Depression

Reduce Worry and Rumination and Improve Emotion Regulation Lowering Anxiety and Depression with Mindfulness

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Reduce Worry and Rumination and Improve Emotion Regulation Lowering Anxiety and Depression with Mindfulness

 

By John M. de Castro, Ph.D.

 

“The practice of mindfulness teaches us a different way to relate to our thoughts, feelings, and emotions as they arise. It is about learning to approach and acknowledge whatever is happening in the present moment, setting aside our lenses of judgment and just being with whatever is there, rather than avoiding it or needing to fix it.” – Elisha Goldstein

 

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. This has led to an increasing adoption of mindfulness techniques for the health and well-being of both healthy and ill individuals.

 

Worry (concern about the future) and rumination (repetitive thinking about the past) are associated with mental illness, particularly anxiety and depression. Fortunately, worry and rumination may be interrupted by mindfulness and emotion regulation improved by mindfulness. These may be some of the mechanisms by which mindfulness training improves anxiety and depression. In today’s Research News article “Mindfulness and Symptoms of Depression and Anxiety in the General Population: The Mediating Roles of Worry, Rumination, Reappraisal and Suppression.” (See summary below or view the full text of the study at: https://www.frontiersin.org/articles/10.3389/fpsyg.2019.00506/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_934868_69_Psycho_20190314_arts_A ), Parmentier and colleagues examine the ability of mindfulness to improve emotion regulation and reduce worry and rumination and thereby improve anxiety and depression.

 

They recruited adult participants online and had them complete an online survey measuring mindfulness, anxiety, depression, rumination, worry, emotion regulation, and meditation history. They found that meditation practice was not associated with anxiety or depression directly but rather through its positive association with mindfulness which was strongly negatively associated with anxiety and depression. Mindfulness was associated with lower levels of anxiety and depression directly and also indirectly through its association with rumination and worry and the emotion regulation mechanisms of suppression and reappraisal. Mindfulness was associated with lower levels of suppression, rumination, and worry and higher levels of reappraisal. which in turn were associated with anxiety and depression.

 

These findings suggest that meditation practice increases mindfulness and this decreases anxiety and depression. It does so directly and indirectly. Mindfulness reduces the tendency to suppress, prevent, anxiety and depression from arising which allows for full mindful appreciation of these emotions and as a result produces an actual reduction in them. It also decreases worry and rumination that normally heighten anxiety and depression. At the same time mindfulness increases reappraisal, heightening the ability to investigate the causes of anxiety and depression, resulting in their reduction. Worry and rumination were the most powerful mediating factors while suppression and reappraisal were still significant factors but substantially weaker.

 

These results support the conclusion that mindfulness directly decreases anxiety and depression. But mindfulness also acts indirectly by affecting has a number of psychological processes including improving emotion regulation and by decreasing the counterproductive cognitive processes of worry and rumination.

 

So, reduce worry and rumination and improve emotion regulation lowering anxiety and depression with mindfulness.

 

“With mindfulness practice, we can learn how to unhook from rumination and cut ourselves (and others) the slack requisite for increasing clarity and ease of being.” – Mitch Abblett

 

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

 

Parmentier FBR, García-Toro M, García-Campayo J, Yañez AM, Andrés P and Gili M (2019) Mindfulness and Symptoms of Depression and Anxiety in the General Population: The Mediating Roles of Worry, Rumination, Reappraisal and Suppression. Front. Psychol. 10:506. doi: 10.3389/fpsyg.2019.00506

 

The present study examined the effects of mindfulness on depression and anxiety, both direct and indirect through the mediation of four mechanisms of emotional regulation: worry, rumination, reappraisal and suppression. Path analysis was applied to data collected from an international and non-clinical sample of 1151 adults, including both meditators and non-meditators, who completed an online questionnaire battery. Our results show that mindfulness are related to lower levels of depression and anxiety both directly and indirectly. Suppression, reappraisal, worry and rumination all acted as significant mediators of the relationship between mindfulness and depression. A similar picture emerged for the relationship between mindfulness and anxiety, with the difference that suppression was not a mediator. Our data also revealed that the estimated number of hours of mindfulness meditation practice did not affect depression or anxiety directly but did reduce these indirectly by increasing mindfulness. Worry and rumination proved to be the most potent mediating variables. Altogether, our results confirm that emotional regulation plays a significant mediating role between mindfulness and symptoms of depression and anxiety in the general population and suggest that meditation focusing on reducing worry and rumination may be especially useful in reducing the risk of developing clinical depression.

https://www.frontiersin.org/articles/10.3389/fpsyg.2019.00506/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_934868_69_Psycho_20190314_arts_A

 

Students and Military who are High in All Facets of Mindfulness Have Better Psychological Health

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Students and Military who are High in All Facets of Mindfulness Have Better Psychological Health

 

By John M. de Castro, Ph.D.

 

“The research is strong for mindfulness’ positive impact in certain areas of mental health, including stress reduction, emotion and attention regulation, reduced rumination, for reducing mild to moderate depression and anxiety, and preventing depressive relapse.“ – Kelle Walsh

 

Mindfulness training has been shown to improve health and well-being. It has also been found to be effective for a large array of medical and psychiatric conditions, either stand-alone or in combination with more traditional therapies. As a result, mindfulness training has been called the third wave of therapies.

 

One of the premiere measurement tools for mindfulness is the Five Factors of Mindfulness Questionnaire. It measures overall mindfulness and also five facets; observing, describing, acting with awareness, non-judgement, and non-reactivity. People differ and an individual can be high or low on any of these facets and any combination of facets. It is not known what pattern of mindfulness facets are most predictive of good mental health.

 

In today’s Research News article “Mindfulness and Psychological Health Outcomes: A Latent Profile Analysis among Military Personnel and College Students.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5800780/ ), Bravo and colleagues recruited active and retired military personnel and college students. They were measured online for mindfulness, depression, anxiety, rumination, suicidality, post-traumatic stress disorder, alcohol and drug abuse symptoms.

 

They found that overall, the greater the levels of mindfulness, the better the mental health of the participants including lower depression, anxiety, rumination, suicidality, post-traumatic stress disorder, alcohol and drug abuse symptoms. The military personnel were higher on all measures except rumination than the college students.

