmart

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Liu, J., Yu, P., Lv, W., & Wang, X. (2020). The 24-Form Tai Chi Improves Anxiety and Depression and Upregulates miR-17-92 in Coronary Heart Disease Patients After Percutaneous Coronary Intervention. Frontiers in physiology, 11, 149. https://doi.org/10.3389/fphys.2020.00149

 

Abstract

Background

Anxiety and depression are common symptoms in patients with coronary heart disease (CHD) after percutaneous coronary intervention (PCI). The 24-form Tai Chi may exert a protective function for CHD patients after PCI by improving anxiety and depression.

Methods

Patients who received PCI after 1–4 days were randomly assigned to the 24-form Tai Chi group (TG) and the control group (CG). The differences in anxiety and depression, using the Medical Outcomes Study 36−item Short−Form Health Survey (SF-36), before and after an average of 10 months of Tai Chi intervention were compared in both groups to analyze the effects of Tai Chi on the emotion and the life quality of CHD patients. Meanwhile, the relative levels of miR-17-92 were measured by using real-time qPCR. The association between the relative levels of miR-17-92 and the anxiety and the depression of CHD patients after PCI was analyzed. Adjusted Cox models were used to explore the effect of Tai Chi exercise in CHD patients.

Results

After 10 months of intervention, the changes in the anxiety subscale (P = 0.002), in the depression subscale (P = 0.008), and in the stress (P = 0.015) scores were higher in the TG group when compared to those of the CG group. The proportion of anxious (P = 0.045) and depressed subjects (P = 0.042) in the TG group was lower than that in the CG group. On the other hand, the increase in the SF-36 scores and in the relative levels of miR-17-92 was significantly higher in the TG group when compared with that of the CG group (P < 0.05). The serum level of miR-17-92 had a negative correlation with the anxiety, the depression, and the stress scores (P < 0.01).

Conclusion

The 24-form Tai Chi improved the anxiety and the depression symptoms and upregulated the miR-17-92 levels in CHD patients after PCI.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7078346/