 

For the college students latent profile analysis revealed 4 mindfulness profiles ““high mindfulness” group (i.e., moderately high on all facets of mindfulness), a “low mindfulness” group (i.e., relatively low-to-average on all facets of mindfulness), a “judgmentally observing” group (i.e., high on observing facet, low on non-judging of inner experience and acting with awareness) and a “non-judgmentally aware” group (i.e., low on observing, high on non-judging of inner experience and acting with awareness).” For the military personnel latent profile analysis revealed 3 mindfulness profiles “high mindfulness” group (i.e., moderately high on all facets of mindfulness), a “low mindfulness/ judgmentally observing” group (i.e., relatively low-to-average on describing, and non-reacting facets of mindfulness and  high on observing facet, low on non-judging of inner experience and acting with awareness) and a “non-judgmentally aware” group (i.e., low on observing, high on non-judging of inner experience and acting with awareness).

 

For both the military personnel and the students, the participants with the “high mindfulness” profile had significantly better mental health than those with the other profiles including lower depression, anxiety, rumination, suicidality, post-traumatic stress disorder, alcohol and drug abuse symptoms. It is important to note that the results were similar in very different participant populations, suggesting that the results are generalizable.

 

The results further suggest that with mindfulness there are very different types of people, expressing mindfulness in different ways and this makes a difference in the relationship of mindfulness to mental health. The results suggest that overall being mindful is associated with good mental health. They further suggest that being generally high on all facets of mindfulness is an even better predictor of good mental health. It may make sense in future research to pay more attention to these different mindfulness profile groups in investigating mindfulness relationships with mental and physical well-being.

 

It is clear that mindfulness is associated with better mental health.

 

“We’ve seen this in the clinical domain for many years. People, in concert with their physicians… actually going off their medications for pain, for anxiety, for depression, as they begin to learn the self-regulatory elements of mindfulness. They discover that the things that used to be symptomatically problematic for them are no longer arising at the same level.” – Jon Kabat-Zinn

 

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

 

Bravo, A. J., Pearson, M. R., & Kelley, M. L. (2017). Mindfulness and Psychological Health Outcomes: A Latent Profile Analysis among Military Personnel and College Students. Mindfulness, 9(1), 258-270.

 

Abstract

Previous research on trait mindfulness facets using person-centered analyses (e.g., latent profile analysis [LPA]) has identified four distinct mindfulness profiles among college students: a high mindfulness group (high on all facets of the Five-Factor Mindfulness Questionnaire [FFMQ]), a judgmentally observing group (highest on observing, but low on non-judging of inner experience and acting with awareness), a non-judgmentally aware group (high on non-judging of inner experience and acting with awareness, but very low on observing), and a low mindfulness group (low on all facets of the FFMQ). In the present study, we used LPA to identify distinct mindfulness profiles in a community based sample of U.S. military personnel (majority veterans; n = 407) and non-military college students (n = 310) and compare these profiles on symptoms of psychological health outcomes (e.g., suicidality, PTSD, anxiety, rumination) and percentage of participants exceeding clinically significant cut-offs for depressive symptoms, substance use, and alcohol use. In the subsample of college students, we replicated previous research and found four distinct mindfulness profiles; however, in the military subsample we found three distinct mindfulness profiles (a combined low mindfulness/judgmentally observing class). In both subsamples, we found that the most adaptive profile was the “high mindfulness” profile (i.e., demonstrated the lowest scores on all psychological symptoms and the lowest probability of exceeding clinical cut-offs). Based on these findings, we purport that the comprehensive examination of an individual’s mindfulness profile could help clinicians tailor interventions/treatments that capitalize on individual’s specific strengths and work to address their specific deficits.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5800780/

 

Improve Executive and Emotional Control of Grief with Mindfulness

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Improve Executive and Emotional Control of Grief with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness for grief is not about whitewashing your pain, or “getting over” your loss. It is about learning how to stay present, cultivate compassion, and make wise choices that will help you cope with this new normal known as life after loss.” – Heather Stang

 

Grief is a normal, albeit complex, process that follows a loss of a significant person or situation in one’s life. This can involve the death of a loved one, a traumatic experience, termination of a relationship, loss of employment etc. Exactly what transpires depends upon the individual and the nature of the loss. It involves physical, emotional, psychological and cognitive processes. Not everyone grieves in the same way but there have been identified four general stages of grief, shock and denial, intense concern, despair and depression, and recovery. These are normal and healthy. But, in about 15% of people grief can be overly intense or long and therapeutic intervention may become necessary.

 

Mindfulness practices have been found to help with coping with loss and its consequent grief.  Mindfulness-Based Cognitive Therapy (MBCT)  was specifically developed to treat depression. MBCT involves mindfulness training, containing sitting, walking and body scan meditations, and cognitive therapy That is designed to alter how the patient relates to the thought processes that often underlie and exacerbate psychological symptoms. This would seem to be an ideal treatment protocol to treat intense grief.

 

In today’s Research News article “Mindfulness Improves Emotion Regulation and Executive Control on Bereaved Individuals: An fMRI Study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6360180/ ), Huang and colleagues recruited participants who had lost a significant relative within the last 4 years and self-reported intense unresolved grief. They completed an 8-week, once a week for 2.5 hours Mindfulness-Based Cognitive Therapy (MBCT) treatment including daily, 30-40 minute, home practice. The participants were measured before and after treatment for grief, anxiety, depression, and emotion regulation.

 

The participants also underwent 3 brain scanning sessions with functional Magnetic Resonance Imaging (fMRI). During 2 of the sessions they performed a numerical Stroop task in which they were to report which of 2 numerals was larger. In one session they were to ignore the physical size of the numeral and only report on the numerically larger numeral. In the second session they were to ignore the numerical magnitude of the numeral and only report on the physically larger numeral. This task measures cognitive interference and executive control.

 

They found that after MBCT treatment there were large and highly significant increases in mindfulness and emotion regulation and decreases in grief, anxiety, and depression. They also found that after treatment the higher the level of mindfulness the lower the levels of grief, anxiety, and depression. In addition, the participants after treatment were significantly better at ignoring irrelevant stimuli and respond faster in the Stroop task. This suggests reduced negative emotionality and improved cognitive control.

 

The researchers observed that after treatment during the cognitive task there was a decrease in activity in the cingulate cortex. These areas are involved in what is termed the Default Mode Network which becomes active during mind wandering and self-referential thinking. In other words, the brain areas associated with a lack of attention to the task at hand became less active. This suggests that there was greater attention to the present moment after MBCT training.

 

Long-term intense grief can be very harmful to the psychological and physical well-being of the individual. The present findings suggest that MBCT practice may be an effective treatment. It appears to reduce the negative emotions and improve the ability to regulate them in grieving individuals. It appears to do so, by altering the brain systems associated with mind wandering. It is during mind wandering where rumination occurs that tends to exacerbate anxiety and depression. So, the brain changes produced by MBCT treatment tend to keep the individual focused on the present lowering the impact of the past on their emotional state.

 

So, improve executive and emotional control of grief with mindfulness.

 

“Mindfulness reminds us that pain and sorrow, like all else, are impermanent.  Does this mean grief goes away completely?  Of course not.   But it does mean that it will change shape and form, it will ebb and flow, some days it will hurt like hell and some days you will start to smile.  It means that our grief, like everything else, is impermanent and ever-changing.  Once we accept this, even if only on a rational level, some of the need to avoid our grief starts to diminish.  We can stop believing it is permanent and will never change, even when we feel it will last forever.  We can start noticing and accepting our grief for what it really is and the small changes every day in our experiences.’ – WYG

 

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

 

Huang, F. Y., Hsu, A. L., Hsu, L. M., Tsai, J. S., Huang, C. M., Chao, Y. P., Hwang, T. J., … Wu, C. W. (2019). Mindfulness Improves Emotion Regulation and Executive Control on Bereaved Individuals: An fMRI Study. Frontiers in human neuroscience, 12, 541. doi:10.3389/fnhum.2018.00541

 

Abstract

The grief of bereavement is recognized as a severe psychosocial stressor that can trigger a variety of mental and physical disorders, and the long-lasting unresolved grief has a detrimental effect on brain functionality. Literature has documented mindfulness-based cognitive therapy (MBCT) as an efficient treatment for improving well-being, specifically related to the mood and cognition, in a variety of populations. However, little attention has been devoted to neural mechanisms with regard to bereaved individuals’ cognition after MBCT intervention. In this study, we recruited 23 bereaved participants who lost a significant relative within 6 months to 4 years to attend 8-week MBCT course. We used self-reporting questionnaires to measure emotion regulation and functional magnetic resonance imaging (fMRI) with the numerical Stroop task to evaluate the MBCT effect on executive control among the bereaved participants. The self-reported questionnaires showed improvements on mindfulness and reductions in grief, difficulties in emotion regulation, anxiety, and depression after the MBCT intervention. The fMRI analysis demonstrated two scenarios: (1) the activity of the fronto-parietal network slightly declined accompanied with significant improvements in the reaction time of incongruent trials; (2) the activities in the posterior cingulate cortex and thalamus were positively associated with the Texas Revised Inventory of Grief, implying emotional interferences on cognitive functions. Results indicated that MBCT facilitated the executive control function by alleviating the emotional interferences over the cognitive functions and suggested that the 8-week MBCT intervention significantly improved both executive control and emotion regulation in bereaved individuals.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6360180/

 

Improve Mental Health in Older Adults with Online Meditation Practice

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Improve Mental Health in Older Adults with Online Meditation Practice

 

By John M. de Castro, Ph.D.

 

“The good news is that there are steps we can take right now to make the goal of “aging gracefully” more attainable. Mindfulness training is one of those steps; research has clearly shown that regular meditation comes with a wide range of physical, mental and emotional health benefits should particularly interest seniors.” – Mindworks

 

Human life is one of constant change. We revel in our increases in physical and mental capacities during development but regret their decline during aging. As we age, there are systematic progressive declines in every system in the body, the brain included. This includes our mental abilities and results in impairments in memory, attention, and problem-solving ability. It is inevitable and cannot be avoided. Aging also results in changes in mental health. Depression is very common in the elderly. The elderly cope with increasing loss of friends and family, deteriorating health, as well as concerns regarding finances on fixed incomes. All of these are legitimate sources of worry. In addition, many elderly experience withdrawal and isolation from social interactions. But, no matter how reasonable, the increased loneliness, worry and anxiety add extra stress that can impact on the elderly’s already deteriorating physical and psychological health.

 

Mindfulness appears to be effective for an array of physical and psychological issues that occur with aging. It appears to strengthen the immune system and reduce inflammation. It has also been shown to be beneficial in slowing or delaying physical and mental decline with aging. and improve cognitive processes. It has also been shown to reduce anxiety, worry, and depression and improve overall mental health. Since the global population of the elderly is increasing at unprecedented rates, it is imperative to investigate safe and effective methods to improve mental health in the elderly. In addition, the elderly frequently have mobility issues and going to a treatment facility may be challenging. A promising alternative is online mindfulness programs. It is not known, however, whether these will be acceptable and effective in elderly populations.

 

In today’s Research News article “Internet Mindfulness Meditation Intervention (IMMI) Improves Depression Symptoms in Older Adults.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6313401/pdf/medicines-05-00119.pdf ), Wahbeh and colleagues recruited older adults aged 55 to 80 years who were not currently meditators and demonstrated symptoms of depression. They were randomly assigned either to a wait list control group or to receive 6 weeks of online 1-hour once a week meditation training with 20 minutes daily guided meditations to be practiced at their convenience. Meditation included both body scan and sitting meditations. The participants were measured before and after training and 7 weeks later for mindfulness depression, resilience, spiritual experiences, insomnia, pain, perceived stress, and satisfaction with the intervention.

 

They found that in comparison to the baseline and the wait list control participants after meditation practice there were significant reductions in depression, insomnia, perceived stress, and pain interference, and significant increases in spirituality. These effects were maintained at follow-up 7 weeks after the end of treatment.

 

These are important findings. The vast majority of the mindfulness training techniques require a certified trained therapist. This results in 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 schedules and at locations that may not be convenient. The online mindfulness training program has tremendous advantages in decreasing costs, making training schedules much more flexible, and eliminating the need to go repeatedly to specific locations. These advantages are particularly important for elderly individuals. In addition, there is evidence that mindfulness programs delivered online can be quite effective.

 

The current findings demonstrate that online meditation training can be successfully implemented with older adults with symptoms of depression and that this program can produce significant improvements in the mental health of the participants. This suggests that such programs can be widely and inexpensively distributed over the internet to improve the well-being of the elderly.

 

So, improve mental health in older adults with online meditation practice.

 

“Meditation – not just medication – is an effective treatment for elderly patients with late-life depression.” – Jennifer Bieman

 

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

 

Helané Wahbeh. Internet Mindfulness Meditation Intervention (IMMI) Improves Depression Symptoms in Older Adults. Medicines (Basel) 2018 Dec; 5(4): 119. Published online 2018 Nov 2. doi: 10.3390/medicines5040119

 

Abstract: Background: Older adults have fewer physiological reserves and are more likely to be affected by stress. Mindfulness meditation has the potential to be an effective treatment for depression, but little research has been conducted on older adults. The primary objective of this study was to evaluate depression symptom changes in older adults (55–80 years old) taking an Internet Mindfulness Meditation Intervention (IMMI) compared to a waitlist control. The secondary aims were to collect data on pain, perceived stress, resilience, mindfulness, sleep quality, and spirituality. Methods: Fifty older adults were randomized to either the Internet Mindfulness Meditation Intervention, a six-week online intervention with daily home practice, or a waitlist control. Measures were collected at baseline, after the six-week intervention period, and again six weeks later after the waitlist participants completed IMMI. Adherence to home practice was objectively measured with iMINDr. Changes in outcomes for the IMMI and waitlist participants were compared. All participants who completed IMMI were then combined for a within-participant analysis. Results: Adherence to the intervention was low, likely due to a traumatic event in the local area of the participants. Compared to the waitlist participants, those in IMMI had improved depression symptoms (p < 0.00005), perceived stress (p = 0.0007), insomnia symptoms (p = 0.0009), and pain severity (p = 0.05). In the within-participant analysis of all data before and after IMMI (i.e., those initially randomized to IMMI and waitlist participants who took it), we found improvements in depression symptoms (p = 0.0001), perceived stress (p = 0.0001), insomnia symptoms (p < 0.00005), pain interference (p = 0.003), and spirituality (p = 0.018). A seven-week follow-up after the original six-week IMMI program showed sustained improvements in the IMMI participants. Conclusions: IMMI improved depression and related symptoms compared to controls despite minimal support from study staff. IMMI offers a low-dose, low-cost, easily accessible mindfulness meditation intervention for older adults with depression symptoms.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6313401/pdf/medicines-05-00119.pdf

 

Improve Severe Mental Illness with Yoga and Mindfulness

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Improve Severe Mental Illness with Yoga and Mindfulness

 

By John M. de Castro, Ph.D.

 

“yoga does in fact have positive effects on mild depression and sleep problems, and it improves the symptoms of psychiatric disorders like schizophrenia and ADHD among patients using medication.” – Alexandra Sifferin

 

Psychoses are mental health problems that cause people to perceive or interpret things differently from those around them. This might involve hallucinations; seeing and, in some cases, feeling, smelling or tasting things that aren’t objectively there, or delusions; unshakable beliefs that, when examined rationally, are obviously untrue. The combination of hallucinations and delusional thinking can often severely disrupt perception, thinking, emotion, and behavior, making it difficult if not impossible to function in society without treatment. Psychoses appear to be highly heritable and involves changes in the brain. Psychoses are very difficult to treat with psychotherapy and are usually treated with antipsychotic drugs. These drugs, however, are not always effective, sometimes lose effectiveness, and can have some difficult side effects. Hence, there is a need for safe and effective alternative treatments for psychosis.

 

Clinically diagnosed depression is the most common mental illness, affecting over 6% of the population. Major depression can be quite debilitating. It is also generally episodic, coming and going. Some people only have a single episode but most have multiple reoccurrences of depression.  Depression can be difficult to treat. 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.

 

Clearly, there is a need for treatment alternatives that can be effective alone or in combination with drugs. Both mindfulness and yoga training has been shown to be beneficial for patients with psychosis and with major depression. It is important at this point to step back and review the published studies of the application of mindfulness and yoga practices for the treatment of severe mental illnesses, In today’s Research News article “Role of Yoga and Mindfulness in Severe Mental Illnesses: A Narrative Review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6329226/ ), Sathyanarayanan and colleagues review and summarize 49 published research studies on the effectiveness of mindfulness and yoga practices for the treatment of severe mental illnesses.

 

They report that the research finds that both mindfulness practices and yoga practice in combination with antipsychotic medications significantly reduces both the positive and negative symptoms of schizophrenia and other psychotic disorders, improves the patient’s ability to effectively engage in everyday activities and also improves higher level thought processes, cognition. With Bipolar Disorder they report that there are only a very small number of studies that suggest improvements but more research is needed. With Major Depressive Disorders both mindfulness and yoga practices have been shown to produce significant reductions in depression alone or in combination with anti-depressive medications.

 

Hence, they find that the current published research supports the use of either mindfulness or yoga practices for the treatment of severe mental illnesses. There is clearly a need for more research, but the studies to date are very encouraging. They suggest that these practices are safe and effective whether used alone or in combination with drugs and may then be a needed alternative treatment to drugs.

 

So, improve severe mental illness with yoga and mindfulness.

 

“Yoga can be an incredible tool for self-growth, empowerment, healing, and health for those with mental disorders.” – Zoie Kanakis

 

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

 

Sathyanarayanan, G., Vengadavaradan, A., & Bharadwaj, B. (2019). Role of Yoga and Mindfulness in Severe Mental Illnesses: A Narrative Review. International journal of yoga, 12(1), 3-28.

 

Abstract

Background:

Yoga has its origin from the ancient times. It is an integration of mind, body, and soul. Besides, mindfulness emphasizes focused awareness and accepting the internal experiences without being judgemental. These techniques offer a trending new dimension of treatment in various psychiatric disorders.

Aims:

We aimed to review the studies on the efficacy of yoga and mindfulness as a treatment modality in severe mental illnesses (SMIs). SMI includes schizophrenia, major depressive disorder (MDD), and bipolar disorder (BD).

Methods:

We conducted a literature search using PubMed, Google Scholar, and Cochrane Library with the search terms “yoga,” “meditation,” “breathing exercises,” “mindfulness,” “schizophrenia spectrum and other psychotic disorders,” “depressive disorder,” and “bipolar disorder” for the last 10-year period. We also included relevant articles from the cross-references.

Results:

We found that asanas and pranayama are the most commonly studied forms of yoga for schizophrenia. These studies found a reduction in general psychopathology ratings and an improvement in cognition and functioning. Some studies also found modest benefits in negative and positive symptoms. Mindfulness has not been extensively tried, but the available evidence has shown benefits in improving psychotic symptoms, improving level of functioning, and affect regulation. In MDD, both yoga and mindfulness have demonstrated significant benefit in reducing the severity of depressive symptoms. There is very sparse data with respect to BD.

Conclusion:

Both yoga and mindfulness interventions appear to be useful as an adjunct in the treatment of SMI. Studies have shown improvement in the psychopathology, anxiety, cognition, and functioning of patients with schizophrenia. Similarly, both the techniques have been established as an effective adjuvant in MDD. However, more rigorously designed and larger trials may be necessary, specifically for BD.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6329226/

 

Mindfulness is Associated with Changing Neural Connectivity in Children and Adolescents

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Mindfulness is Associated with Changing Neural Connectivity in Children and Adolescents

By John M. de Castro, Ph.D.

 

“mindfulness meditation training increases resting state connectivity between top-down executive control regions, highlighting an important mechanism through which it reduces stress levels.” Daniel Reed

 

There has accumulated a large amount of research demonstrating that mindfulness has significant benefits for psychological, physical, and spiritual wellbeing. It even improves high level thinking known as executive function. Its positive effects are so widespread that it is difficult to find any other treatment of any kind with such broad beneficial effects on everything from thinking to mood and happiness to severe mental and physical illnesses. This raises the question of how mindfulness training could produce such widespread and varied benefits. One possibility is that mindfulness practice results in beneficial changes in the nervous system.

 

The nervous system is a dynamic entity, constantly changing and adapting to the environment. It will change size, activity, and connectivity in response to experience. These changes in the brain are called neuroplasticity. Over the last decade neuroscience has been studying the effects of contemplative practices on the brain and has identified neuroplastic changes in widespread areas. In other words, mindfulness practice appears to mold and change the brain, producing psychological, physical, and spiritual benefits.

 

The brains of children and adolescents are different from fully mature adult brains. They are dynamically growing and changing. It is unclear how mindfulness affects their maturing brains. In today’s Research News article “Mindfulness and dynamic functional neural connectivity in children and adolescents.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5610942/ ), Marusak and colleagues examined the relationship of mindfulness with brain activity in the maturing brain. They recruited children and adolescents aged 7 to 17 years and measured them for mindfulness, anxiety, and depression.

 

The children and adolescents then had their brains scanned with functional Magnetic Imaging (fMRI). The scans were evaluated for static connectivity, the relatively permanent connections between brain areas, and dynamic connectivity, the changing connections between areas. They looked specifically at 3 systems in the brain, the central executive network, associated with higher level thinking and attention, the salience and emotion network, associate with the importance of stimuli, and the default mode network, associated with mind wandering and self-referential thinking.

 

They found that mindfulness was associated with better mental health of the children and adolescents with high levels of mindfulness significantly associated with low levels of depression and anxiety. Mindfulness was also significantly associated with the amount of present-moment oriented thinking occurring during the brain scan session. Mindfulness was not associated with static connectivity within the children’s and adolescents’ brains.

 

With dynamic connectivity on the other hand, they found that mindfulness was associated with greater numbers of transitions between connectivity states. That is, the higher the levels of mindfulness the greater the number of times the connectivity pattern in the brain changed from one set of connections to another. Finally, they also found that the numbers of transitions between connectivity states mediated the association of mindfulness with lower anxiety, such that mindfulness was associated with lower anxiety both with a direct association of mindfulness with lower anxiety and indirectly by higher mindfulness being associated with greater dynamic connectivity which was in turn associated with lower anxiety.

 

The results suggest that mindfulness is associated with greater brain flexibility in transitioning from different states and this may allow for less anxiety. This suggests that mindfulness allows for greater ability to see things and evaluate what is occurring in different ways and this helps the youths to better appreciate what is happening and thereby lower anxiety. These are incredibly interesting findings that begin to reveal the neural dynamics occurring in children and adolescents that underlie the ability of mindfulness to improve mental health. Mindfulness isn’t associated with different brain connectivity structures in the brains but rather with different abilities to switch around in real time between systems and this improves mental health.

 

“Just 11 hours of learning a meditation technique induce positive structural changes in brain connectivity by boosting efficiency in a part of the brain that helps a person regulate behavior in accordance with their goals.” – University of Oregon

 

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

 

Marusak, H. A., Elrahal, F., Peters, C. A., Kundu, P., Lombardo, M. V., Calhoun, V. D., Goldberg, E. K., Cohen, C., Taub, J. W., … Rabinak, C. A. (2017). Mindfulness and dynamic functional neural connectivity in children and adolescents. Behavioural brain research, 336, 211-218.

 

Abstract

Background

Interventions that promote mindfulness consistently show salutary effects on cognition and emotional wellbeing in adults, and more recently, in children and adolescents. However, we lack understanding of the neurobiological mechanisms underlying mindfulness in youth that should allow for more judicious application of these interventions in clinical and educational settings.

Methods

Using multi-echo multi-band fMRI, we examined dynamic (i.e., time-varying) and conventional static resting-state connectivity between core neurocognitive networks (i.e., salience/emotion, default mode, central executive) in 42 children and adolescents (ages 6–17).

Results

We found that trait mindfulness in youth relates to dynamic but not static resting-state connectivity. Specifically, more mindful youth transitioned more between brain states over the course of the scan, spent overall less time in a certain connectivity state, and showed a state-specific reduction in connectivity between salience/emotion and central executive networks. The number of state transitions mediated the link between higher mindfulness and lower anxiety, providing new insights into potential neural mechanisms underlying benefits of mindfulness on psychological health in youth.

Conclusions

Our results provide new evidence that mindfulness in youth relates to functional neural dynamics and interactions between neurocognitive networks, over time.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5610942/

 

Interpretation Bias Mediates the Effect of Mindfulness and Acceptance on Anxiety and Depression

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Interpretation Bias Mediates the Effect of Mindfulness and Acceptance on Anxiety and Depression

 

By John M. de Castro, Ph.D.

 

“Anxiety softens when we can create a space between ourselves and what we’re experiencing. When you react in ways that aren’t mindful, they can gradually grow into habits that are detrimental to your health and well-being.” – Mindful

 

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 sufferer 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. Indeed, Mindfulness practices have been shown to be quite effective in altering cognitive processes and  relieving anxiety.

 

Depression is the most common mental illness, affecting over 6% of the population. Depression can be difficult to treat and is usually treated with anti-depressive medication. 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. Fortunately, Mindfulness training is also effective for treating depression.

 

A cognitive tendency that can exacerbate anxiety and depression is interpretation bias. This is a tendency to interpret situations in a negative way even when the situation is ambiguous. This can lead to interpreting even neutral situations as threatening. An alternative explanation for the effectiveness of mindfulness training for anxiety and depression is that it may reduce interpretation bias, making it less likely that situations would be interpreted as threatening and thereby lowering anxiety and depression.

 

In today’s Research News article “Mindfulness, Interpretation Bias, and Levels of Anxiety and Depression: Two Mediation Studies.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6320741/ ), Mayer and colleagues performed 2 studies to examine the relationships of mindfulness, anxiety, depression, and interpretation bias.

 

In the first study they recruited college students and had them complete online questionnaires and psychometric tests measuring mindfulness, anxiety, depression, and interpretation bias. The variables were then subjected to regression analysis. They found that the higher the level of mindfulness the lower the levels of depression, anxiety, and interpretation bias. They further found that the mindfulness association with reduced anxiety and depression was in part the result of mindfulness’ association with reduced interpretation bias. Mindfulness was both directly associated with lower anxiety and depression and indirectly by being associated with lower levels of interpretation bias which, in turn, was associated with lower anxiety and depression.

 

In the second study they recruited a community sample of adults with mixed ages and had them complete online questionnaires measuring mindfulness, anxiety, depression, interpretation bias, and acceptance of internal sensations. They found similar results for acceptance as they found in study 1 for mindfulness, with the higher the level of acceptance the lower the levels of depression, anxiety, and interpretation bias. Also similar to study 1 they found that the association of acceptance with reduced anxiety and depression was in part the result of acceptance’ association with reduced interpretation bias. Acceptance was both directly associated with lower anxiety and depression and indirectly by being associated with lower levels of interpretation bias which, in turn, was associated with lower anxiety and depression.

 

These are interesting findings but they are correlational. So, no clear conclusions regarding causation can be reached. Previous research, however, has clearly shown a causal connection between mindfulness and acceptance and anxiety and depression. This suggests that the relationships observed in the current study as due to mindfulness and acceptance causing the relief of anxiety and depression.

 

The results suggest that the associations of both mindfulness and acceptance of internal states are associated with lower levels of both anxiety and depression and that these associations are in part due to direct associations with anxiety and depression and also indirect associations involving both mindfulness and acceptance being associated with lower levels of interpretation bias that, in turn, is associated with lower levels of anxiety and depression. This suggests that mindfulness and acceptance, in part, affect anxiety and depression by altering the cognitive interpretation of situations, lowering the tendency to interpret situations as threatening and thereby lowering the anxiety and depression that results from threatening interpretations.

 

So, interpretation bias mediates the effect of mindfulness and acceptance on anxiety and depression.

 

“Mindfulness keeps us focused on the present, and helps us meet challenges head on while we appreciate all our senses absorb. On the contrary, focus on the future contributes to anxiety, while perseveration on the past feeds depression.” – Vincent Fitzgerald

 

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

 

Mayer, B., Polak, M. G., & Remmerswaal, D. (2018). Mindfulness, Interpretation Bias, and Levels of Anxiety and Depression: Two Mediation Studies. Mindfulness, 10(1), 55-65.

 

Abstract

In two studies, a possible mediation effect was tested of cognitive interpretation bias in the relation between respectively dispositional mindfulness and acceptance, on the one hand, and symptoms of depression and anxiety, on the other hand. An undergraduate student sample (N = 133; 86% female, Mage = 19.8) and a convenience community sample (N = 186; 66% female, Mage = 36.5) were examined by means of an online questionnaire measuring dispositional mindfulness (FFMQ-SF; Study 1) and acceptance (AAQ-II; Study 2), anxiety (STAI-trait) and depressive (BDI-II) symptoms, and interpretation bias (with the interpretation bias task, IBT). Considering both studies, results showed consistently the expected relations of larger mindfulness skills going together with a smaller cognitive interpretation bias and lower levels of depression and anxiety symptoms. More interestingly, it was found that interpretation bias served as a mediator in the relations between respectively dispositional mindfulness and acceptance, and symptoms of depression and anxiety. With these findings, some more insight in the working mechanisms of mindfulness-based treatments on internalizing psychopathology has been obtained.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6320741/

 

Reduce Anxiety and Depression with Mindfulness

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Reduce Anxiety and Depression with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Being unwilling to experience negative thoughts, feelings, or sensations is often the first link in a mental chain that can lead to automatic, habitual, and critical patterns of mind becoming re-established. By accepting unpleasant experiences, we can shift our attention to opening up to them. Thus, “I should be strong enough” shifts to “Ah, fear is here,” or “Judgment is present.”—Zindel Segal,

 

Meditation training has been shown to improve health and well-being. It has also been found to be effective for a large array of medical and psychiatric conditions, either stand-alone or in combination with more traditional therapies. Meditation practice has been found to improve the regulation of emotions and reduce difficult emotional states such as anxiety and depression.

 

A characterizing feature of anxiety disorders is recurring thoughts, such as impending disaster, that they may realize are unreasonable, but are unable to shake. Indeed, Mindfulness practices have been shown to be quite effective in relieving anxiety. Anxiety often co-occurs with depression and mindfulness training is also effective for treating depression. Anxiety disorders and depression have generally been treated with drugs. But there are considerable side effects and these drugs are often abused. So, there is a need to develop alternative treatments. Since mindfulness- based treatments are relatively new, it makes sense to step back and summarize what is known regarding the effectiveness of mindfulness training for anxiety disorders and for depression.

 

In today’s Research News article “Mindfulness-Based Interventions for Anxiety and Depression. The Psychiatric clinics of North America.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5679245/ ), Hofmann and Gomez review and summarize the published research literature on the effectiveness of mindfulness training for the relief of anxiety and depression.

 

They report that randomized controlled trials found that Mindfulness-Based interventions including the Mindfulness-Based Stress Reduction (MBSR), the Mindfulness-Based Cognitive Therapy (MBCT), Dialectical Behavior Therapy, and Acceptance and Commitment Therapy treatment programs were “moderately-to-largely effective at reducing anxiety and depression symptom severity among individuals with a broad range of medical and psychiatric conditions.” They also report that these programs are effective whether provided in person or over the internet. They are consistently more effective than health education, relaxation training, and supportive psychotherapy, but equivalently effective as Cognitive Behavioral Therapy (CBT).

 

Hence, accumulating controlled research has built a strong case for the use of Mindfulness-Based Interventions for the treatment of anxiety and depression. Since, these treatments are generally safe and effective with little if any side effects, they would appear to be preferable to pharmacological treatments.

 

So, reduce anxiety and depression with mindfulness.

 

“Mindfulness keeps us focused on the present, and helps us meet challenges head on while we appreciate all our senses absorb. On the contrary, focus on the future contributes to anxiety, while perseveration on the past feeds depression. Far too often when we look to the future, we ask ourselves, “What if,” and the answer we give ourselves is often a prediction of a negative result.” – Vincent Fitzgerald

 

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

 

Hofmann, S. G., & Gómez, A. F. (2017). Mindfulness-Based Interventions for Anxiety and Depression. The Psychiatric clinics of North America, 40(4), 739-749.

 

Key Points

  • Research on mindfulness-based interventions (MBIs) for anxiety and depression has increased exponentially in the past decade. The most common include Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT).
  • MBIs have demonstrated efficacy in reducing anxiety and depression symptom severity in a broad range of treatment-seeking individuals.
  • MBIs consistently outperform non-evidence-based treatments and active control conditions, such as health education, relaxation training, and supportive psychotherapy.
  • MBIs also perform comparably to cognitive-behavioral therapy (CBT). The treatment principles of MBIs for anxiety and depression are compatible with those of standard CBT.

Synopsis

This article reviews the ways in which cognitive and behavioral treatments for depression and anxiety have been advanced by the application of mindfulness practices. Research on mindfulness-based interventions (MBIs) has increased exponentially in the past decade. The most common include Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT). MBIs have demonstrated efficacy in reducing anxiety and depression symptom severity in a broad range of treatment-seeking individuals. MBIs consistently outperform non-evidence-based treatments and active control conditions, such as health education, relaxation training, and supportive psychotherapy. MBIs also perform comparably to cognitive-behavioral therapy (CBT). The treatment principles of MBIs for anxiety and depression are compatible with those of standard CBT.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5679245/

 

Mindfulness Improves Depression by Affecting Trait Anxiety

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Mindfulness Improves Depression by Affecting Trait Anxiety

 

By John M. de Castro, Ph.D.

 

“When you become aware of the present moment, you gain access to resources you may not have had before. You may not be able to change a situation, but you can mindfully change your response to it. You can choose a more constructive and productive way of dealing with stress rather than a counterproductive or even destructive way of dealing with it.” – Mindful

 

A characterizing feature of anxiety disorders is recurring thoughts, such as impending disaster, that they may realize are unreasonable, but are unable to shake. Indeed, Mindfulness practices have been shown to be quite effective in relieving anxiety. Anxiety often co-occurs with depression. Mindfulness training is also effective for treating depression. Anxiety disorders and depression have generally been treated with drugs. But there are considerable side effects and these drugs are often abused. So, there is a need to develop alternative treatments. Recently, it has been found that mindfulness training can be effective for anxiety disorders and for depression either alone or in combination with other therapies. The fact that anxiety and depression occur together so often suggests that they may be linked and mindfulness training may affect that linkage.

 

In today’s Research News article “The Factorial Structure of Trait Anxiety and Its Mediating Effect Between Mindfulness and Depression.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6212471/ ), Wang and colleagues recruited college students with depression and measured before and after training for trait anxiety, depression and mindfulness. A second set of students were provided with an 8-week program of Mindfulness-Based Cognitive Therapy (MBCT). It met once a week for 2.5 hours.  MBCT was developed specifically to treat depression. It 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 psychological symptoms. These students were measured before and after training for trait anxiety, depression and mindfulness.

 

They then performed a factor analysis of the trait anxiety scale from the untreated group of students and identified two distinct factors; Trait Anxiety Present and Trait Anxiety Absent. They found that the higher the level of mindfulness the lower the levels of depression and both of the trait anxiety factors. In addition, the higher the levels of both of the trait anxiety factors, the higher the levels of depression. So, trait anxiety and depression covaried and mindfulness was associated with lower levels of these psychological issues. In a mediation analysis they discovered that the association of mindfulness with lower depression was mediated by the two trait anxiety factors. In other words, mindfulness was associated with lower trait anxiety and this was in turn associated with lower levels of depression.

 

In the second group of students they found that MBCT training resulted in significantly lower levels of depression and both trait anxiety factors. Importantly, after MBCT training the mediational relationship of mindfulness to trait anxiety to depression was still present. So, the training lowered levels of anxiety and depression but did not change their relationships with mindfulness, with trait anxiety changes associated with the changes in depression.

 

These results are interesting and suggest a high degree of relationship between trait anxiety and depression. This could represent a conceptual overlap in that both involve rumination regarding past events. On the other hand, it could indicate that anxiety and depression are separate but linked. Perhaps, feeling chronic anxiety may lead to depression. This would explain the mediation analysis wherein high mindfulness is associate with low anxiety and this tends to relieve depression.

 

So, mindfulness improves depression by affecting trait anxiety.

 

“mindfulness-based practices have proved to be helpful in promoting mental well-being, especially by reducing the symptoms of depression and anxiety in various populations. For people with medicine noncompliance issues or people unwilling to start formal psychotherapy, mindfulness-based therapies could be a beneficial alternative to consider.” Han Ding

 

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

 

Wang, T., Li, M., Xu, S., Jiang, C., Gao, D., Wu, T., Lu, F., Liu, B., … Wang, J. (2018). The Factorial Structure of Trait Anxiety and Its Mediating Effect Between Mindfulness and Depression. Frontiers in psychiatry, 9, 514. doi:10.3389/fpsyt.2018.00514

 

Abstract

Background: Increasing studies have found that high trait anxiety is a key susceptibility phenotype that causes depression. Mindfulness-based interventions can target on dealing with depressogenic vulnerability effectively. Evidence indicates that trait anxiety could affect the trajectory of anti-depressive psychotherapy, and play an important role in the relationship between mindfulness and depression. Furthermore, related studies have found that trait anxiety could involve factors beyond anxiety and be a two-factor construct instead of one-dimensional concept. This viewpoint provides a new prospective for exploring the pathways of the two factors of trait anxiety in the complex relationship and further understand the potential mechanism of vulnerable personality mediated the link of mindfulness and depression.

Methods: A cross-sectional survey and a preliminary intervention study were conducted. Thousand two hundred and sixty-two subjects completed a set of self-reported questionnaires that evaluated trait anxiety, mindfulness, and depressive symptoms. Twenty-Three eligible participants with depression were recruited to attend mindfulness-based cognitive training for eight weeks. The same questionnaires were completed 1 week before the training and 6 months after the training. Factor analysis was performed on the 1262-subject sample to explore and confirm the factorial structure of trait anxiety. In addition, mediating effect analysis was conducted in the two studies to test whether two factors of trait anxiety were mediators of the relationship between mindfulness and depression.

Results: The exploratory factor analysis extracted two dimensions of trait anxiety, namely, trait anxiety-present factor (TA-P) and trait anxiety-absent factor (TA-A). And confirmatory factor analysis showed that the fit of the two-factor model was acceptable. Both TA-P and TA-A were significantly negatively correlated with mindfulness and positively correlated with depression, and they played a mediating role between mindfulness and depression. The two factors of trait anxiety had multiple mediating effects on the relationship between mindfulness and depression, and the mediating effect of the TA-P factor was stronger than that of the TA-A factor.

Conclusion: Our results demonstrated a two-factor model of trait anxiety in the Chinese population. TA-P and TA-A played a multiple mediating role in the relationship between mindfulness and depression. The findings provide new perspectives for psychological interventions to treat depression for people with susceptible personalities. Aiming to reduce negative emotional tendencies (TA-P factor) and enhance positive cognition (TA-A factor) may achieve the early prevention and efficient treatment of depression.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6212471/

 

Improve Treatment Resistant Major Depression with Yoga

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Improve Treatment Resistant Major Depression with Yoga

 

By John M. de Castro, Ph.D.

 

“Some people who haven’t responded to traditional treatments might do well with yoga, because unlike antidepressant drugs, yoga and deep breathing target the autonomic nervous system.” – Amanda MacMillan

 

Clinically diagnosed depression is the most common mental illness, affecting over 6% of the population. Major depression can be quite debilitating. Depression can be difficult to treat and is usually treated with anti-depressive medication. But, of patients treated initially with drugs only about a third attained remission of the depression. After repeated and varied treatments including drugs, therapy, exercise etc. only about two thirds of patients attained remission. But drugs often have troubling side effects and can lose effectiveness over time. In addition, many patients who achieve remission have relapses and recurrences of the depression. Even after remission some symptoms of depression may still be present (residual symptoms).

 

Being depressed and not responding to treatment or relapsing is a terribly difficult situation. The patients are suffering and nothing appears to work to relieve their intense depression. Suicide becomes a real possibility. So, it is imperative that other treatments be identified that can relieve the suffering. Mindfulness training is an alternative treatment for depression. It has been shown to be an effective treatment for depression and its recurrence and even in the cases where drugs fail.  Yoga practice is a mindfulness training and has the added benefit of being an exercise which has been also found to be effective for depression.

 

Recently, it has been discovered that there are genetic differences between patients with major depression who respond to antidepressant drugs and those who don’t. In particular non-responders appear to have a 5-HTTLPR variant of the serotonin transporter gene (SLC6A4) and MTHFR 677C>T polymorphisms. The serotonin system in the brain is a target of antidepressant drugs and these genetic variants may underlie non-responsiveness to the drugs. Since, yoga practice appears to be effective for depression in patients who do not respond to antidepressant drugs, it is likely that yoga practice works in spite of these genetic variants.

 

In today’s Research News article “5-HTTLPR and MTHFR 677C>T polymorphisms and response to yoga-based lifestyle intervention in major depressive disorder: A randomized active-controlled trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6278208/ ), Tolahunase and colleagues recruited patients with major depressive disorder and randomly assigned them to receive either a 12-week yoga program or to receive antidepressant drugs (SSRIs). Yoga was practiced for 2 hours per day, 5 days per week, for 12 weeks and consisted of postures, breathing exercises, and meditation. They were measured before and after treatment for depression, other psychiatric conditions, and childhood trauma. Blood was drawn for DNA genotyping.

 

They found that both groups had significant reductions in depression over the treatment period, but, the yoga group had significantly greater reductions in depression and higher remission rates (59% compared to 33%) than the antidepressant drug group. The participants with 5-HTTLPR and MTHFR 677C>T polymorphisms had significantly lower reductions in depression and remission rates in the antidepressant drug group but not in the yoga group. The participants in the yoga group with the polymorphisms benefited with reductions in depression and increases in remission rates to the same extent as those without the polymorphisms.

 

These are remarkable results. Yoga practice produced greater relief of depression than antidepressant drugs and, in addition, yoga practice produced this relief irrespective of the genetic polymorphisms that affect responses to antidepressant drugs. This suggests that yoga practice my work to relieve depression through a different mechanism than antidepressant drugs. Hence, yoga practice appears to be an almost ideal treatment for major depressive disorder, producing high remission rates and great reductions in depression, safely, without major side effects, and irrespective of the genetic polymorphisms that reduce responsiveness to antidepressant drugs. This suggests that yoga practice should be the first line treatment for major depressive disorder.

 

So, improve treatment resistant major depression with yoga

 

“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 Newsletter

 

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

 

Tolahunase, M. R., Sagar, R., & Dada, R. (2018). 5-HTTLPR and MTHFR 677C>T polymorphisms and response to yoga-based lifestyle intervention in major depressive disorder: A randomized active-controlled trial. Indian journal of psychiatry, 60(4), 410-426.

 

Abstract

Background:

There is growing evidence suggesting that both genetic and environmental factors modulate treatment outcome in, a highly heterogeneous, major depressive disorder (MDD). 5-HTTLPR variant of the serotonin transporter gene (SLC6A4) and MTHFR 677C>T polymorphisms have been linked to the pathogenesis of MDD, and antidepressant treatment response. The evidence is lacking on the clinical utility of yoga in patients with MDD who have 5-HTTLPR and MTHFR 677C>T polymorphisms and less likely to respond to medications (SSRIs).

Aims:

We aimed to examine the impact of YBLI in those who have susceptible 5-HTTLPR and MTHFR 677C>T polymorphisms and are less likely to drug therapy with SSRIs.

Settings and Design:

In a 12 week randomized active-controlled trial, MDD patients (n = 178) were randomized to receive YBLI or drug therapy.

Methods:

Genotyping was conducted using PCR-based methods. The clinical remission was defined as BDI-II score ≤ 9.

Statistical Analysis Used:

An intent-to-treat analysis was performed, and the association of genotype with treatment remission consisted of the logistic regression model. A P value of <0.05 was considered statistically significant.

Results:

Multivariate logistic regression models for remission including either 5-HTTLPR or MTHFR 677C>T genotypes showed statistically significant odds of remission in YOGA arm vs. DRUG arm. Neither 5-HTTLPR nor MTHFR 677C>T genotype showed any influence on remission to YBLI (P = 0.73 and P = 0.64, respectively). Further analysis showed childhood adversity interact with 5-HTTLPR and MTHFR 677C>T polymorphisms to decrease treatment response in DRUG treatment arm, but not in YOGA arm.

Conclusions:

YBLI provides MDD remission in those who have susceptible 5-HTTLPR and MTHFR 677C>T polymorphisms and are resistant to SSRIs treatment. YBLI may be therapeutic for MDD independent of heterogeneity in its etiopathogenesis.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6278208/